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Essay of informed consent
Patients informed consent
The concept of consent arises from the ethical principle of patient autonomy[1] and basic human rights.[2
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In the medical field today, whenever a procedure is going to be done on a patient, informed consent must be given to the doctor from the patient prior the procedure taking place. Informed consent is the approval given by the patient to the doctor for treatment. In the case being discussed today, an 80 year old patient, with a history of congestive heart failure, is in the doctor's office complaining of chest pains. After an examination, the doctor believes the best course of treatment would be to have a surgical procedure, in an attempt to save the patients life. During the examination however, the patient expresses the wish to just be able to die. There is no Living will or Do Not Resuscitate (DNR) on file. The patient’s wife is afraid of the surgery, while the daughter is for anything that could save her dads life.
The first thing that needs to take place in this situation is the determination of the competency of the patient. By using the Understand-and-Appreciate method of determining competency, if the patient understands the situation and all the options that are available to him; but also appreciates the options and understand the side effect of treatment or lack there of treatment , the patient is deemed confident. On the flip side, if the patient’s requests fall too far outside the realm of what would be considered normal, that could help in determining whether or not to override the patient’s wishes due to no longer being considered competent. It is the belief that “it is ethically justified to overrule the seriously irrational decision of a competent patient.” (Fredrick Adolf Paola, 2010)
Under the assumption that during the last five years of treating Patient X for congestive heart failure, he never men...
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...rd battle to fight at times. The reasoning behind the refusal may not make sense to everyone, but as long as the patient has been deemed competent, the patients’ right to choose their own medical care becomes number one priority. If, on the other hand, circumstances have found the patient not competent, moving forward to acquire consent from the next of kin of the court appointed surrogate of care is a must to ensure the patient receives the best medical care possible and results in an improved quality care of life for the patient.
Works Cited
Competency to make medical decisons. (n.d.). Retrieved 07 03, 2011, from Stanford. Edu: http://www.stanford.edu/group/psylawseminar/Competency.htm
Fredrick Adolf Paola, R. W. (2010). medical Ethics and Humanities. Juonesd and Bartlett Publiushers.
Lecture notes for HLT-305. (2011, 07 03). State University .
Thank you for contacting the Ethics Committee regarding Mrs. Mitsue Takahashi’s healthcare plans. As you are aware, 83 year old Mrs. Takahashi was recently admitted to the hospital immediately following a stroke. Through looking at her past medical history and running various tests, it was apparent that she suffers from several serious medical complications. Notably, she suffers from dementia which makes it impossible for her to make autonomous decisions concerning her healthcare. Despite poor prognoses from neurology, cardiology, and psychiatry consultations, the patient’s two grandchildren disagree over the next step in their grandmother’s healthcare. You have recommended to the family to have a DNR order written, withhold aggressive cardiac
Social Attitudes Survey noted that 78% of respondents believe that “the law should require doctors to carry out the instructions of a Living Will” (Park et al, 2007). These decisions become important once patients lose their mental capacity, are unconscious, or unable to communicate” (BMA, 2009). The Mental Capacity Act 2005 defines an “advance decision” as a decision made by a person 18 or over, when he or she has the capacity to do so. The implications of a Living Will, make the case against legalising assisted dying weaker. This is because if a person is legally allowed to set out which treatments they will or will not agree to, and can refuse life sustaining treatments by creating a legal document, then why shouldn’t an individual in extreme pain who is able to make the request at the time be able to ask for assistance in
In America, the legal age to sign off on any medical consent is 18 years of age. Seventeen year olds should be able to compose their own medical decisions, and sign off on their own medical consents. Power should land in their hands, accompanied by the professional advice of a doctor. It is your body, be compelled to fabricate a decision without having to have your parent’s signature.
Patients are ultimately responsible for their own health and wellbeing and should be held responsible for the consequences of their decisions and actions. All people have the right to refuse treatment even where refusal may result in harm to themselves or in their own death and providers are legally bound to respect their decision. If patients cannot decide for themselves, but have previously decided to refuse treatment while still competent, their decision is legally binding. Where a patient's views are not known, the doctor has a responsibility to make a decision, but should consult other healthcare professionals and people close to the patient.
...for an aid-in-dying drug, shall submit two oral requests, a minimum of 15 days apart, and a written request to his or her attending physician. The attending physician shall directly, and not through a designee, receive all three requests required pursuant to this section. Some people will struggle with conflicting ethical theories such as the Divine Command Theory which states that the morally right action is the one that God commands. Or others may struggle with their view of Natural Law which states the morally right action is the one that follows the dictates of nature. These are all valid and acceptable ethical standpoints, however, no one knows what they would do being faced with a short determined future of pain and decline. Ethical Egoism is the one theory a true decision would come down to, what’s the best action that provides one with the best self-interest.
