Patient's Rights and Medical Care
In the face of the threat of euthanasia, does the patient have the right to the final word? What are his rights in the area of medical care? This essay will explore this question, and provide case histories to exemplify these rights in action.
For legally competent adult patients, regarding medical care per se - according to Anglo-American law -- every competent adult has the freedom to seek or not to seek medical care and to refuse to consent to any specific treatment proposed, under the common law right of bodily integrity and intangibility:
1. Competent adults may reject even lifesaving care under the right of bodily ...view middle of the document...
Therefore court-ordered life-saving treatment is not a subordination of patient choice. The court will usually order lifesaving or ordinary care, but treatment that is extraordinary is not required.
Regarding minor children, Prof. John A. Robertson, of the Wisconsin University Law School, stated:
"Under traditional principles of criminal law the omission of ordinary care by parents, physicians and nurses creates criminal liability. The crimes committed may include murder, involuntary manslaughter, conspiracy and child abuse or neglect. Generally a person is criminally liable for homicide by omission if: 1) He has a legal duty to protect another; 2) with knowledge or gross negligence he fails to act; 3) and such failure proximately causes the death of the other. The pervasive practice of withholding ordinary medical care from defective newborns demonstrates we have embarked on a widespread program of involuntary euthanasia." (Robertson)
Discussion of the following actual cases is concerned only with whether or not the decisions are legal or illegal and not with their moral implications; whether the cases involve ordinary care or extraordinary care, and whether the decisions given would be legal or illegal:
1. An infant is born with Down's syndrome, indicating probable mental retardation. He needs very low-risk surgery for an easily correctible intestinal defect. If untreated the baby will not be able to retain food and will die. The parents refuse surgery, stating that the mental retardation will mean a less than meaningful life for the baby.
Answer: This case involves ordinary care; illegal decision: Parents may not refuse ordinary care; the refusal of surgery would result in the proximate cause of death for the child they have a legal duty to protect. Courts, however, usually have ruled in favor of parents' refusal.
2. A seven-year-old girl, auto-accident victim with severe internal bleeding, needs an immediate blood transfusion to prevent death. Her parents refuse consent because blood transfusions are forbidden by their religion (Jehovah's Witnesses).
Answer: This case involves ordinary care; illegal decision: Parents may not invoke their right to free exercise of religion to refuse lifesaving care for their child, for that would be a violation of the child's unalienable right to life, which takes precedence over all other fundamental rights.
3. A baby is born with anencephaly (part or most of the brain matter absent), with a prognosis of living only a few weeks or months. A decision is made to withhold all nourishment by mouth or other means.
Answer: Ordinary care; illegal decision: Ordinary care is mandatory for all patients regardless of prognosis. However, in practice, many children like this are starved.
4. A 55-year-old man with severe circulatory problems has gangrene of the leg. Amputation is necessary to save his life. The man refuses consent.
Answer: Ordinary care - with qualifications....