Case Study: Legal & Ethical Principles in Healthcare

This case study explores the legal and ethical principles in healthcare regarding euthanasia and the moral considerations surrounding it.

Running head: CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE
Case Study: Legal & Ethical Principles in Healthcare
Student’s Name
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CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE 1
Case Study: Legal & Ethical Principles in Healthcare
Introduction to the Case Study
Patients on life support machines present moral challenges for the family members and
their relatives, especially when doctors are convinced that the patient may not recover from the
treatment. Sometimes the caregivers are aware that the patient will not recover, but when they
share the truth with the family members, it becomes impossible for the family members to accept
the truth. When there are minimal chances of recovery for a person placed on the life support
system, the healthcare providers may recommend that the machine is switched off to prevent
further emotional and financial stress on the family as well as other patients that may be waiting
to utilize the few available resources in hospitals. Hamilton, Shahaduz, Sandy, and David (2017)
state that switching off the life support machine is a form of mercy killing. Mercy killingis done
in compassion and it can help both the person suffering and the family at large, especially when
the person has been on treatment for a while. However, there have been different views on the
mercy killing, also called euthanasia. Proponents of euthanasia view it as an ethical form of
respecting the wish of the patient and a form of compassion for the patient and the family. On the
other hand, opponents argue that euthanasia is no different from mercy killing and that it is
against the moral law of life (Purcaru, Preda, Popa, Moga, & Rogozea , 2014)). This difference
in views and perspectives attracts the ethical and legal debate on the question of euthanasia. This
paper discusses both legal and ethical moral considerations on euthanasia from the case of
Richard, an Australian that was placed on the life support machine after suffering head injury
that caused placed him in a vegetative state. It is expected that the analysis of this case study will
expound the current public understanding of the Australian laws on euthanasia and explain why
some people may be opposed to euthanasia from ethical point of view.

CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE 2
Ethical Issues in Case Study
Euthanasia attracts ethical concerns because it touches on the moral law of life. The
major challenge that faces nurses and healthcare professionals is the collision between traditional
values and science. According to the case study, Meryl is opposed to the switching off the life
sustenance machine because she is convinced that her husband will wake up from his condition.
This is an example of a proponent of the natural law of life. According to Chakraborty et al.
(2017), proponents of the natural law of live believe that it is only God who can take the life of a
patient away. They are convinced that death is natural and it has to be left to occur naturally. Any
attempt to terminate the life of a living being is considered unethical and interfered with the
dignity of life. While it is true that euthanasia is a painless killing of the patient to alleviate
suffering of the patient and the family members, the strict objection from the proponents of
natural life makes it difficult for nurses and other healthcare professionals to carry out their
duties (Sigley, 2016). Religious beliefs view deliberate withdrawal of the patient from the life
sustenance system as deliberate murder. This is a significant challenge for nurses who have to
attend to patients that are in vegetative state.
Unlike pro-religious believers like Meryl, Lucas holds a different perspective on the
moral issue of keeping the patient in a vegetative state on a life sustenance system. According to
the case study, Lucas had seen the state of Richard and was convinced that the chances of his
friend to recover were diminishing. As a result, he was convinced that the best alternative was to
switch off the life sustenance system. He even recalls that Richard had told him that he would
not wish to be left in a helpless state if he ever suffered from an accident in the workplace. Lucas
is also a proponent of sanctity of life, but he believes that people should die in respect and

CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE 3
dignity. As a proponent of respect to dignity of the patient, Lucas is convinced that the state of
his friend is embarrassing and he should be relieved.
Additionally, Lucas is a proponent of respect for patient’s autonomy. According to the
Guardianship and Administrative Act (2000), all people above the age of eighteen years have the
right to make decisions and those decisions have to be respected accordingly. In this case,
Richard had wished to be treated with dignity. The decision to keep him on the life support
machine is demoralizing and diminishes his dignity as a person. Furthermore, the Queensland
Law Handbook (2016), states that medical ethics should prioritize the respect for people’s rights
and freedoms. In this case, Richard is convinced that the helpless condition of his friend on the
life support machine is devastating and there is a need to intervene and alleviate the suffering of
his friend as well as other people that are touched by his condition.
It is evident from the analysis of the values and beliefs held by both Lucas and Meryl that
they have opposing views in the termination of the treatment of Richard. Meryl is inspired by
religious beliefs that her husband will one day recover from the vegetative state. Lucas is
convinced that the treatment is not adding any value to the patient, hence it should be terminated.
He is ready to defend his belief with the facts that the status of Richard cannot be repaired. He
will also argue that the cost of medication and the emotional stress from the patient is affecting
the patient and the family. He can also argue that the termination of the treatment will create
available space for people who have chances of recovery to use the life sustenance machine
(Sulmasy, Travaline, Mitchell, & Ely, 2016). Meryl will have her reasons for championing for
keeping the patient on the life sustenance, even when he is in a vegetative state. Meryl’s views
the technology of artificial life support as a God-send opportunity to extend the life of patients.

CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE 4
The Universal Declaration on Bioethics and Human Rights has distinct limitations on
what it considers to be the rights of humans. In this paper, two ethical principles from the
Universal Declaration on Bioethics and Human Rights can be used to analyze this case and
resolve the differences Universal Declaration on Bioethics and Human Rights has set principles
that dictate how the case scenario of Richard could be handled. Two of the principles from the
Universal Declaration on Bioethics and Human Rights are discussed here. Article three of
Universal Declaration on Bioethics and Human Rights (UNESCO, 2019) emphasizes respect on
human dignity and human life. This implies that no life can be terminated. The article also
emphasizes respect for human life and value. In this case, everyone has a responsibility to
respect the life of the patient and the wishes he had. As a result, article three of Universal
Declaration on Bioethics and Human Rights supports Lucas’ belief that there is no need to keep
Richard on life support sustenance.
The sixth principle of Universal Declaration on Bioethics and Human Rights talks of slf-
reliance for physical, social, psychological, and intellectual capabilities. This principle is
consistent with Lucas’ emphasis to respect the rights and freedoms of the patient. Additionally,
the patient can only be treated as a person ie he has the capacity to move and make decision. The
assumption that the person is in a vegetative state and will wake up does not qualify him the full
rights of the person. In this case, Richard does not have the moral rights of a person to waste
time and resources on the life support machine.
Legal Issues in the Case Study
Apart from ethical issues addressed above, Richard’s case also attracts legal issues that ill
have to be addressed. Queensland Law Handbook (2016) has dictated some of the considerations
that have to be accounted for in obtaining consent from the patient. Consent to treatment is a

CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE 5
voluntary agreement between the patient and the medical caregiver that the patient is allowing
the medical practitioner to treat the patient (Chrispinus, 2019). In this case, Richard has to be
conscious and mentally stable for him to consent to treatment. According to Bernadete and Lisa
(2019), physicians should warn patients and explain to them the nature and type of medication
before carrying out any medican intervention. In the given case scenario, the doctors explained to
Richard why he was to be treated in the first place but he refused. Doctors could not impose the
treatment to the patient without his consent.
The Australian Government Law Reform (2019) has set standards for obtaining consent
for treatment from patients. According to Kakar, Gambhir, Singh, Kaur, and Nanda (2014),
adults are always considered competent for consent. However, accidents that causes the head
injury like the one of Richard renders the patient incompetent for giving consent to treatment. As
a result, the medical team has to make proper intervention to prevent irreversible damage to the
body before obtaining consent from the patient or the surrogate (Snow & Fleming, 2014). It
would be irresponsible for healthcare providers to sit back and wait for the patient to die. If the
doctor forcefully treats the patient, the patient or the surrogate can sue the doctor for trespassing
the privacy of the patient.
Refusal of consent to treatment does not imply that the healthcare providers cannot
intervene and help the patient (Lamers & Williams, 2016). Even though Richard had refused
consent to treatment in the first case, he should be treated for the head injury. In Australia, the
law requires that the physician treats the person to stabilize the patient before intervening in the
treatment (Queensland Law, 2019). The human aspect of the law requires that one intervenes to
help the patient even when one had refused treatment. It is evident that after the head injury,
Richard cannot give consent to treatment.

CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE 6
According to Stolz, Mayerl, Gasser-Steiner, and Freidl (2017), a person has a right to
refuse treatment. However, this is only possible when one is competent to make decisions.
Richard’s head injury has rendered him incompetent, creating a need for a surrogate that will
make a decision that would be in the interest of the patient. The substitute decision maker has to
be a close relative or a family member (Queensland Law Handbook, 2016). Bernadette and Lisa
(2017) explain that physicians have to treat the patient with care even if they know that he is in
an unconscious state. According to (Queensland Law Handbook, 2016), the process of obtaining
consent from the patient is within the constitution of the land. Some of the conditions necessary
for obtaining consent from the patient involves making sure that the patient understand the
consent and the type of treatment that one is receiving.
The case of Richard raises the question of surrogate decision makers in case patients are
not competent to give consent to treatment. Cai et al. (2015) explain that the Queensland
Government Administrative Act (2000) recognizes the importance of the decision maker in case
the patient cannot give consent to treatment. If Meryl is to be a decision maker, she has to make
a decision that Richard could make if he had the capacity to speak. It is evident that Meryl’s
decision to keep the patient on the life support is against the Healthcare Principles set out in the
Guardianship Administrative Act 2000 which requires respect for autonomy of the patient.
Conclusion
Placing patients on life support machines attract both legal and ethical issues that have to
be addressed. Ethical issues involve the perception of the family members and the beliefs that
one has towards life. Religious beliefs tend to magnify the positive attitude and values that one
has towards life. On the other hand, scientific values are based on facts. The advantage of
scientific facts when it comes to the condition of the patient is that they can be substantiated.

CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE 7
Religious beliefs and cultural values on the other hand cannot be substantiated. It requires that
one believes and acts on faith, even when there is no hope. In the case of Richard, Meryl
represents religious beliefs while Richard represents scientific values.
.

CASE STUDY: LEGAL & ETHICAL PRINCIPLES IN HEALTHCARE 8
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