One can say that a person’s autonomy is proof enough to decide if they choose to discontinue life saving treatment. Be that as it may, when can a medical professional decide to ignore the patient’s request? To answer this question I will be using the principlist method argue when it is necessary for a medical professional to do what is in the best interest of the patient, even if it means violating their autonomy. Autonomy, or respecting one’s actions or choices, is one of the four main principles of morality. Autonomy is a major component of informed consent and to give consent is to be competent. Thus, I will be providing information of what it means to be competent. The second principle of morality is beneficence or the obligation to help …show more content…
He has just been diagnosed with depression and given antidepressants. Before his medications could take effect George has a heart attack. His heart and kidney are affected so that blood cannot be pumped to his kidneys. He is put on renal dialysis until he could recover. But it is not clear if the treatment will prove effective. George, unable to endure the reality of his illness and other detrimental issues, requests to discontinue treatment and be allowed to die. Respecting a person’s sovereignty is essential when working in the medical field. The “rules” of upholding one’s autonomy is to respect the privacy of others, to not lie, to maintain confidentiality, to obtain consent, and to advise one when needed. Physicians should dismiss a person lacking the capacity to make decisions for themselves however it will defy the “ to obtain consent” and “to respect the privacy of others” …show more content…
The patient is lethargic, but has trouble sleeping which can impose serious psychological issues. Before having a heart attack and being put on dialysis, he spoke of “ending it all”. All of these factors prove that George’s competency should be questioned. In order to give informed consent the patient must be competent, a standard for concurrence. Therefore, he cannot approve of treatment if he is lacking decision-making capacity. Since the patient is not able to give informed consent it should be noted that George’s spouse should be the one to determine the best course of action. It would be up to his wife, Helen, to decide what should be done about continuing or discontinuing treatment. If she decides to respect George’s wishes, then treatment will cease. But the renal dialysis will resume if she chooses to ignore George’s request. This is only true if George is unable to achieve competency, such as treating his depression and then reevaluating if he still believes he should no longer be treated with renal dialysis to end his
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 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
The ethical principle of nonmaleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with nonmaleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, suffering of the patient and family would be evident. Autonomy is the right to making own decisions and freedom to choose a plan of action. When making decisions regarding treatment of another person, it is important to respect the expressed wishes of the individual. John says that his mother would want to live as long as she could, but questions arise related to her quality of life and perception of prolonged suffering by prolonging the dying process. In BOOK states that quality of life changes throughout one’s life ...
Patient autonomy was the predominant concern during the time of publication of both Ezekiel and Linda Emanuel, and Edmund D. Pellegrino and David C. Thomasma's texts. During that time, the paternalistic model, in which a doctor uses their skills to understand the disease and choose a best course of action for the patient to take, had been replaced by the informative model, one which centered around patient autonomy. The latter model featured a relationship where the control over medical decisions was solely given to the patient and the doctor was reduced to a technical expert. Pellegrino and Thomasma and the Emanuel’s found that the shift from one extreme, the paternalistic model, to the other, the informative model, did not adequately move towards an ideal model. The problem with the informative model, according to the Emanuel’s, is that the autonomy described is simple, which means the model “presupposes that p...
This freedom of choice, Gawande states, ultimately places a burden on either the doctor or the patient as the patient ultimately choose a course of treatment that is ultimately detrimental as in the case of Lazaroff, a patient with only a few weeks to live, but rather insist on “the day he would go back to work.” Despite the terrible risks and the limited potential benefits the neurosurgeon described, Lazaroff continued to opt to surgery and eventually died painfully as a result of surgery. Gawande suggests that Lazaroff “chose badly because his choice ran against his deepest interests,” which was to live despite his briefing remaining time, ultimately distorting his judgement into choosing a course of treatment that ultimately ended his life in a much more painful manner. Another case of patient decisions that Gawande discusses is Mr. Howe, who aggressively refused to be put on a breathing machine, neglecting the fact that “with antibiotics and some high-tech support...he would recover fully.” As Gawande and K awaited for Mrs. Howe’s decision to save her husband’s life, Mrs. Howe emotionally breaks down
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.
...d how these determinations effect a physician’s approach to various types of critically ill patients? These types of questions come in to play when one attempts to critically analyze the differences between the types of terminally ill patients and the subtle ethical/legal nuances between withholding and withdrawing treatment. According to a review by Larry Gostin and Robert Weir about Nancy Cruzan, “…courts examine the physician’s respect for the desires of the patient and the level of care administered. A rule forbidding physicians from discontinuing a treatment that could have been withheld initially will discourage doctors from attempting certain types of care and force them prematurely to allow a patient to die. Physicians must be free to exercise their best professional judgment, especially when facing the sensitive question of whether to administer treatment.”
Many people are afraid to make decisions concerning their wishes when they die. This includes fear of making wills and making critical decisions that affect lives of others when they are not there. When the patients are terminally ill, they become incapable of making these decisions and they are often assisted or directed by some external forces to make these decisions. This paper exploits options and conditions of different terminally ill patients with a keen look at their mental and health status. It is also going to explore on those patients with DNR (Do not Resuscitate) orders and advance directives.
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
Powell and Lowenstein address many key issues about the refusal of life-saving treatments. They go into depth about what falls into this category of “life-saving treatments,” such as people refusing nutrition and hydration while they have a long life ahead of them with full cognitive ability. They aim to answer questions about whether doctors should allow patients to autonomously make these decisions as well as if the doctors have a duty to follow the patient's wishes. They also discuss the differences in cases with disabilities, chronic diseases, and other health problems along with where to draw the line about patient decisions. Not all of these decisions are the same and deeper understanding of the reasons behind the refusal need to be
The medical Profession recognizes that patients have a number of basic rights. These include but are not limited to the following: the right to reasonable response to his or her requests and need and needs for treatment within the hospital's capacity. The right to considerate, respectful care focused on the patient's individual needs. The right of the patient to make health care decisions, including the right to refuse treatment. The right to formulate advance directives. The right to be provided with information regarding treatment that enables the patient to make treatment decisions that reflect his or her wishes. The right to be provided upon admission to a health care facility with information about the health care provider's policies regarding advance directives, patient rights, and patient complaints. The right to participate in ethical decision making that may arise in the course of treatment. The right to be notified of any medical research or educational projects that may affect the patient's care. The right to privacy and confid...
Personal autonomy refers to the capacity to think, decide and act on one's own free initiative (Patient confidentiality & divulging patient information to third parties, 1996). For a patient’s choice to be an autonomous choice, the patient must make his choice voluntarily (free of controlling constraints), his choice must be adequately informed, and the patient must have decision-making capacity (he must be competent) (Paola, 2010), therefore Physicians and family members should help the patient come to his own decision by providing full information; they should also uphold a competent, adult patient's decision, even if it appears medically wrong (Patient confidentiality & divulging patient information to third parties, 1996).
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
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 this diverse society we are confronted everyday with so many ethical choices in provision of healthcare for individuals. It becomes very difficult to find a guideline that would include a border perspective which might include individual’s beliefs and preference across the world. Due to these controversies, the four principles in biomedical ethic which includes autonomy, beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and acceptable. These principles are not only used to protect the rights of a patient but also the physician from being violated.