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.
Katz states, “the conviction that physicians should decide what is best for their patients, and, therefore, that the authority and power to do so should remain bested in them, continued to have deep hold on the practices of the medical profession “(214).
It is important to be aware of the changing world, changes in the law and how people perceive those who are vulnerable and dependent. At the heart of all of this, the patient’s needs and wishes still have to be at the center of any decision making and effective communication between professionals and patients is inherent in our moral duty to ensure that patients have access to the care they are entitled
It is an important principle that all people receiving a service should be fully informed and consulted in matters relating to their health and well-being and agrees to
According to sense two, legal or institutional effectiveness takes precedence. In other words, a subject’s consent is limited to the scope of the rules of the institution. Faden and Beauchamp illustrate that even if a patient autonomously gives her consent, it does not follow that effective consent is given if the requirements of the institution are not met. Consequently, the authors propose that sense one and sense two should both contribute in defining informed consent. Using Jay Katz’s argument, Faden and Beauchamp argue that sense two should satisfy sense one for there to be some type of balance between the two.
It is important that the patient is aware not only of their rights, but of their individual responsibilities.
The new rules allow patients to participate with all aspect of their healthcare decisions. It focuses on patient’s involvement, decisions, continuous healing and patient control. The new rules are design to meet the patient’s needs. Throughout the years, physicians had more of a paternalistic view with competent patient’s healthcare choices. Even though, the physicians optimal goals is to practice non-maleficence and beneficence care, their knowledge regarding patient’s illness and care paternalistically diminish patient’s autonomy and involvement. The new rules reinforce those principles; it changes patient’s involvement, choices and preferences. It increases transparency, predict patient’s needs, continuity of care among physicians, institute evidence-based decisions and health records access.
Autonomy includes three primary conditions: (1) liberty (independence from controlling influences), (2) agency (capacity for intentional action), and (3) understanding (through informed consent) (Beauchamp & Childress, 2009, p. 100). According to Beauchamp & Childress (2009) to respect autonomous agents, one must acknowledge their right to hold views, to make choices, and to take actions based on their personal values and beliefs (p. 103). Respect for autonomy implies thaturges caregivers to respect theassist a patient in achieving? Heed? the autonomous choices of their patients. From there, patients can act intentionally and with full understanding when evaluating medical treatment modalities. Autonomy also includes a set of rules, one of which requires that providers honor patient decision-making rights by providing the truth, also known as veracity (Beauchamp & Childress, 2009, p. 103). In this case, several facets of the principle of respecting autonomy, specifically veracity, informed
Traditionally, health care was grounded on a paternalistic model where healthcare professionals were viewed as the experts in the field and directed decisions for patient, and patients were passive recipients of care (Gluyas, 2015; Mazurenko et al., 2015). In recent decades, the worldwide recognition of individual patients’ needs and preferences as an important aspect of high-quality healthcare that is responsive to the patient, has stemmed the concept of patient-centred care (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2011).
The Doctor and Patient relationship aspect of Medicine has changed drastically in the last twenty years. It has evolved from paternalism (the doctor makes the decision for the patient) to shared decision making where the patient is considered an equal partner in his/her own health related decisions. Informed consent is the cornerstone for this view. When a patient or a research subject makes an autonomous decision after understanding, the risks and benefits involved with the decision is Informed consent. Complete Informed consent covers the following components: competency, disclosure, comprehension and voluntary. Competency refers to the requirement for the individual to be of legal age and be mentally competent to understand the process.
Although there are several debates against this view point, it is not up to anyone else to make decisions of the ill and infirm. As such it should be recognized that “patients have a right to make
Delivery of excellent healthcare involves a multitude of dynamics including an extremely straightforward requirement of a patient’s permission for treatment or procedure. Informed consent, a patient’s authorization, consist of communiqué between healthcare provider or physician and the healthcare consumer, providing sufficient information allowing the patient to make a knowledgeable decision regarding healthcare treatment
Shared decision making should involve both health professionals and patients in discussions about their care. “While health professionals hold the expert clinical and technical knowledge, patients are experts about their own lives and treatment objectives, and also what is important to them when making decisions. (Lally, Macphail, Palmer, Blair and Thomsom, 2011).
Nurses and physicians would get no input from the patient on their wishes for treatment and care (Giddens, 2016). Health Care has recently advanced by adopting the patient and family centered care model which was designed to “recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respects for the patient’s preferences, values, and needs” (Knuths, 2017). This model allows patients to have a voice on what happens to their bodies and allows them to actively participate in their care. It has also allowed the patient’s family and loved ones to be involved. This involvement has given the patient a strong support system with their best interest in mind. Moving towards this concept has made nurses more aware of patient’s cultural differences, spiritual differences, family preferences, and personal values. This system has lead to better overall care and patient satisfaction. Care has become about the patient and not the provider (Knuths, 2017).