When patients suffering from serious health conditions are towards the end of their lives, they are given an option that can change their lives and the lives of those around them. This option is praised as an act of preserving dignity, but also condemned as an act of weakness. The terminally ill, as well as the disabled and the elderly, are given the choice to end their lives by the method of suicide involving the assistance of a physician. For several years, this method has been under debate on whether this option is ethical or unethical. Not only is this defective option unethical, but it puts ill and elderly patients under pressures that can lead to them choosing this alternative rather than the fighting for their lives.
...ns. Patients should not be so medically ill that they are unable to make this decision. Patients should be fully conscious and understand the implications of their decision. Everything should be documented possibly even videotaped that way the doctor doesn’t lose their job, receive a lawsuit or worst jail!
The Patient Self-Determination Act (PSDA) was implemented to allow patients to state “Do Not Resuscitate” (DNS), or to assign a surrogate decision maker in the event the individual is unable to make the decision. Closed cardiac massage was introduced in 1960 and still the health care provider operated in fear on who to actively resuscitate and they would sluggishly respond on patients who may not benefit based on extent of illness (Ball, 2009). The care providers operated in fear of litigation depending on the family’s response but was fairly relieved by introduction of the Patient Self-Determination Act (PSDA).
There is great debate in this country and worldwide over whether or not terminally ill patients who are experiencing great suffering should have the right to choose death. A deep divide amongst the American public exists on the issue. It is extremely important to reach an ethical decision on whether or not terminally ill patients have this right to choose death, since many may be needlessly suffering, if an ethical solution exists.
It is important that patients and family members understand the conditions under which the patient is suffering from. People have an obligation of preparing themselves for end of live. This can be done by writing a will or an Advance Directive to guide the medical personnel and family members on what the patient wants. It can also be done by assigning a medical care proxy to decide on the patients behalf (Groopman and Hartzband, 2011). Medical personnel need to consider the patients wish and act as per the law when deciding on end-life options. Most of the decisions made by terminally ill patients are biased and compromised.
Some laws allow patients to choose whether they want to choose death or choose to stay on life support. In the Right-to-Die prin...
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
According to the NICE (2015) health and social care professionals should always seek valid consent from people with dementia. This should entail informing the person of options, and checking that he or she understands, that there is no coercion and that he or she continues to consent over time. If the person lacks the capacity to make a decision, the provisions of the Mental Capacity Act 2005 must be followed. The nurse assessed the patient capacity and ensured that the decision made was in the best interest of the patient. The doctor uses specialist knowledge and experience and clinical judgement, and the patient’s views and understanding of their condition, to identify which investigations or treatments are likely to result in overall benefit for the patient (GMC, 2008). They took into consideration how the decision made will benefit Jean. After carrying out a full assessment, it was clear that Jean lack capacity and was therefore place under the mental capacity act
One of the many concerns is allowing incompetent individuals making this irreversible decision, which is why, “all have agreed that this end-of-life option should apply on to competent individual’s”(113). In addition, people opposed to this method argue that patients demanding this process are suffering from depression and not able to make decisions; yet, Rosenfled explains that practitioners most ensure that patients who consent to this medical intervention do it voluntarily, knowingly and
In the case study, Betty was adamant in refusing treatment, despite the risks of the illness progressing and potentially leading to death; under the laws of the medical treatment act (1988) any adult who exhibits competency has the right to refuse treatment, even if refusal of care increases the risk to their health, this right is based on autonomy (3). The information outlined suggests that Betty was capable of making a decision as she fulfils all the elements of consent; therefore she is competent and has the right to deny treatment. Betty acknowledges the risks of not receiving treatment and admits that not receiving treatment will make it difficult, demonstrating her sound understanding of the risk and benefits of the outcomes. For a patient to fulfil the element of understanding they must receive, process and incorporate the information they are provided with into their own personal values and Betty demonstrates this level of understanding by sticking to her values, her decision to stay home and by acknowledging the difficulties and risks of not receiving treatment (3). Once Betty received a diagnosis she was informed by the paramedic of the outcomes and potential risks of not receiving treatment for her condition, Betty was sufficiently informed with information and risks relevant to her situation, enabling her to make an informed decision (3). In order for consent to be considered voluntary, a patient must consent to treatment in an environment free of threat and pressure; if a patients decision is genuine they will also accept responsibility for the outcomes and understand the risks (3). Voluntary consent is a slightly grey area in Betty’s scenario, her son is potentially placing pressure on Betty with his demands, however, Betty expresses responsibility by admitting it will be difficult to and