Posted: August 1st, 2023

Right to Refuse Treatment

Conduct research on the United States Supreme Court case of Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990). The full text of this case, along with numerous case briefs, commentaries, summaries, etc., may be found by simply entering the full name of the case into any major online search engine of your choosing. Alternatively, you may use Westlaw, Lexis or any other professional legal research databank in your research.

• What was the ultimate numerical vote of the court?
• When and how can life support be withdrawn?
• How does death by refusal of treatment differ from suicide?
• How does a living will work and when does it become of legal effect?
• What is a health care directive and how does it work?

After completing your research, summarize your answers, and, along with any other sources, if any, address and support your particular position/view on the following specific issues, and, specifically, how you would apply the Saint Leo University Core Values of Community, Respect, and Integrity into your actions. Be sure to use proper Help write my thesis – APA format for citations.

2) Paper format should be as follows:
a) Introduction
b) Body of Paper
i) Response to Question #1: What are the potential foreseeable financial, psychological, and medical, yet unintended, harmful consequences to one’s family and friends in failing to provide a properly executed will and living will prior to one’s final illness and death?
ii) Response to Question #2: What are the fundamental distinctions between recuperative medical care and palliative care? Who should be included in the decision to modify care from recuperative to palliative? When, if ever, is the right to refuse any and all medical care appropriate when such virtually ensures the death of the patient?
iii) Response to Question #3: What professionals, medical or otherwise, should be involved in advising decisions concerning end-of-life wishes? How does euthanasia differ from a simple cessation of treatment? Who should make end of life decisions for those who are without a family member to take on such a role?
iv) Response to Question #4: What measures can be taken to ensure the quality of ongoing family and social relationships, individually and as a group, to end-of-life patients? What pitfalls are to be avoided in ensuring maintenance of these relationships? What actions may be taken to ensure the spiritual and existential dimensions of the process are respected and integrated?
c) Conclusion
—

Right to Refuse Treatment
Student:
Institution:

