An Ethical Dilemm The Patient 's Right Care

In his article “Whose Body Is It, Anyway?”—appearing in the New Yorker in October 1994—Dr. Atul Gawande highlights the complexities of the doctor-patient relationship vis-à-vis patient autonomy and decision-making. Dr. Gawande explains that a respect for patient autonomy (i.e., allowing patients to choose between courses of treatment, therefore directly influencing their health outcome) is the “new normal” for medical practitioners. However, Gawande also contends that there are times when patients are better served by a voluntary relinquishment of that autonomy.

Throughout history there has been many ethical dilemmas that have resulted in change, and many that have still not been resolve. These dilemmas often result in controversial issues arising, and both sides of the spectrum arguing as to which proposed idea is the morally correct one. Today, there is an enormous controversy in the ethical dilemma involving child care. This issue revolves around whether the views of the parents should be upheld when their child is in danger medically. To further assess the impact of this ethical dilemmas, a case study involving the treatment implemented on a child by a physician while opposing the views and wishes held by the parents will be analyzed in terms of the ethics of the situation, the stakeholders, values,

The issues of physician-assisted suicide (PAS) are both emotional and controversial. Some argue PAS is ethically permissible for a dying person who has chosen to escape unbearable suffering at the end of life; it is the physician’s duty to alleviate the patient’s suffering and justifies aid-in-dying. These arguments rely on the respect for individual autonomy. “Individual autonomy is an idea that is generally understood to refer to the capacity to be one's own person, to live one's life according to reasons and motives that are taken as one's own and not the product of manipulative or distorting external forces.” (STANDFORD REF)

Patient Self-Determination Act (PSDA) passed in 1990, it encourages all people to make advances choices about their future medical care should they become unable to make those decisions in the future due to medical incapacity. PSDA did not create a new right for people but holds care facilities accountable for allowing patients their rights of self-determination covered in the fourteenth amendment. (GAPNA, 2014)

The healthcare system is complex with nearly every decision made posing an ethical dilemma for patients, providers, and healthcare leaders. With an influx of new medical knowledge from evidence based practices and new technologies more decisions are being made available to patients and families. Terminally ill patients for instance are faced with numerous options when it comes to treatment including whether or not they end their life by terminating treatment altogether or seek controversial options such as Physician’s Assisted Suicide. The topic of Physician’s Assisted Suicide or (PAS) is very intricate with numerous pros and cons, moral ethics, and ways to address the issue within the healthcare practice.

The Patient Self-determination Act became effective in 1991, raising legal, moral, and ethical issues in healthcare (Shapiro &Bowles, 2002). The Patient Self-Determination Act (PSDA) is a federal law, and compliance is mandatory, the purpose of this act to ensure that a patient's right to self-determination in health care decisions be communicated and protected (Kelley, 1995). PSDA was put in place to inform patients that they have the right to refuse or accept medical treatment and that information is provided to patients regarding advance directives, so patients are able to make their own medical decisions

In today’s society, suicide, and more controversially, physician assisted suicide, is a hotly debated topic amongst both every day citizens and members of the medical community. The controversial nature of the subject opens up the conversation to scrutinizing the ethics involved. Who can draw the line between morality and immorality on such a delicate subject, between lessening the suffering of a loved one and murder? Is there a moral dissimilarity between letting someone die under your care and killing them? Assuming that PAS suicide is legal under certain circumstances, how stringent need be these circumstances? The patient must be terminally ill to qualify for voluntary physician-assisted suicide, but in the eyes of the non-terminal patients with no physical means to end their life, the ending of their pain through PAS may be worth their death; at what point is the medical staff disregarding a patient’s autonomy? Due to the variability of answers to these questions, the debate over physician-assisted suicide is far from over. However, real life occurrences happen every day outside the realm of debate and rhetoric, and decisions need to be made.

