Shine v. Vega
Patient autonomy is “the right of patients to make decisions about their medical care without their health care provider trying to influence the decision. Patient autonomy does allow for health care providers to educate the patient but does not allow the health care provider to make the decision for the patient” (Patient Autonomy, n.d.). In this case, the conflict to be resolved was “the right of a competent adult to refuse medical treatment and the interest of a physician in preserving life without fear of liability” (Supreme Judicial Court of Massachusetts, 1999). We must remember that Jesus Christ is our head and lawgiver. Our self-rule is to be with Him, with no outside interference in harmony with His laws. A symposium of
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a particular patient’s decision to refuse medical treatment or care and what a Christian perspective is of the case. Background The wrongful death case of Shine v. Vega was to determine if the death of Catherine Shine was contributed to her death a couple years later. Catherine Shine, the patient, and a life-long asthmatic controlled her condition, primarily with prescription medications. Ian Shine, Catherine’s father, was her primary doctor who helped Catherine manage her asthma her whole life. Dr. Jose Vega was the emergency physician at Massachusetts General Hospital (MGH) who treated Catherine. Catherine was terrified of doctors and hospitals, but lived through numerous asthmatic attacks, which never required to be connected to a ventilator, and “consistently opposed the use of a breathing tube” (Supreme Judicial Court of Massachusetts, 1999). In 1990, Catherine suffered an asthma attack while visiting her sister.
Though her symptoms had lessened after using her inhaler, her sister insisted she got to the nearby hospital, MGH, for oxygen to be administered. Shine agreed on the condition that she will only be treated with oxygen only. Catherine was administered oxygen through a mask along with medication, but complained it made her head hurt. A blood gas test was ordered, which showed Shine was “‘very sick’ and the emergency room physician, Dr. Jose Vega, recommended that Ms. Shine be intubated. When she objected, he agreed to continue the oxygen mask instead” (Supreme Judicial Court of Massachusetts, 1999). Catherine and her sister plotted to leave the hospital. They both felt Dr. Jose and the staff was not listening to their demands and continued stance that Catherine felt her breathing had eased …show more content…
significantly. After trying to leave the hospital, Shine was forcibly constrained and a breathing tube was inserted, against her objections. Shrine was released from the hospital the very next day, but the experience traumatized her. Catherine suffered nightmares, missed several months of work, and cried constantly since that experience. Ms. Shine was traumatically traumatized that, two years later she suffered another severe asthma attack and refused to seek medical attention because of her fear of hospitals and doctors. It was only after she became unconscious, her brother was able to call for an ambulance, and after two days in the hospital, Catherine passed away. Catherine’s death resulted in this suit being brought against Dr. Vega, because if her wishes were respected or honored during her previous admission, she would have been more susceptible to seek treatment later when it was needed. Dr. Vega argued that he had no objection to follow Catherine’s wishes, but her consent was not required before her treatment. Although Catherine refused further treatment after the oxygen mask, Dr. Jose believed that he was required to treat her against her wishes. The Massachusetts Supreme Judicial Court stated, “under Massachusetts law a patient has the right to refuse medical treatment except in an emergency, life-threatening situation" and “the right of the state or the obligation of the state to preserve the lives of its citizens ... a right that exists in an emergency room setting to perform treatment without the consent of the patient” (Supreme Judicial Court of Massachusetts, 1999). Therefore, the court ruled in favor of Dr. Jose Vega and was remanded to trial court to determine if Catherine’s situation was truly an emergency situation that required disregard of the patient’s consent. Christian Worldview Catherine Shine made her choice to obtain care in the hospital to ensure her asthma attack had subsided.
God does not force us to choose Him; He instead gives us the choice. He “let us discern for ourselves what is right; let us learn together what is good” (Job 34:4, NIV). Therefore, it is up to the individual to decide what is right or wrong for them. Patient autonomy is more so letting the patient decide their degree of care. Everyone has a preference about what they want and what they believe is right or wrong for them. It is important for one to decide what it is he or she wants or needs out of life or for their life. God will always be there to support one on their journey because he is our father, and he gave us life. He will only intervene when inconsequential situations occur. “The Lord said to Moses, ‘when you return to Egypt, see that you perform before Pharaoh all the wonders I have given you the power to do. But I will harden his heart so that he will not let the people go’” (Exodus 4:21, NIV). Evidently, this is an example where God stepped in and prevented Pharaoh from making this decision. God will put us on the path we need to be on, as a way to direct our steps or decisions on our journey, but he will always let us choose and plan our destiny because he already knows the decisions we will
make.
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
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
At first, I believed that a patient should have the say so and get what they demand. I didn’t feel sympathetic for the health care provider one bit. I was able to look through the eyes of a physician and see the trials that they have to go through. It is not easy making the decisions that they have to make. There job is based on decisions, and most of it is the patient’s. “There will certainly be times when I will be faced with a request from a patient or patient’s representative that I will personally find morally difficult, but one that is still legally and ethically acceptable. must be very difficult to work in an area with little control over what you want to do.” (Bradley 1). Even though I do not fully understand a health care providers everyday role, I do know that they are faced with painful options. I personally feel that I can not work in this field for that exact reason. Health care providers play an extremely important role in our society, and others need to look upon
The Bible tells us God is sovereign and all throughout its contents we see the scriptures confirm the sovereignty of God. There have been many discussions on the selectivity of God pointing to the doctrine of predestination, the doctrine of predetermination, and the doctrine of election. But God makes it clear that He “will be gracious to whom I will be gracious, and will shew mercy on whom I will shew mercy” (Ex. 33:19 KJV).
