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Autonomy in medicine
Pros and cons of cultural diversity in health care
Patient doctor confidentiality
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Recommended: Autonomy in medicine
The ethical issue presented is the physician sharing personal views of “non-traditional” treatments with others while patients are near. There are three healthcare concepts that are supported by ethical theories: autonomy, nonmaleficence, and beneficence.
Patients have the right to autonomy as a principle of ethics. The physician should not have discussed cultural differences within ear shot of patients. One never knows what cultural beliefs a patient practices. Most western physicians do not have a full understanding of traditional healing to Native American patients unless they live in an area with a large population. “Healthcare professionals must consider the patients decision to implement the treatment plan and the appropriate authorization.”
According to Terrence F. Ackerman, as of the 1980s the American Medical Association had to include the respect for a person’s autonomy as a principle of medical ethics (Ackerman 14, 1982). This includes having the physician provide all the medical information to the patient even if the information could cause negative implication onto the patient. The physician is also expected to withhold all information of the patient from 3rd parties (Ackerman 14, 1982). Although it is seen as standard in today’s world, in
In the book The Spirit Catches you and you Fall Down, ethnocentrism can also be seen. Throughout the book the family and the doctors have different ideas of medicine/healing techniques are often disagreed on. It’s important for the doctor to see that biomedicine has its own intentions of saving patient through standard procedures and beliefs. Understanding those terms will shed some light on the culture of the patient, which has their own intentions, beliefs, and rules as well. Breaking down ethnocentrism to find an agreement is a good goal to accomplish in order have successful prognosis and healing. In addition, shedding the ethnocentrism will allow the doctors to see the different cultural beliefs and not judge right away. Although, some cultural remedies may not always work, it’s wrong for people to have the mindset of ethnocentrism without even considering their beliefs first.
“Public health is controversial because, depending upon how it is defined, it may challenge people’s values and demand sacrifices” (Schnieder 2017: 23). Although the overall goal is to create a policy that is inclusive of every group, this is almost impossible. It is impossible because there are too many conflicting views between each group. Public policy may also have a positive or a negative impact on the economy. One of the major conflict with public health policy is that it may be guided by religious beliefs. For example, issues such as AIDS, other sexual transmitted disease, teenage pregnancy, and low birth rates (20) are some of the major issues that end up being controversial when it comes to religion.
The four major ethical principles in health care are: Autonomy – to honor the patient’s right to make their own decision (the opposite is paternalism - the health care provider knows best for the patient), Beneficence – to help the patient advance his/her own good, Nonmaleficence – to do no harm (many bioethical controversies involves this principle), and Justice – to be fair and treat like cases alike. All 4 principles are considered to be in effect at all times. In theory, each is of equal weight or importance. Ethical responsibilities in a given situation depend in part on the nature of the decision and in part on the roles everyone involved play.
There are questions about transplant allocation in regards to the four major ethical principles in medical ethics: beneficence, autonomy, nonmaleficence and justice. Beneficence is the “obligation of healthcare providers to help people” that are in need, autonomy is the “right of patients to make choices” in regards to their healthcare, nonmaleficence, is the “duty of the healthcare providers to do no harm”, and justice is the “concept of treating everyone in a fair manner” ("Medical Ethics & the Rationing of Health Care: Introduction", n.d., p. 1).
Review of “Situationism and Virtue Ethics on the Content of Our Character” by Rachana Kamtekatar
The word ethics is derived from the Greek word ‘ethos’ meaning character or conduct. It is typically used interchangeably with word moral which is derived from the Latin word ‘moves’ which means customs or habits. Ethics refers to conduct, character and motivations involved in moral acts. Ethics are not imposed by a profession, by law but by moral obligation. It is unwritten code of conduct that encompasses both professional conduct and judgement. Ethics helps support autonomy and self-determination, protect the vulnerable and promotes the welfare and equality of human beings. An ethical dentist- patient relationship is based on trust, honesty, confidentiality, privacy and the quality of care.1
Philosophical Ethical Theories As we know, philosophers divide ethical theories into three major classes. They are Metaethics(descriptive), Conceptual(applied), and Normative(prescriptive). Metaethics basically takes the scientific approach to concocting where exactly our ethical principals and philosophies come from (Feiser, 2005). Descriptions and explanations of moral behaviors and beliefs are provided on the basis of facts studied by such specialists of anthropology, sociology and history (Beauchamp & Bowie, 2005).
