1.3 Bouvia v. Superior Court Dawnyel Donaldson Franklin University Healthcare Law and Ethics HCM742-H1WW (F14) Julia Matthews JD/MPH November 13, 2014 The case of Elizabeth Bouvia v. Superior Court is a well-known case in the patient’s right to refuse treatment. Elizabeth Bouvia was born with cerebral palsy, which worsened, as she grew older and subsequently caused her to become a quadriplegic. She additionally developed severe degenerative arthritis that caused her to be in continuous unbearable pain. At the age of twenty-eight her condition had worsened to the point that she was said to be bed ridden and completely dependent on others for her activities of daily living. Although she had many physical challenges she was a …show more content…
The Superior Court of Los Angeles County became a pivotal case in a patient’s right to refuse treatment. In the initial case Ms. Bouvia and her legal team sought a court order to have the NGT removed and to stop all medical treatments she did not consent to. She argued that this treatment would not be a cure for her condition and would not improve her quality of life. The hospital staff argued the interest of the state prevailed over a patient’s right to refuse treatment. They noted that the state and healthcare teams viable interests include: “(1) preserving life, (2) preventing suicide, (3) protecting innocent third parties, and (4) maintaining the ethical standards of the medical profession, including supporting the right of physicians to effectively render necessary and appropriate medical services” (Liang & Lin, 2005). Additionally they sighted Ms. Bouvia’s failed previous attempt to “starve herself to death” in 1983 with the assistance of her medical team. The court denied her request citing these key interests and the fact that medical professionals felt that Ms. Bouvia could live 15-20 additional years with supplemental nutrition justified the state’s interest in preserving her life. The court also stated that any other decision would be condoning a medical team to aid and abet suicide. Immediately after the decision Ms. Bouvia filed a petition for a writ of mandamus with the California Court of Appeals to have the NGT removed immediately and
This problem first began to surface in the 1980s when the court had to face Cruzan v. Director, Missouri Department of Health. In this case the court had to decide by “clear and convincing evidence” that the comatose patient’s (Nancy Beth Cruzan) desire to terminate her life before the courts would allow her family’s wish of disconnecting her feeding tube be carried out. Unfortunately eight of nine judges said no to the proposition and concluded that the right
Advance Directives by the patient designates no feeding tubes, artificial ventilation, or CPR. Concerns regarding alteration of mental status consequential to his illness provoke the physician to seek consultation from the designated Power of Attorney. Nursing responsibilities compel the nurse to consider if the proposed actions of Dr. G violate the patient’s rights of self determination and confidentiality and prompt the nurse to advocate for the patient’s desires regarding medical treatment. Health care providers have a responsibility to honor the patient’s autonomy and provide quality medical care (Badger, 2009 p122). Providing artificial nutrition and ventilation transgresses the patient’s directives and is unethical. The physician appears to be asserting a paternalistic approach in deciding what is best for this patient. Should the interventions be temporary and provide resolution of the condition, the physician can defend his actions as being healing and beneficial. However, there is a chance that the interventions may be permanent and futile; avoiding passive euthanasia and terminal dehydration, serving only to prolonging the illness. Violating the patient’s directives of care by performing invasive procedures can lead to legal incriminations of assault and battery.
S. Supreme Court granted certiorari and began this case as they do in all Due-Process cases by examining the nation's history, legal traditions and practices. (Casey, 505 at U. S. 833; Cruzan at 497 U. S. 261 and Moore vs. East Cleveland, 431 U. S. 494, 503 (1977). Anglo-American common law has punished or disapproved of assisting suicide for seven centuries and rendering such assistance is a crime in almost every state; such prohibitions have never contained exceptions for those who were near death; the prohibitions in recent years were reexamined and, for the most part reaffirmed in a number of states; and the President signed the Federal Assisted Suicide Funding Restriction Act of 1997, which prohibits the use of federal funds in support of physician-assisted suicide. (521 at U. S. 702). It has always been a crime in the State of Washington for an individual to knowingly cause or aide another person to attempt suicide. (§ 9A.26.060(1). The Court held that § 9A.26.060(1) ban on assisted suicide was not a violation of the Fourteenth Amendment and did not result in any fundamental liberty interest protected by the Due Process Clause. (521 at U. S. 702). Although many liberties that are protected by the Due Process Clause revolve around personal autonomy, it does not warrant the sweeping conclusion that any and all important, intimate, and personal decisions are so protected. Id. The Court also held in order for Washington's ban to be constitutional, it had
Dr. Glucksberg charged the State of Washington in violating patients Due Process Clause of the Fourteenth Amendment. The Due Process Clause states that you have certain rights that haven’t been specifically outlined within the Constitution. They argued that you have certain rights to die as you have certain rights to live. However in 1997, the State of Washington said that you should not have this right. This was because they were afraid that once physicians were able to encourage patients to commit suicide, or pull themselves off live giving
Sylvia Law, a published author in the University of Maryland Law Review, in her essay, “Physician-Assisted Death: An Essay on Constitutional Rights and Remedies,” addresses the issues in constitutional law surrounding the controversy of a person’s right to die. In the three parts to her essay, Law contends and considers whether “statutes that criminalize medically assisted suicides violate the liberty and privacy rights of terminally ill” and whether “assisted suicide should be considered a constitutionally protected right and also the ways in which these issues come before the courts”. Her purpose is to analyze and inform on the laws and challenges relating to this issue in order to make readers aware of the problems that are created by the
The recent case of a woman, Brittany Maynard, who chose to end her life before she experienced the severe side effects of Glioblastoma has sparked a debate on whether Physician Assisted Suicide should be made legal in all fifty states. Some people believe that Physician Assisted Suicide violates the Hippocratic Oath, gives a doctor too much power, or leaves vulnerable groups at risk. Others feel that Physician Assisted Suicide will benefit the terminally ill. Physician Assisted Suicide will benefit the terminally ill by offering the option to cease their pain and suffering with a painless medication prescribed by a physician when they feel their quality of life has diminished, and is no longer worth living. With this option available, people can exercise their rights over their body and life, die with a sense of dignity, make organs available to patients who need them if it were legal, and it removes the physician from the death directly leaving it to be a personal exit to one’s life.
