A Legal and Ethical Dilemma Read this paragraph and the Case Study Deciding to place a loved one into a long-term care facility can be extremely difficult

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A Legal and Ethical Dilemma

Read this paragraph and the Case Study

Deciding to place a loved one into a long-term care facility can be extremely difficult. Even more difficult is the thought of your loved one's rights being violated while in long-term care. Patient healthcare rights are not as clearly defined as one would expect, and there are long-term care and other healthcare facilities that create their own sets of patient rights. However, there are also certain indisputable rights afforded to patients across the board.

Read the case study titled "A Legal and Ethical Dilemma". Next, use the Internet to research information on a patient's right to die.

Instructions

Write a 4–6 page paper in which you:

1. Describe the legal and ethical dilemma discussed in the case study. Analyze the key ways in which a patient's right to die relates to this specific case.

2. From your research, specify the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Next, take a position on whether the patient's right to die or the patient's right to be protected from harm should take precedence in this case. Provide a rationale for your position.

3. Imagine that you are a part of the ethics committee investigating this case. Determine the main facts pertaining to the issue that the committee should consider. Suggest one step that the facility should take next in order to resolve the dilemma. Provide a rationale for your response.

4. Use at least three quality academic resources. Note: Wikipedia and other similar websites do not qualify as academic resources.

GRADING RUBRIC

1. Describe the legal and ethical dilemma discussed in the case study. Analyze the key ways that a patient’s right to die relates to this specific case. 30 %	Did not submit or incompletely described the legal and ethical dilemma discussed in the case study. Did not submit or incompletely analyzed the key ways that a patient’s right to die relates to this specific case.	Partially described the legal and ethical dilemma discussed in the case study. Partially analyzed the key ways that a patient’s right to die relates to this specific case.	Satisfactorily described the legal and ethical dilemma discussed in the case study. Satisfactorily analyzed the key ways that a patient’s right to die relates to this specific case	Thoroughly described the legal and ethical dilemma discussed in the case study. Thoroughly analyzed the key ways that a patient’s right to die relates to this specific case.
2. From your research, specify the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Next, take a position on whether the patient’s right to die or the patient’s right to be protected from harm should take precedence in this case. Provide a rationale for your position. 25 %	Did not submit or incompletely specified the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Did not submit or incompletely took a position on whether the patient’s right to die or the patient’s right to be protected from harm should take precedence in this case. Did not submit or incompletely provided a rationale for your position	Partially specified the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Partially took a position on whether the patient’s right to die or the patient’s right to be protected from harm should take precedence in this case. Partially provided a rationale for your position.	Satisfactorily specified the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Satisfactorily took a position on whether the patient’s right to die or the patient’s right to be protected from harm should take precedence in this case. Satisfactorily provided a rationale for your position	Thoroughly specified the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Thoroughly took a position on whether the patient’s right to die or the patient’s right to be protected from harm should take precedence in this case. Thoroughly provided a rationale for your position.
3. Determine the main facts pertaining to the issue that the committee should consider. Suggest one step that the facility should take next in order to resolve the dilemma. Provide a rationale for your response. 25 %	Did not submit or incompletely determined the main facts pertaining to the issue that the committee should consider. Did not submit or incompletely suggested one step that the facility should take next in order to resolve the dilemma. Did not submit or incompletely provided a rationale for your response	Partially determined the main facts pertaining to the issue that the committee should consider. Partially suggested one step that the facility should take next in order to resolve the dilemma. Partially provided a rationale for your response.	Satisfactorily determined the main facts pertaining to the issue that the committee should consider. Satisfactorily suggested one step that the facility should take next in order to resolve the dilemma. Satisfactorily provided a rationale for your response	Thoroughly determined the main facts pertaining to the issue that the committee should consider. Thoroughly suggested one step that the facility should take next in order to resolve the dilemma. Thoroughly provided a rationale for your response.

 

