Sample Business Studies Essays on Living Wills

The right of an individual’s discretion to choose to reject medical attention when terminally ill is a controversial issue in American society. Many liberals hold that an individual has the right to refuse life-prolonging treatment. However, conservatives are adamant that human life is sacred and needs to be preserved at all costs. In the landmark case ruling of Cruzan v. Director, Missouri Department of Health (1990), the Supreme Court decided through a majority opinion that one’s right to refuse medical treatment is personal liberty protected by the U.S. Constitution. The court held that this interest must be expressed through clear and consistent proof that it is the patient’s intention. This led to the need for living wills which expresses the life-saving measures approved by the signor of the will to be applied to him or her when terminally incapacitated.

Case Study

Cruzan V. Director, Missouri Department of Health, 497 U.S. 261 (1990)

Cruzan was involved in an accident that left her in a permanent vegetative state. Her parents wished to end the life-extending treatment she was receiving but the hospital management was inclined to preserving Cruzan’s life. The parent’s sued the hospital management to the Supreme Court. The Supreme Court in a 5-4 majority decision written by Justice William Hubbs Rehnquist, upheld the right to refuse medical treatment. The court held that the Due Process Clause of the Fourteenth Amendment safeguarded an individual’s right to refuse medical treatment as provided under the right to privacy provisions. The court held that a patient’s judgment cannot be substituted by his or her parents or family member’s judgment and that the patient’s intention of refusing medical treatment must be expressed by clear and convincing proof (“Cruzan v. Director, Missouri Dept. of Health,” n.d.). In case the patient is unable to express his or her intentions then the family has to provide adequate proof that the patient held and supported their views regarding the refusal of medical treatment.

The difference between death by the refusal of treatment and suicide is both slim and controversial. The main difference between death by the refusal of treatment and suicide lies in their legality. Suicide is a criminal act that involves an individual taking his own life while death by the refusal of treatment is a constitutionally safeguarded right. Many scholars and critics, however, do not see the differences between the two and largely refer to death by the refusal of treatment as assisted suicide. A living will stipulate a people’s wishes concerning their placement in life-support in case of illness or accidents that render them unable to express their wishes. A living will outline the lifesaving measures the signor wants to be performed on his or her body in case of an illness or accident and whether those treatments should be withdrawn in case doctors estimate limited hopes of recovery. Besides, the signor has to name people to be his or her health care agents to make all the decisions per the will. The living will only take effect upon the medical determination that the signor is in a vegetative state and cannot express his or her medical needs. A health care directive is a separate document from the living will which names the people the signor has named as his or her health care agents. The health care agents are charged with making decisions in line with the signor’s wishes incase the signor becomes incapacitated.

Question 1

Individuals should make both simple wills and living wills during their lifetimes. The making of a properly executed simple will and a living will have numerous advantages to one’s families and friends. The advantages range from financial, psychological to medical advantages and they make making a will worthwhile. Financially, a proper will discloses the wishes and intentions of the deceased. Also, it avoids wastage and misuse of the deceased property as it enables the testator to make full disclosure of all his or her property. In case the deceased died intestate, without a will, the distribution of his estate will be done in line with the rules of intestacy which is not only expensive due to the legal fees involved but also does not consider the deceased’s wishes. Besides, succession by intestacy leads to a significant increase in inheritance tax charged on the deceased estate. A living will also relieve the family from financial constraints caused by undue life-prolonging treatments which are always expensive.

Psychologically, intestacy denies the deceased’s family peace of mind as it exposes the deceased estate to numerous contestations and squabbles over the estate by dependents. These contestations mostly lead to litigations that are expensive and time-consuming to the deceased’s family and pose a big risk of tearing apart the deceased family. The medical consequences of having a properly executed living will are numerous. However, the lack of a living will make choosing and authorizing medical procedures to be performed on an individual quite difficult. Therefore, a living will alleviate the stress imposed on family members and friends when they are forced to make life or death decisions.

A will enables the testator to directly benefit friends and associates who are not part of his family circle as the rules of intestacy only make provisions for the deceased family members and close relatives. In, addition a will may contain the testator’s wishes and directions on how his or her body will be disposed of further making easier the decision-making process for the family and friends.

Question 2

The terms recuperative medical care and palliative care are two different medical terms that are easily confused. Recuperative medical care, also known as medical respite care, involves the administration of acute and post-acute medical care for the homeless people who are too ill or frail to successfully recover from an illness or injury but do not require hospitalization (National Health Foundation, n.d.). Recuperative care provides a safe place for the homeless to heal and recuperate. Since it is heavily funded by the government recuperative medical care is quite cheap and provides a better alternative than the streets for sick homeless people. On the other hand, palliative care is the administration of family-centered care that helps maintain the highest quality of life achievable for those diagnosed with terminal diseases (World Health Organization, 2012). Through early diagnosis, prevention, and treatment palliative care reduces the pain attributed to life-threatening illnesses (Pizzo, Walker, & Bomba, 2014). Research backs palliative care as the best method of tackling advanced serious medical conditions.

