Module case: Informed Consent & End of Life

Mrs. Sparza, a 70-year-old grandmother with limited English skills, is scheduled for surgery on her right eye. Upon entry to the hospital, she and her son review the general admission documents and Mrs. Sparza signs them all. Mrs. Sparza also completes and executes a durable power of attorney for health care. Mrs. Sparza identifies her daughter and son as her agents for decision making in the event that she becomes incapacitated. Mrs. Sparza also specifies that she does not wish any heroic measures and that in the event she goes into a coma she wants life support terminated.

After changing into a patient gown and having her vital signs taken, Mrs. Sparza is taken into the pre-operative room where she is placed on a gurney. After administration of pre-operative muscle relaxant medication, she is rolled into the operating room. Upon entering the operating room, Mrs. Sparza is greeted by Nurse Johnson who asks Mrs. Sparza to sign the surgical consent form. The form is in English and identifies the procedure as surgery of both eyes. Mrs. Sparza is told that she is scheduled for surgery of both eyes and is asked to sign the consent.

When Mrs. Sparza objects and refuses, Dr. Pinnette enters in his green scrubs and talks with Mrs. Sparza with the aid of an interpreter. After a minute of conversation, with tears in her eyes, Mrs. Sparza signs the consent form and is placed under general anesthesia. At 6 a.m. the next day of her hospitalization, Mrs. Sparza suffers a heart attack and her kidneys cease function. She subsequently goes into a coma. Her children are immediately notified and arrive at the hospital at 8:30 a.m. When informed of the doctor's decision to place Mrs. Sparza on a dialysis machine, the son and daughter decline consent and asked that life support be terminated pursuant to the patient's directive.

Mrs. Sparza's cardiologist, Dr. Lox, a world-famous cardiac surgeon, refuses to give the nurses the order to terminate life support. Dr. Lox looks for every excuse to avoid the family. At the family's request, Mrs. Sparza's nurses provide comfort care until 3:30 in the afternoon of the next day. The two-day ordeal is a long and emotionally traumatic experience for Mrs. Sparza's family, who receive relief when Mrs. Sparza's nurse injects a fatal dose of morphine to ease and expedite her death.

Case Assignment

Evaluate and discuss the legal implications of the actions in the foregoing scenario in light of the module materials and your own research. Please be thorough in responding to the following questions:

1. Identify and briefly explain the elements of informed consent;
2. Discuss whether Mrs. Sparza's consent was properly obtained;
3. Identify Mrs. Sparza's rights regarding end-of-life decision making; and
4. Discuss the nature of the act of injecting morphine.
5. Was it legal?

Assignment Expectations

• Be sure to apply critical thinking skills from your analysis of the current literature on the above topics;

• Limit your paper to 3 pages (double-spaced, 10-12 point font), not including title page and list of references;

• Please use at least 3-5 scholarly sources. Please be sure to properly cite all references both within the text (at the end of paraphrased paragraphs) and at the end of your paper. I will grade your paper on your ability to address the assignment criteria listed above with depth and breadth of discussion. I will also critique your writing format (i.e. proper reference citations, spacing, etc.).

Your paper will be evaluated based on the rubric criteria.

Please be sure to provide citations of sources consulted in preparing your paper in the body of the actual document itself (i.e. in addition to furnishing a reference list). Remember, any statement that you make that is not common knowledge or that originates from your synthesis or interpretation of materials you have read must have a citation associated with it. For guidelines on in-text citations, visit the following website: https://owl.english.purdue.edu/owl/resource/560/02/