A Legal and Ethical Dilemma 
'bated by Mon S. Whiteman, PhD, FACMPE • d 
NIA) Evelyn Greene, who has memory ,airment, lives in a private room at Shady gook Skilled Nursing Facility located in a tatiful suburb of a major metropolitan city. She has resided at Shady Brook for tie past 18 months. Before moving into y Brook, Mrs. Greene lived indepen-tly in her own home with assistance a private-duty nursing assistant and housekeeper. She and her husband had 'ded together in this home for more than years. Mrs. Greene is 89 years old and ers from several health problems associ-with aging. Mrs. Greene has one son, David Greene. aid has the power of attorney to handle mother's health care and other personal . David works as a trial attorney in one the city's largest and most prestigious law . He owns a large home in an upscale ghborhood and works hard to put two children through college and another through medical school. His home is an hour's drive from his workplace 
, and Lisa E. Sliney, MS, DMA, Barry University 
463 
and about 20 minutes from Shady Brook. David's wife Barbara has never been close to her mother-in-law and has not shown much interest in her care. Hence, caring for his mother has become a major responsibil-ity for David, and he is having a difficult time dealing with her declining health and the onset of mild dementia. It is becoming increasingly more difficult for David to leave his law practice or the coon room to deal with issues related to his mother. Mrs. Greene's husband was a very suc-cessful land developer who left her with a substantial estate, which meets all of her financial needs. After her husband passed away, Mrs. Greene decided to remain in her home. She was able to maintain her independence until she was 87 years old. when she began to show signs of demen-ia.Sh:iYthereafter,     David de meosveee dn her ime'sier' to keep her mother company becaishewastooweakgooutofher r:in'heri:MsaGrand l ke sthe enjoy the sitter's comPny aentioseg Upon entering Shady Brook. Mrs. Greene became depressed over losing her independence and her home and felt a grow-ing frustration with forgetfulness. She grad-ually lost her appetite, and her desire to eat continued to decline. On the other hand, Mrs. Greene seems to enjoy the smell of certain foods. The associates monitor and document her food intake and her facial expressions when she is offered different foods. Mrs. Greene is particularly fond of Susan Brown, a certified nursing assistant (CNA), who sits with her and helps Mrs. Greene with what-ever little she can eat. When this occurs, her appetite shows some improvement Mrs. Greene also responds well to volunteers who carry out activities at the facility. 
Frustrated Family Member Mrs. Greene has become too weak to eat on her own. When no one is feeding her, she leaves most of her food on the tray. Recently, she has sustained a weight loss of more than 5 pounds per week. Her plan of care needs to be reevaluated, and her situation needs immediate attention. David has been visiting his mother quite regularly. Recently, however, his visits have become less frequent, gen-erally two to three times per week. The associates who work on Mrs. Greene's nursing unit have reported some changes in David's attitude. At one time he became angry with his mother, raised his voice, and spoke to her as if she were a bad child. Although no one was present in Mrs. Greene's room at the time, the asso-ciates working at the nursing station heard David's loud voice. When the charge nurse 
went into Mrs. Greene's room to rind why David was angry, David told her it was none of her business. On Da,d7; subsequent visits. the associates obser,ed that Mrs. Greene would become agitated during David's visits. These issues were brought to the charge nurse's attention. and they were documented in the patient's medical record. 
The Dilemma One day David approached the charn, nurse and exclaimed that his mother had expressed that she wished to die. on his next two visits, David also told the CNA, that his mother's desire was not to eat m-uting so she could just die a quick deal This was the first time the CNAs had heard that Mrs. Greene had expressed a desire to die. The associates also believed that Mrs. Greene appeared to be happier when David was not there. Before the week was over. Daid came into the facility early in the morning on his way to work. He handed a sealed envelope to the incoming charge nurse on the day shift. The envelope was addressti to Betty Wright, Shady Brook's admin-istrator. David said to the charge nun:. "I have been telling you people that mother wishes a speedy death. Tell tO administrator that I will be tiling a losmt_ if my mother's wishes are not carried out David left without visiting his mother.Betty Wright decided to placethe, on the ethics committee's agenda . same afternoon. As a safeguard. B,11);:.; notified the facility's liability ipso. rier of the potential legal action. 
moll of the Ethics Committee f flemoon, Betty met with members of • Tit a es cornrnittee: chaplain, medical direc-tor— director of nursing, charge nurse, social . • worker, two CNAs, and the local ombuds- Betty began the meeting with these „narks: "The man's mother has been declin-ing rapidly and eats very little. He wants his other to die rather than prolong her suffer-ing. I have learned that the son is the heir to las mother's estate, and my overall concern is my trust in his decision or his motives. I think he needs the money to pay for the college expenses for his three children. Although it is not uncommon for some residents to be ignored by family after they are admitted, it is rare that they express the wish to enable the death of a relatively healthy person." The ethics committee is faced with the issue of What is legally and ethically appropriate. The committee deliberates on whether or not to comply with David's request to withhold food as well as the threat of a lawsuit. 
Assignment 465 
Assignment 
I. In a sentence or two, identify the main issue. 2. Outline the facts pertaining to this issue. 3. Identify alternative solutions that the ethics committee might consider. 4. What may be the consequences of the alternatives you have proposed'? Discuss the consequences from the perspectives of (a) Mrs. Greene and (b) Shady Brook. 5. Discuss the alternatives from the standpoint of the patient's rights. 6. What will be your recommendation to the ethics committee? 7. In their deliberations, should the committee members take into con-sideration Betty's comment that David needs the money to educate his children?