Introduction:Case # 4
Autonomyis a primary value in medicine, which sparks health care ethics. Apatient’s autonomy is highly valued to support their overallwellbeing. It is, therefore, reasonable that autonomous persons areusually in the best situation to regulate what is good or bad fortheir health and wellbeing(Sandman et al., 2012).
Answersto Case Questions
Obtaininga valid consent before commencing treatment procedures on a patientis a fundamental part of protecting the autonomy of the patient(Sandman et al., 2012).The important fact, however, is that the patient ‘must be in theright state of mind.’ In the case, the physician’s actions can bejustified because the woman in question was not in her right mind torefuse ‘aggressive’ treatment, which had the hope of saving herlife in the long run. What the physician would have done is toprovide the patient with some essential health care guidelines andcommunicate the same to family members of the patient. It isimperative that the patient understands the risks and benefitsassociated with receiving health treatment. Given how complex theprocedure might be, health care practitioners have an obligation notto disclose the said risks, but can be used to help the patient andhis/her family, derive a well-thought decision. I, therefore, believethat it is right to disregard a patient’s autonomy depending on thestate of mind that the patient portrays. In such a case, a courtorder may make a physician`s critical decision as being ethical.
IfI were part of the team of the health workers, I would take intoaccount several factors to try and reach a joint resolution with thepatient. These factors would include understanding the extent towhich the patient was well-informed about the risks involved, theseverity of burden, and the level of urgency of the case at hand. Atthe same time, I would reassure the patient that her decisions wouldbe respected, only if at the end of the day, the right to life wasfostered and the risk of premature death eliminated, even with theuse of rather ‘aggressive’ treatment, for the good of thepatient. An empirical approach while applying reflective equilibriummay present a challenge. This is attributed to the differencesbetween individual’s moral judgments and the reflection ofdifferences in one’s culture, background, religion, etc. If themoral judgment were liable to reflect posturing bias, then they arelikely to mirror the deep-seated prejudices. Health care providersare faced with a tough choice which requires moral judgments whichare influenced by ethical codes expected in the medical profession.They have a responsibility to provide quality healthcare services,reduce harm, and promote safety while practicing in the patient’ssuperlative interest. In complex situations, it is common tocomprehend whether ethical consideration is pertinent before anaction is facilitated(Smebye, Kirkevold, & Engedal, 2016).
Thereexists a moral conflict in the principle of beneficence and adheringto patient self-sufficiency. This creates a dilemma in judgmentregarding the terminally ill woman in the care facility. Medicalpractitioners may worry about the ethical consequences in that thedisclosures may make a patient more frightened or confused. Theethical implication will be for the physicians to consider otherreliable means to manage ethical dilemmas. It is apparent thatbalancing the act of patient’s autonomy and beneficence isconsidered as one of the most widespread and complicated moralconcerns. For the case above, the role of autonomy of the patientremains contrary to the role of the beneficence of the medicalpractitioner administering treatment. While conforming to eachethical principle may result in different outcomes. Provided thepatient satisfies the conditions of making an independent decision,then the medical practitioner must respect the decision even in anattempt to cause an influence, else wise(Sandman et al., 2012).
Introduction:Case # 5
Medicalpractitioners face challenges in their quest to offer medical care topatients who uphold certain cultural practices, some of which mayappear to be barbaric. It is, however, essential that the drawing ofa line is done to identify the boundaries that rest between ethicsand cultural practices, as the case below will confirm.
Answersto Case Questions
Patientshave a right to receive optimal treatment. In the case under study, Ibelieve that the treatment cannot be deemed as useless, given thatthe practicing doctor must work to ensure that the patient’s(child) pain from the bruises is reduced and overall wellbeing is notcompromised by helping and saving the patient from harm andsuffering.
Traditionalmethods of healing like Cao Gio are deemed to be acceptable and areoften used in some cultures and ethnic groups, as a form ofadministering therapy to patients.Withthe above information in mind, it is clear that the usage of Cao Gioon the child in the case is not to be considered as an instance ofchild mistreatment and so physicians have no obligation to step in tostop cultural practices at this point. With the knowledge that thebruising noted when traditional healing is offered, to that obtainedfrom surgery, both cases result in pain. However, surgical treatmentis done in a regulated manner where pain can be mitigated byadministering pain killers. Therefore, a physician can step in if atraditional healing method worsens the wellbeing of the patient inthe long run and as a result offer modern medicine, which is somewhatcautious in the way pain, is addressed. If child abuse is a concern,the physician should seek for investigation as to whether thebruising on the child’s body is caused by the aforementionedtraditional healing method or from other factors. Physicians musthave a sense of diversity towards a more multicultural society. Withthat in mind, it is apparent that the doctor must not be concernedabout alienating the mother and other persons of her ethnicity,particularly those that are deeply rooted in their culturalpractices, from engaging in modern medicine. I do not believe thatthe physician should call the child protection services to report themother instead, seeking for the conduction of investigation is morereasonable for the establishment of the cause of bruising.
Themoral dilemma exists where there is conflict as to whether thephysician should report the case to child protective services as acase of child abuse. If a child is being harmed, then the case cannotgo unchallenged. But if cultural practices are the cause of theissue, it behooves one to handle the matter a little carefully. Inthis case, I do think that the mother’s intent was probably notevil. However, the outcomes were not. As such, the physician shouldnot take the first step to report her to authorities rather heshould take the time to educate the parent.