Only one fifth of doctors in the Michigan study said they support a ban on assisted suicide.” Vice chair of the American Medical Association, Dr. Thomas Reardon says, “We believe the US supreme court will recognize and honor our ethical code and refuse to declare a constitutional right to physician assisted suicide.” The organizations council on Ethical and Judicial Affairs consistently condemns this practice. “Some suggest that doctors should become more knowledgeable on pain management and suffering, and explain different therapies to help patients improve. Opponents of the Death with Dignity Act claim that the act’s definition of a terminal illness is “unconstitutionally” vague. The opponents also claim that the act violates the first amendment. However, the DWDA is a “ Legitimate Policy Choice that does not violate any constitutional or statutory requirements.” Physician Assisted death that follow the act include terminal sedation, withholding/withdrawing life sustaining treatments or large amounts of pain medication that will lead to
In today’s modern society, to prohibit a law or practice takes greater effort and stronger argument than permitting a law or practice. In result of this, the rights and liberty of an individual are very important and would require captivating reasons to overrule it. Since the decision to choose for physician assisted suicide or euthanasia is extremely personal, the famous “innocent until proven guilty” is to be stressed to a great extent when dealing with this topic on debate terms. An individual has a basic right to determine the course of
The United States is a nation founded on freedoms and liberties, giving each citizen the ability to make their own life decisions. This freedom includes all aspects of one’s life, including medical care. With freedom comes responsibility, and this is true in terms of physician-assisted suicide. The ongoing struggle between those in favor and those opposed to this subject has ravaged the medical field, bringing into question what is morally and ethically right. The fact of the matter is that physician-assisted suicide is neither morally nor ethically acceptable under any circumstance. Not only is it a direct violation of a doctor’s Hippocratic Oath, but it is not constitutionally binding. Physician-assisted suicide would also lead to
Additionally, Doyal and Doyal believe that physician assisted suicide should be legalized because someone who is permanently incapacitated should have the right to cease any assistance in living, including water and nourishment. If a patient is on life-support, the decision can sometimes be made by a doctor to stop life-sustaining treatment. This decision can be made if the condition is detrimental to the patient’s quality of life (Doyal and Doyal). In the article “Legalization,” one example of physician assisted suicide being a necessity to maintain quality of life is a soon to be widow desiring to end her life to bypass the loneliness of living without her husband (Somerville). Boucher discusses a patient who was shot in the neck resulting
A terminal disease diagnosis changes the outlook on life, leaving the choice of either living life to an inevitably painful death or ending the suffering by seeking a different medical option. A person who is terminally ill requires rigorous treatments to slow down the process of death, but there is an alternative option. Physician-assisted suicide continues to gain attention and is being legalized across the world. The process in the United States is slower, yet a few states have already authorized it. People undermine this option for unethical reasons; however, it enables a person in agonizing pain to end their life before becoming entirely incompetent. Doctors across the nation seek this practice in order to help the patients as well as their families; even though, they could be risking their license. Despite moral values contradicting this practice, physician-assisted suicide should be legalized across the United States for terminally ill patients lucid enough to make the decision on their own.
The U.S. Supreme Court upheld court decisions in Washington and New York states that criminalized physician-assisted suicide on July 26, 1997.12 They found that the Constitution did not provide any “right to die,” however, they allowed individual states to govern whether or not they would prohibit or permit physician-assisted suicide. Without much intervention from the states individuals have used their right to refuse medical treatment resulting in controversial passive forms of euthanasia being used by patients to die with dignity such as choosing not to be resuscitated, stopping medication, drinking, or eating, or turning off respirators.9
right to choose what happens to his or her own body, but the life of a patient should not be put
Physician Assisted Suicide has been a very controversial topic in the recent years. P.A.S can also be known as physician assisted death or euthanasia. Many states wonder wither this practice is morally right or wrong. Physician Assisted Suicide is when a doctor administers patient lethal drugs, upon the request of the patient, with the end result being death. A popular question that surfaces when this topic is brought up is: Who should decide if a terminally ill patient had the right to commit physician assisted suicide? In support of the previous statements, this
Quality of life, as defined by the patient’s interests and values, is a factor to be considered in determining what is best for the individual. It is permissible to consider quality of life when deciding about life-sustaining treatment” According to the AMA a patient perception of their quality of life and what they have to deal with on an everyday basis plays a role in a patients right to self-autonomy. When a patient has to make a decision regarding their medical treatment, they are rightfully permitted to take into consideration how they view their life, and what they want their quality of life to be. Elizabeth Bouvia viewed her quality of life poorly, and decided she no longer wanted to live a life where she had to struggle when dealing with the simplest of tasks. Taken from the NY Times Archives in article written by Marcia Chamber in April of 1986 the court stated, “…she herself is imprisoned and must lie physically helpless subject to the ignominy, embarrassment, humiliation, and dehumanizing aspects created by her helplessness”, Bouvia was the only one who could judge her quality of life which gave her the right to make any decision regarding her health she deemed best for herself, and the medical practitioners own burdens and views on quality of life could not have any