Right to Refuse Treatment
What was the ultimate numerical vote of the court?
The case of Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990), the numerical vote o the court was based on the availability of convincing evidence of Nancy Cruzan’s refusal of life support (Shaw, Quill, and Sussman, 2020). According to the fourteenth amendment and the due process clause, the majority agreed on the right to refuse treatment, but the family had not provided enough and convincing evidence (Groenhout, 2020).. According to the case, the hospital had refused to terminate the life-support system without the approval o the court. The Missouri Supreme Court, however, ruled in favor of the due process clause and other policies that rule in favor of the right to refuse treatment.
The court asked for a clear and convincing evidence for the case believing that competent people had no strength and ability to reuse medical treatment compared to competent people under the due process clause (Cerminara, 2020). However, the need to preserve human rights is constitutional and right; therefore, the court demanded or heightened evidence (Groenhout, 2020).. The evidence was necessary because the withdrawal of life is irreversible, and the action there was no proof that the family members were acting in Cruzan’s best interest (RAJKA, and ALUAŞ 2016). The court rules the case on the evidentiary burden instead of the right to die. After the court’s appeal, the family provided clear and convincing evidence proving Cruzan’s refusal of life support. In December 1990, Cruzan was withdrawn from life support.
• When and how can life support be withdrawn?
Life support can be withdrawn according to the common law of informed consent, privacy rights, and the due process right to liberty and in support of clear and convincing evidence. Page 497 of the United States Constitution, there should be evidence that shows the incompetent person would decline life support or treatment (RAJKA, and ALUAŞ 2016). The fourteenth amendment support right to privacy, which supports the refusal of medical treatment. Every individual has the right to live a private life and make personal decisions without interference. The interest of patients is more important; hence, the physician should protect patients’ lives, not make judgments about the quality of an individual’s life, and protect an individual choice of life or death.
• How does death by the refusal of treatment differ from suicide?
An act is considered suicide if the patients going through a critical condition actively end their own lives. At the same time, refusal of treatment involves omitting or forgoing the opportunity to receive medical treatment. Declining medical treatment for a terminal condition is the refusal of treatment, but declining medication knowing the illness will eventually lead to natural causes (Groenhout, 2020). Death cannot be labeled as suicide if the patient omits lifesaving treatment or has denied treatment to postpone death. Determining whether the refusal of treatment is an act of competence or suicide can be determined by the patient’s reaction towards treatment and family reaction. Psychiatrists offer therapy to patients going through the interpersonal feeling of sadness or anger to avoid committing suicide.
• How does a living will work, and when does it become of legal effect?
A living will is created by someone eighteen years old and above with the knowledge and ability to make sound decisions (Tewari, 2019). The physician must tell whether a person can make sound decisions when they can explain what they need and understand doctors, including the consequences of the will. Additionally, the healthcare agent cannot make various prohibitions, such as authorizing mercy killing, abortion, and psychiatric treatment or authorizing sterilization.
A living will becomes legally effective when one cannot make sound healthcare decisions according to the physician (Tewari, 2019). For instance, if a person is critically ill and cannot make wishes concerning healthcare. The doctor, however, certifies the will by writing for it to take effect. The living will address conditions, such as tube feeding, antiviral medication, cardiopulmonary resuscitation (CPR), comfort care and organ donation.
• What is a health care directive, and how does it work?
Healthcare directives is an advanced guide that controls the choices made by physicians concerning a terminally ill person. For instance, when an individual is in a coma or their last stage of chronic diseases, such as dementia (Tewari, 2019). The healthcare directive enables the patient to relieve unnecessary treatment and suffering, plan for medical care and reduce conflict concerning decision making among family or physicians. In most states, the healthcare directive requires agents who fit into the state’s healthcare requirements and laws. For instance, a family member, friend or church member in the community.
Summary
The case of Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990). Provide an overview of the laws about the refusal of treatment. Refusal of treatment is legally acceptable under the United States Constitution under the fourteenth amendment and the due process (RAJKA, and ALUAŞ 2016). The fourteenth amendment considers the right to privacy and liberty to make personal choices. Refusal of treatment is allowed in the presence of an informed consent, which can be informed of a document, such as a living will. A living will and health directives consist of legal instructions in written form concerning individual preference and medical treatment decisions. The living will and directive occur when the patient can no longer make sound decisions and legally takes effect when the physician certifies its release through writing.
Response to Question #1
A last will is used to share properties after death, while a living will is a written wish that includes medial considerations when a person can no longer make sound decisions (Tewari, 2019). According to medical ethics, surrogate decision making is very important before one, final illness or death. The living will consist of next of kin part, including parents, spouse, siblings, friends or children (RAJKA, and ALUAŞ 2016). In case the family or friends fail to appear and execute a living will or in case of a conflict, legal action is taken in the court of law. The legal action involves the appointment of a legal representative to decide based on what the individual may have wanted.
In case the patients die without a properly executed will, the court may share the properties among the family members according to intestate succession rules (Tewari, 2019). The properties can be divided among the surviving family members, such as children, spouses but not relatives. The families and friends of the patients or the deceased may go through emotional stress, especially when conflict arises or when the family has to take cost burdens. The family can undergo psychological care for the treatment of emotional distress by providing various coping mechanisms (Tewari, 2019). For the patients’ medical care, the family and friends are provided with a permit to consent for the patient’s treatment. In case of a lack of progress, the patient is referred for treatments.
Response to Question #2
According to the National Health Care for homeless, recuperative care is a treatment that enables individuals to recover after an illness. In contrast, palliative care is a treatment for chronic illness purposely to stop or relieve pain (Takahashi, Kawada, and Takahashi, 2019). Both palliative and recuperative improve the quality of care where recuperative care is administered to homeless persons going through physical illness and not being hospitalized. Palliative care is involved in the treatment of severe health conditions, such as recurs and acute illness. Palliative care is an advancement or recuperative care wherein a patient has been recuperated for a long time, and the patient is taken to palliative care.
Patients in the recuperative facilities are homeless hence do not have any relatives of families to make decisions concerning medical care (Takahashi, Kawada, and Takahashi, 2019). The agents involved in making a decision involve relatives, the patient in question, a physician is dealing with the patient and a palliative team member. The rightful party should get consent from the patient. In case the patient cannot make a sound decision at the moment and does not have a living will, the patient is, however, taken to the palliative unit, and the court is allowed to make rightful decisions. Refusal of treatment is allowed if the patient is going through a painful terminal illness or the illness demands expensive treatment with no promising outcome (Takahashi, Kawada, and Takahashi, 2019). Some treatments can lead to more serious health conditions in the future, such as mental illness and physical disability. In this case, refusal of treatment I allowed avoiding future challenges.

