Legal & Ethical Implications
Elder Neglect: Legal & Ethical Implications
(Legal & Ethical Implications)
please respond to the two post below(discussion)
Question description
respond to the post below and use scholarly sources as well as the Bible to back your response.
classmate #1- reply to this in at least 260 words(Legal & Ethical Implications)
On January 14, 2005, Shirley P. Correll was accused of murder by purposely neglecting her sick and injured mother; the mother ended up dying because of the lack of care. The court claimed that Ms. Correll was aware that her mother was sick and willfully did not take care of her. Because of the neglect, her mother had serious bodily injury. The defendant claimed that she did not know her mother was sick because there wasn’t enough evidence; she also argued that there isn’t enough evidence as well to prove that she willfully and knowingly neglecting her mothers’ health.
The court decided that there was beyond sufficient evidence. The evidence showed that Ms. Correll was aware of the severe condition of her mother, yet willfully and knowingly decided to neglect her mother and not provide medical treatment for her. Her mother was incapacitated. A medical doctor confirmed that the mother’s undernutrition was very severe and concluded that there was no way that her condition worsened between 2 days. Her mother suffered through malnutrition, yet Ms. Correll failed to seek treatment for her mother; the doctor even instructed Ms. Correll to bring her mother to his office if she experienced any further problems. The doctor concluded that the mother died of pneumonia, which was a predictable consequence of chronic starvation.
Ms. Correll’s punishment was two years in jail but suspended after 30 days in prison. Ms. Correll appealed. The court chose this punishment because I believe they considered this case to be more of a Class 4-6 felony. I agree with the court’s belief that there was sufficient evidence that Ms. Correll was aware of her mother’s health. Her mother, Mrs. Paxton, suffered from her health since the early 1990s. She survived a stroke, her hip bone breaking, early signs of Parkinson’s disease, loss of weight, and bad nutrition. Ms. Correll became her mother’s legal caretaker for a reason. Even Ms. Correll’s estranged sister, Carol Gray, noticed the decline of her mother’s health over time. Back in 2000, Dr. Salama told Ms. Correll for him to have checkups with Mrs. Paxton every 6 months or less. By the time Ms. Correll called for emergency and made an appointment with Dr. Salama, it was basically too late for her mother. I wish that Dr. Salama had home care provided for Mrs. Paxton to receive continual checkups from home, however homecare has been lacking in service and needs to be improved (Mason, 2016).(Legal & Ethical Implications)
As for the punishment of serving 2 years in jail, I believe Ms. Correll should have had a harsher penalty because it was murder. As far back in 1994, the estimated time to be served in prison for murder was 127, or about 10 years (Currie, 1998). Even though 1994 was 11 years before this trial, why change the punishment of 10 years to 2 years for Ms. Correll? That is such a drastic change. Any responsible person [in the state of Virginia] who abuses or neglects an incapacitated adult in violation of this section and the abuse or neglect results in the death of the incapacitated adult is guilty of a Class 3 felony. For Class 3 felonies, a term of imprisonment of not less than five years nor more than 20 years and […] a fine of not more than $100,000 (Code of Virginia, 2004). I don’t agree with the court going against the code.
As the Bible states in Exodus 23:7, “have nothing to do with a false charge and do not put an innocent or honest person to death, for [God] will not acquit the guilty.” Ms. Correll deserved a harsher punishment.
References
Code of Virginia. (2004). Title 18.2. Crimes and Offenses Generally. Retrieved from https://law.lis.virginia.gov/vacode/title18.2/chap…
Currie, E. (1998). Crime and punishment in America. New York, NY: Metropolitan Books.
Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016). Policy & Politics in Nursing and Health Care (7th ed.). St. Louis, MO: Elsevier Inc.
classmate #2- reply in at least in 260 words (Legal & Ethical Implications)
The case of Shirley P. Correll v. Commonwealth of Virginia, 269 Va. 3 is a case from the Virginia Supreme Court. Shirley P. Correll was indicted by a Bedford County grand jury for the murder and felonious abuse or neglect that resulted in serious bodily injury or disease of her incapacitated mother, Nellie S. Paxton. In 1991, Paxton began losing weight, which was attributed to a possible right sided, right hemisphere stroke, per CT. She also reported episodes of confusion six months prior to her visit with Nolan. She was seen by a Neurologist (Dr. Nolan), who then referred her to an Internal Medicine MD due to her physical appearance. Paxton was treated at a hospital for weight loss and anemia, she improved and gained weight.
The following year, Dr. Nolan suggested that Paxton started to show signs of Parkinson’s Disease and experienced hallucinations. Throughout his oversight of the member, Dr. Nolan never addressed Paxton’s nutritional status. Shirley Correll was appointed as Paxton’s legal guardian in 1997. Paxton suffered a fall and sustained a broken hip. Shirley and her sister were educated on the precautions to reduce Paxton’s risk for pneumonia and decubiti. Paxton continued to lose weight between 1997 through February 2000. Dr. Salama (Internal Medicine) diagnosed Paxton with advanced Parkinsonism, multi-infarct dementia, hypertension, atrial fibrillation, osteoarthritis, and early stage decubiti. The decubiti had one stage 2 decubitus (which is a breakdown in the skin layers that could involve the epidermis and dermis) on her lower back. A prescription was prescribed and Correll was informed of Paxton’s treatment plan and the risk for skin breakdown.
