Midterm Paper free essay sample

He would have to endure the stares and the stories of his paralyzed imbs. The moral issue of discharging Dawson from the hospital should be considered because he is suspected of leaving and committing assisted suicide due to his quadriplegic condition. In the case of the baby, the moral issue is also of quality of life. The mother has decided to not have the surgery performed and have nutrients taken away from her child. The baby has lived for less than ten hours and obviously cannot yet make a decision for herself. If the surgery was to be performed and the baby fully recovered, the quality of life would still come into play. Because she does not know how it is to ive with working limbs, she would be able to cope and learn how to function better than in Dawsons case. Although she would be would most likely cope better without limbs, the question arises of What would she be able to do on her own? She would need someone to be with her at all times: to feed her, bath her, go to the restroom with her, dress her, and all other everyday tasks. Thus, the quality of life in this child should be considered when deciding if she should have the surgery to remove the anomalies or not. Previously, the Metropolitan Hospital board had agreed to refrain rom providing breathing assistance and/or nourishment for people who have so stated their wishes. Thus, in this case of Roosevelt Dawson, he has previously met with both his mother and his social worker discussing his choices as to what his options were after he is discharged from the hospital. This can create a legal issue due to the fact that Dawson was originally going to be able to be discharged from the Metropolitan Hospital. If the Metropolitan Hospital were to refrain from discharging Dawson, then that could cause some disagreements with Dawsons wishes and the ants of his social worker and his physicians. Dawson has also been found completely competent, which can provide stability to his life after his current stay at the hospital and thus strengthen his case to leave. Regarding the case of the baby girl, it has been stated, in our text, that contemporary ethical and legal norms hold that all human beings born alive should be treated equally, regardless of disability. This can call for a legal case because if this baby girl were to have been born with legs and arms, would the mother still not want surgery performed? And if she did not ish to have surgery, then that would call into her competence and if she were able to make a proper decision about the situation? If all human beings born alive should her baby girl? Thus, because the mother is not treating her child as if she were a baby without a disability, the hospital can be accused of following through with the wishes of an incompetent woman. According to the Child Abuse Amendments (CAA) of 1984, which ended the political controversy over the federal role in decisions to withhold treatment from handicapped newborns, legal issues could arise from the ospital not treating the baby. This amendment strongly protects the rights and interests of those with disabilities and leaves little room for non-treatment decisions to be based on expected low quality of life or the interests of parents. All children, whatever the extent of their disabilities, are to be granted medical treatment unless they met the narrowly defined exceptions. Also, in our text, at the very least, CAA could be perceived as setting the standard of care to which hospitals and doctors would be held, both by accrediting bodies and by courts hearing challenges to ontreatment decisions. The baby girl case has similarities with the case of Miller v. HCA, in our text. In this Texas Supreme Court decision, while recognizing that parents ordinarily have the right to consent to or to refuse medical care for their children, the court also recognized that an exception to the parental consent requirement arises when an emergent condition exists and treatment must occur immediately to prevent the death of the child. Although, in Miller v. HCA, the court found that the doctors initial resuscitation in Miller was Justified because the situation was an emergency nd there was not enough time necessary to get consent form the parents or from a court. The court only found the doctors actions rationalized because the doctor did not have enough time to consult with the parents before making the life or death decision. In this case, the physician has time to get consent from the mother, which could then be argued, that if the neonatal team would have been taking action without the mothers consent, and would not be Justified. The two cases of Roosevelt Dawson and the baby girl have a several significant similar qualities to them: loss of imbs, the quality of their lives would be questionable, and both Dawson and the baby have other parties trying to make a life or death decision for them. In terms of quality of life, Dawson is a recent quadriplegic patient and the baby girl has been born without limbs. When calling into account the quality of their lives without limbs, should the baby have surgery and Dawson leave the hospital, could be considered of extremely difficult quality of life. Finally, Dawsons social worker is pushing a court order for Dawson to stay in the hospital and not be discharged, while the babys eonatal staff is pushing a court order to disregard the mothers decision on not having the baby undergo surgery and removing the nutrients currently being given. Although there are some similarities surrounding the cases of Dawson and the baby, there are positively some differences that cannot go unmentioned. Firstly in the case of Roosevelt Dawson, he is a twenty-one year old completely competent male, wishing to leave the hospital. But, according to his social worker, he is has the intentions of assisted suicide. In the case of the baby, she is a less than ten hour old female. She cannot take nourishment orally because she has anomalies of the mouth and throat, which can be surgically removed. Her mother is refusing to give the neonatal staff permission for surgery and has asked the hospital not to nourish her baby girl. Because the baby cannot make a decision for herself, her mother is her making specific differences between them, how they should be handled, and how their physicians should interact with both them and their families. In order to relate to the patients in these cases, there are four types of physician-patient relationship models hat should be considered. The first type of relationship representation is the paternalistic model. According to our text, this model ensures that the patients receive the interventions that best promote their health and well being. In other words, the physician is acting as a guardian to the patient strongly suggesting or telling the patient what the best option for him or her would be in that particular scenario. The second type of relationship model is called the informative model. Here, the objective of the physician-patient interaction is for the physician to provide he patient with all relevant information, and the patient selects the option they want, and the physician follows through with their wishes. A fairly to-the-point model: provide the information, make a decision, act accordingly. The third model is the interpretive model. The aim for this model is to illuminate the patients values and what he or she actually wants, and to help the patient select the available medical interventions that realize their values. This model is more interpretive, the physician tries to assess the patients core values and help them make a decision after considering them. Lastly, is the deliberative model with the goal of this model is to help the patient determine and choose the best health-related values that can be realized in the clinical setting. In this model, the physician would suggest the best option for the patients health, not considering any moral values, but only those that would be best clinical wise. Considering all the types of physician-patient relationships explained in the previous paragraph, the best relationship that should be established in the case of Roosevelt Dawson should be the interpretive model. This model would best fit Dawsons case because he needs to know what he values. Because what he values (could be his life, family, friends, functioning limbs) could have him change his mind in wanting to be discharged. Because what would be best for his health and therefore his values, could be to have him stay in the hospital or at home with a physician assisting him and his family. Thus, if he were to realize that his moral values were to stay alive, then the best way to do that would be to listen to the physicians around him. The type of relationship that should be established in the baby girls case should e the paternalistic model. This is because in this model, the physician would act as the babys guardian and implement what is best for the babys life and has obligations, including that of placing the babys interest above his or her own and soliciting the views of the mother, who seems to lack adequate knowledge of the situation. This is the best model for this case because the physician would initially be the guardian for the baby, rather than the mother, and will thus make the best decision for the baby and disregard the views of the mother. To keep in mind moral utonomy when assessing the physician-patient relationships is vital. Moral autonomy is defined in our text as: to act freely, is to act autonomously; to act according to a law you give yourself and not according to the desires of nature or pleasure; and to respect each persons liberty to self-determine their own idea of the looking at various perspectives. Dawsons choice to leave the hospital relates to his ability to act freely; if he does in fact wish to commit assisted suicide, it is to act according to a law he has given unto himself. Thus, to respect each persons liberty to elf-determine their own idea of the good is to respect Dawsons idea that being discharged from the hospital is his best option.