Discussion 7 - Legal and Ethical Obligations to Provide Care

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Evaluate the ethical and legal ramifications involved in the termination or refusal of care and physician-assisted suicide. Discuss why informed consent may be controversial from the patient and family perspective. Provide examples and identify the ethical principles. Support your statements with logic and argument, citing any sources referenced.

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Weekly Discussion Board Rubric Meets Approaches Expectation Expectation Content, Research, and Analysis 5 Points 4 Points Content Demonstrates Demonstrates excellent fair knowledge of knowledge of concepts, skills, concepts, skills, and theories. and theories relevant to topic. 5 Points 4 Points Support Statements are Statements are well supported; partially posts extend supported; posts discussion. may extend discussion. 5 Points 4 Points Writing Writing is well Some significant Quality organized, clear, but not major concise, and errors or focused; no omissions in errors. writing organization, focus, and clarity. 5 Points 4 Points Timeliness Initial before Initial post 1 day deadline. late (Friday). 5 Points 4 Points Quantity Initial post and Initial post and two other posts. one other post. 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No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. Medical Responsibility Ronald Hamowy T hese comments seek to take issue with the contention that society has a responsibility to provide its members with any needed health care. In order to deal with this claim, we must first make clear exactly what it meant by the proposition. I take it that those who embrace this view mean considerably more than that each of us has a moral obligation to contribute to those in need of medical attention who are unable, for one reason or another, to afford the necessary care. This is a moral proposition and is traditionally dealt with under the heading of charity. But the contention, as here used, means considerably more since its main implications are not moral but primarily political. This is not to suggest that there are no moral implications to politicizing the administration of health care. We do well to remind ourselves of a fact that is almost always forgotten or neglected, that any recourse to the political process is ultimately dependent on the use of force. It is in the nature of all law that it seeks to change our behavior from what it would otherwise have been in the absence of the threat of coercion. Either at least some of us would have acted in some way or refrained from acting in some way in the absence of the sanctions that accompany any government directive. This, of course, is as true regarding how we spend our money as of any other command. We are, unfortunately, quick to seek solutions to our social problems by turning to the government, only dimly aware of the fact that these solutions — if indeed they were effective in solving the problems they address — are dependent on compulsion and that truly free societies have recourse to compulsion as rarely as is consistent with social order. The more we force people to act, even in their own interests, the less we are free and the more we compromise the autonomy of each of us. And to place in the hands of bureaucrats decisions as to what and how much medical aid will be extended is to rob individuals of the power to determine the extent to which they control what should be intimately personal choices. That government should ultimately be responsible for the health care of its citizens is predicated on the idea that medical care is a right, not dissimilar from the right we all possess to our own religious beliefs, and that, as is true of all rights, the state has a duty to enforce it. This claim was put forward by President Franklin Roosevelt as far back as 1944 and was reiterated by President Obama, in October 2008.1 But this notion is both philosophically and practically flawed. Ronald Hamowy is a Professor Emeritus of Intellectual History at the University of Alberta and a Fellow in Social Thought at the Cato Institute in Washington, D.C. 532 journal of law, medicine & ethics Ronald Hamowy Philosophically, the use of the term “right” to denote a positive obligation to supply a scarce resource is predicated on a confusion between a right and a grant of privilege. There is probably nothing more pernicious to the language of political philosophy than the vulgarization of the term “rights.” While the point has often ence progresses and we find more ways to diagnose disease and extend life, the cost of the resources that can be applied to any particular patient increases. The effect is that the “rights” of some will of necessity conflict with the rights of others as scarce resources are parceled out. The incapacity to meet total demand logically implies that one’s “rights,” at some point, will The more we force people to act, even in their own interests, the less we are free and the more we compromise the autonomy of each of us. And to place in the hands of bureaucrats decisions as to what and how much medical aid will be extended is to rob individuals of the