Question

Ruth has full decision-making capability. She has just had extensive diagnostic tests. Her physician advises that she has a serious form of cancer, but that certain treatments may well extend her life to 12 or more years. Without any treatment he estimates that Ruth will live from 2 to 2-1/2 years. The doctor explains side effects and alternative therapies. Ruth talks with her husband and children. She tells the doctor that she will not undergo the treatment on account of the side effects. She only wants comfort care. Does Ruth have the legal right to reject treatment even if-as here-that will bring on her death much sooner? A. Yes, but in only some rare cases. B. No C. Yes, in virtually all cases. D. No, unless she has an advance directive specifically refusing this treatment The doctor talks further with Ruth and her husband and persuades her to undergo treatment. At one point it becomes necessary to install a feeding tube and intravenous administration of fluids. Ruth consents to this, but after a while changes her mind. She directs that the artificial administration of fluids and food be ended. The doctor warns Ruth and her husband that without them she will lapse into a coma and probably die in a week or so. Ruth persists in her demand that the tubes be taken out. Does Ruth have the right to have the tubes removed even if-as here-that will cause her death? A. Yes, but in only some rare cases. С B.NO C. No, unless she has an advance directive specifically refusing this treatment. D. Yes, in virtually all cases.

Answer 1

●According to principle of ethics (Principle of Autonomy) a patient who is mentally sound and a major has the fill rights to decide on their treatment .They can accept or refuse a treatment in all cases.

Advance directive is one which gives consent to the healthcare professionals to decide on the treatment when they are not in a state to respond or take decision.This generally includes the life saving procedure like CPR,feeding ,treatment, etc.,

Ans:C.Yes ,but virtually in all cases

● The patient in the grounds of beneficence and doing no harm the feeding tube has to be kept in place as it was first consented.Later to deny this treatment a proper advance directive is needed to prevent legal issues later as the patient will die in a very short period

Ans:C.No unless she has an advance directive specifically refusing this treatment

●The patient who is in coma (incompetent patient) whose right of self determination is affected. it differs according to each state . Withdrawal is a great concern depending upon the nature of illness whether it is a terminal or curable one.It is not considered if patient can be kept alive with non invasive procedure (tube feeding, antibiotics, etc., ) rather than invasive procedure which can cause adverse effects to the patient and cause further problems in the condition.Still there are many cases running in making decision on the removal of feeding tins in a comatose patient

Ans:B.Yes ,but only in some rare cases

●In these type of cases a court appointed guardian is to be done to make decision on life saving procedures to prevent legal consequences

Ans:B.No,unless court appointed him as a Ruth's guardian

●It is the sole and primary responsibility of a provider to screen and monitor patients for any adverse reactions ,failing g to di so is an medical negligence.

Vison loss is because of the doctors medical negligence of not assessing and treating the injured eye

An incorrect diagnosis, and a result of surgery because 9f or is a medical malpractice. In these type of cases always a team approach or expert approach is necessary because surgery is an invasive procedure with it's own side effects

Ans:B.I,II,III