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Right to choose medical treatment
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Ian Shine, Administrator vs Jose Vega & another touches on a very delicate issue. The right of the patient to refuse treatment and the responsibility of the physician to administer treatment. The right of a competent adult to refuse medical treatment should always be respected even if the physician assumes the situation to be life threatening. In this case, Dr. Vega actions cannot be justified. Dr. Vega never discussed the risk or the benefits of intubation with Catherine 2(patient). Even if Catherine was believed to be incompetent to consent, Dr. Vega should have petitioned consent from Catherine’s sister, who was present at the time, he did not. As a result, Catherine was restrained and forced to receive a treatment that she as a competent adult had objected to. …show more content…
Munoz, supra at 123. In this case, Dr. Vega did not follow proper protocol. Consequently, the risk or benefit of intubation was never discussed with the patient. Catherine was administered two blood oxygen test. After the second blood gas test, results became available showing Catherine’s condition had improved. Dr. Vega testified that the results, even if he had read them(he had not) would not have changed his decision to intubate Catherine.
Catherine was not unconscious or unable to give consent. Dr. Vega Stated himself under oath that Catherine exercised her right to refuse medical treatment. Even if Dr. Vegas professional assessment of Catherine deemed her incompetent to make decisions regarding her treatment, consent should have been requested from her sister Anna, who was present. Therefore, receiving consent from a relative would be more reliable considering the consent of an unconscious
Alan Goldman argues that medical paternalism is unjustified except in very rare cases. He states that disregarding patient autonomy, forcing patients to undergo procedures, and withholding important information regarding diagnoses and medical procedures is morally wrong. Goldman argues that it is more important to allow patients to have the ability to make autonomous decisions with their health and what treatment options if any they want to pursue. He argues that medical professionals must respect patient autonomy regardless of the results that may or may not be beneficial to a patient’s health. I will both offer an objection and support Goldman’s argument. I will
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
His initial blood pressure was 113/60 mmHg, her heart rate was 50 beats/min, and his oxygen saturation was 100%. His Glasgow Coma Scale was 8. His physical exam was also remarkable for dry mucous membranes, and distant heart sounds, in addition to weak lower extremity pulses and non-pitting edema. No thyroid goiter was palpable.
Patient consent allows a procedure or contact with the patient’s body by someone other than the patient, usually health care personnel and can be obtained verbally or written. The topic of this memo is obtaining consents as it relates to Mr. Roberts who was brought to the Emergency Department by an air ambulance due to head trauma from a motorcycle accident, he needed emergency medical surgery. This being the case, Implied Consent was enacted, which is when emergency action is required to prevent death or permanent impairment, as with the emergency care provided to Mr. Roberts to prevent permanent brain damage.
Consent is an issue of concern for all healthcare professional when coming in contact with patients either in a care environment or at their home. Consent must be given voluntary or freely, informed and the individual has the capacity to give or make decisions without fear or fraud (Mental Capacity Act, 2005 cited in NHS choice, 2010). The Mental Capacity Act perceives every adult competent unless proven otherwise as in the case of Freeman V Home Office, a prisoner who was injected by a doctor without consent because of behavioural disorder (Dimond, 2011). Consent serves as an agreement between the nurse and the patient, and allows any examination or treatment to be administered. Nevertheless, consent must be obtained in every occurrence of care as in the case of Mohr V William 1905 (Griffith and Tengrah, 2011), where a surgeon obtain consent to perform a procedure on a patient right ear. The surgeon found defect in the left ear of the patient and repaired it assuming he had obtained consent for both ear. The patient sued him and the court found the surgeon guilty of trespassing. Although there is no legal requirement that states how consent should be given, however, there are various ways a person in care of a nurse may give consent. This could be formal (written) form of consent or implied (oral or gesture) consent. An implied consent may be sufficient for taking observation or examination of patient, while written is more suitable for invasive procedure such as surgical operation (Dimond, 2011).
I personally feel that the life of a person is well above all policies and regulations and if an attempt to rescue him or her from death at the right time remains unfulfilled, it is not the failure of a doctor or nurse, it is the failure of the entire medical and health community.