power to determine the extent to which they control what should be intimately personal choices. been made, it bears repeating, that the rights to which serious political discourse refer are negatively conceived. They have reference to the limitations placed on governments and on others regarding attempts to restrain how we may act. This conception of rights is the one put forward in, among other documents, the Declaration of Independence and the American Bill of Rights. Rights so conceived do not require that others be forced to act in specific ways if I am to exercise my rights but only that they refrain from intervening in certain areas without my consent. Thus, my right to life does not entail that others are obligated to do everything within their power to keep me alive but only that they cannot kill me. Unfortunately, advocates of socialized health care commonly employ the term not in this negative manner but in its imprecise sense to refer to some privilege that entails that others not refrain from acting, but positively act in certain ways. They are, of course, not alone in this. The last hundred years have witnessed a serious erosion in political discourse as politicians have increasingly invoked such terms as “liberty” and “rights” solely to elicit certain emotional responses in their hearers. And discussions of health care, far from being immune to such imprecision, have embraced it, especially by those employed as government functionaries of one kind or another. Those who support socialized health care are particularly prone to use the term to refer to privileges which entail an obligation on others to provide certain services, either directly or through the intermediation of taxes. In addition, there are serious practical consequences to conceiving of health care as a right. The demand for medical services at zero price to the consumer far exceeds supply. On the other hand, our resources are, of course, limited and as medical sci- conflict with those of others. And this, in turn, means that some organization will have to be empowered to determine whose rights will be met and whose will be denied. Thus, the ultimate decision for what and how much medical care we will, of necessity, be entitled to rests in the hands of some bureaucracy. The economics here are simple. Whenever the demand for a good or service outstrips the supply, there must be some method of rationing. And there are ultimately only two methods of rationing. The price system reflects our individual demands and the extent to which we want a particular good or service as compared with all the other goods and services available to us. This demand is distinct for each of us and varies from time to time demanding on all the other factors that impinge on our lives. The other method of rationing is by fiat, in which some bureaucracy determines how much medical care will be forthcoming and by imposing costs in forms other than price-waiting lists, overcrowded facilities, etc. A governmentadministered system is thus predicated on the creation of a bureaucracy empowered to make rationing decisions which intimately effect how, when, and how much health care each of us will receive. Nor should we ignore the enormous cost of administering a government health care system. An examination of the administrative costs associated with Medicare underscores the inefficiencies associated with management of the program. While the Center for Medicare and Medicaid Services claims to spend less than 3.1% of total expenditures on administration,2 this figure does not include the spectacularly high costs imposed on physicians and hospitals in complying with the almost 150,000 Medicare regulations. In an often-quoted paper published in 2003, Drs. Steffie Woodhandler and David Himmelstein3 con- health care reform: controversies in ethics and policy • fall 2012 533 S Y MPO SIUM cluded that the administrative costs associated with doctors, hospitals, nursing homes, insurers, and employers accounted for 31% of health care costs in the United States, almost twice the amount as that in Canada. Their recommendation was that the United States switch to a single-payer system similar to the Canadian model. The facts, however, in no way comport with these findings. That portion of Canadian administrative costs associated with their national health insurance system is substantially higher than Woodhandler and Himmelstein report — for a system offering considerably less than does American health care.4 In addition, the portion of the private sector of Canada’s health system is saddled with fewer regulations and is thus spared the substantial costs imposed on American providers. More important, a singlepayer system tends to veil waste, fraud, and gross inefficiencies far more effectively than does one where competition prevails. More suspect are the overall figures put forward for administrative costs in the United States. The National Health Expenditure Accounts5 for 2005 show administrative costs at 7.2% of total health care spending — 14.1% for private insurers and 5.2% for public programs (3.1% for Medicare and 7.0% for Medicaid).6 In sum, a careful examination of the actual costs of administrating a government health