Bio-ethical Situation: Legal and Ethical Analysis in Healthcare

This report provides an in-depth analysis of bioethical issues within the healthcare sector, focusing on legal and ethical responsibilities, particularly concerning patient rights and medical negligence. The report examines a specific case law, the Cassandra Callender case, highlighting the complexities of informed consent, the right to refuse treatment, and the ethical obligations of medical practitioners. It explores the implications of negligence, emphasizing the importance of considering patient preferences and family involvement. The report also references related legal cases, such as Border, Lewisham, and Greenwich NHS Trust, to illustrate the consequences of breaching medical duty and bioethical standards. The conclusion underscores the necessity of upholding bioethical principles to ensure quality patient care and avoid potential legal ramifications, emphasizing the significance of patient autonomy and informed decision-making in medical treatment. The report incorporates relevant journal articles and legal websites to support its arguments.

Running head: Paper 1: Bio-ethical situation
Legal and Ethical Issues in Health Care
Paper 1: Bio-ethical situation

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Paper 1: Bio-ethical situation
Table of Contents
Introduction......................................................................................................................................3
Discussion........................................................................................................................................3
1. Examination of case law..........................................................................................................3
2. Legal and ethical responsibilities.............................................................................................4
3. Negligence...............................................................................................................................5
Conclusion.......................................................................................................................................6
Bibliography....................................................................................................................................7

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Paper 1: Bio-ethical situation
Introduction
Consecutive advancement in medical science has created the opportunity of considering several
issues that hold effects on medical practitioners while dealing with uncomfortable situation.
Bioethical issues can be listed as end of life care, allocation of medical resources, organ donation
and so on. In order to conduct a medical treatment, it falls under professional duty of a
practitioner to consider mandatory ethics of confidentiality and truthfulness, informed consent
and autonomy, non-malfeasance, justice and beneficence. This paper is destined to analyze the
importance of maintaining bio-ethics while conducting medical treatment.
Discussion
1. Examination of case law
Consideration of bioethics in medical field is an important segment of medical science. It depicts
the right of having proper treatment and states the consent of patient regarding receiving specific
treatment. The case of Cassandra Callender serves as one of the exceptional cases in medical
history of the US. This girl of 17 years old was forced to endure chemotherapy against her will.
As Cassandra was diagnosed with Hodgkin’s lymphoma in 2014, she was forced to receive
chemotherapy without the consent of her mother and her. This made the teenager to leave the
hospital and seek another way of recovery.
The denial of having chemotherapy due to belief of having unintended effects in the future
propagated the doctors and health professionals to convince them of having 80%-90% chance of
recovery due to chemotherapy (Klugman, 2015). However, on finding it of no use, Connecticut
Children’s Medical Centre reported to the State Department of Children and Families (DCF) and

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Paper 1: Bio-ethical situation
it appealed to the Superior Court for treatment of Cassandra. As a result, in month of in
November, Court permitted the granted custody of Cassandra to DCF to provide her
chemotherapy and her mother Jackie Fortin was instructed to cooperate with them. In order to
avoid chemotherapy, Cassandra ran from home and appointed an attorney to claim her rights as a
“mature minor” who has the right to refuse treatment.
The dual sides of this case deals with law and ethics with indications towards the right age of
decision-making. Both the court of Connecticut and the US Supreme Court had not dealt with
this type of issue and considered this as a very sensitive case.
2. Legal and ethical responsibilities
The professional responsibility of a medical practitioner also contains the responsibility of
treating patients while following ethics. The example of given case highlights fact of non-
consideration of will of patient and her family. Cassandra chose the Right to refuse treatment
Act to protect herself from having chemotherapy. As most of patients are bound to receive
medical care when in a need of it, Cassandra had claimed to refuse chemotherapy, as she
believed it could cast long-term harm on her health. In case of ethical responsibilities, a patient
would not have the right to refuse treatment if suffering from drug addiction or brain injury.
According to Sankar & Parker (2017), ethical concerns should be incorporated while practicing
legislation. It was ethical responsibility of Connecticut Children’s Medical Centre to consider the
preference of Cassandra. However, Supreme Court of US focused on providing grant to
respective medical centre to take custody of the patient.
The petition of Cassandra’s attorney stated her appeal of the Right to Treatment Act as it
provided her the right to decline medical treatment without her consent (Ncbi.nlm.nih.gov,
2018). As per this legislation, a patient is liable to reject a life saving treatment in exceptional

