Medical Law and Ethics - Doctor-Assisted Abortion - Essay Example

Medical Law and Ethics Defining the question Assessing circumstances that a doctor can be allowed to procure abortion legally Assessing the consequences of conduction abortion Examining the legal consequences of abortion in UK Relating the case to the situation examined. Concluding on the case Doctor Assisted Abortion Abortion is a medical intervention to terminate pregnancy before the baby is born.1 The pregnancy can be terminated by administration of drugs or through surgical procedure. In the UK, abortion can be legally carried procured during the first twenty four weeks of pregnancy after satisfying particular conditions. Under the Abortion Acct of 1967 that is applicable in England, Scotland and Wales requires the abortion to be carried out in health centre by a licensed specialist.2 Also, before a pregnant mother can secure abortion, "there must be consent of at least two doctors" who have made an observation that the abortion will save mother’s life either physically or mentally than having the pregnancy intact. Under certain circumstances, the Act allows doctors to prescribe an abortion even after "twenty four weeks of pregnancy if the life of the mother in is at risk of death," permanent incapacitation as a result of pregnancy, or if the baby is likely to have permanent and several mental or physical disabilities after birth. The act is not applicable in some parts of UK such as Ireland. The law does not in any way obliged by the law to procure an abortion. However, if the doctor declines to procure an abortion for moral reasons they should recommend another doctor who may be willing and able to assist the patient.3 Abortion poses a significant risk to pregnant mothers especially if conducted after the first twelve weeks of pregnancy. Some of the risks involved include destruction of the womb, haemorrhage and damage of the cervix.4 In the case of Lydia her pregnancy if much advanced because it is about twenty-eight weeks old. Her husband has been made redundant, but there is no risk that either the baby or the mother will suffer physical or mental damages as a result of the pregnancy. Her husband is opposed to the idea of abortion and only Lydia believes abortion is the best option due to their economic status. Therefore, Dr. Morgan should not authorize abortion for Lydia because the condition does not fulfil the legal requirements. In fact, considering the circumstance that surround the issue it is more dangerous for Lydia to procure an abortion than bringing forth the baby. For example, the pregnancy is at an advanced stage and abortion may result to physical complication such as haemorrhage, womb damages, and destruction of cervix or even death of the mother. The risk involved in abortion is greater than taking care of the child. Furthermore, her husband is against abortion. Therefore, because the Lydia’s claim is of an economic nature and has no medical base the doctor has no legal base for recommending an abortion. It is likely that if they carry out an abortion against her husband consent he may opt to sue the hospital of or Dr. Morgan and thus causing legal liability. Bibliography CIBA Foundation Symposium. Abortion: Medical Progress and Social Implications. (John Wiley & Sons, 2009) 192 Harte Colin. Changing Unjust Laws Justly: Pro-Life Solidarity with "The Last and Least."(CUA Press, 2005) 363 House of Commons. Scientific developments relating to the Abortion Act 1967: twelfth report of session 2006-07, Vol. 2: Oral and written evidence. Great Britain. (The Stationery Office, 2007) 259 Keown John. Abortion, Doctors and the Law: Some Aspects of the Legal Regulation of Abortion in England from 1803 to 1982. (Cambridge University Press, 2002) 228 Note Define procedure for organ transplant Examine the procedure for obtaining organ for transplant Examine the procedure for obtaining consent to use deceased organ Relate the process to the case Draw conclusion on the case Organ Transplant The procedure of removal, storage and use of organs or part of organs from the deceased person is directed by the HT Act.5 The Act specifies the procedure for obtaining consent for using the organ for the purpose of transplant. The healthcare practitioners have to establish whether the deceased had granted consent for use of the organ and in case of lack of consent from the deceased the healthcare practitioners have to use the right procedure for obtaining consent in accordance to the HT Act.6 For the doctors to determine whether the deceased had given any consent for the use of organs or not, they should check from the organ donor register and in case they establish the grant of consent they should contact the family members and especially those who were immediate companions of the deceased.7 The healthcare givers should discuss with the relatives of the deceased to establish the will of the deceased regard donating the organ and come into a consensus. However, if there were no consent and the relatives are not aware of what the deceased wishes were, the medical practitioners should discuss with those relatives and close associates of the deceased to agree on whether to use the organs or whether not to use them for a donation. The consent in this case should be given the “person who was in a qualifying relationship immediately before the death.” 