Ethics, the Constitution, and the Dying Process

Ethical Issues in Artificial Nutrition and Hydration: A Review

“…28 The ultimate outcome of Schiavo reaffirms the judicial ruling in Cruzan several decades earlier that ANH is a medical treatment like mechanical ventilation and can be withheld or withdrawn in accordance with the wishes of an autonomous patient or a proxy. 29,30 An informed consent discussion must precede, and be the basis of, any decision regarding ANH. Adequate informed consent requires 3 essential elements: (1) that the patient or a surrogate is provided sufficient medical information; (2) that the patient or a surrogate possesses decisional capacity; and (3) that the patient or a surrogate is able to exercise voluntarism (the capacity to make a decision free of coercion).…”

Ethical Issues in the Treatment of Severe Brain Injury

“…He further ruled that, given her diagnosis and prognosis, the plan to remove her feeding tube was in accordance with her prior stated wishes and ordered it to be removed. Judge Greer concluded that the evidence that removing her feeding tube represented her true wishes satisfied a strict legal standard of evidence by being “reliable,”“credible,” and “clear and convincing.” After a lengthy judicial process during which his ruling was sustained repeatedly by state and federal appellate courts, and after unprecedented 57 and unpopular 58 legislative involvement by both the Florida legislature and the United States Congress to reverse the ruling, her feeding tube was removed and she died.…”

Coming to Terms with Perfection: The Case of Terri Schiavo

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