Paternalism is defined as “The overriding of a person’s actions or decision-making for his own good” (51). This means you are making a decision for another person in order to try and help them. Everyday doctors around the world do everything they can to try and help their patients and do whatever they can to make their lives better and healthier. It is important to allow the patient to decide what they want to do; it is their body they are dealing with. However, sometimes a doctor has to make a decision for their patient in order to protect them from some kind of harm they could end up causing themselves. In medicine, there are many factors that change what a physician will decide to do for a patient. Sometimes, a patient is not capable …show more content…
In this case, it generally is a close family member or healthcare proxy. A proxy is someone who is legally appointed to make decisions on behalf of the patient, when he or she is incapable of making those decisions themselves. In other circumstances, the doctor is the one who has to make these decisions for the patient. When this occurs the doctor is being paternalistic. Some people believe that a doctor being paternalistic is wrong in all cases. I believe in some cases a doctor needs to be paternalistic in order to prevent the patient from doing something harmful to themselves. I think in the case where a physician is trying to prevent the patient from “making irreversible decisions,” or when a physician is trying to prevent the patient from “making decisions under psychological or social pressure.” (71) It is a doctor’s duty to prevent their patient from doing something detrimental to themselves. In the case where a doctor is preventing their patient from “making irreversible decisions,” (71) they could be preventing them from taking addictive drugs or drinking too much alcohol. When a doctor is preventing the patient from “making irreversible decisions” (71) they could be stopping the patient from committing …show more content…
Consent is the process of agreeing to do something. In the medical field, when a patient gives consent they are stating that they allow a doctor to do whatever necessary to help them. There are three types of consent. The three types are, expressed or informed consent, implied consent, and third party consent. Expressed consent is when a patient verbally says to you ‘yes you can do that’. Generally for informed consent, the person is given a paper with an explanation of what is going to be done to them, the outcomes expected, and the risks that are involved. “The “informed-consent form” is a relatively recent development. It lists as many complications as we doctors can think of everything from a mild allergic reaction to death-and, in signing it, you indicate that you have accepted these risks. It has the mark of lawyerdom and bureaucracy, and I doubt that patients feel any better informed after reading it. It does, however, provide an occasion to review the risks involved” (Whose Body is it anyway, 91). This way they know exactly what they are getting into and are able to understand better what can happen. Implied consent is when a patient is unable to tell you yes or no so you assume that if the patient were able to express what they want they would say yes to the procedure. This is used in the case of a patient being unconscious and therefore unable to
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
Competent adults have the legal right to make decisions about their own health care without being challenged by a physician. However, in some instances, those same competent adults cannot make medical decisions for their children without the courts stepping in and overriding the parents’ legal rights. One of the most challenging and complicated task as a parent is to make a medical decision about their child that could mean life or death (The Canadian Bar Association, 2012).
...r away from the thread of paternalism because the doctor is not inclined or able to take advantage of the patient.
Not only do health care providers have an ethical implication to care for patients, they also have a legal obligation and responsibility to care for the patient. According to the Collins English dictionary, a duty of care is ‘the legal obligation to safeguard others from harm while they are in your care, using your services or exposed to your activities’. The legal definition takes it further by making it a requirement that a person act towards others and the public with watchfulness, attention, caution and prudence which a reasonable person in the circumstances would use. If a person’s actions fail to meet the required standard, then the acts are considered negligent (Hill and Hill, 2002). If a professional fails to abide to the standard of practice for their practice in regards to their peers, they leave themselves open to criticisms or claims of breach of duty of care, and possibly negligence. Negligence is comprised of five elements: (1) duty, (2) breach, (3) cause in fact, (4) proximate cause, and (5) harm. Duty is defined as the implied duty to care/provide service, breach is the lack thereof, cause in fact must be proven by plaintiff, proximate cause means that only the harm caused directly causative to the breach itself and not additional causation, and harm is the specific injury resultant from the breach.
Decision-making would be so much easier if we all maintained our autonomy in making the decision, however, because our decisions do not always abide by autonomistic values paternalistic intervention must occur. The purpose of autonomy is to allow us to choose to do things that affect only ourselves and does not negatively affect those around us. Unfortunately, many choices do, whether we know it or not, involve those in our environment. Paternalism is in place to protect the rights that are in our best interest and that will benefit us in the long run. Paternalistic intervention occurs when decisions are no longer in our best interests. If the decision is like to be regretted and irreversible in the future, paternalism is again justified. Autonomy is a fleeting concept, for as soon as someone chooses to do something that will later cause an addiction, his or her autonomy is lost. They no longer have the decision to do or not to do the action; it becomes a need.