8 The deceased may appoint a representative or representatives to give consent on his or her behalf. In case the deceased had appointed more than one representative only one of them may give the consent the medical experts on behalf of the deceased. However, if there was no representative appointed and the deceased had not expressed his or her opinion regarding the issue the qualifying person can give the consent without any objection from other family members.9 In the case under discussion Nellie who died after being on a mechanical ventilator. Dr. Black intended to use her organs for transplant into other patients. He did not find any donor card from her and had to consult her family members for their consent. Lack of the donor card could imply there was no consent given by the deceased. However, considering the fact that there is a conflict between the parents of the deceased and her spouse Dr. Black has followed the legal procedure for obtaining consent. The deceased parents’ have given the consent for use of their late daughter’s organs while her husband is against the idea. The doctor has to accept the opinion of the qualifying relationship. The qualifying relationship requires the "consent be given by a person who was in a qualifying relationship immediately before her death." Therefore, the fact that her parents have given consent but her husband has declined their request implies they cannot use her organs for transplant. The doctor should consider the consent of the qualifying relationship who is her husband. Bibliography FarrellAnne-Maree, Price David and Quigley Muireann. Organ Shortage: Ethics, Law and Pragmatism. (Cambridge University Press, 2011) Jackson Emily. Medical Law: Text, Cases, and Materials. (Oxford University Press, 2013) 990 Madsen Klein L. Organ Transplantation: A Clinical Guide. (Cambridge University Press, 2011). McLean Sheila A. Autonomy, Consent and the Law. (Routledge, 2009) 256 Note Assess the risks associated with surgery operations Examine doctor’s responsibility to inform the client of the possible risk Assess the law relating to surgical operations Relate the case with the law Conclude on the case Risk of Surgery Every surgery operation has its own risks whether minor or fatal. Patients are supposed to acquire sufficient details regarding the risks associated with each operation in order to help them make an informed decision.10 The doctors have a duty to inform their patients of eminent risks they may face as a result of the operation or any other medical procedure.11 The doctor information to the patients is very essential because it helps them make an informed decision. The patients have to weigh between the problems they are going through and the risk they will get exposed to as a result of medical operations.12 Doctors should avoid exposing their patients to unexpected danger without their consent even in a situation where the patient has no alternative but to undergo the operation.13 The reason for giving the patients full information about the eminent risks associated in situations is to help them prepare psychologically for the outcome.14 The doctor has a responsibility to inform the patients even of the most unlikely events so that their patients may not be caught by surprise. The doctor should share with their patients about the possible outcome and help them to make a decision. That not only helps the doctors to avoid legal consequences in case of an unexpected outcome, but also it helps them to establish good rapport with their patients. The patient learns to trust their doctors and wins their confidence irrespective of the outcome of the operation as long as the patient was adequately informed about it.15 In this case, Dr. Roberts conducted an operation on Maya to remove a lump from her neck. Before the operation, she asked her doctor whether the operation posed any risk to her voice, but the doctor described it as a simple operation and told her not to be worried of anything. After the operation, she had no problem with her voice but her neck developed complications of stiffness. Her doctor informed her that it was a rare case and he did not have explained it to her because it would cause her unnecessary worries. The doctor had ignored that information prior to her operation because he thought there was a remote chance for the occurrence of such a complication. In this case, Dr. Roberts was liable for failing to inform his client of the risk of having stiff neck as a result of surgery. Although the patient had asked specifically about the risks of the surgery to her voice, the doctor should not have expected the patient to imagine there could be a problem of neck stiffness. There are other risks such haemorrhage that are most common in all surgical operations and the doctor did not mention it either. Even though the doctor cannot mention some of the issues such as risk of death as it may cause unnecessary fear if that risk occurs the doctor cannot escape the liability. Since Dr. Roberts failed to mention about stiffness of the neck and it occurred the doctor is liable for his client for not giving inadequate information. Furthermore, her client may lose trust on him in the future and even have mistrust for Prestown Hospital. Bibliography Crellin J. K. Expectations and Physicians Responsibilities: Voices of Medical Humanities. (Radcliffe Publishing, 2005) 165 Garden James, Bradbury Andrew W., Forsythe John, and Parks Rowan W. Principles and Practice of Surgery: With Student Consult Online Access. (Elsevier Health Sciences, 2012) 592 Gleeson Michael J, Clarke Ray. Scott-Browns Otorhinolaryngology: Head and Neck Surgery 7Ed: 3 volume set. (CRC Press, 2008) 3900 McConachie Ian. Anesthesia for the High-Risk Patient. (Cambridge University Press, 2009) 302 Note Determine the issue in the case and categorize as euthanasia Examine the conditions under which person’s life may be brought to an end Assess the moral and legal circumstances of euthanasia Relate the situation in the case with legal and moral issues Conclude on the case Patient Request for Ending Life The process of ending someone’s life deliberately to save him or her from suffering is referred to as “euthanasia or mercy killing.”16 For example, patients who are suffering from critical illnesses may request their doctors to take away their lives in order to end their sufferings. The doctor may use an overdose of muscle relaxant to terminate the life of the patient and alleviate further suffering.17 Assisting someone to end his or life in UK is illegal and treated as assisting someone to commit suicide. The issue is treated as either manslaughter of murder” and the punishment administered on those crimes may even be a life imprisonment.18 The English law recognizes two categories of euthanasia that can be described as active or passive.19 It is active if the doctor gives the patient something to facilitate his or her death, and passive if the doctor withdrawals something that was supporting the life of the patient thus facilitating his or her death. Also, euthanasia may be