Case Study
Capacity, Choice and Advance Directives
The following passage is from an article written by Andre Picard that appeared in The Globe and Mail, Feb. 10, 2014:
Margot Bentley was a long-time nurse, working mostly with patients with dementia. She was determined not to die a slow, lonely, frightful death like so many of her patients. So she planned ahead. Bentley wrote a living will, one that clearly stated that, when her time came, she did not want heroic measures taken to keep her alive. She also discussed the issue with her children, fully and openly, and they were in agreement….Yet today, the 82-year-old, who is in the final stages of dementia, is being kept “alive” against her wishes and those of her family….
….Here’s what Margot Bentley wrote in her living will, when she was compos mentis: “I direct that I be allowed to die and not be kept alive by artificial means or ‘heroic measures,'” she wrote eight years before her diagnosis. She also specifically stated that her caregivers should dispense “no nourishment or liquids” if she was in a condition where it was clear there was no reasonable chance of recovery….
….Bentley, who lies in bed in a semi-vegetative state, is fed three times a day. A care worker puts a spoonful of puréed food to her lips and she eventually opens her mouth and the food is pushed in; then she swallows, often with difficulty. The family argues that she is doing so by reflex; the health-care institution caring for her argues that it is a demonstration of the will to live.
the case scenario link

Should oral feeding be considered healthcare or a necessity of life?
You are the Health administrator of the Long term care facility/Hospital
— Argue for the Hospital as the Health administrator of the long Term care facility: why heroic measures taken to keep her alive.
— use an ethical decision-making framework to guide the discussion with evidence
—make a clear plan of action to address the situation is stated as a conclusion or a recommendation.

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