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CASE: SPOUSAL RIGHTS IN DECISION MAKING Mr. Martin sustained debilitating injuries as the result of an automobile accident. He suffered severe subcortical brain damage, significantly impairing his physical and cognitive function- ing.45 His injuries left him totally paralyzed on the left side. He could not speak or eat and had no bladder or bowel control. Martin remained conscious and had some awareness of his surroundings. He could communicate to a very minimal degree through head nods. The trial court determined that Martin did not have nor would he ever have the ability to have the requisite capacity to make decisions regarding the withdrawal of life-support equipment. The evidence demonstrated that Martins preference would have been to decline life-support equipment given his medical condition and prognosis. The trial courts decisionwas based on the following four-part test for determining whether a person has the requisite capacity to make a decision: Does the person have sufficient mind to reasonably understand the condition? Is the person capable of understanding the nature and effect of the treatment choices? Is the person aware of the consequences associated with those choices? Is the per son able to make an informed choice that is voluntary and not coerced? The trial court also determined that Mrs. Martin, the patients spouse, w guardian for him. She petitioned to withdraw her husbands life support. Martins mother and sister counter petitioned to have Mrs. Martin removed as the patients guardian. The Michigan Court of Appeals held that the evidence was sufficient to support a finding that the patient lacked capacity to make decisions regarding the withholding or withdrawal of life sustaining treatment. As to the patients desire not to be placed on life-support equipment, there was sufficient evidence to show that the patient had a medical preference to decline treatment under circumstances such a dence to show that the patients spouse was a suitable guardian. as a suitable s those that occurred. There was also sufficient evi- The test for determining whether Martin had the requisite capacity to make a decisi regarding the withholding or withdrawal of life-supporting medical treatment was clear and convincing-he did not have sufficient decision-making capacity. The evidence was just as clear that he never would regain sufficient decision-making capacity that would enable him to make such a decision. It was the general consensus of all of the experts that Martins condi tion and cognitive level of functioning would not improve in the future. on Testimony from two of Martins friends described statements made by him that he would ant to be maintained in a coma or in a vegetative state. In addition, Mrs. Martin described numerous statements made to her by Martin prior to the accident that he would not want to be maintained alive, given the circumstances described previously here. The trial court found that Mrs. Martin was credible. The court of appeals found no reason to dispute the trial courts finding as to Mrs. Martins credibility In contrast to allegations made by the patients mother and sister, the evidence was clear that Mrs. Martins testimony was credible. There was no evidence that Mrs. Martin had anything but her husbands best interest at heart. There were allegations, but no evidence, that financial considerations or pressure from another individual influenced Mrs. Martins testimony Ethical and Legal Issues Knowing that the patient had some ability to interact with his environment, discuss the four-part test for determining the patients ability to make a decision. Do you agree with the courts decision? Explain. Should the concern of the mother and sister have carried more weight in removin custody from Mrs. Martin? What influence do you believe the mother and sister might have had on Mrs. Martin? 1. 2. 3.

Please answer the case questions. Do not hand write

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Answer #1

Four part test indicates testing the four important aspect to determine the individual capacity for decision making and interaction abilities.Communication, appreciation,understanding and rationalization are the four abilities to assess the individual ability.

The court's decision is correct by the reasonable medical condition and by the choice of the patient's guardian it is legal and correct to give this kind of decision.

The individual who is taking part of patient care in all aspect such as physical care and financial aspect is have more rights in taking these decisions because they are one who have taken responsibility for the client mainly it will be a spouse decision so the mother and sister decision is not weigh much.

Influence is not on Mrs.Martin may be they have thought to take care of Mr.Martin they may believe that have the circumstances for Martin survival.

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