Case Analysis : Whose Pain Is It Anyway?

Although autonomy is very important, it is significant that the family fully understand all BOOK> To avoid violating autonomy, health care workers must fully understand the involved disease processes, the options available for treatment, and possible outcomes.

Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment

A fundamental right for all competent patients is autonomy, or the right of self-determination. Patients are free to make their own judgments of any situation based on their own criteria. Charlie’s mom is definitely playing an important role, she is not letting Charlie make his own judgments. She instead of building his confidence is making him feel terrified with all the words she just said.

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

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

Every patient has a right to decide on their own course of treatment and freely consent to that treatment. In order to make an educated decision they must be provided with the proper information to make an informed choice (Opinion 8.08 - Informed Consent, 2006). It is the physician’s legal and ethical obligation to provide this information when making their recommendation on treatment. The choices given must be in accordance with good medical practice (Opinion 8.08 - Informed Consent, 2006). The informed consent is the legal policy, either written or verbal, that gives full disclosure of all the information including potential risks that is applicable to the patient’s condition and treatment being offered (Kazmier, 2008).

To begin with the person is the centre of the plan, to be consulted with and their views must always come first: It should include all aspects of their care, and every professional should work together to provide it. (Leathard 2000) Autonomy refers to an individuals’ ability to come to his or her own decisions and requires nurses to respect the choices patients make concerning their own lives (Hendrick 2000).However Gillon Argues that the principle respect for autonomy may need some restriction, otherwise we may be morally obliged to respect an autonomous course of action with unthinkable consequences.( Gillon 1986) Every human being has an intrinsic value, they all have a right to well being, to self-fulfilment and to as much control over their own lives as is consistent with others (British Association of Social Workers 2002).Professional Judgement and patient preference cannot be suspended if practice is to be safe and effective rather than routine(DOH 2005) Alex had to attend this session as it was within his Timetable, how could it have been effective?, he was unhappy and

Informed consent stands for self-determination and respect for autonomy. Autonomy is the most influential ethical principle and the main focal point in health care. It is a major concept in relation to informed consent and its simplest form can be seen as the patient’s right to determine what will or will not be done to his or her body. Expanding societal values and evolving patient centred healthcare system influences nursing practice greatly. In Canada, physicians are legally responsible for obtaining informed consent but nurses are also involved in every aspect of the informed consent process. For e.g. Nurses can perform this role when they notice that patients

Informed consent is an integral part of the medical process, but what is it? How can the principles of Informed Consent conflict with each other or with patient care? It is important to examine Informed Consent very carefully and explore how the principles of Beneficence and Patient Autonomy work with each other for the best interests of the patients, even if the patient is refusing some treatment that is important in the standard of care. However, it may be possible that Informed consent and these elements work against one another, and conflict with the best interests of the patient.

Autonomy stresses that everyone has the right to decide what happens to his or her own body. This legal right requires that doctors must receive consent prior to treating a patient. Doctors must

Likewise, Lewis and Soule (2006) point out that autonomy is a valuable ethic in nursing practice, which involves the freedom to be able to make important, non-mandatory decisions that are consistent with ones choice of practice. Most importantly, Lewis and Soule also suggest that autonomy is deemed as most valuable when the nurse has control over the information and knowledge needed for the patient to be able to make decisions, to help the patient chose the correct decision through the specific training and education that nurses provide service users with, so the

There are times that self-determination has opposition with the values and beliefs of health care providers. The five step ethical decision making model is in place for patients that are unable to make their own health care decisions due to incompetency; paternalism is not the method used anymore. “In relation to health care, paternalism manifests itself in the making of decisions on behalf of patients without their full consent or knowledge. (Burkhardt & Nathaniel, 2008). Value systems, which includes a patients and family morals, play a factor in ethical decision making.

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

Autonomy applies to the profession of nursing because the patient should always be allowed to make decisions regarding their care while being treated with respect and dignity; however, autonomy can serve as a limiting agent when the patient decides to refuse care that would be of benefit to them. Autonomy is a sensitive issue because it allows the patient to choose to die and all health care can do from that point is allow the patient to do so comfortably. With healthcare always being one step ahead, it allows a surrogate to serve as a voice piece for that patient when they are unable to make decisions. However, that surrogate can end up making decisions they think is best for the patient ignoring the patients’ will. The responsibility of the nurse and interdisciplinary team is to inform and educate the patient and patient’s surrogate on all aspects of care to include medical diagnosis, treatment, and care plan so that the patient and