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Autonomy and patient rights
Importance of consent in health law
Autonomy and patient rights
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Short Essay
As a matter of ethics and the given law, there are controversial aspects outlining the fundamental elements an individual is to consider when making medical decisions. Following the Canadian legal system, adults who understand the consequences of their medical choice have the ability to decline any medical treatments they would like even if it has the ability to save their lives. That is the idea of an individual being a self-proprietor. The Canadian common law acknowledged that an individual has the right to control their body. Tort battery, being when unwanted physical interference takes place without his or her permission has constantly protected bodily security . Physicians frequently encounter the question on whether minors have these rights. There have been many deliberations surrounding the idea of whether children have he ability to consent or decline medical procedures over the objection or approval of the parent. The extent children have to make such decisions is varied from countries around the world with Canada being one of them.
Canadian law has reached the fundamentals outlining that the decision-making capacity in which an adolescent carries is not strictly associated to the age of the individual but more on the maturity that one possess. In 2009, a case took place, A.C. v. Manitoba, which revolved around a fourteen-year-old girl who was hospitalized with Crohn’s disease. She was a Jehovah’s Witness and had signed an advance medical directive stating not to receive any blood transfusions no matter the circumstances . Her condition was very serious and without the blood transfusion she would die. For that reason a judge granted an order for treatment so she was given the blood transfusion pursuant to th...
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...ems to be the most promising solution to promote the perseverance of common pool resources. The solution to the tragedy of the commons mentioned by Garret Hardin being the formation creating common pool resources as private property will not be as promising as the solution provided by Justice Douglas in creating common pool resources as legal persons. There are many concepts discussed that can be used to preserve and regulate nature such as property concepts along with the concepts of the legal person. It is fundamental to believe that nature tends to play a big role in individuals lives even though it may not seem that way. This conclusion is a result of the many cases revolving around this element. Although the solutions to preserve common pool resources have been discussed, it will always be a question as to who or what concept will become dominant in this area.
Jahi McMath is a 13-year-old girl living in Oakland, CA who was declared brain dead by multiple neurologists more than three months ago. Jahi was declared brain-dead December 12th after barriers during surgery a few days earlier to remove her tonsils, adenoids, and uvula at Children's Hospital & Research Center Oakland. At least three neurologists confirmed that Jahi was unable to breathe on her own, had no blood flow to her brain, and had no sign of electrical activity in her brain. Moreover, a court order kept Jahi's body on a ventilator while independent experts could be brought in to confirm the results (Wells, 2014). Even so, the McMath family was able to secure the release of Jahi's body through the county coroner, who issued a death certificate, and have been keeping her on a ventilator at an undisclosed facility ever since. This all occurred after Children’s Hospital released Jahi due to her severe brain damage along with the probability of the hospital receiving profit from discharging Jahi before her or her family were ready for her to be released (Johnson and Rhodes, 2010, p. 61).
In pediatric cases, the parents/guardians are initially given the right to make decisions for their minor
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.
Within public health, the issue of paternalism has become a controversial topic. Questions about the ethics of public health are being asked. The role of ethics in medical practice is now receiving close scrutiny, so it is timely that ethical concepts, such as autonomy and paternalism, be re-examined in their applied context (Med J Aust. 1994). Clinically, patients are treated on a one on one basis, but public health’s obligation is toward the protection and promotion of an entire population’s health. So, based on this difference, the gaping questions targeting public health now becomes, under what conditions is it right to intervene and override an individuals’ autonomy?
In conclusion, every patient is worried about their rights to care but not so much are focused on the rights of the physicians providing the care. It is hard to establish a respectable practice if you are required to perform care for instances in which you object or do not want to be a part of. This detracts from the ethical background of practice and procedure every physician should hold to the highest standard.
Informed consent is the basis for all legal and moral aspects of a patient’s autonomy. Implied consent is when you and your physician interact in which the consent is assumed, such as in a physical exam by your doctor. Written consent is a more extensive form in which it mostly applies when there is testing or experiments involved over a period of time. The long process is making sure the patient properly understands the risk and benefits that could possible happen during and after the treatment. As a physician, he must respect the patient’s autonomy. For a patient to be an autonomous agent, he must have legitimate moral values. The patient has all the rights to his medical health and conditions that arise. When considering informed consent, the patient must be aware and should be able to give a voluntary consent for the treatment and testing without being coerced, even if coercion is very little. Being coerced into giving consent is not voluntary because others people’s opinions account for part of his decision. Prisoners and the poor population are two areas where coercion is found the most when giving consent. Terminally ill patients also give consent in hope of recovering from their illness. Although the possibilities are slim of having a successful recovery, they proceed with the research with the expectation of having a positive outcome. As stated by Raab, “informed consent process flows naturally from the ‘partnership’ between physician and patient” (Raab). Despite the fact that informed consent is supposed to educate the patients, it is now more of an avoidance of liability for physicians (Raab). Although the physician provides adequate information to his patient, how can he ensure that his patient properly ...
