PHI-2635 Lecture Notes - Lecture 1: Terri Schiavo Case, Advance Healthcare Directive

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1 Nov 2016
November 1st, 2016
What is an advance directive?
- A written expression of a patients wishes
- Legal document usually written by or in conjunction with attorneys; not in
conjunction with medical doctors
- Reods the patiet’s ishes fo edial teatet at the tie the douet is
- Designed to apply when a patient becomes terminally ill or incapable of making
decisions by themselves
- It is important for unusual desires to be recorded
Formerly Competent Patient
- Karen Ann Quinlan was 20 years old and had a lot of alcohol and possible narcotics.
Once she had gone home from the party, she lost consciousness and stopped
breathing. By the time they got her to the hospital, she was without oxygen to her
brain for at least 30 minutes
- Suffered severe brain damage
- This case sets up the right to remove a patient from life-sustaining treatment
- Her parents wanted to remove her from the respirator, but the doctor refused
Advance Directive: extending autonomy beyond the point where you can actually
exercise autonomy
- Supposed to epess the patiet’s o uiue alues, ut a lot of the do’t ake
sense to the physician
Proxy Directive
- Choosing a person to speak for you if you become incompetent
The moral standardthe principle of autonomy extended
- A person who is incompetent cannot exercise autonomy
- A decision that is made while competent is usually viewed as binding when someone
becomes incompetent
The legal standardsubstituted judgment
- The judgments that your decision-makers make, are based on your values and your
Are advance directives always followed?
- No
- If the doto does’t thik that ou ould e pepaed to ake judgets i that
time period that the directive was made
Terri Schiavo Case
- Woman was diagnosed as being in a persistent vegetative state
- Disagreement between her husband
- Parents claimed that Terri would never want to be taken off life support
- Attempts to legalize PAS and euthanasia
What needs to be in an Advance Directive?
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