Patient Participation in Decision-Making

Patient Participation in Decision-Making

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Are decision making of doctors really beneficial for patients? Often patients give up all autonomy for the doctor’s perceived great knowledge of the health services. But as in all humans self-interest almost always clouds one decision on what is best. Terence Ackerman claims noninterference is bad because it does not consider effects of illness of a patient (Degrazia, Mappes, and Ballard 70-140) . Meaning that noninterference in regards to autonomy; makes the doctors job and decision very simple, “let the patient decide.” This is often a tragic case because most patients do not understand the consequences or benefits of a health decision or procedure. Thus why Edmund Pellegrino argues the central paradox in medicine is the tension between self-interest altruism, which means unselfishness (Degrazia, Mappes, and Ballard 70-140). Lying to patients for self-interest is an injustice on all levels and I will prove why.
In a recent and very disturbing case a doctor named Kermit Gosnell was doing abortions. One may ask, well what the big issue is. Yes abortions are a sad but common part of our society. Before I discuss the terms in how the abortions were carried out, I will disclose who he was helping. People in the West Philadelphia are part a very impoverished community. Dr. Gosnell catered to poor, immigrant, and minority women (Walters, and Dale ). So was he being the hero and savior to these women or doing an injustice? Dr. Gosnell’s procedures often consisted of late term abortions, which is after 23 weeks. Dr. Gosnell was performing abortions as late as 7 months. Often the procedure for late abortions is to dismember the body inside the uterus and remove by pieces. Dr. Gosnell was inducing labor and doing what he termed as “snipping.” After the babies were born he would cut open their necks and with scissors cut the spinal cord (Walters, and Dale ). And with Howard Browdy’s transparency model of informed consent there was a huge injustice to the patients. The transparency model consists of the physicians basic thinking is rendered clear or transparent. This is achieved through talking out loud with the patient and in a language or laymen terms for patient understanding. At least two women died from the procedures, while scores more suffered perforated bowels, cervixes, and uteruses.

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Almost none of the sedated patients knew their babies had been delivered alive and then killed. Many were first-time mothers who were told they were 24 weeks pregnant, even if they were much further along
Under Pennsylvania law, abortions are illegal after 24 weeks of pregnancy, or just less than six months, and most doctors won't perform them after 20 weeks because of the risks. Those are acts of a virtuous doctor who puts the patient and well-being first. These are average prices for abortions: Up to 12 weeks LMP- $395; 13 & 14 weeks LMP- $495; 15 & 16 weeks LMP- $650; 17 & 18 weeks LMP- $825; 19 & 20 weeks LMP- $1050; 21 & 22 weeks LMP $1350; 23 weeks LMP - $1750; More than 23 weeks LMP- $2250 ( madison). His prices were not that much different, Dr. Gosnell was saying yes where majority of other doctors would have said no. Gosnell didn't advertise, but word got around. Women came from across the city, state and region for illegal late-term abortions. People knew near and far that if you needed a late-term abortion you could go see Dr. Gosnell, white women from the suburbs were ushered into a separate, slightly cleaner area because Gosnell believed they were more likely to file complaints. They paid $325 for first-trimester abortions and $1,600 to $3,000 for abortions up to 30 weeks. The clinic took in $10,000 to $15,000 a day he made millions since the clinics opening in 1979 (Walters, and Dale).
I am totally against what Dr. Gosnell was performing. Not only was he going against what is the accepted standard for other doctors, he was lying to his patients. I am strong advocate of Roger Higgs who believes lying should be totally a last resort after all alternatives have been sought out (Degrazia, Mappes, and Ballard 70-140). Dr. Gosnell was lying to give comfort to the women there and receive money. On the surface of the women it seemed like a win-win situation, but in reality women were being physically destroyed and swindled. After the abortions they would still suffer from lack of sanitary condition, instruments, and proper procedure. There are few to no supporters of what he has done for so long.



Works Cited

Walters, P. , and M Dale. "DA: West Philadelphia abortion doctor killed 7 babies with scissors." 6 ABC Action News 21 jan 2011. Web. 19 Oct. 2011. .
Madison abortion Clinic
http://www.midwestabortions.com/fees.html
Degrazia, D., T.A. Mappes, and J.B. Ballard. Biomedical Ethics. 7th . New York: McGraw-Hill Higher Education, 2011. 70-140.


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