The final project for this course is an analysis of the legal and or ethical issues involved in the below health care scenario. See questions to be answered at end of this factual scenario below. I have also provided, after the formatting requirements for the paper, two articles that will aid you in your analyzing the scenario and writing your paper.The two articles to base the analysis of your paper are entitled:This is the final paper for the class and must be doublespaced and be approximately 4-6 pages in 12 point New Times Roman font. Include a cover page [not counted as a page] which should have student name and title of your paper. See more formatting requirements later in these paper instructions.NOTE: For this paper it is unnecessary to do any research beyond the two articles I furnished with this assignment. Both are after the specific paper requirements. You may use all the articles in the class also. To do internet research would only be wasting your valuable time.A 72 year old woman was admitted to the Neurological Intensive Care Unit following a cerebral hemorrhage which left her with severe brain damage and ventilator dependent. One year before this event, the patient and her husband had drawn up living wills with an attorney. She was diagnosed by her treating physician as being in a permanent unconscious condition. The patients living will specified that the patient did not want ventilator support or other artificial life support in the event of a permanent unconscious condition or terminal condition.The patients husband is her legal next of kin and the person with surrogate decision-making authority. When the living will was discussed with him, he insisted that the patient had not intended for the document to be used in a situation like the present one. Further discussion with him revealed that he understood that the patient would not be able to recover any meaningful brain function but he argued that the living will did not apply because her condition was not imminently terminal. He further indicated that he did not consider his wife to be in a permanent unconscious condition. The immediate family members (the couples adult children) disagreed with their fathers refusal to withdraw life support.The treatment team allowed a week to pass to allow the husband more time to be supported in his grief and to appreciate the gravity of his wifes situation. Nevertheless, at the end of this time, the husband was unwilling to authorize withdrawal of life support measures consistent with the patients wishes as expressed in her living will. End of scenario.You paper should have 3 major sections. Each is numbered 1, 2 and 3.Must use underlined headings below.Headings will be:[state the issue] then discussion[state the issue] then discussion[state the issue] then discussionFor each legal/ethical issue above discussa. Why each is a legal /ethical issue?b. Discuss each issue in the context of the scenario facts andc. Define the concepts you useMust use underlinedheadings below.Headings will be:[then discussion][then discussion][then discussion]This is an independent paper and you are on the honor system not to discuss or consult with any students or other individuals about this paper.You may use the information we have discussed in the class, the articles in the class, and the two articles I have furnished below. Just so you know, all you need to read to analyze the questions for your paper are the two articles I have furnished with this assignment and information in the class.The paper must be:Paper must be in narrative format not outline or bullets.Grading rubric for assignment is with assignment in Assignments area of class.In the course of practicing medicine, a range of issues may arise that lead to consultation with a medical ethicist, a lawyer, and/or a risk manager. The following discussion will outline key distinctions between these roles.Many health care facilities have in-house or on-call trained ethicists to assist health care practitioners, caregivers and patients with difficult issues arising in medical care, and some facilities have formally constituted institutional ethics committees. In the hospital setting, this ethics consultation or review process dates back to at least 1992 with the formulation of accreditation requirements that mandated that hospitals establish a mechanism to consider clinical ethics issues.Ethics has been described as beginning where the law ends. The moral conscience is a precursor to the development of legal rules for social order. Ethics and law thus share the goal of creating and maintaining social good and have a symbiotic relationship as expressed in this quote:[C]onscience is the guardian in the individual of the rules which the community has evolved for its own preservation.The role of lawyers and risk managers are closely linked in many health care facilities. Indeed, in some hospitals, the administrator with the title of Risk Manager is an attorney with a clinical background. There are, however, important distinctions between law and risk management. Risk management is guided by legal parameters but has a broader institution-specific mission to reduce liability risks. It is not uncommon for a hospital policy to go beyond the minimum requirements set by a legal standard. When legal and risk management issues arise in the delivery of health care, ethics issues may also exist. Similarly, an issue originally identified as falling within the clinical ethics domain may also raise legal and risk management concerns.To better understand the significant overlap among these disciplines in the health care setting, consider the sources of authority and expression for each.Note: If a health care facility is also a religious facility, it may adhere to religious tenets. In general, however, clinical ethics is predominantly a secular professional analytic approach to clinical issues and choices.law, professional standards and individual institutions mission and public relations strategies and is expressed through institutional policies and practices.There are two primary types of potential civil actions against health care providers for injuries resulting from health care: (1, and (2). Medical treatment and malpractice laws are specific to each state.Information that must be conveyed to and consented to by the patient includes: the treatments nature and character and anticipated results, alternative treatments (including non-treatment), and the potential risks and benefits of treatment and alternatives. The information must be presented in a form that the patient can comprehend (i.e., in a language and at a level which the patient can understand) and that the consent must be voluntary given. An injured patient may bring an informed consent action against a provider who fails to obtain the patients informed consent in accordance with state law.From a clinical ethics perspective, informed consent is a