described as voluntary, non-voluntary or involuntary.20 Voluntary euthanasia is where a person facilitates his or her death. Involuntary is where the death is caused by someone against the victims wish while non-voluntary is where one person facilitates the death of another person who is not in a capacity to make a voluntary decision, but in accordance to the victim’s prior wish. The English law gives an alternative to euthanasia.21 For example, the adult patients may boycott treatment as long as they have full information about the consequences of their decisions and as long as they do it voluntarily. This is cannot be regarded as a crime and no one is punishable for failing to accept treatment. In this case, Dr. Jones is taking care of Katie, a cancer patient and believes she has a slim chance of surviving the illness. Because of her immense suffering and despite the use of pain relieving mediation, she has requested the doctor to take away her life. Therefore, she is asking the doctor to facilitate her death. That is what can be described as voluntary euthanasia because the request is made by the patient herself. Dr. Jones should not succumb to the request of his client. A doctor assisting the patient to end her life is in the admission of defeat because the mission of the doctor is to support life and not to end it. The doctor should explore every means to alleviate patients’ suffering and create hope for life. The doctor will be negating his professional duty of care for the patients’ life. Furthermore, the patients are likely to lose trust with Dr. Jones and other doctors since they feel that such doctors have no mercy on human lives and can end it any time they wish. The doctor should show all his care for the patient and give them hope of living even in circumstances that is so hopeless. In so doing, other patients in critical conditions will trust their doctors and entrust their lives on them. Furthermore, Dr. Jones will avoid legal charge against murder if he takes care of the patient despite their precarious condition. Bibliography Atkinson Rowland. Shades of Deviance: A Primer on Crime, Deviance and Social Harm. (Routledge, 2014) 276 Crown. Euthanasia and assisted suicide – Arguments http://www.nhs.uk/conditions/euthanasiaandassistedsuicide/pages/arguments.aspx Dev Harveer, Sanders Stephan and Metcalfe David. So You Want to be a Doctor?: The Ultimate Guide to Getting Into Medical School. (Oxford University Press, 2013)368 Youngner Stuart J. and Kimsma Gerrit K. Physician-Assisted Death in Perspective: Assessing the Dutch Experience. (Cambridge University Press, 2012) 403 Note Recognize the issue as involuntary ending of someone’s life Assess the reason for decision to end someone’s life Examine the legal issues that can allow or prohibit someone to end another person’s life against his or her consent. Draw conclusion on the case Involuntary Ending of Patient’s life The case of Dr. Gilford and her patient Sophia is one of involuntary euthanasia. According to this case, Sophia was involved in an accident and sustained critical injuries. She has been on a life support machine for more than two years and her condition does not seem to improve. Both her doctor and her family members believe all the life support should be withdrawn from her so that they can alleviate her further suffering. On the contrary, Sophia had left her directive that in case of persistent vegetative state no one should end her life, but every effort should be made to save her life. The case of Sophia is complicated because her doctor and her family members intend to take a decision that is against her wishes. Probably, the family members feel burdened to pay huge hospital bills for her and believe they should do away with her just to save the family resources since there is no hope of her to live a normal life in the future. The doctor could be sympathizing with the family members since he is convinced the patient will not be able to recover.22 In addition, they believe that because of the pain she is going through they will be doing her a great favour is they help to end her life. However, just as discussed in the case of Dr. Jones and Katie, the doctor has a duty to protect the lives of the patients irrespective of the circumstances they are going through. The doctor who admits to end patient’s life admits defeat. He makes the patients in similar condition to lose faith and trust in doctors and hospitals thus violating the ethical principles of healthcare practitioners. Furthermore, it is a way of declaring that some problems are beyond the scope of the doctor. The family members of the patient are in the admission that they are tired with their beloved one who is in hospital.23 The suggestion of ending the patient’s life by the family members is an immoral act because relatives should be the frontline to support the treatment of their patient. Furthermore, the patient had declared her wish that everything should be done to protect her life irrespective of the prevailing situation.24 The doctor should implement the will of the patient by ensuring her life is taking care of at all cost. It is against the law for the doctor to withdraw life support machine on the patient and yet he understands the consequence of his action will result to death of the patient.25 The family members should seek financial assistance to fulfil the wish of the patient by ensuring they do everything they can to support her life. This will relieve them the financial burden that may be the cause for desperation and desire to give up on her. Bibliography Anderson Owen A. and Wearne Mike J. Informed consent for elective surgery—what is best practice? (Journal of the Royal Society of Medicine, 100(2): 2007) 97–100. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1791005/ Hubrecht, Robert C. and Kirkwood James. The UFAW Handbook on the Care and Management of Laboratory and Other Research Animals. (John Wiley & Sons, 2010) 848 Palmer Stephen. Suicide: Strategies and Interventions for Reduction and Prevention. (Routledge, 2014) 288 Smith, Stephen W. End-of-Life Decisions in Medical Care: Principles and Policies for Regulating the Dying Process. (UK: Cambridge University Press, 2012)350 Read More