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Essay of informed consent
Importance Of Confidentiality In Patients Care
Ethics of medical informed consent
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Therapeutic privilege involves the deception of patients by their doctors. If a doctor feels that pertinent information may potentially do more harm to the patient than good, he may withhold that information. It was once widely believed that if a terminal patient found out he/she were going to die, the information would ultimately cause him/her more harm and anguish. To “protect” their patients, doctors often withheld such information. Grounds for this justification are in the principles of beneficence and nonmaleficence.
Therapeutic privilege is no longer deemed ethical as it disregards the moral principle respect for autonomy. For a patient to be able to act autonomously, the patient must possess a certain amount of knowledge regarding his/her healthcare. Doctors that engage in therapeutic privilege and withhold relevant information are not granting their patient the right to make autonomous choices regarding his/her prognosis or treatment options. This violates informed consent, in which the patient is adequately informed and granted disclosure.
Case #17-1 Therapeutic Privilege: Scaring the Patient to Death with News about Risks provides a good example of why some physicians choose to omit getting a patients consent for certain procedures. Dr. Therapides suspects that her patient has a block in his abdominal aorta and knows that to locate it she must inject the patient with sodium urokon. She is also aware that the procedures has risks and in some cases results in paralysis or even death. Yet, Dr. Therapides feels that the patient, who is already frightened and apprehensive, may become more apprehensive if he is aware of the risks associated with the procedure. Dr. Therapides believes that she should be granted therapeutic p...
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...decision. While Dr. Therapides may feel that her patient will become more frightened after hearing about the risks associated with the procedure, I still feel that it is her duty to inform him.
The patient may not ever be “fully informed” but, the pertinent information in this case must be disclosed if Dr. Therapides plans to follow protocol. In following the elements of consent, she must make sure that her patient has the capacity to make a decision in his healthcare and voluntarily agrees to do the surgery. Dr. Therapides must also disclose the possible risks and benefits of the treatment options and give her professional recommendation. Lastly, Dr. Therapides should make sure that her patient understands what the options are in regards to his treatment, diagnosis, and prognosis, and is able to make a decision and either authorize or refuse the recommendation.
American Medical Int’l, Inc. According to this theory, individuals’ decisions are guided by what they are supposed to do, not by consequences or effects. That is to say, a person’s action is ethically right if it coincides with a prevailing moral duty (“Deontological Ethics,” 2007). In the dilemma involving the patient Riser, Dr. Lang violated the theory of deontological ethics by not performing his duty of acquiring informed consent from the patient. By standard of conduct, Dr. Lang was supposed to present a consent form to Riser prior to the operation that would explain the procedure of a femoral arteriogram (although it was supposed to be bilateral arteriograms instead) and thoroughly explain the possible benefits and risks of the procedure. As a result, the patient should have the right to decide whether the femoral arteriogram should be performed or not. However, Riser was not aware of the femoral arteriogram at all. Therefore, deontological ethics should have been followed, which would advise Dr. Lang to follow the ethical duties of a healthcare professional, and those include obtaining informed consent from the
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
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
Healthcare creates unique dilemmas that must consider the common good of every patient. Medical professionals, on a frequent basis, face situations that require complicated, and at times, difficult decision-making. The medical matters they decide on are often sensitive and critical in regards to patient needs and care. In the Case of Marguerite M and the Angiogram, the medical team in both cases were faced with the critical question of which patient gets the necessary medical care when resources are limited. In like manner, when one patient receives the appropriate care at the expense of another, medical professionals face the possibility of liability and litigation. These medical circumstances place a burden on the healthcare professionals to think and act in the best interest of the patient while still considering the ethical and legal issues they may confront as a result of their choices and actions. Medical ethics and law are always evolving as rapid advances in all areas of healthcare take place.
Principles of Biomedical Ethics, by Tom Beauchamp and James F. Childress, has for many critics in medical ethics exemplified the worse sins of "principlism." From its first edition, the authors have argued for the importance and usefulness of general principles for justifying ethical judgments about policies and cases in medical ethics. The organization of their book reflects this conviction, dividing discussion of particular ethical problems under the rubrics of the key ethical principles which the authors believe should govern our moral judgments: principles of autonomy, nonmaleficence, beneficence and justice.
Dr. Nemur and Dr Strauss are arguing about whether or not they should use Charlie,“Dr Nemur was worried about using me but Dr. Strauss told him Miss Kinnian recommended me the best from all the people who she was teaching”. This shows that Ms Kinnian recommended Charlie and most likely reviewed the surgery. Ms.Kinnian cares for Charlie, so would not recommend him without looking into the surgery. What this argument fails to consider is the fact that Ms. Kinnian was the only one that reviewed it. There was no other person allowed. Dr. Nemur even specifically told Charlie not to tell anyone, “ Joe Carp said hey look where Charlie had his operation what did they do Charlie put some brains in. I was going to tell him, but I remembered Dr. Strauss said no”. This goes to show how little people are allowed to know about the operation. Even the friend of the patient is not allowed to know. This is no ethical because then people that care are then not allowed to give their review on the subject. Therefore there may not be a proper amount of people that is needed for a proper
Denise Dudzinski, PhD, MTS, Helene Starks, PhD, MPH, Nicole White, MD, MA (2009) ETHICS IN MEDICINE. Retrieved from: http://depts.washington.edu/bioethx/topics/pad.html
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.
However, it has been reported that telling a patient the truth may significantly improve their wellbeing as they approach the end of their life. One study revealed that truth telling may reduce terminal cancer patients’ uncertainty and anxiety, as indicated by lower scores on a Hospital Anxiety and Depression scale, and higher scores on a Spiritual Well-being scale (Kao et al. 2013). Furthermore, while there is no explicit principle regarding lying within the Hippocratic Oath, honesty is a virtue that is closely associated with physicians and health care providers. In fact, honesty can be closely related to respect for persons, which implies that it is necessary for the maintenance of the physician-patient relationship. Honesty about all relevant aspects of a patient’s diagnosis, prognosis and treatment are necessary to build trust, and to obtain informed consent.
...d how these determinations effect a physician’s approach to various types of critically ill patients? These types of questions come in to play when one attempts to critically analyze the differences between the types of terminally ill patients and the subtle ethical/legal nuances between withholding and withdrawing treatment. According to a review by Larry Gostin and Robert Weir about Nancy Cruzan, “…courts examine the physician’s respect for the desires of the patient and the level of care administered. A rule forbidding physicians from discontinuing a treatment that could have been withheld initially will discourage doctors from attempting certain types of care and force them prematurely to allow a patient to die. Physicians must be free to exercise their best professional judgment, especially when facing the sensitive question of whether to administer treatment.”
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
Patient confidentiality is one of the foundations to the medical practice. Patients arrive at hospitals seeking treatment believing that all personal information will remain between themselves and the medical staff. In order to assure patients privacy, confidentiality policies were established. However, a confidentiality policy may be broken only in the case the medical staff believes that the patient is a danger to themselves or to others in society. Thesis Statement: The ethics underlying patient confidentiality is periodically questioned in our society due to circumstances that abruptly occur leaving health professionals to decide between right and wrong.
Disclosure of pertinent medical facts and alternative course of treatment should not be overlooked by the physician in the decision making process. This is very important information impacting whether that patient will go along with the recommended treatment. The right to informed consent did not become a judicial issue ...
...ns. Patients should not be so medically ill that they are unable to make this decision. Patients should be fully conscious and understand the implications of their decision. Everything should be documented possibly even videotaped that way the doctor doesn’t lose their job, receive a lawsuit or worst jail!