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There is usually a struggle when addressing end of life issues for patients, family and providers due to a variety of reasons. Health care providers usually see issues of end life such as consultation with the patient as time wasted which could be used on other patients. Patients usually may make statements for or against euthanasia before serious injury but may change their minds afterwards. For parents it is the duty of the health care provider to provide care for the patient to their maximum capability (Kuebler. et al. 2006).

A medical physician ought to provide as much information as possible on alternative options to his patient before starting a procedure. The ethical and legal issues usually taken into account usually are considered in the context of whether the physician provided information which is in the ordinary course of treatment offered by other doctors. He must offer to his patient any information which any doctor of repute would provide (Pozgar, 2005).

While it is the duty of the physician to provide his patient with all information concerning potential serious harm of a medical procedure and alternatives, he is not obliged to do the same if such disclosure would be potentially harmful to the health of the patient (Pozgar, 2005).

The purpose of the Patient Self Determination Act is giving information to patients on their rights in making decisions regarding their health care. It also ensures that patients know these rights are supposed to be communicated to them by the physician. It also informs patients of their right to attorney. The act gives powers to patients such as the right to be involved and direct medical decisions affecting them, and the right to reject or accept medical procedures (Ulrich, 2001).

A patient who is competent and alert has a right to refuse any medical treatment and hence any refusal by a patient would stand even if the spouse disagrees. The principle of preserving life if there is uncertainty concerning the patients wishes would only arise if the patient is suspected of not having fully comprehended the consequences of his refusal. The hospital would not be able to win in court if it administers transfusion and the patient proves that he was fully aware and competent when refusing treatment (Lynch, 2008).

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