Tuesdays With Morrie Essay, Research Paper
The Fourteenth Amendment in the Constitution states: No state shall deprive any person of life, liberty, or property, without due process of law. One specific case shows the extreme debate over this Amendment and the countless ethical questions that arise from this Amendment. On January 11, 1983 Nancy Cruzan was in a serious car accident and was found face down on the ground. She had suffered significant oxygen deprivation, which severely damaged her brain. Brain damage of this severity is irreversible. This left her life in a persistent vegetative condition in a Missouri state hospital. This condition allows a person to show motor reflexes but evinces no indications of other significant cognitive function (Supreme Court Collection .) Mr. And Mrs. Lester Cruzan then made the difficult decision to cut off the artificial nutrition and hydration of their daughter Nancy, and allow her death to occur. Both the hospital and the state refused, using the Fourteenth Amendment as the reason for the decision along w/ assisted suicide policies. So the question presented now is: Do hospitals or medical persons have the
authority to break the constitutional “right to live” without the patient’s
consent?
Two answers can be provided for this question. One being that the hospital and medical persons could have authority to break the constitutional right to live without the patient s consent. And the second being that the hospital and medical persons could not have the authority to break the same right to live without the patient s consent. Both answers will be researched and explored and applied to the reading of From Cruelty to Goodness by Phillip Hallie. Before these two answers are analyzed, the message of Phillip Hallie s essay will be defined and explained.
In the essay From Cruelty to Goodness , author Phillip Hallie discusses the positive and negative ethics of goodness. To follow the negative ethic is to be decent, to have clean hands. But to follow the positive ethic, to be one s brother s keeper, is to be more than decent-is to be active, even aggressive (Hallie 59). He describes that the negative ethic is to refrain from certain actions and the positive ethic is to go above and beyond in other actions. The constitutional right to live and whether medical persons should break this right without the patient s consent can be looked at in both the positive and negative ethics of goodness.
In the case of Nancy Cruzan, the state denied her parents the right to end their daughter s artificial nutrition and hydration with the reasoning that it would violate the constitution. The conflict of assisted suicide policies also arose and added to the state s decision to not allow the Cruzan s to terminate their daughter s life. The state, in refusing to allow the hospital end all lifelines to Nancy, was acting as the negative ethic of goodness. The state and the hospital only wanted to keep Nancy alive so that they were abiding by the constitution, not because they were concerned with the well being of the woman. The state argued that Nancy did not give any evidence that she did not want to live life as a vegetable and did not prove that she wished for the withdrawal of medical treatment or of hydration and nutrition (Supreme Court Collection .) Using this, the state claimed that taking away all medical assistance would be violating her constitutional right to live. The courts and the hospitals were only showing decent hands that are associated with the negative ethic of goodness.
This shows that hospitals and medical persons do not have the authority to break the constitutional right to live without the patient s consent with only abiding by the negative ethics of goodness. The hospitals had to obey the laws of the constitution and therefore could not terminate the medical treatments being used to keep Nancy Cruzan alive. The state was doing only what was necessary in order to follow the law. The negative ethics forbid them to do what is in the patient s best interest. If the hospital would want to only be in accordance with the negative side of goodness, then just following the law would accomplish that. Following the law is enough to be good and to be have decent hands but it is not enough to be one s brother s keeper or have strenuous nobility (Hallie 59). The law hopes to provide for the best in all situations so that all parties are satisfied. The state of Missouri, in this case, relies on its interest in the protection and preservation of human life, and there can be no gainsaying in this interest .we do not think a State is required to remain neutral in the face of an informed and voluntary decision by a physically-able adult to starve to death (Excerpts from the Supreme Court Decision .) The idea of the constitutional law is to benefit everyone but in addition, to also disregard the positive ethic of goodness.