system reveal substantially higher numbers than generally supposed. Careful cost accounting serves no real purpose when dealing with bureaucratic entities since, unlike with profit-making organizations, it is unlikely that uneconomic units will be consolidated or shut down. In the absence of such constraints, it is simple, when calculating how much the government is spending on a program, to slough off a portion of its costs onto other programs and miscellaneous expenditures. Thus, none of the following are included in the operating expenses of Medicare: (1) the cost of collecting the taxes to fund the program; (2) program marketing and outreach; (3) the cost of auditing the program; (4) the costs associated with negotiating contracts; (5) building costs; (6) staff salaries of those employees not directly employed by the Medicare system but whose duties center on Medicare affairs; and, (7) the costs of congressional resources used in setting Medicare fee schedules.7 The Office of the Inspector General of the Department of Health and Human Services has conceded that the amount of waste and fraud in the Medicare and Medicaid system amounts to many billions of dollars. To give some idea of the magnitude of the problem, it is worth noting that the Chief Counsel of the OIG, in testifying before the Subcommittee on Oversight of the House Committee on Ways and Means, said that 534 “in fiscal year (FY) 2009, the Centers for Medicare & Medicaid Services (CMS) estimated that overall, 7.8 percent of the Medicare fee-for-service claims it paid ($24.1 billion) did not meet program requirements.”8 The larger the program, of course, the more incentive to waste resources and to abuse the regulations governing payment. In September 2009 President Obama conceded that “there are hundreds of billions of dollars of waste and fraud” in the health care system.9 There is simply no possibility that such massive fraud and misuse of resources could occur in the private sector because of the dispersion of buyers and sellers and the existence of price signals that immediately call attention to these anomalies. It is much easier to spend other people’s money than one’s own and not be too concerned with waste and inefficiencies when the costs fall on some faceless anonymous entity. There lies behind most criticisms of a health care system operating according to the principles of a free market: a deep distrust of private enterprise and a suspicion that the profit motive should play no role in this crucial aspect of our lives. This follows conventional Marxist analysis that the relationship between health care provider and patient should not be a commodity relationship comparable to selling refrigerators or providing piano lessons, where the participants are in some sense adversaries, but one in which they are cooperative and benevolent.10 This view, however, completely misconstrues the nature of free markets and their alternatives. Markets are predicated on the harmony of interests between buyers and sellers who seek to satisfy their own welfare by satisfying that of the people with whom they deal. Far from being an antagonistic relationship, the relation between buyer and seller is a cooperative one. The nature of unhindered markets is that both parties freely enter into an agreement to trade a good or service because the trade is beneficial to both. Compulsion plays no role in the exchange. It is not predicated on the notion that one party owes the other something that impels him to act. The competition that is central to a system of free markets is the competition we have to satisfy the demands of others, thereby benefitting ourselves. This distinction is often lost when people refer to “competitive” markets. More important, the nature of exchange is such that each of us remains autonomous, making our own decisions and acting on them as we freely choose. Whether we like it or not, we are all born, live, and die as independent beings, and the nature of our association with each other is either voluntary or coerced, that is, originating in decisions we make for ourselves or in those made for us. There is no third alternative. journal of law, medicine & ethics Ronald Hamowy That we are part of some organic body and that we are interconnected so that we “belong” to and are responsible for each other is basically antithetical to our notion of the sovereignty of the individual. Nothing is more elemental to the nature of man than that he be in control over the decisions that affect him. And no decisions are more central to his existence than the medical care he receives. This extends to being able to determine the type and degree of medical care he opts for and to choose among those who might provide is to increase the premiums for non-smokers. And the only groups that benefit from the legal mandate that health insurance must cover the costs of alternative medical practice such as acupucture or naturopathic medicine are their practitioners. These requirements add unnecessary costs to health insurance policies and doubtless contribute to why a portion of the population has foregone medical coverage.11 I am unsure why free markets remain so distrusted after they have proven themselves time and again