Some Issues Raised:
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Autonomy
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Clinical Judgment
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Futility
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Patient Virtues
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Quality of Life
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Right to Demand Treatment
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Right to Refuse Treatment
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Self-Determination
Thelma S. is twenty-five years old and married with one child age
2. She was 16 weeks pregnant when her automobile was struck by a drunk
driver and the head trauma has left her severely brain damaged. Her mental
status has deteriorated since her admission to the hospital and at twenty
weeks into her pregnancy two neurologists have determine that Ms. S. is
in a permanent vegetative state. Her husband holds her Durable Power of
Attorney for Health Care in Ohio. He asserts that his wife would not want
to continue to live in this PVS and he is considering withdrawing all life-support
from her including ventilator support and medically administered nutrition
and hydration. She has given him the authority to do this in her advance
directive documents. Her attending physician is trying to persuade Mr.
S. to maintain her life-supports until the fetus develops further so that
the fetus will stand a good chance of survival. He figures that another
3 months will give the fetus sufficient time to develop for a decent chance
outside the uterus. Mr. S., however, is inclined to follow his wife's wishes
and wants to withdraw life support which will result in death of both the
mother and the fetus.
Some Discussion Questions:
1. What clues does Roe v. Wade provide for the resolution
of this case?
2. What does the Ohio advance directive law say about this case?
3. What help does a reflective view of the value of life provide
for the resolution of this case?
4. Would Ms. S. be harmed if she were kept on life supports until
the fetus can be safely delivered?
5. Who is the patient in this case and what ethical framework best
suits the promotion of the well-being of the patient in this case?
6. How do the principles of autonomy, beneficence, and justice figure
into this case? Which principle(s) should govern the decisions made in
this case?
7. What strategies would you implement to bring this case to a resolution
which maximizes the well-being of the patient?