For example, the withdrawal of fluids and nutrition from a dying patient, when does a healthcare professional determine the provision of fluids and nutrition serves no medical purpose in sustaining life and human care (Furlong, B., & Morrison, E. E. 2014, p. 173)? From a clinical standpoint, it is not ethical to withhold life-sustaining treatment, but, is it the “right choice and decision. Does this decision impede on the patient’s bodily integrity, self-determination, and autonomy? From an institutional standpoint, society views healthcare professionals as responsible care givers, and they sustain life, not take away. This is conflicting because does withholding life-sustaining treatment, help or harm the patient? Healthcare professionals are morally obligated to help other, do good, and do no harm. But, in this situation of withdrawing fluids and nutrition from a dying patient, this question is asked “how, clinically, does withdrawing nutrition and hydration benefit a patient and avoids doing harm (Furlong, B., & Morrison, E. E. 2014,

As stated in Joseph A. Carrese’s article “Refusal of Care: Patient’s Well-Being and Physicians’ Ethical Obligations,” introduces the fundamental principles and responsibilities that physicians have in order to preserve the welfare of their patients in any circumstances. On the other hand, Debbie Dempsey, author of “Refusing Treatment: Practical, Legal, and Ethical Issues,” strongly supports the patient’s right to make their own medical choices, whether it be to accept or decline any help. W.D Ross solidifies the dependent yet incompetent patient to not refuse care and treatment because the physician has a duty of fidelity, beneficence and a duty to

The Hippocratic Oath is often seen as the determining factor of all medical decisions, but those decisions can be based off of the wrong participant’s point of view. With a multitude of ethics to follow, physicians have always decided what course of action is the most beneficial to their patients. Living in a constantly shifting society, however, has shed light on the power struggle between the rights of patients and the ethics of medicine. In the case of physician-assisted suicide, the conflict of power should resolve with the ultimate decision-making power resting in the hands of the patients.

The Patient’s Bill of Rights is a set of protections set up by President Obama on June 22nd, 2010. It was a collaborative effort by the Departments of Health and Human Services, Treasury, and Labor. The Patient’s Bill of Rights protects children and others with pre-existing conditions by allowing them guaranteed coverage, allows Americans’ to have their personal choice of physicians, and ends the lifetime limits on care consumers may receive. The factors within the Patient’s Bill of Rights keeps American citizens’ protected by allowing them freedom with

In modern medical ethics, patient autonomy is largely believed to be a major principle when making decisions about an individual’s health. It allows patients to have the right to practice their autonomy willfully and freely. Children and mainly adolescents have the right to take part in medical decision making to some degree. In most cases, the parent, child, and doctor are all in agreement, but this may not always be the case in some situations, instigating physicians to face problems and practice their ethics. No patient should be treated as incapable to make decisions based on mental immaturity unless his or her irrationality or mental immaturity is proven.

There are many legal and ethical situations that healthcare providers will be faced with when providing medical treatment to either a child or an elderly adult. While there is often much discussion regarding the elderly and do not resuscitate orders, there are often times when the decisions for health care of a child may be overlooked. Some of the legal issues that may be faced by healthcare professionals are informed consent, confidentiality, reproductive services and child abuse. Patients have the right to decide what is done to their own bodies, but for children under eighteen, their parents decide for them. A major issue faced by healthcare professionals is parental refusal for treatment. Healthcare providers will be faced with many conflicting ethical and legal situations regarding refusal of a minor’s healthcare and treatment. These issues

Relationships between individuals are complex, and the patient-physician relationship is no exception. The relationship between patient and physician is the keystone for the practice of medicine. However, circumstances may sometimes arise which lead to unequal partnership between the physician and patient. One circumstance is the competing values between the patient and physician when engaged in a conversation about medical assistance in dying (MAiD). MAiD occurs when an authorized physician or nurse practitioner provides a drug that will intentionally end that patient's life at the patient's request.

Within healthcare, practitioners often have to make difficult decisions regarding the care of their patients. This could be to do with giving or withdrawing treatment, or as simple as sharing risk information (Glover, 1997). Ultimately, the practitioner must be able to rationalise any decision they have made (Morrison, 2009). With this in mind, the following assignment will draw upon an ethical dilemma and explore how theoretical perspectives can be utilised within the decision making process. Therefore it will also be pertinent to draw upon the law, and how this influences actions within health care. To facilitate this discussion, I will identify a scenario from practice that