Throughout history, the doctor-patient relationship has evolved considerably. Dating back to ancient times, the interaction between doctor and patient began as a purely paternalistic model in that the doctor’s attitude on treatment took precedence over everything else, including the patient’s desires and values. It was not until the late twentieth century that medicine began to utilize a model placing more emphasis on patient autonomy. In order to keep in line with the legal standards of informed consent and medical malpractice, the use of an “informative model” was implemented, turning physicians essentially into technician specialists who are knowledgeable about medicine and treatments. Such a doctor-patient relationship model neglects …show more content…
In today’s medical practice, the doctor-patient relationship predominantly conforms to the “informative model,” in which the physician acts as a glorified technician, providing the patients with all the necessary information on their illness and treatment options, while failing to provide them with any professional advice or analysis on their best possible options. This model, while providing freedom and control over medical decisions, does not constitute true patient autonomy. It is “an oversimplification [of autonomy] to define it as simply permitting a person to select, unrestricted by coercion, ignorance, physical interference, … his or her preferred course of action from a comprehensive list of available options” (Emanuel 85). That is, control over medical decisions alone does not constitute patient autonomy, as frequently, patients in these scenarios cannot make sense of most of the information given to them by their physician, either due to lack of knowledge or the presence of emotional stress. Thus, individuals are left to make decisions regarding their life’s future without truly understanding all the options. The adoption of the deliberative model would not only eliminate this issue completely, but would also prompt improved prognosis of patients, as physicians would be allowed the right to guide …show more content…
With the domination of the informative model seen throughout today’s medical practices, many physicians lack the capacity to articulate and persuade patients of the values underlying their treatment recommendations and are thus demoted to serving as “information machines.” Implementation of the deliberative model in medicine would serve as an effective means of encouraging a more caring approach, in that physicians would “cultivate a partnership with the patient and together, negotiate a management plan which allows for physician’s professional recommendations and for patient’s ideas, concerns and expectations” (Chin 154). Rather than utilizing a model in which there is typically poor understanding of one another’s goals and values, the mutual approach to treatment seen in the deliberative model would facilitate trust, as well as understanding, in the doctor-patient
Alan Goldman argues that medical paternalism is unjustified except in very rare cases. He states that disregarding patient autonomy, forcing patients to undergo procedures, and withholding important information regarding diagnoses and medical procedures is morally wrong. Goldman argues that it is more important to allow patients to have the ability to make autonomous decisions with their health and what treatment options if any they want to pursue. He argues that medical professionals must respect patient autonomy regardless of the results that may or may not be beneficial to a patient’s health. I will both offer an objection and support Goldman’s argument. I will
According to Terrence F. Ackerman, as of the 1980s the American Medical Association had to include the respect for a person’s autonomy as a principle of medical ethics (Ackerman 14, 1982). This includes having the physician provide all the medical information to the patient even if the information could cause negative implication onto the patient. The physician is also expected to withhold all information of the patient from 3rd parties (Ackerman 14, 1982). Although it is seen as standard in today’s world, in
In this context, new emphasis is being placed on the rights of patients. Recent federal legislation, for example, requires all health care facilities receiving Medicare or Medicaid monies to inform patients of their right to make medical treatment decisions. This includes the right to specify "advance directives," [1] which state what patients wish to be done in case they are no longer able to communicate adequately.
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?
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.
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 ...
This essay will examine truth-telling in terms of patient autonomy verses the physical and psychological harm it could bring, Dealing with a number of key issues that have been identified during my
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
Autonomy is identified as another professional value and one that the nurse must possess. Autonomy is the right to self-determination. Nurse’s respect the patient’s right to make a decision regarding their healthcare. Practical application includes, educating patients and their families on their choices, honoring their right to make their own decision and stay in control of their health, developing care plans in collaboration with the patient (Taylor, C. Lillis, C. LeMone, P. Lynn, P,
Will, J. F. (2011). A brief historical and theoretical perspective on patient autonomy and medical decision making: Part ii: The autonomy model. American College of Chest Physicians 139(6), 1491-1497.
Historically, medical paternalism was once the core ethical principle for physicians to practice medicine. Since the modern times, more and more people are getting close attention to patients’ rights when getting medical service, and medical paternalism has gradually aroused controversy. The current argumentation of medical paternalism mainly appears on its justification, with the focus on these two ethical values: respect for autonomy and beneficence. In this paper, I will further defend Alan Goldman’s position that medical paternalism should be refuted in some medical settings, in which the autonomous decisions made by once-competent but current incompetent persons should still be respected. Medical paternalism not only falsely views the
As nurses, it is important that we “be both empowered and competent enablers of patient empowerment.” (Burkhardt & Nathaniel, 2014, p. 493) We take an oath to follow an ethical code which requires us to act as our patient’s advocate while providing safe nursing care. Nevertheless, we cannot make any medical choice or decision on their behalf. We also cannot empower them, “because to do so removes the element of choice.”
Abstract This paper focuses on the legal aspects of communication between the healthcare supplier and the patients and also explores other aspects of communication like consent and the aspects thereof and also discusses the importance of communication in developing better doctor-patient relationship. It also delves into the patients’ rights and discusses theories concerning ways to radically improve communication in healthcare. This paper talks about the potential outcomes of bad, improper or incomplete communication or poor understanding of procedures. It discusses lawsuits filed by patients and complaints from patients, it also focuses on responsibility of information and the adverse effects that might arise from its mishandling Keywords:
There are two essential components that compose the legal right of patient autonomy. The first component involves the patient having the capacity and ability to make a willful decision. The second component involves the autonomous decision itself which relies on independent informed decision making process. The first components is well illustrated by Justice Benjamin Cardozo in the 1914 court case of Scloendorff v. Society of New York Hospital where he stated that “every human being of adult years and sound mind has a right to determine what shall be done with his own body...”. The second component is better illustrated through the process of informed consent as the person who is autonomous may find him or herself constrained from acting freely due to the fact that the physician or hospital didn’t ensure that the patient had adequate comprehension of the information provided.
There will always be a need for healthcare as people are always sick in some way or they are out of balance with their health in some way. There are so many specialty areas in the healthcare field that it allows for a variety of specialists to be apart of a patient’s decision making process. It does pay to be knowledgable. Take the time to read each one of the patient’s rights and under-stand what it means to have a choice.