as such a spectacular engine of progress and as the underlying cause of modern wealth creation. Anyone familiar Self-responsibility is not a burden — or at least with the history of the last 50 years not just a burden — but a method of insuring that must be impressed by the immense success in producing and distributthe each of us has plenary control over our lives. ing goods and services and the develAnd the only economic system compatible with opment of the technological means individual autonomy is one of free markets, which for securing its production. One need only look at the material progalso serves as the most efficient system for the ress of Japan and South Korea since production and distribution of goods and services. the end of World War II and of China since the economic reforms of Deng Xiaoping in 1978 to see how effective free markets are in transforming poverty into wealth.12 these services. Self-responsibility is not a burden — or at least not just a burden — but a method of insurYet despite the overwhelming evidence, huge numbers ing that the each of us has plenary control over our of otherwise intelligent people continue to insist that lives. And the only economic system compatible with capitalism only benefits the rich. individual autonomy is one of free markets, which also What is particularly exasperating is the charge serves as the most efficient system for the production made by many of those who support wholesale government intervention in the health care system that and distribution of goods and services. the claims of economists who point to the inefficienPrivatizing government health care will do much to cies and opportunities for fraud inherent in such a syseliminate the billions of dollars lost to the waste and tem are thoroughly unrealistic and that the real world inefficiencies endemic to central planning. At the same simply does not reflect the idealized conclusions of time, it will unleash the forces that drive capitalism to classical economics. At the same time, the advocates reduce the costs of medical care and health insurance. of a governmental-administered medical system offer This is not the place to outline all that could be done up the image of a kind and beneficent bureaucracy to reduce the substantial medical costs we all confront selflessly dedicated to the public weal and refuse to in the face of government regulation, but certainly the judge how in reality such systems have always worked. limitations placed on the sale of private health insurHow much proof must be offered before it is finally ance could be eliminated so that it would be available admitted that progress in any area, including health to more people. care, is a function of the freedom permitted individuNo sensible reason exists for most of the regulaals to compete with each other in reducing costs and tions imposed by the federal government and the variincreasing quality? ous states that prohibit the sale of insurance limited Yet even allowing for all of this, what are we, as a to catastrophic expenses or that place limits on lifecompassionate society, to do about those people who time or annual payments. And why prohibit the sale are in need of medical care and who simply cannot of policies that exclude preexisting conditions or that afford it, even after we have repealed the restrictive mandate mental health coverage or coverage for the legislation that now hobbles the market? It is at this expenses incurred in childbirth. Nor does it make point that self-responsibility merges with our fellow sense to require that all applicants, regardless of the feeling for those less fortunate than ourselves and risks they assume to their health, be charged the same issues in charity. We are charitable because we have a premium for the same coverage. The only effect of sense of responsibility for ourselves and know what it including smokers in the same pool as non-smokers health care reform: controversies in ethics and policy • fall 2012 535 S Y MPO SIUM means to fall short of some goal. To shift responsibility to some entity whose resources are dependent on the use of force is not compatible with a basic respect for individuals, which is the underpinning of charitable society, nor is it in any way efficient. For those who claim that private charity will fall short of being able to care for those in need of medical help is to badly underestimate how charitable our society is. Americans currently surrender 28% of their wealth to federal, state, and local governments in the form of taxes.13 Yet in the face of such a sizable tax burden, charitable contributions from American individuals, corporations, and foundations totaled $303 billion in 2009 and public charities had total revenues of 1.37 trillion dollars.14 Surely a nation so philanthropic would insure that no one who lacked the means to afford it went wanting for needed medical care. References 1. Franklin D. Roosevelt, in his State of the Union Address of January 11, 1944, declared that all Americans “have the right to adequate medical care and the opportunity to achieve and enjoy good health.” During the presidential debate held in Nashville, Tennessee, on October 7, 2008, Obama maintained that “I think [health care] should be a right for every American.” 