A Legal and Ethical Dilemma Case study Discussion Deciding to place a loved one into a long-term care facility can be extremely difficult. Even more diffic

A Legal and Ethical Dilemma Case study Discussion Deciding to place a loved one into a long-term care facility can be extremely difficult. Even more difficult is the thought of your loved one’s rights being violated while in long-term care. Patient healthcare rights are not as clearly defined as one would expect, and there are long-term care and other healthcare facilities that create their own sets of patient rights. However, there are also certain indisputable rights afforded to patients across the board.

Read the case study titled “A Legal and Ethical Dilemma”, located on pages 463-465 of your text. Next, use the Internet or Strayer Library to research information on a patient’s right to die.

Write a four to six (4-6) page paper in which you:

Describe the legal and ethical dilemma discussed in the case study. Analyze the key ways in which a patient’s right to die relates to this specific case.
From your research, specify the potential repercussions for failure to comply with the wishes of a patient who has requested to withhold a life-sustaining procedure. Next, take a position on whether the patient’s right to die or the patient’s right to be protected from harm should take precedence in this case. Provide a rationale for your position.
Imagine that you are a part of the ethics committee investigating this case. Determine the main facts pertaining to the issue that the committee should consider. Suggest one (1) step that the facility should take next in order to resolve the dilemma. Provide a rationale for your response.
Use at least three (3) quality academic resources. Note: Wikipedia and other similar websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

Identify the factors that have led to the current realities of long-term care in the United States.
Assess the various stakeholder groups of long-term care along with the nature of the relationship(s).
Evaluate the impact of litigation on long-term care providers and practices.
Use technology and information resources to research issues in long-term care management.
Write clearly and concisely about long-term care management using proper writing mechanics. Background Mary Evelyn Greene, who has memory impairment, lives in a
private room at Shady Brook Skilled Nursing Facility located in a beautiful
suburb of a major metropolitan city. She has resided at Shady Brook for the
past 18 months. Before moving into Shady Brook, Mrs. Greene lived
independently in her own home with assistance from a private-duty nursing
assistant and a housekeeper. She and her husband had resided together in
this home for more than 50 years. Mrs. Greene is 89 years old and suffers
from several health problems associated with aging. Mrs. Greene has one
son, David Greene. David has the power of attorney to handle his mother’s
health care and other personal affairs. David works as a trial attorney in
one of the city’s largest and most prestigious law firms. He owns a large
home in an upscale neighborhood and works hard to put two of his children
through college and another one through medical school. His home is
about an hour’s drive from his workplace and about 20 minutes from Shady
Brook. David’s wife Barbara has never been close to her mother-in-law and
has not shown much interest in her care. Hence, caring for his mother has
become a major responsibility for David, and he is having a difficult time
dealing with her declining health and the onset of mild dementia. It is
becoming increasingly more difficult for David to leave his law practice or
the court room to deal with issues related to his mother. Mrs. Greene’s
husband was a very successful land developer who left her with a
substantial estate, which meets all of her financial needs. After her
husband passed away, Mrs. Greene decided to remain in her home. She
was able to maintain her independence until she was 87 years old, when
she began to show signs of dementia. Shortly thereafter, David moved her
to Shady Brook. David also hired a part-time “sitter” to keep her mother
company because she was too weak to go out of her room on her own.
Mrs. Greene seems to enjoy the sitter’s company and likes the attention
she gets. Upon entering Shady Brook, Mrs. Greene became depressed
over losing her independence and her home and felt a growing frustration
with forgetfulness. She gradually lost her appetite, and her desire to eat
continued to decline. On the other hand, Mrs. Greene seems to enjoy the
smell of certain foods. The associates monitor and document her food
intake and her facial expressions when she is offered different foods. Mrs.
Greene is particularly fond of Susan Brown, a certified nursing assistant
(CNA), who sits with her and helps Mrs. Greene with whatever little she can
eat. When this occurs, her appetite shows some improvement. Mrs.
Greene also responds well to volunteers who carry out activities at the
facility. Frustrated Family Member Mrs. Greene has become too weak to
eat on her own. When no one is feeding her, she leaves most of her food
on the tray. Recently, she has sustained a weight loss of more than 5
pounds per week. Her plan of care needs to be reevaluated, and her
situation needs immediate attention. David has been visiting his mother
quite regularly. Recently, however, his visits have become less frequent,
generally two to three times per week. The associates who work on Mrs.
Greene’s nursing unit have reported some changes in David’s attitude. At
one time he became angry with his mother, raised his voice, and spoke to
her as if she were a bad child. Although no one was present in Mrs.
Greene’s room at the time, the associates working at the nursing station
heard David’s loud voice. When the charge nurse went into Mrs. Greene’s
room to find out why David was angry, David told her that it was none of
her business. On David’s subsequent visits, the associates observed that
Mrs. Greene would become agitated during David’s visits. These issues
were brought to the charge nurse’s attention, and they were documented in
the patient’s medical record. The Dilemma One day David approached the
charge nurse and exclaimed that his mother had expressed that she
wished to die. On his next two visits, David also told the CNAs that his
mother’s desire was not to eat anything so she could just die a quick death.
This was the first time the CNAs had heard that Mrs. Greene had
expressed a desire to die. The associates also believed that Mrs. Greene
appeared to be happier when David was not there. Before the week was
over, David came into the facility early in the morning on his way to work.
He handed a sealed envelope to the incoming charge nurse on the day
shift. The envelope was addressed to Betty Wright, Shady Brook’s
administrator. David said to the charge nurse, “I have been telling you
people that my mother wishes a speedy death. Tell your administrator that I
will be filing a lawsuit if my mother’s wishes are not carried out.” David left
without visiting his mother. Betty Wright decided to place the issue on the
ethics committee’s agenda for that same afternoon. As a safeguard, Betty
also notified the facility’s liability insurance carrier of the potential legal
action. Meeting of the Ethics Committee That afternoon, Betty met with
members of the ethics committee: chaplain, medical director, director of
nursing, charge nurse, social worker, two CNAs, and the local ombudsman.
Betty began the meeting with these remarks: “The man’s mother has been
declining rapidly and eats very little. He wants his mother to die rather than
prolong her suffering. I have learned that the son is the heir to his mother’s
estate, and my overall concern is my trust in his decision or his motives. I
think he needs the money to pay for the college expenses for his three
children. Although it is not uncommon for some residents to be ignored by
family after they are admitted, it is rare that they express the wish to enable
the death of a relatively healthy person.” The ethics committee is faced with
the issue of what is legally and ethically appropriate. The committee
deliberates on whether or not to comply with David’s request to withhold
food as well as the threat of a lawsuit.

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