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? And if so, is the paternalistic intervention justified? Part of the concern
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 ...
Health professionals are constantly working on improvements because of ethical concerns that they face in their everyday lives. The relationship between a physician and a patient is often seen as a relationship with no errors or ethical concerns but that is not the case. There are constant adjustments that are made to ensure everyone is accounted for and treated in a humane manner. Although the health system focuses on accommodating for everyone, there are many times that adolescents suffer due to their inability to make their own decisions in a health setting. Adolescents do not have the ability to make their own decisions towards their health without parental or guardian consents and many times they also base their final decision on the bias opinions of their physician or parent/guardians. Some important key concepts to understand when analyzing this issue is what paternalism and autonomy means. Autonomy is when a person can freely make their own decisions and paternalism is when someone disregards a person’s decision, and does not allow autonomy (Vaughn,71). It is important to realize that promoting adolescent autonomy at an early age allows adolescents to practice self-care and be well informed about medical procedures (Beacham & Deatrick, 2013). In order to prevent these issues from
In the face of the threat of euthanasia, does the patient have the right to the final word? What are his rights in the area of medical care? This essay will explore this question, and provide case histories to exemplify these rights in action.
A patient’s spouse or other family members have no right to override the patient’s decisions or their doctor’s understanding of them. Though, the patient’s doctor does have the right to overrule their living will. For example, if a patient’s doctor believes that going along with their wishes in spite of their living will, will harm someone else like an unborn child in a mother’s womb, he can overrule it. Circumstances defined in a person’s living will may not always concur some situations. When this happens, the patient’s medical care team will make a decision based on the “spirit” of the living will to be careful, and will contact anyone named in the patient’s living will along with their primary care doctor or clergy in attempt to spell out the patient’s desires since they are not able to overrule the living will. Clearly, when everyone involved are in agreement with the patient’s requests, the situation is made much easier. Legal and ethical dilemmas are possibly created if everyone involved is not supportive. A patient should review his or her living will every year due to advancements in science and medical treatments that may affect them in the future along with the possibility of their feelings changing, based on many factors and laws that may change over the years. There are three different types of living wills a person can make. One is a statement made by a person diagnosed with a terminal condition before any deterioration and after all medical measures have been exhausted. Another is a statement made by a person of good health and quality of life that is written prior to becoming ill. The third is a statement of issues surrounding a patient’s religious convictions which could include their spouse, stepchildren, adopted...
Roger Higgs, in “On Telling Patients the Truth” supplies commonly used arguments for paternalistic deception. For the purposes of this paper, paternalism will be defined as, “interference with one’s autonomy or self determination for their own good.” The first argument for paternalistic deception is founded on the idea that medicine is a technical subject where there are very few guarantees (613). Thus, Higgs supplies the argument that not only is it impossible for a patient to understand the true breadth of their diagnosis and prognosis, but additionally that medical predictions are not medical truths. The second argument for paternalistic deception comes from the belief that patients do not actually want to know the truth about their condition, and could suffer from worse health outcomes if they are told the truth (614, 615).
As a future physical therapist, I believe that practicing a certain degree of paternalism is necessary. The degree how much I practice paternalism will depend on my future work setting. If I happen to be in an outpatient setting, then I can be a educator and therapist to my patients, and help them to achieve whatever goal they want to achieve while maximizing the regaining of their physical functionality. But if I happen to be in an facility where I have to treat mentally challenged people, then practicing paternalism with a strong sense of beneficence will be the best option I have. Patneralism is necessary in physical therapy, but it will not do harm to both patients and therapists if it being practiced with good intentions for the patients and wisdom.
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
Informed consent is a very serious decision a patient has to make when it comes to their health and consenting to procedures that are believed to cure or treat their current health status. It is important to address the effectiveness of the role a physician play in the informed consent process assuring that the patient has given truly informed consent and what safeguards can be put in place to assure the patient is exercising informed consent. Informed consent is based on the fact that the person consenting is a rational individual that is aware of the action to which he/she is consenting. Allen and McNamara (2011) notes that "On the standard understanding, the important elements of informed consent are the provision of information, the voluntariness of the choice and the competence of the chooser to make the choice— so the potential research participant should be provided with information relevant to the decision to participate, they should be able to choose freely about their participation and they should be competent to decide.
Patients’ have the right to know all details related to the service or treatment that will be provided and the right to refuse any such service or treatment before it happens. This informed consent will communicate exact procedure details, pain intensity and or disability period encountered, risk involvement, and any alternative methods of treatment and its risks. A patient will receive a concurrence...