communicationand should not simply be treated as a requiredfor the patients signature. Similarly, the legal concept of informed consent refers to a state of mind, i.e., understanding the information provided to make an informed choice. Health care facilities and providers use consent forms to document the communication process. From a providers perspective, a signed consent form can be valuable evidence the communication occurred and legal protection in defending against a patients claim of a lack of informed consent. Initiatives at the federal level (i.e., the Affordable Care Act) and state level (e.g., Revised Code of Washington 7.70.060) reflect approaches that support shared decision-making and the use of patient decision aids in order to ensure the provision of complete information for medical decision-making.Many states measure the providers actions against a national standard of care (rather than a local one) but with accommodation for practice limitations, such as the reasonable availability of medical facilities, services, equipment and the like. States may also apply different standards to specialists and to general practitioners. As an example of a statutory description of the standard of care, Washington State currently specifies that a health care provider must exercise that degree of care, skill, and learning expected of a reasonably prudent health care provider at that time in the profession or class to which he belongs, in the State of Washington, acting in the same or similar circumstances.III.There are a number of common ethical issues that also implicate legal and risk management issues. Briefly discussed below are common issues that concern medical decision-making and provider-patient communication.If a patient is capable of providing informed consent, then the patients choices about treatment, including non-treatment, should be followed. This is an established and enforceable legal standard and also consistent with the ethical principle of respecting the autonomy of the patient. The next two sections (Surrogate decision-making; Advance directives) discuss how this principle is respected from a legal perspective if a patient lacks capacity, temporarily or permanently, to make medical decisions. The third section briefly introduces the issue of provider-patient communication, and highlights a contemporary dilemma raised in decisions regarding the disclosure of medical error to patients.The determination as to whether a patient has theto provide informed consent is generally a professional judgment made and documented by the treating health care provider. The provider can make a determination of temporary or permanent incapacity, and that determination should be linked to a specific decision. The legal term(or) may be used to describe a judicial determination of decision-making capacity. The designation of a specificmay either be authorized by court order or is specified in state statutes.If a court has determined that a patient is incompetent, a health care provider must obtain informed consent from the court-appointed decision-maker. For example, where a guardian has been appointed by the court in a guardianship action, a health care provider would seek the informed consent of the guardian, provided that the relevant court order covers personal or health care decision-making.If, however, a physician determines that a patient lacks the capacity to provide informed consent, for example, due to dementia or lack of consciousness, or because the patient is a minor and the minor is legally proscribed from consenting, then a legally authorized surrogate decision-maker may be able to provide consent on the patients behalf. Most states have specific laws that delineate, in order of priority, who can be a legally authorized surrogate decision-maker for another person. While these laws may vary, they generally assume that legal relatives are the most appropriate surrogate decision-makers. If, however, a patient has previously, while capable of consenting, selected a person to act as her decision-maker and executed a legal document known as aorthen that designated individual should provide informed consent.In Washington State, a statute specifies the order of priority of authorized decision-makers as follows: guardian, holder of durable power of attorney; spouse or state registered partner; adult children; parents; and adult brothers and sisters. If the patient is a minor, other consent provisions may apply, such as: court authorization for a person with whom the child is in out-of-home placement; the person(s) that the childs parent(s) have given a signed authorization to provide consent; or, a competent adult who represents that s/he is a relative responsible for the childs care and signs a sworn declaration stating so. Health care providers are required to make reasonable efforts to locate a person in the highest possible category to provide informed consent. If there are two or more persons in the same category, e.g., adult children, then the medical treatment decision must be unanimous among those persons. A surrogate decision-maker is required to make the choice she believes the patient would have wanted, which may not be the choice the decision-maker would have chosen for herself in the same circumstance. This decision-making standard is known asIf the surrogate is unable to ascertain what the patient would have wanted, then the surrogate may consent to medical treatment or non-treatment based on what is in the patientsLaws on surrogate decision-making are slowly catching up with social changes. Non-married couples (whether heterosexual or same sex) have not traditionally been recognized in state law as legally authorized surrogate decision-makers. This lack of recognition has left providers in a difficult legal position, encouraging them to defer to the decision-making of a distant relative over a spouse-equivalent unless the relative concurs. Washington law, for example, now recognizes spouses and domestic partners registered with the state as having the same priority status.A parent may not be permitted in certain situations to consent to non-treatment of his or her minor child, particularly where the decision would significantly impact and perhaps result in death if the minor child did not receive treatment. Examples include parents who refuse medical treatment on behalf of their minor children because of the parents social or religious views, such as Jehovahs Witnesses and Christian Scientists. The decision-making standard that generally applies to minor patients in such cases is known as thestandard. The substituted judgment standard may not apply because the minor patient never had decision-making capacity and therefore substituted judgment based on the minors informed choices is not able to be determined. It is important to note that minors may have greater authority to direct their own care depending on their age, maturity