Competence Marginal And Otherwise By Benjamin Freedman Summary

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

Acting on behalf of an individual’s best interest, who may lack mental capacity and are unable to make this decision them self.

This case raises conflict between two principles one for respecting autonomy and beneficence. Due to Mildred being in a semicomatosed and paralyzed state, she does not have the ability to think autonomously. So, the following authority to help with decisions to be made during this time would be her three children. Her three children want to stop the tube feeding, but the physician objects that it’s unethical to “starve” a patient so that she will die sooner. The physician is not acting autonomously due to the fact of not listening to the patients children who know their mother and what she would want, but he is also not acting with beneficence because he's not helping to promote the well- being of Mildred who is now in this state not able to make her own decisions in addition to having a feeding tube which is the only thing keeping her alive.

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

In his essay, The Refutation of Medical Paternalism, Alan Goldman states his argument against a strong doctor-patient role differentiation, in which the doctor may act against a patients’ immediate will in order to carry treatment in the patients’ best interest. Goldman frames his entire argument around the single assumption that a person’s freedom to decide his future is the most important and fundamental right as he claims “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.”[1] He claims that the majority of people would agree that they are the best judges of their own self-interest

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

This assignment will critically analyse and justify the decisions based around a fictitious patient using a clinical decision making framework highlighting its importance to nursing practice. The chosen model will demonstrate clinical decision making skills in the care planning process. The patient’s condition will be discussed in-depth explaining the pathophysiology, social, cultural and ethical issues where appropriate in the care planning and decision making process. Any vulnerability that the patient may experience will be discussed and dealt with in the care planning and decision making process. The supporting evidence based literature will be analysed and

This situation is definitely linked to the term competence. Competence is basically the ability to deliver decisions about medical interventions. According to Vaughn, people who are incompetent in this sense cannot give their informed consent (Vaughn, 2013, P. 181). I agree with this because if my sister has Paranoid Schizophrenia she cannot give her informed consent when it comes to her health because she is not in the right state of mind to do so. according to an article I found in the Huffington Post mentally ill patients are like children, and they are not competent enough to make decisions for themselves, and they have to second guess all their decisions.

Surrogates are those people who, by law or custom, are appointed to make decisions in the place of the incompetent or doubtfully competent patient regarding medical treatment (Garrett 43). The idea of the surrogate is that they will defend the patient’s autonomy by advocating treatment decisions based solely on what the patient would want. This means that the surrogate must ignore the interests of all other parties involved, including that of family, friends, and the surrogate themselves, when making treatment decisions for the incompetent patient (Garrett 71). In order to ensure that the surrogate is actually defending the patient’s autonomy, the substituted judgment principle is described as a main responsibility of the surrogate. The substituted judgment principle states that the surrogate should make decisions for the patient based on what the patient would choose as deduced from the patient’s written statements, oral notifications, or the patient’s actions and values (Garrett 70). This usually ensures that, when available, a person who knew the patient well will be their surrogate. However, there are many problems that arise with the substituted judgment principle in

Autonomy can be defined as self-determination, self-rule, or self-governance. (3) The legitimate idea of autonomy fills in as the reason for various choices ensuring a man's substantial honesty. Specifically, cases have held that skilled grown-ups or youngsters' folks have the privilege to pick regardless of whether to experience medical intercessions. (4) Before individuals settle on such a decision, they have a privilege to be educated of actualities that may be material to their decision, for example, the nature of their condition and its prognosis, the potential dangers and advantages of a proposed test or treatment, and the contrasting options to the proposed intercession. Individuals additionally have a privilege to be educated about and to control the consequent utilization of tissue that has

The rights and limitations of an individual’s decision making include, various issues like written or oral consent from patient or a representative, and patient’s mental ability to make decisions about their treatment. According to the common law right of 1891, the decisions regarding the treatment are made by individuals with decision making capacity and even after they lose their capacity their decisions do continue. An adult is said to have decision making capacity when they attain the age of 18 or when the person is not deemed incompetent by the court or when the results of the decision are well understood by the individual. In conditions of temporary incapacity, close family members can make the decision and if time doesn’t permit during emergency, the health care providers can decide about treatment to save the life. According to the right of self-determination, any competent individual who cannot handle the treatment can reject completely (Steiner, 2014).

In this case the Medical Doctor made a decision based on his personal beliefs. The Medical Doctor did not take into consideration the suffering and anguish that the patient and his family was enduring. Mrs. Huttman stated that she purposely failed to hit the panic button when Mac hands went cold in hers. Mrs. Huttman

With cases like this, it is important to take into consideration the effects of the surgery, the likelihood of success with the surgery, and the overall condition of the suffering patient. However, there should also be moral compensation that plays a role and this includes justice and rationality. With all these key factors, one must decide is proceeding with such a risky procedure, if it will benefit the individual or if it will be considered ineffective post-surgery. In this case, the primary focus was her overall state of being, since she is considered mentally retarded. This is seen through statements such as: “Noooo. She—is—not—eligible –because—of—her—quality– of –life—Because—of—her—mental—delays”, “Well, you know a transplant is not forever. She will need another one in twelve years. And then what? And do you have any idea of the medications she will need to take to keep her healthy”, and “These medications she has to take after the transplant, they are very dangerous” (Rivera, 2012). In essence, questions such as these, play a role in determining if an individual is ‘qualified’ in a sense, to undergo such procedures. The reason, is because a person may not be considered successful post-surgery, if that is the case, the procedure may be useless. This can be seen as wasting not only the hospital and insurance company’s money, but also creates stress on the family itself, causes a burden

The fact that it is a psychological disorder that causes individuals to want to amputate their limbs may be a sufficient reason to criminalise those who carry out the procedure of amputating a person’s healthy limbs as in essence they are not actually able to give an informed consent particularly if one is following the guidelines laid out in the Mental Capacity Act 2005 meaning that it can be concluded as the bodily harm of mentally ill patients. Muller raises a case against amputation based on the principle of autonomy. On the one hand autonomy can be used to argue for the rights of body modifications like for plastic surgery for aesthetic or sexual purposes but on the other hand the autonomy of BIID patients is heavily doubted. Autonomy requires insight, free will and rationality, those suffering from a neuropsychological condition cannot be classified as autonomous and thus performing an amputation on them should be prohibited. This then turns the attention to those who do not suffer from a medical

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