2. However, this figure does not include Medicare’s share, which is substantially greater than 3.1%, of general governmental administrative expenses. See M. Matthews, Medicare’s Hidden Administrative Costs: A Comparison of Medicare and the Private Sector (Alexdandria, VA: The Council for Affordable Insurance, 2006) and B. Zycher, Private Health Insurance: Would a Single Payer System Save Enough to Cover the Costs of the Uninsured?, Medical Progress Report No. 5 (New York: Center for Medical Progress of the Manhattan Institute, 2007). 3. S. Woodhandler, T. Campbell, and D. Himmelstein, “Costs of Health Care Administration in the United States and Canada,” New England Journal of Medicine 349 (August 21, 2003): 768-775. 4. For a comprehensive survey of the Canadian health care system and its limitations, see B. J. Skinner, Canadian Health Policy Failures: What’s Wrong? Who Gets Hurt? Why Nothing Changes (Vancouver: Fraser Institute, 2009). 5. See United States Census, Statistical Abstract of the United States: 2011 (Washington, D.C.: Government Printing Office, 2010): 100 (Table 132). 6. McKinsey & Company estimated that in 2006 health administration and insurance costs accounted for $145 billion while total health care spending came to $2,053 billion. This 536 amounts to 7.06%. McKinsey & Company, Accounting for the Cost of US Health Care: A New Look at Why Americans Spend More: Executive Summary, December 2008, at 14. 7. American Medical Association, “Administrative Costs of Health Care Coverage,” available at (last visited August 17, 2012). 8. Testimony of Lewis Morris, Chief Counsel, Office of Inspector General, U.S. Department of Health and Human Services, on Reducing Fraud, Waste, and Abuse in Medicare, before the Committee on Ways and Means, Subcommittee on Health, Subcommittee on Oversight, House of Representatives, April 19, 2011, available at (last visited August 17, 2012). 9. President Barack Obama in a statement to the Joint Session of Congress on September 9, 2009, quoted by Vincent L. Frakes, Policy Director for the Center for Health Transformation, testifying before the Committee on House Oversight and Government Reform, February 11, 2011, available at (last visited June 22, 2011). 10. See J. Ehrenreich, “Toward a Healing Society,” in E. F. Paul and P. A. Russo, Jr., Public Policy: Issues, Analysis, and Ideology (Chatham, NJ: Chatham House Publishers, Inc., 1982): at 186-197. 11. The Wall Street Journal on August 23, 2009, reported that the executive vice president of the American Association of Retired Persons, Mr. John Rother, noted that the annual cost for an individual plan for a 25-year old man in New Jersey in 2006 was $5.880, while a similar plan in Kentucky would have cost $1,000. See “The Compeition Cure,” Wall Street Journal, available at (last visited August 17, 2012). 12. A. Maddison, The World Economy: Historical Statistics (Development Center Studies: Paris: Organization of Economic Cooperation and Development, 2003), and Historical Statistics for the World Economy, 1:2003 A.D. show the following GDP for the three nations: (1) Japan: 1946: 1,444; 2003: 21,218; (2) South Korea: 1946: 686; 2003: 15,732; and (3) China: 1950: 448; 1972: 802; 1978: 978; 2003: 4,803. See (last visited June 24, 2011). 13. See the Tax Foundation’s Special Report (no. 190) on Tax Freedom Day, dated March 2011, which calculates that in 2011 Americans will have paid all their taxes by April 12. 14. Giving USA Foundation, Center for Philanthropy at Indiana University, June 9, 2010. The National Center for Charitable Statistics at the Urban Institute reports that public charities in 2009 had revenues of 1.373 trillion dollars, and of this number, 54%, or $741 billion, were devoted to health. journal of law, medicine & ethics Copyright of Journal of Law, Medicine & Ethics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted. PRINTED BY: Matthew Langner . Printing is for personal, private use only. No part of this book may be reproduced or transmitted without publisher's prior permission. Violators will be prosecuted.
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Running head: LEGAL AND ETHICAL OBLIGATIONS TO PROVIDE CARE

Discussion 7 - Legal and Ethical Obligations to Provide Care
Name
Institution

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LEGAL AND ETHICAL OBLIGATIONS TO PROVIDE CARE

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Legal and Ethical Obligations to Provide Care
Introduction
The Hippocratic Oath is a fundamental tenet of the medical profession. Medical
practitioners swear by it so that they can have a standard to act by in medicine: one that will
always keep the best interests of the patients at heart. The discussion in this paper looks into how
ethics in the medical profession interacts with dying. Naturally, the study and application of
medicine exist to make people better. That is why there is so much controversy surrounding the
role of the doctor in the process of death. The discussion in this paper looks into the debate from
the perspective o the patient and their families. The ethical considerations around...


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