The decision to modify care from recuperative care to palliative care lies with the patient unless he or she is unable to make the decision. In case the patient is incapacitated to make a coherent decision, the decision of modifying care is vested on family members. The patient has the right to decide to refuse all medical care appropriate to his condition when such care virtually leads to his or her death. In case the patient is medically incapacitated and cannot express his or her wishes then family members can decide on the patient’s behalf.

Question 3

End of life wishes is quite sensitive and grave matters that should be handled carefully and with deep thought and reflections. A patient should first seek the professional advice of medical practitioners to get their informed opinions. If the patient has a lawyer he should consult the lawyer for legal advice more so concerning his wills and the requisite policies involved when one chooses to reject medical attention. Moreover, the patient should consult his or her family and consult them apart from informing them of their wishes. Most important is the fact that the patient’s wish should be followed as long as he or she makes the wish while having the requisite capacity. In case the patient is incapacitated then the family members should make the end of life decisions for the patient. However, if the patient lacks family members, then the people nominated in his or her living will are responsible for making the decisions according to the patient’s wishes. A modern trend in palliative care is that hospitals seek key information on end of life-decisions upon admission of the patient (Pizzo, Walker, & Bomba, 2014). This makes decision making by the hospital much easier.

Euthanasia is the administration of a lethal injection by a physician to a patient. It is mainly done to alleviate the patient from suffering. However, it is largely deemed illegal and it is termed as mercy killings. Though many states in America such as Montana and Oregon provide for assisted suicide euthanasia is outlawed. Cessation of treatment, however, involves the medical practitioners stopping the administration of life-prolonging treatment at the authorization of the patient. Therefore, the patient’s death or suicide is assisted through the cessation of treatment.

Question 4

Various measures can be incorporated into a patient’s end-of-life decision making to ensure that the quality of life for the ongoing family and social relationships of individuals do not take massive hits by the patient’s decision of withdrawing life-prolonging treatment. Most importantly, the patient should discuss his decision to put an end to his treatment and help the family understand his reasons. This is important in ensuring that both the family and the patient understand, support and cope positively with the illness and grief of the patient’s death.

Since death is not entirely a medical event as it incorporates social, psychological and spiritual issues care should be taken to avoid unnecessary pitfalls. First, precaution should be taken to ensure that the patient is provided with the necessary pain relievers. Cessation of treatment from a terminal illness is mostly accompanied by debilitating pain and discomfort apart from the worsening of symptoms and care should be taken to ensure that the patient is provided with the requisite pain relievers (Pizzo, Walker, & Bomba, 2014). Secondly, both healthcare providers and family members should understand the needs of the patient and if possible help in their fulfillment. This is important in creating a loving and supportive environment as the patient faces his final moments. Further, the family members and relevant healthcare providers should ensure that the patient receives spiritual assessment and direction if needed. Spiritual guidance is quite important as it helps strengthen the patient’s resolve, helps him to come to peace with his situation and alleviates depression and anxiety.

Actions should be taken to ensure the respect and integration of both the spiritual and existential dimensions of the process. Spiritual guidance and nourishment should be provided to the patient. Besides, the cultural and historical context, roles and interests of the patient should also be incorporated into the process.

In reflection of the above issues, I would apply the Saint Leo University Core Values of community to create a socially responsible society that respects every individual’s rights, including the right to terminate one’s treatment, and supports the terminally ill. Besides, I would respect other people’s choices and provide honest opinions and support to those in need.

An individual’s right to die has been a controversial issue in the American political, legal and social circles since the 1980s. The courts have ruled on this issue and have upheld the individual’s right to die by terminating life-prolonging treatment. The political setting is however still largely divided with many states legalizing assisted suicide while others holding steadfast on their belief on the sacred nature and need for preservation of life. The issue brought to the fore the need for a living will which enables individuals to make decisions on the life-saving measures they want to be applied to them in case of illness or accidents. Besides, the issue of terminating treatment largely contributed to the formation of palliative care which is focused on the treatment of pain and suffering caused by terminal illnesses.

 

 

 

References

Cruzan v. Director, Missouri Dept. of Health, 497 U.S. 261 (1990). (n.d.). Retrieved from https://supreme.justia.com/cases/federal/us/497/261/

National Health Foundation. (n.d.). Recuperative Care. Retrieved from https://nationalhealthfoundation.org/recuperative-care/

Pizzo, P. A., Walker, D. M., & Bomba, P. A. (2014). Dying in America: Improving quality and honoring individual preferences near the end of life. Washington, DC: Institute of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25927121

World Health Organization. (2012, January 28). WHO Definition of Palliative Care. Retrieved from https://www.who.int/cancer/palliative/definition/en/