Ethical Dilemmas In The Medical Field

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).

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.

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

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

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)

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

First, the relationship between a doctor and patient is a valuable asset in today’s medical environment. In this case, Merry didn’t understand that her diagnosis was worsening after refusing treatment, her autonomy was to have control of her own life decisions. As a result, Merry’s family chose to deny

First, disclosure of information to the patient will sometimes increase the likelihood of depression and physical deterioration, or result in the choice of medically inoptimal treatment. Second, disclosure of information is therefore sometimes likely to be detrimental to the patient’s health, and perhaps hasten his death. Third, health and prolonged life can be assumed to have priority among preferences for patients who place themselves under physicians’ care. Fourth, Worsening health or hastening death can therefore be assumed to be contrary to patients’ own true value orderings. Lastly, paternalism is therefore justified: doctor may sometimes override patients’ prima facie rights to information about their risks and treatments or about their own conditions in order to prevent harm (Vaughn, 96.)

I could not phantom what my family’s life would be like if my mother had agreed to those risky experimental procedures. I’m so thankful she said no each time because if she’d given in, I don’t know if my father would be here today. This experience has lead me to realize some critical disparities within health care. Healthcare should be provided to everyone. The potential cost of health care can deter persons in need of treatment. Whether a general checkup or an emergency room visit, the expenses that arise from either of these visits can result in a financial burden for patients -- especially the ones who do not have much money to begin with. From how I see it, healthcare is a privilege. Money directly affects health care and treatments. This is turn can question informed consent for proposed medical treatments. One major health care disparity is the proper implementation of informed consent from health care professional to patient. This is an issue because money's influence on health care can deter from what should be in the best interest of the

In our society and classrooms, more often than not, it is argued that when a physician and their patient have a paternalistic relationship, it is deemed unacceptable and needs to be addressed. However, Komrad argues that a paternalistic relationship can actually be a beneficial factor between a physician and their patient. Komrad creates the concept of a limited paternalism where it “preserves an individual’s freedom as much as possible in the hope of eventually broadening it” (42). One of the main components of this paternalism is acknowledging that from the very beginning of a physician-patient relationship, it is an asymmetrical relationship because of the patient’s already diminished autonomy. A patient has an automatic diminished autonomy

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.

The decision making process for patients has evolved in recent years from a process based on physician paternalism to an activity based on individual autonomy. Autonomy has been defined as the decision-making freedom of the individual by basing on his or her own values (1). As patients are more involved in medical decision-making concerning their health and wellbeing so too are parents for their children (1). Minors are generally considered incompetent to make legal-binding decisions in regards to health care decisions (1). As such, parents are given the power to make decisions on their behalf. In cases where parents decide to forgo treatment for their children, complex ethical, legal, cultural, and spiritual factors must often be taken into account. The complexity of these occurrences highlights the important implications on a healthcare decision-making perspective but as well as a broader societal perspective. This brief will assess key ideas and institutions that support and challenge the decision

Everyday, healthcare professionals are faced with ethical dilemmas in their workplace. These ethical dilemmas need to be addressed in order to provide the best care for the patient. Healthcare professionals have to weigh their own personal beliefs, professional beliefs, ethical understandings, and several other factors to decide what the best care for their patient might be. This is illustrated in Mrs. Smith’s case. Mrs. Smith is an 85 year old who has suffered from a large stroke that extends to both of her brains hemispheres which has left her unconscious. She only has some brain stem reflexes and requires a ventilator for support. She is unable to communicate how she wishes to proceed with her healthcare. Mrs. Smith’s children, Sara and Frank have different views regarding their mother’s plan of care. The decision that needs to be made is whether to prolong Mrs. Smith’s life, as Sara would like to do, or stop all treatments and care, as Frank feels his mother would want. In the healthcare field, there are situations similar to this case that happen daily where moral and ethical judgment is necessary to guide the decision that would be best for the patient. The purpose of this paper is to explore and discuss, compare and contrast the personal and professional values, ethical principles, and legal issues regarding Mrs. Smith’s quality of life and further plan of care.

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

Autonomy - Patient advocacy is one of the many critically important roles of nurses. They not only provide physical care but also provide emotional support to their patients. As the state of the patient is very vulnerable it is the nurses who serve the purpose of uplifting their morale. Hence, they take considerable care of the fact that the autonomous decisions of the patient aren’t compromised because respect for autonomy is one of the essential fundamental guidelines of clinical ethics. For the concerned physician and the nurses, respect for autonomy also includes creating the optimal conditons necessary for autonomous self determination besides respect for the patients’ right to taking decisions for the self. All individuals consult a physician or go to the hospital seeking for help and guidance in deciding for their health simply because they do not have necessary knowledge required to make decisions. Patients need to be adviced, calmed and all their isssues should be addressed to. Nurses have to take care that the patient doesn’t makes choices under any sort of constraint. In this case, autonomy is being breeched as the patient’s choice to take painkillers is interfered due to directions to the staff from her family, failing to comply with which they warned to take legal actions. The hospital staff should have instead consulted with the VCAT for the appointment of a guardian who after proper knowledge about the patient from the hospital end could have taken a more