Mrs. Ard brought a wrongful death law suit against the hospital (Pozgar, 2014). The original verdict found in favor of Mrs. Ard, but the hospital appealed the court’s ruling (Pozgar, 2014). During the course of the appeal, an investigation of the records showed no documentation, by a nurse; of a visit to Mr. Ard during the time that Mrs. Ard stated she attempted to contact a nurse (Pozgar, 2014). The nurse on duty stated that she did check on Mr. Ard during that time; however, there were no notes in the patient’s chart to backup the claim that Mr. Ard had been checked on (Pozgar, 2014). One expert in nursing, Ms. Krebs, agreed that there was a failure in the treatment of Mr. Ard by the nurse on duty (Pozgar, 2014). ...
Patient autonomy was the predominant concern during the time of publication of both Ezekiel and Linda Emanuel, and Edmund D. Pellegrino and David C. Thomasma's texts. During that time, the paternalistic model, in which a doctor uses their skills to understand the disease and choose a best course of action for the patient to take, had been replaced by the informative model, one which centered around patient autonomy. The latter model featured a relationship where the control over medical decisions was solely given to the patient and the doctor was reduced to a technical expert. Pellegrino and Thomasma and the Emanuel’s found that the shift from one extreme, the paternalistic model, to the other, the informative model, did not adequately move towards an ideal model. The problem with the informative model, according to the Emanuel’s, is that the autonomy described is simple, which means the model “presupposes that p...
Patients are ultimately responsible for their own health and wellbeing and should be held responsible for the consequences of their decisions and actions. All people have the right to refuse treatment even where refusal may result in harm to themselves or in their own death and providers are legally bound to respect their decision. If patients cannot decide for themselves, but have previously decided to refuse treatment while still competent, their decision is legally binding. Where a patient's views are not known, the doctor has a responsibility to make a decision, but should consult other healthcare professionals and people close to the patient.
Within public health, the issue of paternalism has become a controversial topic. Questions about the ethics of public health are being asked. The role of ethics in medical practice is now receiving close scrutiny, so it is timely that ethical concepts, such as autonomy and paternalism, be re-examined in their applied context (Med J Aust. 1994). Clinically, patients are treated on a one on one basis, but public health’s obligation is toward the protection and promotion of an entire population’s health. So, based on this difference, the gaping questions targeting public health now becomes, under what conditions is it right to intervene and override an individuals’ autonomy?
his own life how he wishes, even if it will damage health or lead to
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
The patient might just be waiting for the disease they have caught to kill them, but it does not always go so quickly . ¨Ending a patient's life by injection, with the added solace that it will be quick and painless, is much easier than this constant physical and emotional care¨ (Ezekiel Emanuel, 1997, p. 75). If a patient is terminally ill and will not get better, it allows them to end the suffering. If the physician has to keep a constant eye on the patient and they need constant care and the patient is not getting better, the option is there if they want to end all of it they can. Sometimes dealing with all of the physical care like medications and not being able to live completely normal with a disease is hard. It can get extremely hard and stressful that all the patients can think about doing is ending it, this alternative gives the patient a painless option. According to Somerville (2009), ¨… respect for people's rights to autonomy and self determination means everyone has a right to die at a time of their choosing¨ ( p.4). The patient deserves to choose whether they want to keep fighting or if they cannot go any farther. The patient should not have to push through a fight they have been fighting and know they cannot win. According to Kevorkian ¨the patient decides when it's best to go.¨ Nobody tells the patient when they have to end their lives, they understand their body and know
As nurses, it is important that we “be both empowered and competent enablers of patient empowerment.” (Burkhardt & Nathaniel, 2014, p. 493) We take an oath to follow an ethical code which requires us to act as our patient’s advocate while providing safe nursing care. Nevertheless, we cannot make any medical choice or decision on their behalf. We also cannot empower them, “because to do so removes the element of choice.”
Autonomy is very important in healthcare today. Patient autonomy and professional autonomy are two things to be considered in the medical profession. Patient autonomy is the right of the patient to make decisions regarding their own healthcare. Professional autonomy on the other hand is the right of the healthcare provider to turn down treatments that are unrelated to the condition of the patient and/or a concern for safety. Taking into consideration Rule Utilitarianism, Kant’s Deontology, Virtue Ethics and the Feminist Theory of power relationships, Dr. Brown should not renew Mr. Noble’s prescription for tranquillizers until there is evident proof that it is treating his condition.
Joffe, S. (2003). What do patients value in their hospital care? An empirical perspective on autonomy centred bioethics. Journal of Medical Ethics, 29(2), 103-108. doi:10.1136/jme.29.2.103
Most people like to believe that when making medical decisions the one that results in the chance of survival is the one chosen. But as we look at a few cases we discover that others choose what they believe to be their faith over medical treatment, ultimately resulting in death. There is an old tale passed down regarding religion and the medical field. “There’s a man who’s stuck on a boat in the water when a vicious storm occurs. The lifeguard tries to save him, but the man says no, my God will save me!