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Paper 1: Bio-ethical situation
cases. Though in some cases, patients who are addicted to drug or alcohol do not have the right
to claim the previously mentioned law, respective guardians or family members are liable to take
decisions on their part. However, in above-mentioned case, ethical consideration has also been
affected, as the Medical authority of Connecticut did not consider Cassandra’s mother’s
reluctance of giving her chemotherapy.
Similar issues have risen in case of Border, Lewisham, and Greenwich NHS Trust (2015) where
it was clearly indicated to the damages of medical negligence (Mentalhealthlaw.co.uk, 2015).
This case also states the absence of consent regarding insertion of cannula, which depicts the
breach of medical duty of respective authority. According to Lo et al. (2014), avoidance of legal
guidelines propagates chances of ethical and legal issues in medical sectors. This case of Border,
Lewisham and Greenwich NHS Trust was also treated as a case of medical negligence; breach of
bioethics, and hence, declared to provide suitable measurements to respective patient.
3. Negligence
As stated by Kramer, Kinn & Mishkind (2015), medical negligence and avoiding ethical
responses could broaden scope of ill treatment. In case of Cassandra, the medical authority of
Connecticut could be marked for not understanding the psychological demand of the patient. The
prime negligence in this case can be listed as not being able to maintain medical duty, not
considering family law as they neglected to take her mother’s opinion in consideration and
forceful medication without her and her mother’s consent. Combined result of this negligence
has led Cassandra to escape from her home and claim for the Right to refuse treatment Act. The
medical authority as well as Supreme Court of US and DCF neglected the fact of her and her
mother’s concern to receive chemotherapy.

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Paper 1: Bio-ethical situation
Conclusion
Consideration of Bioethical issues are important part of medical treatment as it provides the
opportunity to handle the ethical issues and patients consents while following regulations. It is
medical responsibility of a healthcare to consider preference of its patients, and hence,
negligence in maintaining so could be a subject to be a serious offence. The dilemma of rejecting
medication could bring a fatal consequence for deterioration of health system within a country.
However, the proper application of medical ethics along with consent of patient can reduce
chances of medical dilemma. On the other hand, the bioethical issues needs to be considered
when a patient needs to be very specific in areas of human experimentation, organ
transplantation, resuscitation, assisted reproduction and so on. Thus, extensive research on the
ethical-legal cases of the US presents a sense of favor for the autonomous decision-making of
customer-oriented people.

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Paper 1: Bio-ethical situation
Bibliography
Journals
Cohen, I. G., Amarasingham, R., Shah, A., Xie, B., & Lo, B. (2014). The legal and ethical
concerns that arise from using complex predictive analytics in health care. Health
affairs, 33(7), 1139-1147. Retrieved on 29th June 2018 from
https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2014.0048
Dailey, M., Geary, S. P., Merrill, S., & Eijkholt, M. (2017). Enabling Donation after Cardiac
Death in the Emergency Department: Overcoming Clinical, Legal, and Ethical
Concerns. The Journal of emergency medicine, 52(4), 588-592. Retrieved on 29th June
2018 from https://www.sciencedirect.com/science/article/pii/S0736467916310162
Hamel, M. B., Ruger, J. P., Ruger, T. W., & Annas, G. J. (2015). The elusive right to health
care under US Law. N Engl J Med, 372(26), 2558-63. Retrieved on 29th June 2018 from
https://www.researchgate.net/profile/Jennifer_Ruger/publication/279305329_The_Elusiv
e_Right_to_Health_Care_under_US_Law/links/55c4d78608aeca747d6180a5.pdf
Kopala, B., & Burkhart, L. (2005). Ethical dilemma and moral distress: Proposed new
NANDA diagnoses. International Journal of Nursing Terminologies and
Classifications, 16(1), 3-13. Retrieved from
https://search.proquest.com/docview/194432373?accountid=188056
Kramer, G. M., Kinn, J. T., & Mishkind, M. C. (2015). Legal, regulatory, and risk
management issues in the use of technology to deliver mental health care. Cognitive and
Behavioral Practice, 22(3), 258-268. Retrieved on 29th June 2018 from
https://www.sciencedirect.com/science/article/pii/S1077722914000807

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Sankar, P. L., & Parker, L. S. (2017). The Precision Medicine Initiative’s All of Us Research
Program: an agenda for research on its ethical, legal, and social issues. Genetics in
Medicine, 19(7), 743. Retrieved on 29th June 2018 from
http://bioethics.pitt.edu/sites/default/files/event-image/Sankar%20%26%20Parker%20-
%20PMI%27s%20All%20of%20Us%20Research%20Program%20-
%20gim2016183a.pdf
Websites
Klugman, C. (2015). CASSANDRA C: RIGHT TO REFUSE TREATMENT OR
PROTECTING A MINOR* Retrieved on 29th June 2018 from
http://www.bioethics.net/2015/01/cassandra-c-right-to-refuse-treatment-or-protecting-a-
minor/
Mentalhealthlaw.co.uk (2015). Border v Lewisham and Greenwich NHS Trust [2015] EWCA
Civ 8, [2015] MHLO 8. Retrieved on 29th June 2018
http://www.mentalhealthlaw.co.uk/Border_v_Lewisham_and_Greenwich_NHS_Trust_(2
015)_EWCA_Civ_8,_(2015)_MHLO_8
Ncbi.nlm.nih.gov (2018). The right to refuse treatment: a model act. Retrieved on 29th June 2018
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1651109/