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Elizabeth Bouvia

Force Feeding and Hydration
by

Kathleen Bolsover, RN, BSN

on 20 September 2012

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Transcript of Elizabeth Bouvia

Elizabeth Bouvia Born in 1958 Right to Die Figure Cerebral Palsy, Quadriplegic and Severe Degenerative Arthritis Starvation
Comfort measures: Pain medication and hygeine
Relief from a life lacking quality Elizabeth's Wishes Preserve Life Elizabeth's conditions imposed many physical disabilities:
Immobile and bedridden
Unable to care for herself
Chronic pain
No form of financial income
Relying on Public Assistance
Forced to leave her parent's home when they could no longer care for her
Elizabeth's husband left her
Also graduated college, but unable to work Circumstances: "Letting go of all burdens. It is being able to be free of my physical disabilities and mental struggle to live."
"It's not that I don't have the will to live, but it is too much of a struggle to live within the system or to depend on someone in the system. In reality, my disability is going to keep me from doing the living I want to do." Motive Conclusion Riverside's Actions When Elizabeth's weight fell between 65 and 70 pounds, a nasogastric tube was inserted against Elizabeth's wishes and written instructions Elizabeth Bouvia v. Riverside Hospital The American Hospital Association (AHA) Policy and Statement of Patient's Choices of Treatment Options

Council on Ethical and Judicial Affairs of the American Medical Association's statement of "Withholding or Withdrawing Life Prolonging Medical Treatment" Supported By Argument: Suicide
All persons have the right to terminate their life
The hospital's refusal to assist was discrimination
Refusing life-sustaining treatment is not suicide, but accepting death Elizabeth Bouvia v. Riverside Hospital Supported Through Analogy Riverside Hospital Right to End Life??? My intent is to die.. I intend to starve myself to death... Hospital Mission Is Assisted Suicide Legal in the United States? 1983, Age 26, Riverside
General Hospital 1986, High Desert Hospital Appellate Courts- Not State policy to preserve life Trial Court, State should
Preserve Life Arguments: Refusal of Unwanted Medical Treatment
Removal of the NG Tube
A competent patient right to refuse any medical treatment, even if it may save or prolong his or her life.
Assistance required to eat constitutes as a medical treatment and she has the right to refuse Autonomy
A patient's healthcare wishes should be honored Beneficence:
Binds the physician to provide care that promotes patient's well being, relief of suffering and preservation of life Conflict **State prevails over Patient's Right to refuse treatment Prevent Suicide Protect Innocent Third parties Maintain Ethical Standards Physician -Sustain Life/relieve suffering Prevent Suicide Autonomy Beneficence VS. Which Ethical Value Prevails? Can they both work together?? What effect do you feel this case had on those involved? Forced Tube Feedings Ethical Dilemma Autonomy Beneficence Summary Defendent's argument How do you think Elizabeth's stance effects stereotypes of disabilities? What are some social effects that can
come from this case? Hippocratic Oath The court did note that Bouvia had no dependents, which would
support a finding that innocent parties would not be injured by Bouvia's
decision to refuse treatment. States duty to preserve life is most signifiant Fisher, L. J. (1987, November 1). The suicide trap: Bouvia v. Superior Court and the right torefuse medical treatment. Loyola of Los Angeles Law Review, 21(1), 218-254.
Johnson, M. (1984). Right to life, fight to die: The Elizabeth Bouvia saga. Advocado Press. Retrived from: http://www.normemma.com/advocacy/artbouvia.htm
Liang, B., & Lin, L. (2005). Bouvia v. Superior Court: Quality of life matters. Virtual Mentor, 7(2). Retrieved from: http://virtualmentor.ama-assn.org/2005/02/hlaw1-0502.html
Stradly, B. (2010, September 7). Elizabeth Bouvia: v. Riverside Hospital: Suicide, Euthanasia, Murder: The line blurs. Golden Gate University Law Review, 15(2), 407-413.
Elizabeth Bouvia v. the Superior Court of Los Angeles County (225 Cal. Rptr. 297) 1986. Retrieved from: http://www.lawandbioethics.com/demo/Main/Media/Resources/Bouvia.htm References Ethical Dilemma Right Not to Eat Force Feeding How could this case effect the hospitals mission? Values? Lehigh Valley Hospital To heal, comfort, and care....... Class Verdict Pro-Elizabeth Pro-Hospital Right not to Eat Ethical Values Elizabeth Bouvia today?? NG TUBE STAYS NG TUBE REMOVED V.
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