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Little Falls Hospital Risk Management, Week You Decide

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RISK MANAGEMENT ASSESSMENT OF LYDIA BEVINS

Risk management Assessment of Lydia Bevins

Venkata Pulakanti
HSM 542_W5_You Decide
Keller Graduate School of Management

Risk Management Assessment of Lydia Bevins
Director of Risk Management-

Felicia Larue, CEO for Little Falls Hospital Has brought the Case of Lydia Bevins to my attention to assess and ensure the rights of the patients and the risks that may be associated with Little Falls Hospital are minimal.
Lydia Bevin is a 45 –year-old woman, has been on a ventilator for respiratory assistance for over six months because of an automobile accident. Lydia Bevins is paralyzed and is only able to communicate through head nods. It is uncertain as to whether Lydia Bevin is able and capable of making healthcare decisions on her own. She is married to Harry Bevins for four years. Mr. Bevins requested that the life sustain support keeping Lydia alive to be withdrawn. The Health Care Proxy Law of New York states that Harry Bevins has the “legal right to make decisions on behalf of his wife, since he is her legal guardian and surrogate decision maker.” (Health Care Proxy, 2001). Mr. Bevins states that his decision is made because, he and his wife had discussed this prior to the accident and what she would want to happen. There is an advanced directive: however, Mr. Bevins does not know the whereabouts as Lydia has the advance d directives prior to their marriage. Eileen Redfield, Lydia’s mother wants to give her child every chance she can to live. She believes Lydia could have a chance at recovering from the accident. She thinks ending her life is not the answer. Mrs. Redfield stated that she consulted with a couple of other physicians in which they told her that Lydia might get better and live a better life. I have contacted Mrs. Redfield in order to obtain those physicians names to ensure we have exhausted all possibilities. Dr. Bob Prichard patient’s physician is not sure what advice to give the family about patient’s length of survival. New York’s Family Health Care Decisions making Act (FHCDA) and as mentioned above the New York Health Care Proxy Law need to address in this assessment. In further review of the FHCDA it “allows the family to make decisions for an incapacitated patient, regardless if the patient has either a signed advanced directive and the surrogate decision maker has direct knowledge of the patient’s wishes or will act in the best interest of the patient”. (Swindler, 2010). Due to the fact that Harry Bevins is Lydia’s direct appointed guardian, it allows for him to make the decision to stop life sustaining initiatives. However, Mr. Bevins decision can only be based on a doctor making the decision that Lydia is incapacitated and is unable to make healthcare decisions herself. In order to understand the underlying implications of Lydia’s health care decisions, we need to know what each option is. If Lydia is withdrawn form life support treatment, then the risk for Lydia to die is imminent with no chance of recovery. This would conclude that Lydia’s wishes would be granted and would be kept with State legislation. If this is the option then counseling, physician, hospital staff caring for Lydia and debriefing session with family will need to take place. (Swindler, 2010). Other option is to continue with the treatment for Lydia Bevins as suggested by her mother, Eileen Redfield. This does go against Lydia’s wishes as stated by Mr. Bevins. This does give Lydia a chance to possible recovery but will prolong the suffering. Based on the above options it is the Hospital’s recommendation to continue the life support for duration of no more than 3 months and re-evaluate Lydia’s condition with two physician assessments. If after the evaluation there is no improvement then treatment will be withdrawn. Since there is a dispute emerged between husband and mother of Lydia Bevins about withdrawing the life support, hospital’s Ethics review committee should review the case and assess the legal and ethical consequences of each of the alternative actions. It is Little Falls Hospital’s ethical responsibility to ensure that Mr. Bevins clearly understands the decision he is about to make in regards to his wife’s healthcare and that this decision is in the best interest of Lydia Bevins.
References:
Health Care Proxy. Appointing Your Health Care agent in New York State. 2001. Retrieved on august 8, 2015 http://www.health .ny.gov/professionals/patients/health_care_proxy/
Swindler, R.N. (June, 1 2010). New York’s Family Health Care Decision Act. Retrieved on august 8,2015 from NYSBA Health Law Journal I Spring 2010 I Vol.15 I NO.1 http://www. Nysba.org:

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