The second answer the questions proposed could be the following: The hospitals and medical persons do have the authority to break the constitutional right to live and therefore following the positive ethics of goodness. This does not happen very often due to the fact that the law usually overrides the desires of the people. The doctors or physicians could stop medical treatments to those who are in extreme pain and suffering with the reason being to end all suffering that may be unbearable (Life News ). Although the patient may not be able to make the decision on his/her own, he/she might have close relatives that would know best what the patient would want. In the case of Nancy Cruzan, oral statements had been made to relatives and friends prior to the accident demonstrated that she did not want to be kept alive unless she could have a halfway normal life (Excerpts from the Supreme Court Decision ). This could have been evidence enough that Nancy did not want to continue life in the state that she was in.
If the physician can determine that a particular plan of care for the patient, including the use of particular treatment, is clearly most in accord with the patient s values and if the patient s family and direct caregivers are in agreement, then that particular plan of care should be pursued. This would be the product of the positive ethics of goodness. In this way, the physicians and hospitals are going out of their way to ensure the best interest of the patient. The emotional aspect of goodness then comes into the picture and the law is seen as something less. Taking time out to discuss the course of action for a patient with his/her family would contain a certain type of nobility as the positive ethics of goodness call for. The physician in consultation with the family, if available, and other direct caregivers, should identify the plan of care that would most generally be thought to advance most such patients interests and if family and direct caregivers concur, it should be implemented (Part II: DECSIONS INVOLVING PATIENTS ). Going beyond the call of the law, the hospitals and medical persons display the best case of the positive ethic of goodness. Allowing hospitals and medical persons to have the authority to break the constitutional right to live is in all accordance with positive ethics of goodness.
The answer I present to this question is one of mixed opinions. I believe that the law does make a valid point in making it clear that they understand that the constitution states that no human shall be deprived of life. However, in certain circumstances this can be overridden and other alternatives can be made in the patient s best interest. In the case of Nancy Cruzan, I believe that when her parents wanted the termination of her nutrition and hydration, they were doing what they believed was best for their daughter. They were no doubt good parents, but somewhere the line had to be drawn in reference to why Nancy was being kept alive. She had no signs of improving and therefore her existence was clearly all mechanical and electronic. I believe that her parents knew that if the hospital terminated her medical treatment that it was not patient assisted suicide. If it is in the patient s best interest to have all medical terminated, then it should be done, and then the positive ethics of goodness are shown because the medical persons are going beyond just what the law says. The law is only there to have set guidelines to keep society in order. It just provides for the negative ethics of goodness. I believe that in cases where the patient is unable to decide for his/her self, that the course of action taken should be decided between the doctor and family if available. This would prove to be the highest form of the positive ethics of goodness and the law would be overriding the negative ethics of goodness.
In the debate over the constitutional right to live , we mainly see that the negative ethics of goodness are utilized. In the case of Nancy Cruzan, for the longest time, the state overruled everything and Nancy was not allowed to have her life terminated. The state then only provides for the negative ethics of goodness because it is in accordance with the Fourteenth Amendment. The positive ethics of goodness are not touched upon when goodness involves the law. By having her parents fight for the right to end Nancy s life, and having the law finally give them that right, the positive ethics of goodness were finally demonstrated. This case and Hallie s ideas show us that we need to go above and beyond the call of duty to follow both ethics of goodness even if that means a fight for what is lacking.
Works Cited
Hallie, Phillip From Cruelty to Goodness Schmersahl and Stay. 59.
Excerpts from the Supreme Court Decision in CRUZAN BY CRUZAN v. DIRECTOR, MISSOURI. 13 Feb 2001. http://www.cortland.edu/www/polsci/cruzan.html
Life News (a publication of WELS Lutherans for Life) 1991. http://www.publicagenda.org/issues/overview.cfm?issue_type=right2die
Supreme Court Collection: Cruzan v. Director, DMH 497 U.S. 261 (1990). http://supct.law.cornell.edu/sucpt/html/88-1503.ZS.html
Part II: DECSIONS INVOLVING PATIENTS WHO HAVE LOST THE CAPACITY TO MAKE DECISIONS AND WHO HAVE NOT EXECUTED AND ADVANCE DIRECTIVE . http://www.ualberta.cal ethics/bb5-1.html#lost
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