1. Hannah is a 55-year-old morbidly obese woman with a history of diabetes, high blood pressure, and irregular heartbeat. She was recently hospitalized with acute kidney failure. Prior to this hospitalization, Hannah lived in a nursing home for 5 years where she became increasingly immobile and gained 150 pounds. She has now developed an ulcer on her tailbone and moving her for any reason elicits screams, cries, and pleas to let her die. She says she has simply had enough and adamantly refuses to be turned, to accept wound care or to be washed.
Discuss the legal and ethical issues that arise in the care of this patient and advise on how these issues should be resolved.
How to approach this question:
– What are you being asked to do?
– Identify the legal and ethical issues in this case and advise on how they should be resolved
– What ethical principles apply here? E.g., Respect for autonomy, non-maleficence
– Explain how you understand these principles in the context of this case i.e., what is meant by respect for autonomy and how does it apply to Hannah
– Are there conflicting ethical principles i.e., does the duty of non-maleficence (do no harm) come into conflict with respecting Hannahs autonomy?
– How should we decide in such cases?
Legal issues:
– What does the law tell us about how someone like Hannah should be treated?
– How does the law respect autonomy?
– From a legal standpoint. What would a strict interpretation of the law require us to do?
– Are there any other factors that we should take into account?
– What do you think is the likely outcome?
– Try to give examples from material covered in lectures, e.g., refer to cases I have mentioned or legislation such as the ADM Act if relevant.
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