Ethical Principle Of Autonomy In Healthcare

Principle theme Five days at Memorial by Sheri Fink tells the story of the days after Hurricane Katrina at one hospital in New Orleans. Memorial hospital owned by Texas based Tenet corporation had 312 short term acute care (STAC) beds, and leased the seventh floor to Lifecare for a long term acute care (LTAC) hospital. Lifecare’s LTAC at Memorial cared for medically fragile patients with long term complex medical needs. The hospital and health care providers received intense scrutiny after the hurricane due to the higher numbers of dead patients in comparison to comparable New Orleans hospitals, out of the 34 patients which died at the facility, 24 were Lifecare patients.

-Autonomy: the ability to make decisions unaided by others. Or patient over a certain age has the right to refuse treatment. -Veracity: legal principle that states that a health professional should be honest and give full disclosure to the patient. Which basically means, “informed consent”.

193). Healthcare providers are called to follow beneficence, the duty to promote the wellbeing of others (Essential learning: Law and ethics, 2022). More specifically, they can utilize paternalism, which is the ability to override the patient’s autonomy for their best interest. Some of the healthcare staff thought of following beneficence as using paternalism to heavily sedate the patients to the point of euthanization to prevent them from suffering a slow, painful death. They were using paternalism to decide that euthanization was more in favor of the patient’s best interest as most of the patients receiving sedation were not conscious enough to make the decision for

The physician is rendering the aid the patient requests and respecting the patient’s autonomous decision to exercise their right to

Ethics of healthcare depends on 4 moral standards and how they are utilised; autonomy, non-maleficence, beneficence, and justice. Autonomy, which means self-governance, is the rule for regarding the privileges of a person to settle on a choice for them self, and respecting that decision. In healthcare this implies regarding a patient's choice on treatments, regardless of the possibility that it could bring about damage or demise to themselves. Autonomy is about self-rule, control free, without impact or influence from any other person, and is tied in with making an educated and un-forced choice about their care and medicines, based from their qualities and inclinations. Alongside autonomy is the principle of justice, which incorporates reasonableness

The respect for autonomy principle entails that a physician must always acknowledge and the patientʻs right to evaluate their options and decide for themselves despite the opinion of the physician. The principle of Nonmaleficence entails that once a patient decides a path for treatment, the physician should take the actions necessary to ensure that the treatment is successful and that the patient is as safe as possible. Both principles imply that the patientʻs well being is always the central priority for physicians. The respect for autonomy principle is contrary to the principle of nonmaleficence principle in the sense that the patient may not always choose a treatment option that is the safest, yet the physician must comply and do whatever

A moral dilemma that arises in a doctor-patient relationship is whether or not the doctor should always tell their patient the truth about their health. Although withholding information was a common practice in the past, in today’s world, patient autonomy is more important than paternalism. Many still are asking if it is ever morally permissible for a doctor to lie to a patient, though. David C. Thomasma writes that truth-telling is important as a right, a utility, and a kindness, but other values may be more important in certain instances. The truth is a right because respect for the person demands it.

This follows the Care Act (2014) as Patrick has been given control of his own care, by having a say in the decision. The next step is deciding a course of action, in this step Jeff has to identify his responsibility and assess how he could reduce any risks. He thinks the best course of action to do this would be to arrange a consultation for Patrick with the sexual health advisor. Step four is testing the decision, and consulting the Equality Act (2010) shows that this would be the right decision if Patrick’s health status is kept confidential, because it may prevent possible discrimination. Simon (the sexual health advisor) assured Patrick that any information about him will be

But in Donald’s case it was the total opposite. He went to the hospital with his mind already made up to die, which goes against what the doctors have being taught to do, and the principle of beneficence. The doctors decided to reject his autonomy because they knew he had an immense possibility of having a happy live and not just simply acting in a paternalistic way. In the end the doctors decisions was the right choice, when Donald stated, “I am enjoying life now, and I’m glad to be alive” (Munson6).

Atul Gawande in his article “Whose body is it, anyway?” introduced couple of cases, which discussed a controversial topic, doctors dealing with patients and making important medical decisions. These are difficult decisions in which people might have life or death choices. Who should make the important decisions, patients or doctors? Patients don’t usually know what is better for their health and while making their decisions, they might ignore or don’t know the possible side effects and consequences of these decisions.

The four core ethical principles that are called into question in the movie “Miss Evers’ Boys” are autonomy, beneficence, nonmaleficence, and justice. Autonomy refers to the right of the patient to function independently and the ability to self-direct. This means that patients are entitled to decide what will happen to them, and if deemed competent, they have the right to either consent to or refuse treatment. All nurses and healthcare personal would be required to respect the patient’s wishes, even if they do not agree with them. Beneficence is the core principle that refers to the act of ‘doing good’ and advocating for the patient.

Consent is patients’ rights because they have right to know what is happening to their life which is fundamental value in professional practice (Department of Health (DH), 2001). Dougherty and Lister (2015) state that consent is a patient’s rights to refuse or to accept a treatment. However, Dimond (2010) said that consent is a voluntarily decision which can be given orally, verbally, written or implied for example if you ask a patient to take their blood pressure and they offer their arm. Eyal (2012) also states that consent promote trust in medical procedures that people may seek and comply with medical advice and participate in medical research. Bok (2013) argues that there are problems with the trust-promoting as many patients give consent despite being to some extent distrustful.

When contemplating the difficult relationship between physicians and their patients, Emanuel introduces four different models. These four different models consist of different understandings of the goals of the physician-patient interactions, a physician’s obligation, the role of the patient’s values, along with patient’s autonomy. The paternalistic model is understood to be that the physician can decide what is in the patient’s best interest, thus not including the patient in an extensive rapport. The informative model can also be known as the scientific or consumer model. This model focuses on the physician providing their patient with all the relevant information necessary in order for the patient to make an informed decision based on their values.

Ethics in health care play a vital role every day. The practice of health care includes many scenarios that have to do with making adequate decisions when it comes to patient’s life. For the purpose of this paper, I want to explain the occurrence and some of the ethical concerns found in a case of an elderly patient, who believed in Curanderos and didn’t realize the harm she was doing in regards to her health by not taking her medications. This was a case I found in the book Ethics in Administration a Practical Approach for Decision Makers. The case is the following, Porter Sanders was the assistant administrator at a home health program.

Patients have a right to complain about the doctor's refusal to the Management. Provision of Treatment requires patient’s choice and informed consent. Even if a patient has signed a general consent clause, the patient can still refuse medical treatment or procedures. However, in exceptional or emergency situations a doctor may be legally justified in performing surgery or providing treatment without the patient's consent. The patient should be competent and capable of making such a decision to give a consent.