Question

Question text

Case Study

David, who has suffered from ALS for 20 years, is now hospitalized in a private religious hospital on a respirator. He spoke with his physician before he became incapacitated and asked that he be allowed to die if the suffering became too much for him. The physician agreed that, while he would not give David any drugs to assist a suicide, he would discontinue David's respirator if he asked to do so. David has now indicated that through a prearranged code of eye movements that he wants the respirator discontinued. David had signed his living will before he became ill, indicating that he did not want extraordinary means keeping him alive.

The nursing staff has alerted the hospital administrator about the impending discontinuation of the respirator. The administrator tells the physician that this is against the hospital's policy. She states that once a person is placed on a respirator, the family must seek a court order to have him or her removed from this type of life support. In addition, it is against their policy to have staff members present during such as procedure.

After consulting with the family, the physician orders an ambulance to transport the patient back to his home, where the physician discontinues life support.

Please answer the following Case Questions (20 points):

1. What were the primary concerns of the hospital?

2. What were the physician's primary concerns?

3. When should the discussion about the patient's future plans have taken place with the hospital administrator?

4. What is the physician's liability for the death of this patient due to withdrawal of life support in the patient's home?

Answer 1

1.The primary concern of the hospital was it was not having a policy of discontinuing a respirator in their hospital with a living directive only.Apart from this the staff cannot stay with the patient when these types of procedure are done. But when a patient is placed on a respirator the family members should get legal order to discontinue respirator.At this state if the life support is weaned in the hospital ,it can raise to legal concerns for the hospital damaging its name and reputation in the society when things comes into air.

2.The physician primary concern is to respect the patients will,ensure a painless,smooth dyeing process occurs as per the patient visits. If the physician does this in hospital it can lead to legal issues on him,as a way of malpractice against the hospital policy.Now his concern is to transfer the patient to home to ensure that this process can be done.

3.It should have been discussed with the hospital administrator at the time of admission because it is a must to attach living will at that time.It is also the responsibility of the management to look after these documentation and prevent any problems in the future.

4.The physician should be liable in regards to this case as per the American Medical Association code to avoid any issues later.To prevent this the physician are supposed to explain this in clear to the family members what can be expected at the time of withdrawing life support and after it.This can give them an idea and be prepared to face the situation and handle it effectively emotionally.