Medical Doctors Ability To Go Beyond The Call Of Consent

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)

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.

Many times it is uncertain to decide what is best for a human being when they are brought into hospital emergency rooms. As health itself is such a complex and dynamic subject matter, doctors do their very best to ensure the patient gets the treatment they need. However, there is a system in place, which suggests physicians should perform such medical intervention if those are the patient's wishes. The following is a ethical case dilemma regarding Michael. Michael, 21 year old patient, consented to being a organ donor prior to his motor-vehicle accident, and is medically declared brain dead. There is a ethical dilemma for both the physician and patient regarding what the right thing to do is, as Michael’s family value’s are in conflict of interest with his interest and consent being organ donor. Thus, The nature of this dilemma can be experienced from different perspectives. The who is having difficulty in accepting the brain death of Michael, hence the doctors informing Michael’s consent on being a organ donor affects the family. The family is unable to decide for their loved one as to when to “pull the plug” as they strongly believe that his life should be sustained as the heart is yet beating.The family is unable to cope with the situation and disagree with the medical team that their family member, Michael, has suffered from brain death and should not longer be kept on life sustaining support. The family also is not accepting of his consent for organ procurement.

The healthcare professional has a legal responsibility to ensure that the patient understands the information being given, can evaluate the available choices and is making the decision voluntarily.

In the United States all patients are granted certain rights and if denied these rights they can take legal action. Every individual has the right to participate in all aspects of their care (Pozgar, 2012). Patients must be informed by their care team of the risks, benefits, and alternatives to treatment. After that it is up to the patient to determine whether or not they want to forego treatment or not. “Failure to respect this right can result in legal action for assault and battery” (Pozgar,

As stated in Joseph A. Carrese’s article “Refusal of Care: Patient’s Well-Being and Physicians’ Ethical Obligations,” introduces the fundamental principles and responsibilities that physicians have in order to preserve the welfare of their patients in any circumstances. On the other hand, Debbie Dempsey, author of “Refusing Treatment: Practical, Legal, and Ethical Issues,” strongly supports the patient’s right to make their own medical choices, whether it be to accept or decline any help. W.D Ross solidifies the dependent yet incompetent patient to not refuse care and treatment because the physician has a duty of fidelity, beneficence and a duty to

Informed consent is defined as “permission granted in the knowledge of the possible consequences” and is the backbone to honorable physician patient interactions. Unfortunately, throughout history there have been many cases where physicians have used a patient’s lower socioeconomic status to manipulate the obtaining of informed consent. The AMA Code of Medical Ethics predates back to 1847, yet cases continue to arise directly breaking their key principles. These principles include autonomy, justice, beneficence, non-maleficence; and if followed ensure patients receive a high quality of care. Informed consent prior to any participation in experiments or procedures is essential for physicians to act within these guidelines. Autonomy allows patients to have free will and make decisions without coercion. Justice keeps all individuals in mind so resources are distributed fairly and all individuals are treated the same. Beneficence and Non-maleficence focus on the intent of the procedure to do only good and no harm. Even with these principles established there are discrepancies in on how they unfold in a clinical setting. The American Medical Association states physicians should assess their patient’s understanding of their medical condition, the recommended treatments, and document the physician-patient interaction. The Tuskegee, Abdullah vs Pfizer, and The Skid Row Cancer Studies are a few cases where these principles were ignored so physician and big pharmaceutical

Patient's decision-making is influenced by several factors. Patients may change their decisions, from accepting or refusing treatment depending on the available treatment options. The capacity of the individual to make informed medical decisions can differ as the patient's status changes cognitively, emotionally, and/or physically and as the proposed treatment interventions change. Treatment refusal is a common situation faced by clinicians. Patients do not usually refuse the medical advice if the advice is of good intention. When patients refuse an advice, it indicates some underlying reasons related to the patients or family, factors associated with the physician as well as social and organizational issues.