Response to Question #3
Decisions concerning the end-of-life wishes depend on various factors, such as whether the patient has a living will or not or whether the patient is admitted. In case a person is faced with a serious health condition, the individual is allowed to make decisions based on finances and medical care. Financial decision is made and documented in the form of a will where details of the property are written (Shaw, Quill, and Sussman, 2020). In contrast, a living will and an advanced healthcare directive documents wish concerning medical care. For instance, the type of treatment to receive and an ant/proxy designed to make decisions when the patient can no longer make sound decisions. However, a proxy makes decisions if the decisions made, and wishes of the patient and a power of attorney are not clear.
The end of life decisions includes burial arrangement and organ donation. However, physicians have the right to change various aspects of the living will, for example, change the type of treatment recommended in case medical care is contrary to the institution’s health policies (Tewari, 2019). Physicians also follow the reasonable professional standards and reasonable person’s standards in maintaining a duty of care, a critical obligation. In the case of a poorly executed living will/will, legal action is taken where the court has to make decisions about medical care and financial decision. For instance, the court appoints a legal conservator to make financial, medical decisions and take care of the patient. A doctor, a proxy and a conservatorship are the three people allowed to make decisions in the absence of a family member.
Response to Question #4:
The social needs and requirements of the patients are important where the family of the patient is considered. A plan is developed to take care of the family and the patient during the recovery process (Takahashi, Kawada, and Takahashi, 2019). Professionals and family members conduct meetings meant to make decisions, answer various questions, and inspire and give hope in case of doubts. Social care is extended to children, where children receive pediatric care during the period. The healthcare system should uphold professional codes, ethics and standards during palliative care. For instance, sensitive information concerning a patient’s medical condition should be secured and stored concerning privacy and confidentiality requirements.
Apart from cultural and social care, a spiritual car is very critical, especially to the patient. Spiritual care is necessary when responding to the family’s needs, guided by a priest or a trained person (Takahashi, Kawada, and Takahashi, 2019). The main factors considered during the spiritual session involve forgiveness of sins, fear of the unknown and beliefs of life after death. Spiritual intervention should be planned and conducted according to the patient’s and family’s cultural beliefs to avoid contradictions.
Conclusion
Today, talking about death is not a big issue than the past, where societies upheld very strong cultural beliefs. Death may occur after a long-time illness involving a terminal illness. According to the United States constitution, the right to refuse medical treatment is considered when the family has clear evidence, informed consent, and due process and liberty. Ethicists tend to criticize the right to refuse treatment, basing the argument on the right to life.
The right to refuse death can be documented in a living will where the patient may refuse certain treatment types, such as organ transplant or tube feeding. The living will provide information about the patent’s financial and medical conditions, especially when injured in a palliative care unit. In case the living/lastly will is not provided in the course of illness or death, the court takes action. The court makes decisions for the family trough selecting a conserver ship when the patient is in the palliative care unit. Social and spiritual care is required to extend hope and bring the family together. Social and spiritual care is provided upholding cultural beliefs and norms of the community. Lastly, the healthcare professions should uphold professional ethics and standards, such as privacy and confidentiality, to avoid exposing the patient and the family and trust issues.

References
Cerminara, K. L. (2020). Cruzan’s Legacy in Autonomy. SMU L. Rev., 73, 27.
Groenhout, R. (2020). Reformed theology and conscientious refusal of medical treatment. Christian bioethics: Non-Ecumenical Studies in Medical Morality, 26(1), 56-80.
RAJKA, M., & ALUAŞ, M. (2016). LEGAL REGULATIONS ON PATIENT’S RIGHT TO REFUSE MEDICAL TREATMENT. Studia Universitatis Babes-Bolyai, Bioethica (2011), 61.
Shaw, M. H., Quill, T. E., & Sussman, B. L. (2020). The Legacy of Cruzan: Balancing the Moral Agency of Surrogates and the State. SMU L. Rev., 73, 179.
Takahashi, S., Kawada, K., & Takahashi, O. (2019). Does the Relationship between Home and Palliative Care Wards Change-The Influence of the Revision of Medical Compensation. Gan to kagaku ryoho. Cancer & chemotherapy, 46(Suppl 1), 63-65.
Tewari, T. (2019). PERSPECTIVES ON EUTHANASIA AND LIVING WILL. Journal of the Gujarat Research Society, 21(10), 667-676.

Order | Check Discount

Tags: Masters Essays, PSY Papers, PSYC, Psychology Assignment, Psychology Dissertations