72-year-old woman was admitted to the neurological intensive care unit following a cerebral hemorrhage that left her with severe brain damage and ventilator dependent. One year before this event, the patient and her husband had drawn up living wills with an attorney. The patient’s living will specified that the patient did not want ventilator support, or other artificial life supports, in the event of a terminal condition or a permanent vegetative state.
The patient’s husband is her legal next of kin and the person with surrogate decision making authority. When the living will was discussed with him, he insisted that the patient had not intended for the document to be used in a situation like the present one. By this, the husband apparently meant that although the patient would not be able to recover any meaningful brain function, her condition was not imminently terminal. The husband did not consider his wife to be in a permanent vegetative state.
The treatment team allowed a week to pass, with the goal of providing the husband more time to be supported in his grief and to see how ill his wife was. Nevertheless, at the end of this time, the husband was unwilling to withdraw life support measures consistent with the patient’s wishes as expressed in her living will.Research the following questions and include in your analysis of the above case. Research the following questions and include in your analysis of the above case
Differentiate between advanced directive, and POLST (Physicians Order for Life Sustaining Treatment) forms (with emphasis on Oregon law).
Research and give the definition of permanent vegetative state – what tests are done to determine this condition?
Research and describe what ventilator support entails. How are the nutritional needs of the patient met while attached to a ventilator?
How legally binding are these forms?
What are the legal and ethical issues at stake in this scenario?
What should be done? Can the husband’s wishes be overridden?
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