Ethical and legal concerns occasionally clash such that health practitioners are faced with a dilemma choosing which to follow. The MORAL Model can be used to decide on the issue to avoid ethical or legal biasness.
The Case
In 1990, the Supreme Court ruled against the removal of Nancy Cruzan’s feeding tube despite the patient being in a persistent vegetative state (PVS). From a legal perspective; the ruling seemed fair because it promoted the patient’s right to life. However, it clashed with the principles in the APA Code of Conduct. According to Peter (2018), the ethical principles in the APA code emphasizes patients’ beneficence, maleficence, justice, and autonomy in their treatment. The principles also guide health practitioners in decision-making. For instance, the ruling overlooked Cruzan’s implied consent, and the patient’s represented autonomy for tube removal.
Options
The two viable options for Cruzan’s treatment are either to continue with the feeding tube or to stop it. With a continued feeding tube; the treatment could sustain Cruzan in her vegetative state( Grant, 2015). However, her suffering will continue due to the brain injury she sustained. On the other hand; the removal of the feeding tube will end Cruzan’s life and suffering. As such limited harm will be inflicted on Cruzan.
Option of Choice
The second option is more viable as compared to the first because it promoted the patient’s autonomy and beneficence. As such, the removal of the feeding tube upholds Cruzan’s autonomy since her parents represent her preferred choice( present the interest of their incapacitated daughter). Secondly, the option is fair to Cruzan’s implied consent as cited by one of her housemates, and limits the harm faced by Cruzan.
References
Grant E. R. (2015). Cruzan at 25, Schiavo at 10: Legal fiction is it time to outgrow. Center for Bioethics and Human Diversity. https://cbhd.org/content/cruzan-25-schiavo-10-legal-fictions-it-time-to-grow
Peter, E., (2018) Overview and Summary: Ethics in Healthcare: Nurses Respond. OJIN: The Online Journal of Issues in Nursing, 23(1). https://www.doi.org/ 10.3912/OJIN.Vol23No01ManOS