Copyright Goodheart-Willcox Co., Inc 30 Unit 1 Foundations of Medical Law and Ethics Similarly, some consider non-malfeasance to be a fundamental prin- ciple, but it can be considered a subset of beneficence. You will notice that ethical rules, while fundamentally focused on the patient, extend to professional conduct with colleagues and others. This particularly applies to truthfulness and conduct required to maintain the integrity of the profession. Professional Codes of Ethics and State Laws Generally, professional ethics apply only to the ethical conduct of mem- bers of a particular profession. However, many professional codes of eth- ics have been included in state law as a means to enforce professional licensing or certification. In addition, these codes are sometimes refer- enced in separate legal actions and litigation in attempts to define stan- dards of care in court actions. For example, the well-publicized case of Terri Schiavo involved administrative hearings, civil litigation, state and federal legislation, and Supreme Court review. Terri Schiavo had been in a “vegetative state” from 1990 to 2005, during which time her husband/conservator wanted to end artificial life support for her (Figure 2.9). The main issues involved in this case were patient ethics and consent. The court had to determine whether statements Terri made earlier in her life about not wanting drawn-out artificial life support should be honored (as requested by her husband) or not (as requested by her parents). This case involved extraordinary publicity, appeals up through the federal courts, denial of review by the Supreme Court, a special act of Congress to keep Terri at least temporarily alive, and special legislation in Florida that was overturned by the Florida Supreme Court. Ultimately, the original Florida District Court finding in favor of the husband’s arguments indicating the patient’s previously expressed opinions was allowed to prevail and life support was removed. Another example involving patient auton- omy was the infamous Jack Kevorkian, a ­ Michigan physician who advocated for and prac- ticed assisted suicide. After five trials involving three acquittals and one mistrial between 1994 and 1999, he was convicted of second-degree murder and sent to prison, where he served eight years of a 10- to 25-year sentence. Although his license had been revoked eight years earlier, Kevorkian claimed he was simply implementing his patient’s wishes. However, he Photographee.eu/Shutterstock.com Figure 2.9 When a patient is in a vegetative state, the topic of artificial life support may cause ethical issues such as patient autonomy and consent.