Question 1, Bioethics
The tenets of informed consent dictate following the five guidelines of understanding, disclosure, understanding of the disclosure, willful acting on the disclosure, and consent to the disclosed action. However, these tenets in applicability have met specific resistance in society and the legal paradigms. The Ashley Good case provides instances where conflicts arise between the five principles and the legal doctrines, as seen in June 2016 when the court issued an order authorizing Susan M. Joseph, her temporary guardian power, to use all medically approved treatments but limited to feeding by force to counter her chronic Anorexia nervosa. The law cites the right to refuse life-sustaining treatment; however, the court excluded that right from the patient in this instance. This law requiring a competent person to refuse life-sustaining treatment is a fundamental principle about patient autonomy (U.S. Supreme Court opinions by Chief Justice and Year, 2016). The principle also applies to incompetent persons who refuse treatment; thus, regard to mental disorders should not be limited in this instance, as held by the New Jersey Supreme Court.
The bioethics code is at times conflicted between healthcare practitioners and society, as seen in Cruzan v. The Director of Missouri Department of Health, a litigation case where a young woman, Nancy Beth Cruzan, was in a vegetative state, and her parent sought to discontinue her vitamin, but the hospital refused to consent to the request. The court, however, affirmed that the patient had the right to refuse treatment, which was constitutionally allowed. Society thus sometimes conflicts with these tenets, but they are self-determinant under the rule of law. For an incompetent person, the right is held by a representative such as a family member. In the Ashley Good case, the parent supported her decision to refuse medication as her ailment started when she was very young. The court-appointed guardian sought to have a contemporary ruling, which resulted in her developing re-feeding syndrome that eventually damaged her heart. Thus, they petitioned the same court to overrule its judgment. The Department of Human Services was opposed to this petition suggesting the use of nasogastric tubes three times daily even when it meant the use of restraints, which, according to her psychiatrist, would be harmful because of her fragile body.
The case provides parameters of conflicts between the law, ethics, and common sense. The case underscored the variables relating to medical practitioners and patients who should have the right to make informed medical decisions. Dr. Pertschuk proposed three treatment plans for Ashley Good: force-feeding, therapy using her dogs, and experimental ketamine. These treatment plans were retrogressive and were opposed by various faculty in the court, one being the Ethics committee, her psychiatrist, and her family; they proposed that she be allowed to enter palliative care (U.S. Supreme Court opinions by Chief Justice and Year, 2016). The issues of what is best and what is ethical are two conflicting prerogatives that need clarification significantly with mental disorder patients. Doctors should not view mental disorder patients as innate objects but should follow the five guiding principles to allow the decision to be patient-centred. Patients should have informed consent allocation, as seen in the Ashley Good and Quinlan cases.
In conclusion, the Ashley Good and Quinlan situation significantly explains the complicated connection between bioethics, law, and patient independence. Problems arise when societal norms and legal ideas conflict with bioethics principles. To properly deal with the moral dilemmas concerning mental health patients, it is essential to consider one’s right to refuse treatment while still making sure there is informed consent.
Question 2: Women’s procreative choice
Roe v Wade was a landmark case that saw the implementation of abortion rights, which has been in jurisprudence around the world and has helped different structurally discriminated women make informed decisions regarding their unborn children (Roe v. Wade, 410 U.S. 113 (1973)). The recent overturning of this decision in the case of Dobbs v. JWHO will have significant ramifications for the women who seek abortion, citing various reasons for their actions. One such challenge will involve the threat of their constitutional right to abortion, which significantly affects marginalized groups. These populations primarily affected by this law previously had challenges accessing proper healthcare and faced discrimination and abuse. While the biblical worldview may accept it, certain instances may be punitive.
The criminalization of abortion will open another avenue of punitive laws regarding pregnancy that will mainly affect the population that mainly has health challenges during pregnancy due to lack of access to healthcare. The laws may also affect their prenatal and maternal healthcare, which will additionally affect this population. These effects will be felt globally as the Roe case has had a global effect for over 25 years now in human rights advisement that now will be in jeopardy due to the recent ruling that has revised the Roe case. The jurisprudence on abortion rights and women making a mark in the global fraternity will also be affected by this novel ruling (Kaufman et al., 2022). The ruling has revised the freedom that women have fought for decades globally to their unique right to abortion.
The abortion statute regression affects other stakeholders that had invested in this statute, such as the liberalization of abortion that has been giving access to abortion services to vulnerable populations globally. It has helped women involved in rape and are unwilling to have those children and those in forced marriages. Thus, the blow that the decision has given such initiatives will lender them incapacitated to offer such services. Additionally, in the United States, other private persons have invested significantly in abortion; thus, these laws will affect them financially, and eventual closure is anticipated (Kaufman et al., 2022). Various activist groups have also invested in the prerogative of abortion through strategies to inform the population about the pros of abortion and combating misinformation about abortion in society. Social work has also been at the forefront of educating society on issues of abortion, sometimes encouraging women whose socioeconomic difficulty to perform abortion. This was regarding their lack of proper sustainability of the infant, which could lead to abandonment, having a significant number of homeless children that eventually depend on the government and nonprofit organizations.
The landmark Supreme Court decision in Roe v. Wade brought hope to women who have been discriminated against for centuries. The constitution adopted the ruling to formulate the abortion statute, giving women autonomy of their bodies and privacy in the decision-making; this decision robs them of these rights. These rights incorporated the right to sexual intimacy, contraception, and same-sex marriages; thus, many may feel that these rights are also in jeopardy following the regression of the Roe ruling. Many are calling for the protection of these women’s rights and access to abortion, with others asking the Justice Department to protect women’s right to seek abortion in states where abortion will be legal (Roe v. Wade, 410 U.S. 113 (1973)). Looking back at the Fourth Amendment, which protects privacy from government intrusion, which this law will ultimately infringe on, many are wary of the coming changes following this recent ruling. The ramifications of the aftermath of the overturning of the Roe ruling are still yet to be evidenced.
To summarize, the recent Roe v. Wade ruling threatens women’s global reproductive rights, affecting healthcare access and privacy. The results ripple through different populations, creating a considerable setback.
References
Kaufman, R., Brown, R., Martínez Coral, C., Jacob, J., Onyango, M., & Thomasen, K. (2022). Global impacts of Dobbs v. Jackson Women’s Health Organization and abortion regression in the United States. Sexual and Reproductive Health Matters, 30(1). https://doi.org/10.1080/26410397.2022.2135574
Roe v. Wade, 410 U.S. 113 (1973). Justia Law. (1973). https://supreme.justia.com/cases/federal/us/410/113/
U.S. Supreme Court opinions by chief justice and Year. Justia Law. (2016). https://supreme.justia.com/cases/federal/us/ in the matter of Ashley Good
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