| Course | HLTH 3100 Ethical and Legal Issues in Healthcare |
|---|---|
| Week | Week 6 |
| Paper type | Discussion post with two peer replies |
| Length | About 680 words, 4 pages |
| Format | Discussion post, APA 7 citations |
| School | Walden University |
| Program | BS in Healthcare Administration |
| Updated | October 2026 |
Free sample paper for HLTH 3100 Week 6
Week 6 Discussion: Initial Post
When the Daughter Asks for a Feeding Tube and the Father Once Said No Machines: Why His Earlier Words Should Guide the Decision
In the case for this week, Mr. Chen, 79, has had a large stroke and cannot speak or understand what is said to him. His neurologist expects little recovery, and by any accepted test of decision-making capacity he cannot take part in this choice himself (Appelbaum, 2007). His daughter, whom he named as his health care agent, is asking for a feeding tube and full resuscitation. Two years ago, at a primary care visit, Mr. Chen told his physician, who wrote it in the chart, that he would not want "machines or tubes" if he could no longer recognize his family. I side with his earlier words. A surrogate is there to choose what the patient himself would have chosen, and in this case we have unusually specific evidence of what he would have wanted.
When a patient's wishes are known, the surrogate is held to substituted judgment, which means reconstructing his choice rather than substituting her own preferences or her view of what is best for him (Beauchamp & Childress, 2019). Best interest is the fallback when the patient's wishes are unknown. Here they are known, documented and specific to the situation that has occurred. The daughter's role as agent gives her authority to speak for him, but that authority exists to carry his values forward, not to replace them.
The strongest objection. My classmates who disagree have a serious point. Mr. Chen made his statement while healthy, and research suggests that people often underestimate the quality of life they would accept after an illness they have not yet experienced. His daughter knows him now, and maybe she believes he would choose differently. Why should a sentence in a two-year-old chart outweigh his own child's judgment?
My answer. Surrogates, even loving ones, are less accurate than we hope. A systematic review found that surrogates predicted patients' treatment preferences correctly only about two-thirds of the time (Shalowitz et al., 2006). That is not a criticism of the daughter; it reflects how hard it is to separate what we want for someone from what they would want. When the patient left specific words about this exact situation, those words are better evidence than any surrogate's prediction. And the objection about changing preferences cuts both ways: we cannot know he changed his mind, and he never said so. I would ask the daughter what she thinks her father meant, share his words with her gently and help her see that following them is a way of honoring him, not abandoning him.
My position: when a patient's earlier words are specific to the situation, they should guide the surrogate's decision, and the team's job is to help the surrogate carry them out. What evidence would change your mind about Mr. Chen?
Reply to Lauren
Lauren, you argued that the daughter has legal authority as his agent, so the team should follow her. Legal authority matters, and the team should not override her without process. But in most states, state law expects an agent's choices to line up with what the patient is known to have wanted, and the ethical standard points the same way (Beauchamp & Childress, 2019). If she insists on the tube despite his clear words, I think the right step is an ethics consultation, not simply doing what she asks or ignoring her. Would that address your concern about authority?
Reply to Samuel
Samuel, you asked how I can be sure "machines or tubes" includes a feeding tube, since some people mean only ventilators. That is the weakest part of my position, and you are right to press on it. I read "tubes" as including feeding tubes, but the physician's note does not say what he meant. I would want to ask the physician who wrote it whether Mr. Chen gave examples. If the answer is unclear, the earlier words still count, but less than I claimed, and the daughter's knowledge of him matters more. Thank you for that.
References
Appelbaum, P. S. (2007). Assessment of patients' competence to consent to treatment. New England Journal of Medicine, 357(18), 1834-1840. https://doi.org/10.1056/NEJMcp074045
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Shalowitz, D. I., Garrett-Mayer, E., & Wendler, D. (2006). The accuracy of surrogate decision makers: A systematic review. Archives of Internal Medicine, 166(5), 493-497. https://doi.org/10.1001/archinte.166.5.493
The Walden HLTH 3100 Week 6 instructions
Midterm threads on surrogate decisions typically ask you to take a position when a surrogate's request conflicts with a patient's earlier statements. State your side in the first paragraph. Name the decision standard you are applying, such as substituted judgment or best interest, and explain when each applies. Present the strongest objection to your position fairly, not a weak version. Answer it with evidence, for example research on surrogate accuracy, and with reasoning about the patient's specific words. Suggest how the team should approach the surrogate. Fit all of this within the post's length limit. In replies, take legal points seriously, propose processes for disagreement and concede weaknesses when a classmate finds one.
How the HLTH 3100 Week 6 example is put together
The first paragraph sets out Mr. Chen's condition, his daughter's request and his recorded statement, then takes a side. The second explains substituted judgment and the agent's role, citing Beauchamp and Childress and noting he lacks capacity under Appelbaum's tests. The third states the objection that healthy people underestimate later quality of life. The fourth answers with Shalowitz and colleagues on surrogate accuracy, argues that specific words outweigh prediction and suggests sharing his words gently. The highlighted sentence sums up the stance. The reply to Lauren respects the agent's legal authority and proposes an ethics consultation. The reply to Samuel concedes uncertainty about whether tubes included feeding tubes.
Reading the HLTH 3100 Week 6 rubric
Faculty usually reward posts that commit to a position early and defend it against the strongest objection. Surveying both sides without choosing earns less. Credit increases when the writer names the correct decision standard and applies it to the specific facts. Evidence, such as research on surrogate accuracy, strengthens a reply to objections more than repetition does. Faculty value respect for the surrogate as a person and attention to process when disagreement persists. Conceding a real weakness in a reply shows intellectual honesty and often earns explicit credit. Staying within the length limit, writing clearly and citing sources in APA style complete the expectations. Posts that name what evidence would change the writer's mind also tend to stand out, because they show the position is held for reasons.
Common HLTH 3100 Week 6 mistakes, and how to avoid them
Surrogate posts often say the family should decide because they know the patient best, without asking which standard applies. Others dismiss the surrogate's view without acknowledging her authority or grief. Some never consider whether the patient's words were specific enough to apply. Decide your position first, then write the best objection you can and answer it. Check whether the patient's words describe the situation that has actually occurred. Suggest how to talk with the family, not just what the answer is. Our writers can draft a midterm post for this course that takes a clear position on a surrogate case and answers the strongest objection.
Get a HLTH 3100 Week 6 example written to your instructions
A free initial post and two replies for HLTH 3100 Week 6 come back within 24-48h of the thread prompt and rubric arriving. Reply-day rules and citation minimums vary by classroom, so those get copied from your instructions, and the post argues the side you name or the better supported one when you name none.
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HLTH 3100 Week 6 questions, answered
Where can I find a free HLTH 3100 Week 6 sample paper?
The post on Mr. Chen's case and both replies are reproduced here and can be read by anyone without charge.
Which side does the HLTH 3100 Week 6 post take?
It sides with Mr. Chen's earlier words, because under substituted judgment the surrogate should decide as he would have decided.
What is the strongest objection to that position?
That his statement was made while healthy, people often underestimate the quality of life they later accept, and his daughter knows him now.
How does the post answer it?
With research showing surrogates predict patients' preferences correctly only about two-thirds of the time, which makes his specific words better evidence.
What weakness does the writer concede?
That machines or tubes may not clearly include a feeding tube, so the physician who recorded it should be asked what he meant.