Themoral dilemma emanates when the physician is in confusion as towhether to call the child protective services and report the motheror whether to treat the young patient and educate the mother on thedangers imposed by the cultural practice. The fundamental ethicalimplication for the study would be for the doctor to educate themother about the harms of Cao Gio and offer her that similarpractices need not be facilitated again for the betterment of theboy’s health. In conclusion, there is the need for aculture-centered standpoint in medical practice to inhibitencapsulation in health care providers’ worldviews.
Manyfactors come into play when physicians seek to report a case of childabuse, which includes the family, information surrounding the injury,and references drawn from other colleagues. Physicians may reducetheir decisional burden and report such cases by being involved ineducation programs related to child abuse, consulting with otherstaff, and familiarizing themselves with reporting regulations.
Introduction:Case # 6
Thesubject of euthanasia in medicine is shrouded with highuncertainties. The active voluntary, physician-assisted, and theassisted suicide euthanasia are the most common types of euthanasiathat remain to create controversies in the contemporary world.
Answersto Case Questions
Ifthe patient was to die after a short while say six hours, he/she doesnot deserve to do so by virtue of euthanasia and so the choice ofquick death should not be considered as an extension of the patient’sautonomy. The short amount of time the woman has to live is ethicallyrelevant, whether modern medicine is applicable and working or not.Any living thing or being must be treated with a mind that leanstowards ethics at all costs. There is, therefore, no ethicaldissimilarity between the patient’s life ending in six hours, in aweeks’ time or a year, the bottom line is that the ethics thatpertain to promoting life are of vital importance. The onlydistinction that rests is that the longevity of the life of a patientis prolonged due to the palliative care that is received. The rightfor the woman’s self-determination is not dominant to influencecommitments on the part of those to assist her to exercise certain‘health needs’. The woman in the case being incapacitated doesnot give her the right to force another person into helping her die,instead good palliative care should be provided. It is ‘economiccommon sense’ that performing euthanasia on patients is acost-effective method to lessen the mounting costs of palliativecare. I, however, object such views but instead, believe that thecost factor excuse should not be brought in when caring for the womanin the case study. Being with the woman closely during the movetowards the transition from the current life to the next life is whatI deem to be of utmost value.
Legalizingpractices like euthanasia is likely to kindle a conflict of interestbetween the patient and the doctor. The reason being that emergenceof cases, which function to destabilize the rights of vulnerablepatients willbe mundane. The aftermath is the occurrence of a compromise on theethics and essence of the medical practice. Passinga terminally ill patient to another doctor who can administereuthanasia does not free me as a physician from ethical obligationsbecause I will still be aware of a colleague’s intents whichconflict with the medical profession ethical code.
Deathwith Dignity Act
TheDeath with Dignity Act was set to assist those who opt for theservices that foster a ‘necessary quick fix’ during thetransition to the next life. The requirements of the request in thecase above are unreasonable. The fear of pain is the key problem withthe patient`s euthanasia request. The patient simply wants a quickfix by the use of euthanasia, which should not be the case. Instead,her doctor must seek aggressive care for the patient during her lastmoments rather than giving up and thus assist to end her life.
Rulesand guidelines must be present to contain behaviors and activities.In the medical world, guidelines come in handy for that matter.Guidelines, and in line with the woman in the case above are meant topromote control in an individual from being swayed by the state ofmind, feelings or fears. In the case, guidelines ensure thatintegrity of autonomy is not impaired despite the patient having thesaid rights to autonomy. The guidelines are not aimed at protectingthe doctors in prohibiting them from administering the euthanasiadrug to the woman in the case, rather, they are meant to fosterethics, morals and offering ‘aggressive’ care to patients. Ithink that the usage of euthanasia drugs should be prohibited giventhat the use of such drugs, upon the requests of patients or theirfamily members, jeopardizes the integrity of the right to autonomy,in addition to being unethical.
Thereexists a difference between prescribing a drug and giving the drug toa patient because in giving a drug, the doctor has the fullknowledge, intent, and is directly acting to cause the death of apatient. In the prescription of drugs, the doctor acts passively inthe pursuit of ending the life of a patient (Math& Chaturvedi, 2012).It is not recommended for terminally ill patients regardless of theseverity of their illness say suffers from HIV, to receive assistancein dying because people have a natural right to life the moment theyare conceived.
Thejustification of euthanasia does not justify the assisted suicide ofhealthy patients instead, it attempts to explain assistance in dyingto terminally ill patients. It is possible that weakness ofeuthanasia law gives the possibilities of terminally ill patients tobe influenced by family members this is because it is perceived to bean economical option. The statement on the AMA’s views thateuthanasia is distinct from the role of physicians as healers iscorrect. Euthanasia is simply ending life when on the other hand theessence of medicine and the medical profession is intended forhealing by instigating and restoring health and wellness to apatient. Physicians are the only options at offering euthanasia giventhe fact that they are not only knowledgeable on lethal medicationand the dosages, but also, limiting the administration of theeuthanasia drugs to physicians further fosters significance of theethical prohibition.
Math,S. B., & Chaturvedi, S. K. (2012). Euthanasia: Right to life vs.right to die. TheIndian journal of medical research,136(6),899.
Sandman,L., Granger, B. B., Ekman, I., & Munthe, C. (2012). Adherence,shared decision-making and patient autonomy. Medicine,Health Care and Philosophy,15(2),115-127.
Smebye,K. L., Kirkevold, M., & Engedal, K. (2016). Ethical dilemmasconcerning autonomy when persons with dementia wish to live at home:a qualitative, hermeneutic study. BMChealth services research,16(1),1.