Written Assignment for MODULE 10 CARE OF THE DYING
From: Munson, Ronald. INTERVENTION AND REFLECTION.6th ED.,Belmont, California: Wadsworth Publishing Company,2000 . Page 243 Scenario #3
On April 8th, 1984, William Bartling was admitted to the Glendale Adventist Medical Center in Los Angeles. He was twenty-seven years old and suffered from five ordinarily fatal diseases: emphysema, diffuse arteriosclerosis, coronary arteriosclerosis, an abdominal aneurysm, and inoperable lung cancer. During the performance of a biopsy to diagnose the lung cancer, Mr. Bartling’s left lung collapsed. He was placed in ICU, and a chest tube and mechanical respirator were used to assist his breathing.
Mr. Bartling complained about the pain the respirator caused him, and he repeatedly asked to have it removed. When his physician refused, he pulled out the chest tube himself. This happened so often that eventually Mr. Bartling’s hands were tied to the bed to keep him from doing it. He had signed a living will in attempt to avoid such a situation.
Although after discussions with Richard Scott, Mr. Bartling’s attorney, Mr. Bartling’s physician in the hospital administration agreed to disconnect the respirator, the hospital’s attorney refused to permit it. He argued that, since Mr. Bartling was not terminally ill, brain dead, or in a persistent vegetative state, the hospital might be open to legal action.
Mr. Scott took the case to Los Angeles Superior Court. He argued that Mr. Bartling was legally competent to make a decision about his welfare and that, although he did not want to die, he understood that disconnecting the respirator might lead to his death. The hospital’s attorney took the position that Mr. Bartling was ambivalent on the question of his death. His statements “I don’t want to die” and “I don’t want to live on the respirator” were taken as inconsistent and so as evidence of ambivalence. Removing the respirator, the attorney argued, would be tantamount to aiding suicide or even committing homicide.
The court refused to either allow the respirator to be removed or to order that Mr. Bartling’s hands be freed. To do so, the court ruled, would be to take a positive step to end treatment, and the only precedents for doing os were in cases in which the patients were comatose, brain dead, or in a chronic state of vegetative state.
The case was then taken to the California court of Appeal, which ruled: “If the right of a patient to self-determination as to his own medical treatment is to have any meaning at all, it must be paramount to the right of a competent adult patient to refuse medical treatment is a constitutionally guaranteed right which must not be abridged.”
The rule came too late for Mr. Bartling. He died twenty-three hours before the court heard his appeal.
ASSIGNMENT MODULE 10
PART 1. Reading Comprehension
State what the Rule Utilitarian and Natural Law positions would be in this case above involving William Bartling and why you think so for each position.
PART 2. Critical Thinking
Using the DIALECTICAL PROCESS state what your ethical position would be on the case of William Bartling and why. You are to take a position and defend it. You should use some ethical principle to decide what you think is the morally correct thing to do. You must state those principles and explain how they have been applied to the situation. You should indicate that you have rejected alternative positions to your own and the reasons why you have done so. In so doing you need to enunciate clearly the values and ethical principle(s) you are using to both reject the alternative positions and to defend or support your own. The ethical principles were presented in Module/Chapter 2 and include Egoism, Utility, Natural Law, Categorical Imperative, Maxi-Min Principle, Existentialism, Feminism. Refer to one or more of these as ethical principles when answering assignments. Do not use the Moral Principles of Health Care as Ethical Principles. The Moral Principles involved in Health Care include: Autonomy, Informed Consent, Truth Telling, Confidentiality, Privacy. These are NOT the basic ethical principles such as include Egoism, Utility, Natural Law, Categorical Imperative, Maxi-Min Principle, Existentialism, Feminism. The moral principles are popular and recognized in several ways in health care including in “codes” and in statements of “rights” because there are so many of the Basic Ethical Principles that support the moral judgment that these MORAL Principles of Health Care are a MORALLY GOOD THING.
Use this template or form to make certain that you include each part of the process-parts a to e
Label your parts with the letters a to e to make very clear that you have done each part.
Dialectical thinking: the 5 parts
a. Take a position on this question or issue Be as exact as you can be. Be precise in your use of language (ethical principles and values).
b. Provide the reasons why you think this position is better defended by reason and evidence than are the alternative positions Position defended using reasoning (ethical principles and values) in support of the judgment (conclusion of the argument). You state the reasons why the position you take makes sense and has evidence and reasons (ethical principles and values) to support it other than your feelings or personal preference or your opinion or what you were brought up to believe or what just about everyone you know thinks or believes. Philosophers have offered such reasons (ethical principles and values). and evidence for the positions they have taken and you should consider them and if you agree you can and should so state them in support of your own position.
c. State the reasons why you found the other positions that use other (ethical principles and values). flawed or less defensible than the one you are defending
d. State the criticisms of your position from those who use other (ethical principles and values).
e. Respond to those criticisms from those using other (ethical principles and values).-a rebuttal- how do you defend your position in light of those criticisms?
_____VIDEO on Dialectical Process http://www.youtube.com/user/PhilipPecorino#play/uploads/21/zziTWJPbYyU_________________
NOTE: A Case Study is due for this module at the same time the written assignment is due!
Communicate clearly the values and ethical principle(s) you are using to both reject the alternative positions and to defend or support your own. The ethical principles were presented in Module/Chapter 2 and include Egoism, Utility, Natural Law, Categorical Imperative, Maxi-Min Principle, Existentialism, Feminism. Refer to one or more of these as ethical principles when answering assignments.
Do not use the Moral Principles of Health Care as Ethical Principles. The Moral Principles involved in Health Care include: Autonomy, Informed Consent, Truth Telling, Confidentiality, Privacy. These are NOT the basic ethical principles such as include Egoism, Utility, Natural Law, Categorical Imperative, Maxi-Min Principle, Existentialism, Feminism. The moral principles are popular and recognized in several ways in health care including in “codes” and in statements of “rights” because there are so many of the Basic Ethical Principles that support the moral judgment that these MORAL Principles of Health Care are a MORALLY GOOD THING.
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