Going to a different country or area of the world can open up anybody’s eyes to see that culture makes a huge impact on the understanding and practices of healthcare that seem to be so common to other areas of the world. When a person lives in one country their whole life, that person may not realize how different the life they live is from someone in a foreign country. If a person is going to receive treatment from someone with a different cultural background, they should be expected to get treatment to respects their own culture. Massachusetts College of Pharmacy and Health Sciences having such a diverse variety of students has their own cultural competency definition that states “effectively and comfortably communicate across cultures with patients of differing backgrounds, taking into account aspects of trust in order to adopt mutually acceptable objectives and measures”. In the book Dancing Skeletons: Life and Death in West Africa by Katherine Dettwyler, the issue of culture and healthcare are greatly prevalent. Katherine Dettwyler herself goes to West Africa as an anthropologist and her horizons are broadened when during her research she comes in contact with how much culture has an impact on healthcare and everyday life.
Advocating for diverse patients is important. In this paper I will be discuss a personal ethical dilemma in which I have encountered. I will give an objective interpretation of both my side as well as my patient’s side of the dilemma. Then I will describe the conflicting values and beliefs that I and the patient had. Then I will give the information I was lacking concerning the patient’s culture. Lastly, I will define culturally congruent care.
An individual’s culture and belief may significantly impact the type of services they require. In addition, it may affect the time, place, and method in the delivery of health care
In this diverse society we are confronted everyday with so many ethical choices in provision of healthcare for individuals. It becomes very difficult to find a guideline that would include a border perspective which might include individual’s beliefs and preference across the world. Due to these controversies, the four principles in biomedical ethic which includes autonomy, beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and acceptable. These principles are not only used to protect the rights of a patient but also the physician from being violated.
Certain religious groups reject westernized medicine, like the Amish. Yet, for the most part most religions allow their medicinal practices to work in tandem with westernized medicine. For example, First Nations people tend to have a very holistic view when it comes to their surroundings and medicine. Aboriginal traditional approaches to health and wellness include the use of sacred herbs like sage or tobacco and traditional healers/medicine (pg. 5, Singh, 2009). However, they will not reject help from professionally trained doctors and medical staff. Much like other religions, First Nations put a strong emphasis on family/community. Consensus or decision-making is fairly common for them. A practitioner or medical staff member must remember to respect ceremonial objects such as tobacco or traditional blankets, include immediate family members when making a treatment decision, and to accommodate spiritual practices. Normally, organ donation is accepted UNLESS the organ is being removed from someone who is not deceased. First Nations’ believe that their bo...
The American Medical Association (AMA) developed a Code of Medical Ethics which includes: the patient has a right to obtain and discuss health information related to benefits, risks, and costs of treatment alternatives; patient’s can make decisions pertaining to healthcare suggested by the physician; the patient has the right to courtesy, respect, dignity, and attention to healthcare needs in a timely manner; and the patient has a right to confidentially, continuity, and adequate health care. (emedicinehealth, 2011). Communicating openly and honestly between the patient and doctor will allow both parties to make decisions to properly take care of needs.
There are many times that I may not agree with a patient with their treatment choice. However, as their nurse I am their advocate. As their advocate I try to help them get all the answers they need by using available resources. A big concept to remember when caring for patients is to respect their culture and involve their culture in their care. Unfortunately, when culture is not involved conflicts can occur. The purpose of this paper is to describe an ethical dilemma, discuss both sides of the issue and define culturally congruent care.