I use different strategies when I do clinical decision making especially working with birth to18-years-old, our physical therapy program alone will not provide a good clinical decision making skills. Besides our physical therapy program I take every year continuing education in my field (Pediatric) through online or onsite seminars. I learned a lot now, when compare to the beginning of my physical therapy carrier. Our learning is never going to stop especially in our heath care field and every day we learn something new in our field. When I was in college my principal used to tell us that after we finish our physical therapy program we should work under senior physical therapist for at least two years to gain more experience before working independently. In the beginning, I was not really comfortable working with babies. But now I want to work only with children not adults because I am very comfortable with children after learning them well. I am still learning and getting more experience with children every day. ever before.
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
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
... event arises and it was due to lack of assessment of genuine comprehension. I think the best system of obtain consent would incorporate a regulated system that accommodated each institution and their requirements, but also equally weighed the importance of true understanding of facts and realization of the patient’s capacity to make decisions. But even if this was established as standard practice, there would still be the issue of how the assessment is made and how accurate it is due to other influences i.e. current injury status or medications needed for full psychological and or conceptual functioning. There could also be an issue of how to regulate such a subjective issue; each physician is going to have different ethical views and this will inevitably influence how he/she assess the patient and their ability to make the best decisions concerning their health.
The delivery of healthcare mandates a lot of difficult decision making for healthcare providers as well as patients. For patients, much of the responsibility is left to them especially when serious health problems occur. This responsibility deals with what treatments could be accepted, what treatments could be continued, and what treatments could be stopped. Overall, it considers what route should be taken in regards to the health interests of the patient. However, there are circumstances in which patients cannot decide for themselves or communicate what they want in terms of their healthcare. This is where the ethical issue concerning who should be responsible for making these important healthcare decisions occur if a patient was to be in this sort of situation. Healthcare providers can play a role in the healthcare decision making as their duty is to act in the best interest of the patient.
Advocates of this issue believe that minors should have the right to be in charge of their medical decisions. Dr. Eric Kodish believes that decisions made by teenagers on the older side who are able to make a righteous decision should be carried out. “I think the ethics of modern American life suggest that if people have the capacity to make a decision, they should be free to refuse treatment” (Shute 1). Advocates of minors being able to make their own medical decisions believe that if the minor shows enough maturity understanding of their desired action, then it should be respected and carried out. Dr. Eric Kodish uses what he calls “The Rule of 7s” to determine when a child should be allowed to make the decision.
An example to illustrate this would be the case of Mr DB 25 year old that had a car accident with serious injury that required blood transfusion. He refused the treatment as he was a Jehovah Witness and he was conscious even after the accident. His decision was accepted in respect for his autonomy, however if he was unconscious the healthcare team would normally carry out the blood transfusion as this is classified as an emergency and they would act in his best
The idea of “the child” is constantly evolving, and children appear to be maturing more rapidly each year. As a response, laws pertaining to minors have had to keep up with these social changes. In the health care context, the competency of children is constantly scrutinized and challenged. Accordingly, reforms to past laws that deemed minors lacked decisional capacity have resulted in the “mature minor” doctrine. Although this doctrine allows minors a degree of independence in the decision-making process it maintains many grey areas. The age of consent is inconsistent across provinces and territories, and the guidelines used to assess competence are vague and sometimes arbitrary. With such inconsistency in the measuring of adolescent competence, it brings me to question the competence granted freely to adults. To rightfully judge competence there must be a prototype, something that I and others can form a explicit definition around. With what I have collected, since individuals gain decision-making autonomy when they reach the age of consent, than the defining characteristic of comp...
The state’s common pool resource was and still continues to be water. This delicate resource in the American west is in danger of disappearing, and for the millions of people living in large cities are desperate to continue to use it. But the issue of common pool resources is not one that is recent but is one that has been plaguing California since its founding. When California’s population started to grow around the turn of the twentieth century, the town official within the state started to run into some common pool resource issues, water. Cities, such as San Francisco and Los Angeles, used whatever power they had to own and control what little water the California environment produced. The cities are large and successful municipalities today because of what they had to do to control the water all those years ago. The city used tactics, such as buying out the land, petitioning the government, and, sometimes, illegal actions, to win the waters of California and their success back then highly shows in their success