Dr. Salama examined Paxton in January 2000 and did not observe any signs or symptoms of malnourishment. An albumin level was taken, which was within normal limits and indicated a “good nutritional status”. A follow up appointment for July 2000 was cancelled. Correll scheduled an appointment with Dr. Salama’s office on September 18, 2000, because she was “very concerned about Paxton’s condition”, so an appointment was scheduled for 2:30pm. Ten minutes after the appointment was made, Correll summoned emergency medical personnel to transport Paxton to the hospital. EMS reported that Paxton was severely dehydrated and unresponsive, only responding to painful stimuli. Paxton’s eyes and cheeks were very sunken, blood pressure and pulse were low, and was said to be “pretty close to going in shock”.
The hospital Nurse indicated that Paxton had a decubitis on her right hip and the information provided by Correll was not consistent with the physical assessment of the member. Dr. Salama cared for Paxton in the hospital and agreed that Paxton’s condition could not have started over the weekend. Paxton suffered from moderate to severe dehydration, stage 3 and early stage 4 decubiti, and bacteremia. Paxton’s albumin level upon admission to the hospital was 2.6. Albumin needs 21 days to make a change, so a couple of days of no water or food would not have this type of effect on the albumin levels. The decubiti were reported to be “black in appearance and had hardened”. Paxton’s oral mucous membranes were dry, and her tongue was cracked. Correll advised to Martha Anderson (geriatric clinical nurse) that she did not know how to use the Duoderm patch correctly. Jones (wound care nurse) advised that nutrition is essential to wound healing and Paxton’s decubiti were preventable. Paxton’s decubiti started to heal after being in the hospital for four days and her nutritional status improved. Paxton was discharged from the hospital to a nursing home, where she could not feed herself. Paxton readmitted to the hospital after three days and expired because of pneumonia.
The evidence of the case established beyond a reasonable doubt that Paxton’s daughter, Correll, knowingly and willfully failed to provide medical treatment to her incapacitated mother. Paxton’s medical condition was explained to her daughter in January 2000 and she was advised to bring Paxton back to the doctor’s office if her condition worsened. Correll failed to seek treatment for Paxton, which ultimately resulted in her death.
I do not totally agree with the court’s decision to hold Paxton’s daughter accountable for the abuse/neglect of her mother because I do not have all of the information available to make that determination of Correll’s mental ability to care for another person. I feel that there was not enough information to determine if Correll was capable of taking care of her mother. The qualifications to be a guardian are very minimal. There is no information on Correll’s mental status and it could have been a situation where she became the legal guardian for financial reasons or because the courts are inundated with legal guardian cases. The quality and content of clinical documentation and evidence of functional deficits for guardianship procedures in the United States is lacking (Moye, Wood, Edelstein, Armesto, Bower, Harrison, & Wood, 2007). The is a need to collaboration between clinical and legal professionals to advance the reform of guardianship across the United States to protect the rights and dignity of the elderly. I also feel that the Physicians that were involved in her care in the community hold some responsibility. Dr. Nolan never thoroughly evaluated Paxton’s nutritional status and only assumed that this is the way she was. Dr. Salama did not perform the necessary assessments to help him discern if there were any social concerns that would place Paxton at risk for abuse. The rationale for Paxton’s weight loss was never evaluated and there was no information given in reference to statements made by Paxton. All healthcare workers are mandated reporters of abuse and neglect. According to Orfila, Coma-Solé, Cabanas, Cegri-Lombardo, Moleras-Serra, & Pujol-Ribera (2018), “The detection of elder mistreatment is emerging as a public health priority; however, abusive behaviors exercised by caregivers are little known and rarely detected among primary health care professionals. The risk factors were there, 82.8% of caregivers are women, access to limited social support, and the recipient of care had known cognitive deficits. The case mentioned that Correll’s sister was estranged from her. There was joint responsibility of the caregiver and the medical professionals in ensuring that Paxton was receiving the care that she needed. Psalm 71:9 states, “Do not cast me off in the time of old age; forsake me not when my strength is spent.” We must be the eyes and the ears of vulnerable people and make sure we do not ignore things that we think are normal.
References:(Legal & Ethical Implications)
Mason, D. J., Gardner, D. B., Outlaw, F.H., & O’Grady, E. T. (2016). Policy & politics in
nursing and health care (Seventh ed.). St. Louis, MO: Elsevier.
Moye, J., Wood, S., Edelstein, B., Armesto, J. C., Bower, E. H., Harrison, J. A., & Wood, E.
(2007). Clinical evidence in guardianship of older adults is inadequate: Findings from a
tri-state study. The Gerontologist, 47(5), 604-612. doi:10.1093/geront/47.5.604
Orfila, F., Coma-Solé, M., Cabanas, M., Cegri-Lombardo, F., Moleras-Serra, A., & Pujol-Ribera,
E. (2018). Family caregiver mistreatment of the elderly: Prevalence of risk and associated
factors. BMC Public Health, 18(1), 167. doi:10.1186/s12889-018-5067-8
PDF: Correll v. Commonwealth, 269 Va. 3
