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Patient autonomy case
Ethics and patient autonomy
Ethics and patient autonomy
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Recommended: Patient autonomy case
Marmar Tavasol
Word Count: 603
Morality of Deception
Based on the class discussion on truthfulness and paternalism, I believe that hiding the full truth from Mrs. Cortez is the most ethical act to take. The reading on the book and discussions on patient autonomy include the premise that the patient is mentally stable and able to understand and exercise free will as a result of the honesty that they were given. However, in Mrs. Cortez’s case, a patient with dementia, being honest only causes emotional harm and does not give her any long term understanding of the objective world. Furthermore, she is fragile and ill and most likely not able to handle being told such tragic news over and over again. The doctors and nurses at Grove Manor should keep the truth regarding George from Mrs. Cortez.
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Utilitarians believe that if an action results in the maximum happiness for the greatest amount of people and the least amount of pain, it is ethical. In this case, the utility of Mrs. Cortez, someone that is not autonomous due to dementia, shall be prioritized by keeping the truth from her if the truth causes grievances. The death of George is an intensely sad happening for Mrs. Cortez and therefore, the news of it shall be kept from her. Initially, the doctors and nurses gave her the news that her son has passed away; relieving them from their duty of honesty. At this point, their duty is not to tell the whole truth, but to ensure the overall well-being of Mrs.
The one example of this that I found most relevant in the book is the situation of Armando. Armando was shot and the bullet lodged in the spinal canal. It caused enough damage to make him a paraplegic, but not enough to kill him. The ethics committee had decided that it was best to encompass a DNR because he had no health insurance, and his quality of life was not what it was before. When the doctors went to approve this with Armando, he denied the DNR and said that he wanted what ever was necessary to be done to him to save his life (Belkin p. 58-59). This made Cindy worried for the cost of keeping him alive was substantial. All the doctors and caretakers believed that he should be placed under DNR, however that was not what Armando wanted. The doctors believed that was the wrong decision. This correlates to what the quote was from the book on page 70; doctors can tend to be narrow-minded when it comes to the care of a patient. They believe that their course of action is the best and do not agree if the patient wants something different. This I have found is also true in my own personal experience with doctors. For example, when I was about 17 my wisdom teeth were growing in. I was in terrible pan from two of my wisdom teeth being impacted. My
One of the most complex, ever-changing careers is the medical field. Physicians are not only faced with medical challenges, but also with ethical ones. In “Respect for Patients, Physicians, and the Truth”, by Susan Cullen and Margaret Klein, they discuss to great extent the complicated dilemmas physicians encounter during their practice. In their publication, Cullen and Klein discuss the pros and cons of disclosing the medical diagnosis (identifying the nature or cause of the disease), and the prognosis (the end result after treating the condition). But this subject is not easily regulated nor are there guidelines to follow. One example that clearly illustrates the ambiguity of the subject is when a patient is diagnosed with a serious, life-threatening
Utilitarianism argues that, we need to consider how much overall happiness of the action could bring, considering everyone involved. For example, how will Brittany’s choice for euthanasia affect her husband, friend, and parents? In Craig’s case, how will his choice for euthanasia affect his wife, son, and daughter? In both of their cases, that devastation that they will die is already difficult for them, and their families. Craig’ wife and his two children were sad that he was making the decision to die before his illness consumed him. Her daughter speaks on how hard it was for her, and in a sense relieved, she was not present when her father took his own life. Brittany was a newlywed, it was extremely sad for her husband and brother in law to know she was taking her life beforehand. To make a choice an act-utilitarian would need to balance out the overall happiness compared to the suffering. Both Brittany and Craig will eventually die. If they both let their terminal illness progress they would inflict extreme suffering on themselves and their family as they witnessed their pain. In Craig’s case, his illness will get worst it will cause paralysis. His major concern was on how would he be able to let
The case of Marguerite M presents an ethical dilemma. Medical ethics play a special role in medicine and is directly concerned with its practice. Its role has continued to evolve as changes develop in
The ethical principle of nonmaleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with nonmaleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, suffering of the patient and family would be evident. Autonomy is the right to making own decisions and freedom to choose a plan of action. When making decisions regarding treatment of another person, it is important to respect the expressed wishes of the individual. John says that his mother would want to live as long as she could, but questions arise related to her quality of life and perception of prolonged suffering by prolonging the dying process. In BOOK states that quality of life changes throughout one’s life ...
Firstly, by looking at the first patient, whether she gets a kidney from her father or a “cadaver kidney” , there will be no difference because she needs a kidney nonetheless. The second patient however, cannot agree to give his kidney away because one of the main reasons is that he’s scared and lacks “the courage to make this donation”9. So right at this point, it can be seen that it would be better if the father didn’t give his kidney away because it wouldn’t cause him any happiness, whereas the daughter has two options to gIn everyday life, whether on a personal base or on a professional base, difficult scenarios, or also known as moral dilemmas, are present. Depending on whom the person is or what their belief and value systems are, the issue can be ‘resolved’. In this particular case, questions arise about whether it is morally right to lie to family members when something can be done, ignoring the fact of its after effects. The case will be explained in details later on including the patient’s state, but to answer this ethical question, two theorists will be presented for the con and pro side. For the con side, the deontologist Immanuel Kant will be presented with his theory that lying is prohibited under all circumstances, as for the pro side, John Stuart Mill will be presented for the utilitarian theory stating that whichever decision brings out the most happiness is the right decision. After discussing the case, my personal view of what is right will be stated with my own reasons, which is that lying is the right decision to be taken.
