Tonya Archer Case Study: End-of-Life Ethics Paper Guide

This assessment asks you to take a position and defend it four different ways, which is why it cannot be answered by summarising the case. The central question is blunt: should the hospital continue life support because Tonya's parents want it, when the medical evidence points to brain death? Answer that in a sentence, early, and then spend the paper justifying it — first through ethical principles and a moral theory, then through your professional code, then through a named hospital's mission and values, and finally through the position an accrediting body would take. Those four are the scoring guide criteria written as questions, and a paper that argues brilliantly from principle while never mentioning the Joint Commission has left a competency unaddressed. Decide your answer before you start drafting, because the four supports have to converge on one position and it is very hard to reverse-engineer them onto a conclusion you reached halfway through.

The end-of-life issue here is more specific than "end-of-life issues," and naming it precisely is most of the analysis. This is not a withdrawal-of-treatment case in the ordinary sense, because a determination of brain death is a determination that the patient has died — not a judgement that further treatment would be futile for a living patient. Those two are ethically different and the paper should say so. If death has been declared by neurological criteria, the question is not whether to withdraw care but whether the hospital may continue physiological support on a deceased person at a family's request, and for how long. If instead you read the case as a futility dispute, say that too, and defend the reading. Whichever line you take, the distinction between brain death and futility is the single piece of conceptual work that separates a strong paper from a sympathetic one.

Principles and moral theory are asked for separately and they are not the same thing. The principles are the familiar four — autonomy, beneficence, non-maleficence, justice — and the case pulls them apart: whose autonomy, when the patient cannot exercise it and the parents are speaking in her stead? Does continuing support benefit anyone, and does it harm the family, the staff, or other patients waiting on the bed? Justice is genuinely live here because intensive care is finite. Then the moral theory — consequentialist, deontological, virtue-based, or a care ethic — is the framework that tells you how to break the tie when the principles conflict. Name yours and use it, rather than listing all four and choosing none. The scoring guide asks you to apply the theory to a specific case, so the test is whether your chosen framework actually produces your conclusion rather than decorating it.

The professional code section has a trap built into it, and the brief flags the trap itself. You are asked whether your code supports your view, and explicitly invited to say what your code *gets wrong* about a case like this if it does not. That permission is worth taking. Identify the code for your own specialty, quote the provisions that bear on this case — dignity at end of life, advocacy for the patient, the duty to the patient rather than to the family — and be honest where it is silent or ambiguous. The preparation questions push in the same direction by asking whether your code distinguishes the legal from the ethical. It usually does, and this case is precisely where that distinction bites. A paper that finds its code conveniently endorses everything the writer already believed is a paper that has not read the code closely enough.

The two institutional sections are where this assessment differs from every other ethics paper you have written, so do not rush them. You are asked to name a real hospital and locate its actual mission, vision and values statement, then test your position against it. That means quoting the statement and reasoning from its wording — a hospital whose values lead with compassion and family-centred care supports a different answer from one that leads with stewardship and evidence-based practice, and pointing that out is the analysis. The accrediting body question then asks what the Joint Commission would say, which turns on its standards for ethics, rights and responsibilities, and its expectation that a hospital has a functioning conflict-resolution process. Naming a real institution and a real standard is what pulls the paper out of the abstract, and it is also the part that cannot be written without doing the independent research the brief asks for.

The mechanics are tight and stated: two to three double-spaced pages, Times New Roman 12 point, current APA formatting for citations and references. Two pages across four required supports means roughly half a page each once you have stated your position, so there is no room for a long recitation of the case facts — assume the reader knows the case. The scoring guide also asks for validation through relevant examples and supporting evidence in APA citations, which means the hospital statement and the accrediting standard need to be cited as sources, not paraphrased from memory. Write the position sentence first, build the four supports under it, and cut the narrative summary last. Check each competency against your draft by name before submitting, since this assessment is marked criterion by criterion and an unaddressed competency costs more than a weak one.