“Nursing should not ‘borrow’ theories from other disciplines.” Refute this statement by providing specific examples from your current nursing practice. Describe the importance of increased nursing collaboration with other disciplines.
Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook
(‘‘Airedale NHS Trust v. Bland’’ 1993) on the interface between the two conflicting
principles of autonomy and preservation of life. It was accordingly ruled that the principle
of ‘‘best interests’’ was not applicable in cases where the patient had the mental capacity to
make relevant decisions about her medical treatment, and therefore, a doctor was under an
obligation to respect the wishes of the patient, even if it was plain to all parties, including
the patient, that death would ensue.
The approach to the issue on end of life adopted by the US courts is not entirely
dissimilar to the law in the UK (it is noted that although the House of Lords in Airedale
130 J Relig Health (2016) 55:119–134
123
NHS Trust v Bland (‘‘Airedale NHS Trust v. Bland’’ 1993) declined to apply the test of
‘‘substituted judgment’’ used by the US courts in the case of an incapable patient, Lord
Hoffman at p. 857 noted that such principle, to the extent that it pays respects to what most
likely would have been the patient’s views, ‘‘may be subsumed within the English concept
of best interests’’). In the absence of the expressed wishes of a patient (be it in the form of
oral statements or advance directives), decisions are based on the patient’s presumed
wishes (Meisel 2008). This is known as the doctrine of ‘‘substituted judgement’’. Under
this doctrine, a surrogate appointed by a patient is legally authorised to make decisions on
behalf of the patient, or where there is no surrogate, the patient’s family members, based on
the patient’s values and beliefs. This practice marks the difference between the USA and
the UK positions; in the UK, it is not a legal requirement for relatives to assent on behalf of
a patient who is unable to give consent (per Lord Goff in Airedale NHS Trust v Bland
(‘‘Airedale NHS Trust v. Bland’’ 1993 at p. 872). Discussions with relatives are never-
theless of utmost value because they assist in providing indications about the patient’s own
attitudes and values concerning treatment (Kinsella and Booth 2007).
The prolific Florida case of Theresa Marie Schiavo (‘‘Schiavo ex rel. Schindler v.
Schiavo’’ 2005) is noteworthy not only to illustrate the application of the ‘‘substituted
judgement’’ test, but also due to the controversial intervention of the executive body and
conservative groups in the dispute surrounding her medical care, which attracted intense
media coverage. Theresa Schiavo was in a persistent vegetative state for 15 years, fol-
lowing a cardiac arrest. Although she suffered from irrevocable cerebral cortex, she was
able to breathe on her own and was kept alive through artificial nutrition and hydration
which was delivered by way of a tube implanted in her body. After having accepted the
grim medical prognosis that his wife’s incapacity was permanent, Michael Schiavo
attempted to seek the court’s permission for the removal of her feeding tube so that she
could die peacefully, stating that it would have been against Theresa’s wishes and values to
have her life prolonged in a vegetative state with no hope of recovery. Since The
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