In the US, the initial system concentrated on physician knowledge about an intervention and not the patient requirement, i.e., the physician was to decide the best practice as well as information to disclose to a patient. However, there was a recognizable trend towards the informed consent (Culhane et al., 2012). A case between Salgo and Leland Stanfors Jr. University Board of Trustees clearly provided a clear indication of the court resistance and struggle to adopt the autonomous approach rather than the physician paternalism (Culhane et al., 2012). The jury argued that the patient has the right to information of any risk associated with a practice. However, they argued for the physician in the sense that he/she is placed in a position to make choices that protect the patient.

The healthcare industry has taken the stance that every patient has a right to be informed before making health care decisions. The end of the last century saw the development of a healthcare model centered on the patient’s autonomy and choice. This was in attempt to do away with the paternalistic and authoritarian manner that had previously characterized medicine. Paternalism is the substitution of one individual’s judgment (in this instance being a public health professional) in place of another’s decision-making abilities, for the purpose of promoting that individual’s welfare. The new relationship between healthcare providers and a patient is treated as a type of contract that is invalid without the patient’s consent (Showalter, 2004). As Dr. Jane Orient explained, since the Nuremburg Trials consent has been treated as an absolute necessity before any and all medical procedures. She believes that 3rd party encroachments, in this case the government, on the doctor-patient relationship are both dangerous and undemocratic. She claims that they put the doctor in a situation of having to harm their patient and therefore break their Hippocratic Oath to follow public health policy. Dr. Orient also discusses how this medical model is reminiscent of a Socialist State, one that would disvalue the individual in order to

It might be useful to view the moral principles that apply to this case. First, patients have the right to made a decision on whether or not to receive medical treatment. This follows

Many in the healthcare profession today are challenged with different ethical values; when it comes to healthcare provider and patient relationship. One of those ethical values is when to show mercy and no harm to those left in a health provider care. Most healthcare givers would, but what about those who are providing care in a government interrogation area? In this summarization; two valuable principles, beneficence and nonmaleficence will be discussed. Also, an in-depth analyzation of a case study of a military doctor whose ethics will may be tested.

Finally, at the heart at which governs how doctors act and behave are the four principles of medical ethics (autonomy, beneficence, non maleficence, justice) and professionalism. From a BH tutorial on ethics and professionalism, there was a case in which an elderly man’s vision was slightly below the values required to drive. If one was to come to a straightforward conclusion, it will be that as a doctor you will not sign his medical report form stating his medical fitness to drive. Despite showing justice and non maleficence to the patient, there is a conflict between autonomy and beneficence. However if the doctor was to sign it, it would put people on the road at risk. It would also be unfair on the people who was in this similar situation

It is a common and acceptable practice that when the patient needs the treatment for any life threatening condition he will be bound to follow the directions of the doctors and most of the time they willingly do so. However, there is usually a confusing moment when the patient refuses to follow the advice of the doctor on medication or suddenly changes his mind and stops following the instructions. At this point, the doctor must then make a decision on whether to continue the medication in total disregard of the opinion of the patient, or to try and talk the patient out of the opinion and continue the medication or to follow to the letter the instructions of the patient.

Imagine you are injured or sick and have sought a doctor’s help. Although you trusted your doctor, something, something seemingly very in control of the doctor, went wrong. You are angry and confused, but also think of the commonality of medical malpractice. So, why do doctors, who are supposed to help, harm? Though many flaws influence it, malpractice can be, and often is unintentional. Most doctors aren’t trained to harm their patients. Inexperience and lack of medical discovery led to unintentional suffering of the patient. Personal flaws, like lack of willingness to abandon previous medical methods and shortcomings in communication also harm patients. Further reasons why doctors harm are socio-medical understandings that breed hate, prejudices stemming from a society’s belief about certain people, such as the medical practice under the Nazi regime. Additionally, displayed in the case of Ignác Semmelweis, judgement of one to oneself can be detrimental to any progress one’s ideas could make. We will examine these concepts through Jerome Groopman’s “Flesh-and-Blood Decision Making”, Sherwin Nuland’s The Doctors’ Plague and Barbara Bachrach’s “In the Name of Public Health”. Those who practice medicine are, unfortunately, unfree from the imperfections that plague all of humanity. Through these intimate and varied faults, doctors do harm.