We all know death is an inevitable part of life. In the olden time, most people died at home but currently the majority of deaths are happening either in a hospital or a nursing home. With recent changes in technology, we can either delay or bring the person back to life. Dr. Schimke indicated, “for almost any life-threatening condition, some form of intervention can now delay the moment of death” (Schimke, 1986). The right to natural death is basically any adult who is competent and aware has the right to refuse treatment or decline life-prolonging treatment. “The purpose of these laws is to permit patients to choose a ‘natural’ death, unencumbered by medical technology” (deathreference.com). The first State in the United States to pass this Act was California and it was passed in 1976. Some choose to make that decision prior to their deaths to prohibit their loved ones of making such an impossible decision. They usually have either a will in place indicating that or sign a form. That is very important for patients that have Alzheimer’s or dementia. Elderlies and terminally ill patients have a right to decide how and when they die or whether or not to be resuscitated or put on life support should they die. For elderlies, the physician should ensure to ask whether or not they have a POA in place, a living will or any document that allows someone to make decisions for them should they become incapacitated. This should be asked before the patient becomes incapacitated to avoid conflict with the families or perhaps lawsuits.
As a physician, it is their duty to cure their patient and better the patient’s condition. We can all understand how difficult it would be to have to overlook that or having to communicate that with the patient and their family. I believe that such topic should come from the physician since they are the care providers and usually have to disclose all information to the patients and family members. However, I think it’s a topic that is hard to address without offending someone so what is the right way to bring the subject up? In Dr. Schimke’s essay, he described the six elements of consent as “(1) the diagnosis; (2) the nature and purpose of the proposed treatment of procedure; (3) the risks, consequences, and side effects; (4) the probability of success; (5) reasonably available alternatives; and (6) result to be anticipated if nothing is done” (Schimke, 1986). All physicians must obtain the consent of their patients prior to treating them.
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When one think about it, if you resuscitate someone who then ends up in a coma and is unable to communicate their desire on whether or not to prolong their lives, it then becomes a decision their family have to make which is an extra burden on what they are dealing with. The Constitution also defends the rights of dying patient to decline medical care. In that instance where further means of treatment is rejected by either the patient or their family, it will then be left to their own bodies resources or if their bodies can’t treat itself, then they will achieve what we know as “a natural death”.
Throughout reading about this, the main thing that kept coming to mind was Jehovah’s Witnesses and their beliefs on giving or receiving blood. Carlos Petrini explained that “Jehovah’s Witnesses refuse transfusions of whole blood, of red and white corpuscles, platelets and plasma. They also refuse both natural and recombinant hemoglobin, although positions differ among them regarding blood-derived products such as albumin, immunoglobulin and coagulation factors” (Petrini, 2014). In conditions where a Jehovah’s Witness would need a blood transfusion to survive, they would be refusing that treatment not just based on their right to a natural death but based also on their religious beliefs, which should always be respected. Now, what happens in a situation when someone is not terminally ill but is in a life-threatening position? Mr. Bernard M. Dickens responds to this by stating “such refusal is not suicidally motivated, of course, since it is inspired by the hope and expectation of survival, perhaps by divine intervention” (Dickens, 848).
- Dickens, B. (n.d.). The Right to Natural Death. Retrieved from https://lawjournal.mcgill.ca/wp-content/uploads/pdf/4715089-dickens.pdf
- Lens, V. (n.d.). Death and Dying. Retrieved from http://www.deathreference.com/Me-Nu/Natural-Death-Acts.html
- Petrini, C. (2014, January). Ethical and legal aspects of refusal of blood transfusions by Jehovah’s Witnesses, with particular reference to Italy. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934270/
- Schimke, T. (1986, July). The Natural Death Act: Protection for the Right to Die. Montana Law Review, 47(2). https://scholarship.law.umt.edu/cgi/viewcontent.cgi?article=1777&context=mlr
- Wale, J. (2016, October 5). Elderly patients and informed consent. Medical News: The Business of Healthcare. Retrieved from https://www.medicalnews.md/elderly-patients-