A Patient's Rights to Refuse Treatment and How it Relates to Learned Helplessness of Individuals
The concept of learned helplessness was first suggested by M. Seligman
an animal psychologist, in 1975. During a series of experiments
involving rats and dogs, he discovered that the animals which had some
control over their environment (in being able to prevent a series of
electric shocks) would always try to avoid the undesirable stimulus;
whereas the animals which had previously had no control over their
environment (and so were unable to prevent the shocks) eventually
became apathetic and would not try to escape the stimulus, even if it
was possible to do so.
It was found that
“Because these animals have learned that nothing they did work, they
did nothing.” [Page 237] (Brannon & Feist, 1992)
The animals concerned had therefore learned to be helpless, but had
also learned to apply this helplessness to other situations, where
there was no perceived controllability.
The concept of learned helplessness has been criticized, however.
Skevington (1995) notes three studies that criticize learned
helplessness, namely Dent & Teasdale (1988), Lewinsohn et al. (1981)
and Skevington (1993). Skevington (1995) states
“All three studies showed little support for the learned helplessness
antecedent hypothesis that depressive attributions precede
depression.” [Page 147] (Skevington, 1995)
With particular regard to the duration of arthritis, Skevington (1995)
maintains that learned helplessness is not a significant feature, a
position she also maintains for chronic low back pain sufferers.
However Skevington (...
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Clifford, C (1985) Helplessness: a concept applied to nursing
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Gross, R. D. (1992) Psychology: the science of mind and behavior, 2nd
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Hinchliff et al. (1993) Nursing practice & health care, 2nd edition,
Edward Arnold, London.
Nichols, K. A. (1984) Psychological Care in Physical Illness, Croom
Helm, Sydney.
Pitts, M & Phillips, K (1991) The Psychology of Health: an
introduction , Routledge, London.
Reich, W (1975) The Mass Psychology of Fascism , Penguin,
Harmondsworth. Translation of Die Massenpsychologie des Faschismus
Skevington, S. M. (1995) Psychology of pain, John Wiley, Chichester.
Weinman, J (1995) “Health Psychology”, in Colman, A. M. (editor),
Controversies In Psychology, Longman, London [Pages 76-92]
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 this paper, I will be arguing a that in the Please Let Me Die case, the patient did not give informed consent to rejecting treatment due to a variety of factors. In summary, the patient was a 25-year-old male named Dax Cowart who suffered severe burns over 65% of his body after a propane gas explosion. He had several fingers amputated and his right eye removed after he was stabilized. He was discharged with minimal use of his hands, totally blind, and needed assistance with daily activities. He asked that treatment be discontinued throughout his hospital stay and rehabilitation, but his request was denied because his physicians deemed him not competent. I believe he was not competent because of his injuries; as is said about many patients
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 ...
The case study addresses the rights of the parents to decline further medical treatment for their son and his rights as the patient to refuse further treatment. The authority to...
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
The concept of autonomy in the medical practice brings many different views. Autonomy is the ability individuals have to be self-governing. In these different views there exist two schools of thought, one is the belief that people are born with the ability to do what they want their body and no organization can tell them what to do with their body, like the government. On the other hand, some people believe that it is more complicated and conditional on mental competency so that person can make rational decisions. However, the majority of people seem to advocate for autonomy. A particular largely uncontroversial discussion arises with the case of Dax Cowart, who had his right to autonomy taken from him in a tragic accident and is therefore, an advocate for autonomy. As an ethics committee, we were to discuss this case in accord with four questions: can Dax Cowart refuse treatment, is no, why. If yes, then when could he be released, and if yes to the first question what would your decision be if Cowart asked for physician assisted suicide. I will be discussing the major points, consensus, and the reasons for the consensus from the committee. In addition, I will summarize the case and state my own opinion.
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.
Though these legislative guidelines deal with the rights of a patient to refuse current medical treatment, ...
There are many ethical issues that arise in the Karen Ann Quinlan case. First, there is the ethical right that each person has to receive or refuse medical treatment. But this can ethically problematic because some would see death as an intrinsic evil; therefore choosing death would be unethical. This, however, can be categorized as part of the larger issue of patient autonomy, the patient's right to live and abide by their own personal choices (Garrett 29). Recent thought has affirmed the idea of patient autonomy in medicine, now making it a central dogma of the American medical practice. In this case, patient autonomy is threatened because the patient is not able to communicate their desires for treatment. The physician cannot ask, and therefore cannot know, if the patient would want to continue treatment or withdraw treatment. In this case, the Karen was deemed incompetent...
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
This paper will address the ethical dilemma of informed consent vs the right to refusal of treatment by the patient. I will show the
In nursing practice any adult consenting to any treatment or procedure must be believed to be mentally capable of making a decision. Consent must be given i...
Professional practitioners need to be competent, their doctoring skills and knowledge must be up to date and maintain a good relationship with their patients and their colleagues. The patients’ rights and declaration civil rights enlists expectations of a professional medical practitioner in the field. To practice professionalism, the medical practitioners have to come to terms with the fact that every individual; race, color, creed, national origin, sex, an honorably discharged veteran, sexual orientation or any physical disability has a right to any medical attention available and should not be discriminated in any way. Matters of concern arise whether we as the professionals really adhere to the set laws protecting rights of patients and their civil rights (Washington State Legislature, 2014) (Washington State Legislature, 2013).
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 ...