Refusal Of Care For The Elderly Good Or Bad?

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).

A physician must understand that when it comes to deciding to withhold or withdraw life sustaining treatment it is ultimately the patient’s decision unless the patient is not competent enough to make this choice. I believe that a person can lose their life at any point. Death is certain and no one can run from it. In my opinion, a patient’s autonomy is of utmost importance anytime during healthcare however the physician can name some recommendations of what would be the best option for the patient. When it comes to patients they deserve to be treated with respect and ultimately be treated as an end not as a means to an end.

17. Pellegrino argues for a three-tiered system of obligations incumbent upon physicians. They are in ascending order of ethical sensitivity.

The American Medical Association (AMA) published a Code of Ethics for Physicians that includes a list of certain principles physicians should follow in order to be good physicians, practicing in an ethical fashion. This list, which was first adopted in June of 1957 and revised as recently as June of 2001, demonstrates some principles that are not universally accepted to be critical to the ethical practice of a physician. In particular, all physicians do not completely believe the claim that “A physician shall support access to medical care for all people” (Principles of Medical Ethics). Theorist, H. Tristam Engelhardt believes that the lack of access to care for some may be unfortunate, but it is not unfair and that this access does not need to be mandated, nor does believing it should be make you an ethical physician. In fact, Engelhardt supremely believes that by providing access of care to all, you will hurt certain patients that already have access to care, negating your function as a physician practicing beneficence. Engelhardt would retract this statement from the Principles of Ethics. However, this belief of and drive to implement access of care to all is critical to one’s job as a physician and it goes against core values of physicians to claim otherwise. Theorists such as Tom Beauchamp and Norman Daniels would agree that the universal access to health care is a critical component of the values physicians hold.

Rarely any physician intends to harm patients when he or she provides treatment to them. Patients see physicians and specialists in full faith that they will get help with a condition. What complicates the patient-doctor relationship is that the outcome of each patient’s treatment is different because of individual health conditions and the course of treatment chosen by the doctor. Problems arise when a patient is not satisfied with care provided by the doctor or in extreme cases when a patient dies. Since most of the time it is hard to clearly determine whether the outcome was solely a result of the course of treatment chosen by the doctor or whether other factors played a role too, quite often patients take their

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

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

The nurse in the case study is faced with an ethical and professional, dilemma. How can she be an advocate for her patient Mr. E? Dr G. is proceeding on a course of action or plan of care that is directly contrary to the patients advance directive and his verbalized objections to the course of treatment proposed by the physician and that is concerning for her. There are multiple issues to consider. For the nurse, she needs to think about her code of ethics, her scope of practice and the legal issues regarding advance directives and Durable Power Of Attorney (DPOA). She also needs to consider the patients right to privacy and confidentiality. As with most areas and issues in modern healthcare the statues can be

With the statement, “warmth, sympathy, and understanding may outweigh the surgeon 's knife or the chemist 's drug” physicians are given the responsibility to step down from their systematic ways of scientific thinking and make decisions on the level of human kind. The modern oath also provides for the necessary address of issues in liability in relation with a physicians judgment. This is predominately done by promoting the uniting of colleagues and defending a physicians right to be unsure in a world of so many unknowns. This acceptance and appreciation is essential for fostering a comradely among physicians that challenges each to think independently, dispute their own peers and still be conducive of making advancements.

To argue the first premise, he appeals to common knowledge that doctors hold their occupations because they are more knowledgeable in a medical context on the options for improving health and longevity. With this in mind, he then establishes that individuals who consult physicians do so in order to prolong their life and improve their well-being. By establishing these foundational premises for paternalism in a medical context, Goldman can now argue that given a patient that is determined to be acting out of line with his true values and his actions might result in harm that is severe, certain, and irreversible, it is the physician’s professional to override the patients’ immediate rights in order to preserve that patients’ more long-term desires. But how can the physician determine whether the patient is acting in line with his true values in the case of withholding medical information from the patient?

The idea of a privilege to reject treatment was based on fundamental rights to security, break even with assurance under the law, and due process. At the end of the day, automatically hospitalized patients still have a privilege to choose what happens to their bodies. The privilege of a patient to reject treatment depends on five sacred insurances the eighth amendment's assurance against merciless and abnormal discipline the first alteration's assurance of free discourse (opportunity of thought/thoughts) the first revision's assurance of flexibility of religion the all the more extensively translated appropriate to protection the fourteenth amendment's insurance of freedom (the privilege to be free from unjustified interruptions on

I must be aware, as the patient’s advocate, of the choice of each individual patient regarding his or her medical management or, as in this case, the withholding of treatment.

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.

Patients in the United States have a right to refuse care if treatment is being recommended for non-life-threatening illnesses according to the Washington School of Medicine (2012). The simple task of refilling a prescription, or choosing to not get a flu shot are all acts of not following through with treatment mechanisms. Patients often times refuse medical treatment for far more reasons than just religious beliefs. Subconscious emotion reasons about side effects, pain, healing time, and the procedure itself scares patient’s away (Washington School of Medicine, 2012).

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.