The right and duty to die
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The Right and Duty to Die. Quinlan. How does the court justify the right of a competent person to refuse medical treatment? Constitutional right Balance right of individual to refuse treatment with state’s right to preserve life Medical ethos of providing aid to the dying.

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The Right and Duty to Die

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The right and duty to die

The Right and Duty to Die


Quinlan

Quinlan

  • How does the court justify the right of a competent person to refuse medical treatment?

    • Constitutional right

    • Balance right of individual to refuse treatment with state’s right to preserve life

    • Medical ethos of providing aid to the dying.


Saikewicz the state s countervailing interests

Saikewicz-- The state’s countervailing interests

  • Preservation of life

    • Pg. 583-589

  • Protection of the interest of innocent third parties

    • Pgs. 593-595

  • The prevention of suicide

    • Pg. 589-90

  • Maintaining the ethics of the medical profession

    • Pgs. 590-93

  • Encouraging the charitable and human care of afflicted persons (Bergstedt case, note 1, p.586)

  • Evaluate each of these


Conroy

Conroy

  • How does Conroy expand on the rationale justifying the right of a competent individual to forego medical treatment?

  • How does Conroy affect the continuing precedential effect of Quinlan?


Cruzan v director missouri department of health

Cruzan v. Director, Missouri Department of Health

  • How does Cruzan deal with the question of the right of a competent individual to refuse medical treatment?

    • Right implicit in the concept of “informed consent.”

    • Inference from prior decision that the right is embodied in 14th amendment’s protection of life, liberty and property.”

    • Notion of a “liberty interest.”


Notes and questions

Notes and Questions

  • Would patients be discouraged from seeking care if life-sustaining care could not be withdrawn?

  • Is there a difference between withholding and withdrawing care legally or morally

  • What role does cost play in the debate over the right to withhold or withdraw life-sustaining care?

  • What is the state’s interest in the preservation of human life divorced from the individual’s interest in his/her own life?

    • If the state has an independent interest, how do we balance it against the interest of the individual?


Notes and questions1

Notes and Questions

  • How to Quinlan and Conroy differ on the balancing of state and individual interests?

  • Consider problem of Mr. Cure on page 588 and questions at end of the note.

  • What is the difference between the withdrawal of life support and assisted suicide?


Lane v candura and dhs v northern

Lane v. Candura and DHS v. Northern

  • What are the facts of Candura and what does the court hold?

  • What are the facts of Northern and what does the court hold?

  • What distinguishes the cases?


Notes assessing competence

Notes: Assessing Competence

  • Should patients have to explain their rationale for rejecting or accepting treatment?

    • Is an explanation necessary to

      • Assess competence

  • What respect should be shown to adolescents’ decisions

    • Consider Belcher v. Charleston Area Medical Center, pg. 598

  • Should patients who tend to vacillate about their medical decisions be required to submit to a waiting period before their decisions are implemented?


In re conroy in re jobes cruzan

In Re Conroy/In re Jobes/Cruzan

  • How are the patients in Conroy and Jobes alike or dissimilar.

  • What rules are established in New Jersey for a surrogate decisonmaker to withhold or withdraws life support?

  • What does Cruzan add to the discussion?


Problems

Problems

  • Family Decisionmaking, pg. 631 note 6

    • Should families decisions be controlling?

  • Disagreement among family members

    • How resolved

    • Should some family members hold trump cards?

  • Should living wills and proxy designations be combined?

  • What advice do you give clients concerned that they have heard doctors don’t follow living wills?


Problems1

Problems

  • Problem, Page 640

  • Review the cases on page 644-45. Which ones do you agree with; which ones do you disagree with?


Anderson v st francis st george hospital

Anderson v. St. Francis-St. George Hospital

  • What are the facts of this case?

  • Is continued life a compensable injury?

    • No

  • Why?

    • Even accepting breach of a duty and causation, issue is damages and court finds there is not way to put a price on continued life.

    • Rejects notion that patient could be awarded damages for pain and suffering flowing from continued life.

  • Why are courts reluctant to impose damages for providing unwanted treatment?


Physician assisted suicide

Physician Assisted Suicide


In re baby k

In re Baby K

  • What are the facts of this case?

  • Why, given the medical assessment of futility, is the physician's professional judgment ignored?


In re wanglie

In re Wanglie

  • What are the facts of this case?

  • Can the patient’s insurer refuse to pay for her continued medical care on the grounds that such care is futile and contrary to medical advice?


In re bowman

In re Bowman

  • What are the facts of this case?


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