My initial response to the issues was only based on the hospital policies regarding the care of the patients within the hospital. However, when I was guided down the different paths and made to look through the different ethical lens, I found it tough to do so and seem to resort to my core values of autonomy and rationality. By putting the patients’ first, hospital policies, and then their loved ones in the first scenario, I determined that a compromise was necessary. Whereas in the second scenario, I feel as no agreement was needed just staff education (EthicsGame Simulation, 2016). In this particular case, Carlotta, the RN shift supervisor, needed further training to understand the hospital policy on who is or is not considered to be family (EthicsGame Simulation,
In “Should Doctors Tell the Truth?” Joseph Collins argues for paternalistic deception, declaring that it is permissible for physicians to deceive their patients when it is in their best interests. Collins considers his argument from a “pragmatic” standpoint, rather than a moral one, and uses his experience with the sick to justify paternalistic deception. Collins argues that in his years of practicing, he has encountered four types of patients who want to know the truth: those that want to know so they know how much time they have left, those who do not want to know and may suffer if told the truth, those who are incapable of hearing the truth, and those who do not have a serious diagnosis (605). Collins follows with the assertion that the more serious the condition is, the less likely the patient is to seek information about their health (606).
Truth in medicine is a big discussion among many medical professionals about how doctors handle the truth. Truth to a patient can be presented in many ways and different doctors have different ways of handling it. Many often believe that patient’s being fully aware of their health; such as a bad diagnosis, could lead to depression compared to not knowing the diagnosis. In today’s society doctor’s are expected to deliver patient’s the whole truth in order for patients to actively make their own health decisions. Shelly K. Schwartz discusses the truth in her essay, Is It Ever Ok to Lie to Patients?. Schwartz argument is that patients should be told the truth about their health and presented and addressed in a way most comfortable to the patient.
From deontological perspective, nurse must always tell the truth regardless of the outcome. Utilitarian would argue that withholding the truth or telling a lie is permissible if it may produce better outcome for a patient or prevent harm. According to Tuckett (2012), the principle of truth telling is often violated during provision of care to dementia patients and based on intention to eliminate distress, anxiety, or depression (beneficence and non-maleficence). It can be argued that withholding the truth or telling lie is deceptive to patient’s autonomy, however permissible if can be justified. Such as, “Providers have a responsibility to determine the resident’s level of insight over time to ensure decisions to deceive are genuinely in the resident’s best interest. In the context of lying to a resident with dementia, lying is conceptualized as therapeutic” (Tuckett, 2012,
Pergert, P., & Lützén, K. (2012). Balancing truth-telling in the preservation of hope: A relational ethics approach. Nursing ethics, 19(1), 21-29.
Mercy killing, the act of taking someone who is undertaking immense pain or suffering, is required in situations such as Lennie’s, where someone is in the utmost danger of a slow, painful, and torturous death. George and Lennie’s situation offers a prime example of a mercy kill in ethical circumstance which the assisted death of another should be excused as morally justifiable. Therefore, mercy killing should not only be allowed, but we are obligated to act in a situation where someone is suffering as much as
Charlotte’s parents thought otherwise, the Ethics Advisory Committee had to get involved. The debate surrounded if the doctors were in the right to control the life of someone who were incapable of deciding themselves, or is it the parents right. The Ethics Advisory Committee, stated that the parents were superior to those of the hospital and the hospital should conduct with less painful test. Charlotte’s parents wanted the doctors to continue testing until it was determined that her life diffidently had no chance of remaining. Because, of Charlotte’s parents’ desires unfortunately caused Charlotte to die a painful death without her parents. If the patient is unable to speak for their selves, the family should be able to have some say in the medical treatment, however; if the doctors have tried everything they could do, the hospital should have final decisions whether or not the patient dies or treatment
The moral of Utilitarianism is, “What is going to reduce the most pain?” Also, when dealing with utilitarianism everyone else’s happiness matters meaning that when you do something for someone even though you do not want to do that for he/she you know that the outcome will make them happy and that’s all that matters. Most of the time when you make someone else happy it makes you happy so therefore your happiness counts equally as well. “The Ethics of care is sometimes seen as a potential moral theory to be substituted for such dominant moral theories as Kantian ethics, utilitarianism, or Aristotelian virtue ethics.” (Held, 115). Care Ethics is based on morality with particular others including emotions in particular relationships, in both private and public life. Care Ethics is difficult to define, but has several distinct features. The Top 3 are moral importance of meeting the needs of particular others, values emotion rather than rejecting it and rejects abstract impartiality. Morality includes reasons and
In critical and complicating medical cases, family members often find it tedious to decide as to what mode or procedure of treatment is idyllic for the recovery of their patient. In such cases, well-qualified and medically educated can play a pivotal role in deciding the kind of treatment that should be given to the patient to enhance its recovery. In a contrary situation a nurse may know that administering a particular drug may improve the patient’s condition, but may be refrained from conducting the required action due to doctor’s absence or non-permission. There are numerous cases through which ethical dilemmas in the profession of nursing can be discussed. Nurses in order to remain within the defined boundaries ...