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Legal And Ethical Principles Of Consent In Health Care
1393 Words3 Pages
Q.1
Consent is agreeing with an action that is proposed by another person (NSW Health, 2005). The principles of consent include valid consent, voluntary decision-making and ability to make an informed decision. In legal and ethical principles you must gain valid consent before starting a procedure, this principle reflects on the decisions the patient has to their own bodies and is a fundamental part of good practice (NSW Health, 2005).
For consent to be valid an individual must consent to the procedure freely and voluntarily, hence consent should not be forced or obtained by assault or battery. When consent is given it must be specifically related to the procedure, this consent should not be manipulated and falsely described to a patient ability to make an informed decision refers to a person who has the legal capacity (NSW Health, 2014). Therefore the individual must have the capability to retain information that is given to them; for example the person must process the information, believe it and balance the risks and benefits of undergoing the procedure (NSW Health, 2014). Additionally, voluntary decision-makings give a right to the patient to refuse a procedure at anytime. Consequently, healthcare care staff are required to respect the patient’s desires, despite the fact that not taking action may lead to death or serious harm (NSW Health, 2014).
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In the case study, it states Mr Smith is refusing to have the procedure done as it will result with a scar and Mr Smith has stated “I would prefer to die than have a scar”.
It then states that Dr Green is influencing Mr Smith’s decision-making by asking Rebecca to intervene. This would require Rebecca to provide Mr Smith with information to influence his response however she would persuade him by not concealing all the risks of a procedure (NSW Health,
2005). Thus, Rebecca should inform Dr Green that if she does not disclose all the information to Mr Smith then they would have not obeyed by the principles of consent as the patient would be agreeing to a procedure that he does not have clear appreciation and understanding of the facts implications and consequences of an action (NSW Health, 2005). Therefore, Rebecca should state to Dr Green that she would not attempt to influence Mr. Smith’s decision by talking to him, unless she is to state both the benefits and implications of the procedure. Q.2. Consent is based around the four-biomedical principles; these include autonomy, non-maleficence, beneficence and justice (Staunton, P.J., & Chiarella, M., 2013). Autonomy relates to being in control of ones self’s choices without others interfering or attempting to take control (Staunton, P.J., & Chiarella, M., 2013). Non-maleficence reflects on the concept of not implying harm (Staunton, P.J., & Chiarella, M., 2013). Beneficence connotation is to act in the best interest of the patient. Justice refers is the act of unbiased and unprejudiced distribution of goods and services (Staunton, P.J., & Chiarella, M., 2013). In the case study, it states Mr Smith is refusing to have the procedure done as it will result with a scar and Mr Smith has stated “I would prefer to die than have a scar”. As the doctor is unlawfully performing the procedure, as he did not gain valid consent it exhibits as autonomy. Autonomy is being compromised as patient is being restricted of their own decision-making by the involvement and influences of others (Staunton, P.J., & Chiarella, M., 2013). Dr Green and Rebecca are both acting in beneficence this is as; they are attempting to benefit the patient, as they want to get the growth that could be potentially cancerous removed (Staunton, P.J., & Chiarella, M., 2013). Conversely, they are not respecting the patient’s wishes of refusing the procedure, as he does not want to be left with a scar, therefore acting Furthermore, this case conveys, as non-maleficence as the procedure is being forced on the patients against their desire, as they are inflicting harm on Mr Smith against his will (Staunton, P.J., & Chiarella, M., 2013). Justice is not being portrayed as the services have not being biased or unprejudiced towards the patient (Staunton, P.J., & Chiarella, M., 2013). In this scenario autonomy outweighs beneficence as the patient had denied the procedure on multiple occasions. Autonomy is a principle element of consent and should not be compromised if that is the patient’s wishes, therefore by the medical staff are pressuring a procedure to optimise health and prevent harm to the patient if the cancer malignant but will still impose harm by resulting in a scar. Additionally, non-maleficence is conflicted with autonomy as staff are conflicting harm as they are going against the patients desire of having the growth cut out, hence restricting and interfering with the patients decision making. Q.3. Trespass is performing a task without receiving permission from the other person. Trespass is compromised of three elements; these include assault, battery and false imprisonment (Staunton, P.J., & Chiarella, M., 2013). Assault refers to verbally threatening someone and leading them to believe that those actions will be carried out however not physically making contact with the person. Battery relates to threats that have lead to physically caring out those actions. False Imprisonment is where there has been deliberate, complete and direct restraint. False imprisonment can be categorised into direct or indirect restraints (Staunton, P.J., & Chiarella, M., 2013). The case study first presents as assault as Dr Green verbally demanded that Mr Smith has his growth cut out otherwise he will die from cancer, portraying strong intentions of physically harming Mr Smith. This may have lead Mr Smith to think that these actions would occur. Furthermore, by doctor proposing to do the procedure without consent it further emphasises the elements of assault (Judicial Commission of New South Wales, 2015). Secondly, battery will be exhibited if the doctor carries out the actions that he had previously stated, as he did not receive consent from Mr Smith. Battery will occur if Dr Green performs the procedure without having the legal documents that allows him to perform the procedure (Judicial Commission of New South Wales, 2015). Additionally, false imprisonment will be portrayed if Dr Green performs the procedure where he has not gained consent and is going against that patient’s desire (Judicial Commission of New South Wales, 2015). Due to Dr Green proposing going ahead and perform a procedure on Mr Smith without his consent it will result in false imprisonment being deliberate, complete and both direct and indirect restraints (Staunton, P.J., & Chiarella, M., 2013). Indirect restraints are conveyed when Dr Green says he has to get the procedure done or he will die from the cancer, additionally a direct restraint is present as Mr Smith can not physically escape the procedure (Staunton, P.J., & Chiarella, M., 2013). Q.5. a) Rebecca’s personal values may consist of fairness, compassion, honesty, and respect. Additionally, her professional values comprise of confidentiality, maintenance of requisite boundaries and self-care (Gentile, 2010d). Honesty is a difficult value to discuss as it reflects on both personal values and professional values. Moreover, ethical and legal rights form the pillars of honesty, thus forming a difficult issue to discuss with Dr Green. Honesty is closely aligned professionally with telling someone the truth; therefore in the case study Rebecca should not compromise Mr Smith of the truth or manipulate the truth, which leads to inflicting harm to Mr Smith (Gentile, 2010d). By Rebecca manipulating the truth she breaks her value of honesty, but if Rebecca decides to follow her value of honesty she is then faced with conflicting with Dr Greens desire to manipulate information and perform a procedure without obtaining valid consent. d) I believe that the GVV framework would facilitate the discussion between Rebecca and Dr Green; this is due to the framework breaking down individuals values and portraying how to act when conflict arises (Gentile, 2010d). By understanding the framework, Rebecca would identify her own values, understand her choice, anticipate that her values may result in conflict, identify the purpose of presenting her view, would reflect on her own knowledge and what she perceives to differentiate from right and wrong, would appropriately voice the manner and be educated on how to reason with Dr Green (Gentile, 2010d). Moreover, the GVV framework encourages individuals to set out their values within the workplace by challenging individuals to structure their ideas, beliefs and values
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