Dax's Case Summary

Katz states this about informed consent, “to suggest that informed consent with remain a fairy tale as long as the idea of joint decisionmaking, based on commitment to paint autonomy and self-determination, does not become an integral aspect of the ethos of medicine and the law of informed consent” (222).

Treatment without consent - Charlotte, the nurse on duty, had forced James into getting the injections therefore causing him emotional distress. Treating a competent patient who has validly refused treatment could constitute an assault or battery. The legal provisions supporting a competent patients’ right to refuse treatment in Australia can be found in both legislation throughout all the States and common law. The Australian Charter of Healthcare Rights is also a helpful source of guidance as it reinforces the common law position that is based upon the principle of patient autonomy. The High Court of Australia first articulated the principle or refusal of treatment in Marion’s case, stating that a legally competent person has a right “to choose what occurs with respect to his or her own person.” Under the NSW Health Patient Charter, consent in regard to an operation, procedure or treatment is both a specific legal requirement and an accepted part of good medical practice. Medical practitioners are also expected to clearly explain proposed treatment, and adequately inform their patients on significant risks and alternatives associated with the treatment.Failure to do this could result in legal action for assault and battery against a practitioner who performs the procedure. Charlotte made no effort to explain or gain a consent from James.

The two ethical dilemmas that stick out to me in the case are patient autonomy, and distributive justice. Patient autonomy is the patient’s right to make decisions about their care, including whether to accept or decline treatment (Taylor, 2014). Because the patient did not fully understand the information relayed in the consent form or the procedure, her patient autonomy may have been violated. This also may mean the consent form may not be valid. A signed consent form from a patient affords the hospital with an assumed duty to care for that patient (as cited Taylor, 2014). And the patient has given the medical professional permission to provide treatment. Therefore, it is important that the patient fully understands and can communicate that understanding when consenting to

For this Media Project, I chose to watch an episode of a Grey’s Anatomy that contains a medical ethics dilemma. I watched Season 2 of Grey’s Anatomy, Episode 23 “Blues for Sister Someone.” In this episode, a woman asks Dr. Addison Shepherd to clandestinely tie her fallopian tubes (tubal ligation) while she gives birth to her 7th child through C-section. She does not wish to have any more children (seven is already a huge burden), but her devout Catholic husband does not allow birth control. Hence, she pleads Addison to help end her childbearing abilities (tying her tubes would be permanent birth control). She begs Dr. Shepherd to do the surgery in private so here is no medical record

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.

We came to this decision because we felt that if a few professional psychiatrist can render him mentally competent than he should be allowed to make his own decisions because it is moral. This is moral because people should be allowed to do what they want with their body, and as Cowart says it is, “the right to control your own body is a right you’re born with…” (Cowart 2). However, this is refuted when that person cannot make rational decisions because that person would be mentally incompetent. People that are mentally incompetent are incapable of making decisions that are in their best interest. We also discussed his mother and how all she cared about is for him to receive treatment which we thought was a bit selfish. This is a typical parental perspective considering that parents do not want to outlive their children. However, she should have sought out what was best for him and what he was going to be happy with and not her. As a group we also felt that he should have received better pain treatment especially since Cowart found out later that they could have done more for his treatment. If someone is in as much pain as he was and when a doctor is confronted with the request to die, that doctor should be doing everything he or she can to bring down the pain.

The third and final reason why I agree that Dax should not have been able to refuse treatment and have other people assist in his death is because Dax Cowart would have been treating himself and those he requested this of as merely a means. According to Kant’s philosophy, “we must always treat people (including ourselves) as ends and not as means only”. (Munson p. 752).

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

Charlies doctors acted unethically when they asked if Charlie wanted to do the operation. The doctors didn’t ask Charlie these questions. "Has the patient been informed of benefits and risks, understood this information, and given consent? Is the patient mentally capable and legally competent, and is there evidence of incapacity? If mentally capable, what preferences about treatment is the patient stating? If incapacitated, has the patient expressed prior preferences? Who is the appropriate surrogate to make decisions for the incapacitated patient? Is the patient unwilling or unable to cooperate with medical treatment? If so, why?"(Siegler). The doctors just told Charlie that the operation will make him smarter. This was very unethical by the doctors who kind of took advantage of Charlie just for research.

Some of the positive aspects of Dax being permitted to die would be that he would not have to endure such torturous treatments. He would not have to live his life permanently handicap and traumatized. He would not have gone through divorce so many times. It was never mentioned in the reading but he may have had survivor's guilt because his dad did not survive the accident. If the doctors put him out of his misery as he so pleaded he would not have to live with the guilt. There is a high possibility that he was ridiculed and made fun of because of his disfigurement. He would not have to worry about that if he were dead. He would not be alive so he would not have to live with anything that I just mentioned.

Another issue with the implementation of Informed consent arises when the patient waives the right to Informed consent and leaves the right to make the decision on the physician. Though legally correct, this can cause psychological stress for the physician especially when the decision is about a life threatening medical condition. Moreover, this also makes the patient vulnerable to abuse. (Manthous, DeGirolamo, 2003)

In regards to informed consent, the mature minor doctrine requires the physician or other healthcare provider to make determinations on a case by case basis. The physician should employ the same criteria used to determine the ability of an adult to consent whose decisional

The decision of the Supreme Court could be considered ethically right. It was right to revoke the physicians’ decision, as it wasn’t in agreement with what the Canadian Health Care Consent act (HCCA) section 26 stipulates “A health practitioner shall not administer a treatment under section 25 if he has reasonable grounds to believe that the person, while capable and after attaining 16 years of age, expressed a wish applicable to the circumstances to refuse consent to the treatment.”3 Also, in medical ethics, it is the obligation of health care providers to allow the patients to make their own medical decisions. They should have autonomy in their decision making, that’s if they completely comprehend all the medical diagnosis, prognosis and all outcome of treatment options4. Starson had a full understanding of his options, he was fully

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.

Consent can be quite tricky, a legal minefield for healthcare teams, this is due to the patients who will give or refuse to give private information about themselves who is legally competent but