Special orders from the 'grave'

The U.S. Constitution and the Amendments have guaranteed certain basic rights to each individual, however, there is no constitutional right that is absolute nor the rights  to make decisions treated unconditionally.  The cases reviewed disclosed issues of rights to informed consent, privacy, refuse treatment, advance directives, assisted suicide, and providing clear and convincing evidence.

In Canterbury v. Spence we learned that there is a right to be informed of possible risks, benefits and alternatives of a proposed diagnostic or treatment.  Patients also has the right to consent or decline any and all interventions including life saving or life prolonging treatment.  However, it is the treating physician’s responsibility to educate and inform patient in order to ascertain informed consent.  It is also his/her duty to give full disclosure since he has the expertise, skills and knowledge but the degree of disclosure has limitations if it would adversely affect the outcome of the procedure.  Information provided should be within reasonable scope for the patient to understand.  The patient can also consent and withdraw at any time during the interface of a medical or surgical operation.

Likewise, the Cruzan case led the courts to decide on the common law right to informed consent.  The Living Will statute clearly defines the concept of clear and convincing evidence of a patient’s wishes.  Constitutionally, all competent persons are protected by this constitutional right but an incompetent person would not since they are unable to make an informed and voluntary choice to exercise the right of choosing between life and death.  Unless their wishes were clearly outlined in an advanced directive, then it’s the duty of health care giver to establish life support.

Consequently, one ponders the clear and convincing evidence standard as it applies to the interest of the medical field, the state and surrogates.  As for the surrogates, their actions are questioned because of the likelihood that they might not act to protect the patient.  The states interest lies in preserving life while the medical field’s interest may lie in the monetary gain of providing their services.  I strongly believe that Nancy Cruzan’s parents were more than qualified in exercising such a right but the state of Missouri required the rights of the constitution which upheld the clear and convincing evidence of a patient’s wishes instead of confiding in the family’s decision.

Then there was Vacco v Quill which pointed out the distinction between refusing treatment and assisted suicide.  New York State worked to support a ban on assisted suicide which posed a violation of the Equal Protection Clause of the Fourteenth Amendment.  It is alleged that terminally ill patients have the right to get assistance with their deaths by removing life support systems while competent patients are prohibited from receiving self administering prescribed drugs that will hasten their death.  The issue of equality even in the passage of death seemed quite the contrary to the American value system that promotes the preservation of life.  This matter brought forth great contradiction in the processes of law.  Everyone has equal protection of the law but this case presents issues of classification and distinction.  Life support systems are artificial processes which is different from a person functioning on their own.  Therefore patients should be allowed to experience death naturally since it is a natural process.  In physician assisted suicide, the physician who should be the healers and preservers of life are actively involved in hastening a patient’s death.  Passing such a law will impose many risk factors including but not limited to psychological pressure, misuse (intentional killing), and a significant effect on public policy.  How would others perceive our nation if we are willing to kill people at will with their permission?  What will happen when all faith is lost in our doctors as healers?