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
Health Care workers are constantly faced with legal and ethical issues every day during the course of their work. It is important that the health care workers have a clear understanding of these legal and ethical issues that they will face (1). In the case study analysed key legal and ethical issues arise during the initial decision-making of the incident, when the second ambulance crew arrived, throughout the treatment and during the transfer of patient to the hospital. The ethical issues in this case can be described as what the paramedic believes is the right thing to do for the patient and the legal issues control what the law describes that the paramedic should do in this situation (2, 3). It is therefore important that paramedics also
In the scenario the decision made by the RN and the paramedics have breached the respect of autonomy of Elsie and failed to respect the decision made by Elsie. Megan-Janes 20.. implifies that people have the right and are to free to choose and act on their choices provided that their decision and act doesn’t impinge on moral interest of other people. Likewise Elsie’s choice to not to get advance treatment was of no harm to any other people rather than herself. In health settings Principle of Autonomy protests the patients right to be respected as dignified human being capable of making decision what is right for them even if everyone thinks that it is not right( ).In short health professionals must allow patient to participate in the decision making when it comes to their care and treatment. Furthermore (Harris 2011) have explained that it is very vital to respect patient’s autonomus decision to refuse intervention which is based on the principle of autonomy. Furthermore, in the scenario where the pressure of patient’s autonomy is in line, the argument depends on other moral principles( ).In this says Principle of non-maleficence gives justification. The Principle of non-maleficence says above all do no harm which means not to injure others or harm them ( ). Likewise , the RN and the Paramedics in the scenario had no intention of doing any harm to Elsie rather than saving her life. ( ) suggested that in nursing context the principle of non-maleficence would provide justification for performing any act which unfairly injures or makes a person to suffer which was avoidable. This will explain why the health professionals performed those acts despite the protest of Elsie which resulted in death of Elsie. Principle of Beneficence is another moral principle which defends against the principle of
While the doctors were most likely using their standard of best interest, autonomy is an ethical principle that plays in Cassandra’s defense. Autonomy can be described as an agreement to respect another’s right to self-determine a course of action. In this case, it is difficult to argue that autonomy played a role in the decision-making. In the article, it is stated that for the legal situation that occurred to happen is unusual, but in extreme cases, where parents of minors refuse treatment when the patient will surely die, results in action by the Department of Children and Families. The patient, Cassandra, however, was 17 almost 18. This is not using autonomy it is purely the department using the standard of best interest in their opinion.
The patient was a 34 year old female that was admitted during the night shift to the Transitional Care Unit (TCU) through the emergency department for nausea and vomiting times three (3) days. In the emergency department, she was treated with fluid resuscitation of Normal
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
In this case, I would not jeopardize my professional relationship with Marie by breaching her trust. The care ethics approach does not undermine the patient’s values and preferences. It emphasizes the importance of the nurse-and-patient relationship. In health care, the paternalism model acknowledges that health care providers are the sole decision-makers for their patients as they know what is best for them (Collier & Haliburton, 2015, p. 87). The patients are expected to be adherent and obey the treatments that the health care providers implement (Collier & Haliburton, 2015, p. 87). However, patients should be included in the decision-making process. They have the right to be involved in their own care and make decisions that are free of coercion. Sometimes, the patient’s values, beliefs and preferences may not be in-line with the health care providers’ preferences and they have to respect those differences. In Marie’s case, she has the right to be respected in terms of her preferences and choices, especially that she was given all the information regarding her condition and treatment and she was competent enough to make those decisions. Using the care ethics approach, I am able to consult Marie first and determine why she does not want to receive the treatment that could ultimately save her life. Marie could have her own preferences such as a different surgeon that has the ability to
Neonatal resuscitation is intervention after a baby is born to strengthen it’s breathe or to boost its heartbeat. Approximately 10% of neonates require some assistance to begin breathing at birth, but only 1% require serious resuscitative measures. Informed consent regarding neonatal resuscitation is a constant ethical debate. This discourse ordinarily occurs between doctors and parents; parents often feel that the decision has been made for them, believing that they were not fully informed of any consequences that may occur before making their final action plan, or thinking that their opinion was not taken seriously; however, doctors see the procedure in a different light, that the parents can’t choose the best option for the child regardless of counseling, or performing as the parents wished but believing that the result could have differed if the parents had known all the effects that it will have further down the line, or convinced that they would have made a better
Looking back the simulation lab, I realize that I have so much to learn about myself as I played the role of the primary nurse in the total knee replacement scenario. In the situation, my colleague and I found out that our patient, Kari Bradshaw, was bleeding. My first thought is to grab an ice pack and didn 't recognize that I need to put pressure on the dressing. After my partner checked the vitals, I decided to call the technician to get the lab results. I reported the diminished hemoglobin count to the physician only to realize that I did not have the vital signs values. I received an order for saline bolus during the phone call. I also put the patient in two liters of oxygen in nasal prongs but the oxygen saturation was not improving so I turn it up to four liters. At that moment, my patient passed out. My colleague called the doctor and got an order for oxygen via non-rebreather mask to the patient and infuses two units of packed red blood. She also asked us to prepare the patient for the operating room. I asked the other nurse for vital sign assessments