Eva Reebel PHIL 2420 Med Ethics Dr. Lorkowski April 5, 2024. Medical Paternalism Case Study Summary of the Case In the recent article “When Fear Undermines Autonomy,” Sheila Kaplan discusses how fear can hinder autonomy in the medical world. She examines how patients often experience losses that can end up changing the way that they think and make decisions. If a medical professional does not recognize a person’s medical state, they will not be able to properly assess and correct their ability to act autonomously. Kaplan outlines a case where a diabetic woman, Mrs. G., went to the hospital in need of an above-the-knee amputation. She was immediately highly accepting of this change and what it would bring to her life, such as requiring a wheelchair. …show more content…
However, in cases where a person is typically rational and fully autonomous, events might take place where their judgment may have bias or errors. Autonomy can be temporarily reduced in situations such as drugs, alcohol, extreme emotional distress, a lack of information, or illness. In cases like these, it is important to consider helping improve their judgment, rather than simply respecting their decision with no further examination. Similar to Dworkin, I believe that if their choice does not align with what a fully rational person would choose to do, then paternalism may be justified while their mental state is altered. Dworkin and I would agree that paternalism should be accepted when it serves to protect the well-being of the vulnerable who are unable to make rational decisions for themselves. While respecting autonomy is crucial, protecting those who are vulnerable is more important; individuals may believe that they are entirely rational, while they are truly rationally impaired. Paternalism should take place where a person is not able to think clearly enough to make their own decisions, but the goal should be to work with them to bring them back to a reasonable state of autonomy, as Dworkin also mentions. If an individual’s decision is persistent after improvement, then it should be
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
Daniel Challahan attempts to argue that Euthanasia is always seriously morally wrong in his article, “When Self-Determination Runs Amok.” Callahan discusses several reasons depicting why he believes that Euthanasia is morally impermissible. John Lachs, however, does not see validity in several of Callahan’s points and responds to them in his article, “When Abstract Moralizing Runs Amok.” Two points from Callahan’s article Lachs challenges are the fundamental moral wrong view and the subjectiveness of suffering.
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...
The concept of autonomy in the medical practice brings many different views. Autonomy is the ability individuals have to be self-governing. In these different views there exist two schools of thought, one is the belief that people are born with the ability to do what they want their body and no organization can tell them what to do with their body, like the government. On the other hand, some people believe that it is more complicated and conditional on mental competency so that person can make rational decisions. However, the majority of people seem to advocate for autonomy. A particular largely uncontroversial discussion arises with the case of Dax Cowart, who had his right to autonomy taken from him in a tragic accident and is therefore, an advocate for autonomy. As an ethics committee, we were to discuss this case in accord with four questions: can Dax Cowart refuse treatment, is no, why. If yes, then when could he be released, and if yes to the first question what would your decision be if Cowart asked for physician assisted suicide. I will be discussing the major points, consensus, and the reasons for the consensus from the committee. In addition, I will summarize the case and state my own opinion.
Decision-making would be so much easier if we all maintained our autonomy in making the decision, however, because our decisions do not always abide by autonomistic values paternalistic intervention must occur. The purpose of autonomy is to allow us to choose to do things that affect only ourselves and does not negatively affect those around us. Unfortunately, many choices do, whether we know it or not, involve those in our environment. Paternalism is in place to protect the rights that are in our best interest and that will benefit us in the long run. Paternalistic intervention occurs when decisions are no longer in our best interests. If the decision is like to be regretted and irreversible in the future, paternalism is again justified. Autonomy is a fleeting concept, for as soon as someone chooses to do something that will later cause an addiction, his or her autonomy is lost. They no longer have the decision to do or not to do the action; it becomes a need.
A simple definition of the human psyche is the embodiment of the human spirit. However, when one takes a more in-depth look, it becomes much more complex than the tidy little package that the definition would infer. The psyche has a direct link to thoughts, emotions, reactions and consequences. Of these components, emotions have the most significant impact on the human essence. The way in which humans view and react to the world around them is directly linked to the conscious and subconscious feelings associated with a particular activating event. The human psyche is driven by a wide variety of emotions ranging from love, hate, anger, happiness, fear, and courage to name but only a few. Of these, fear has the power to disrupt the body and spirit in profound ways as it encompasses all emotions. Therefore, it is the strongest emotion associated with the human condition.
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?
...f such a decision, the government has aright to step in and help the person. This is because at this understanding of the situation, the person is not capable of making a decision that he would likely consent to at after fully understanding the situation. As in the seat belt case, often times, a person does not fully understand that not wearing a seat belt contradicts his true desires and that no possible good or benefit can come from not wearing it. However, when a person is making a rational decision between two things that he values, he is the only person that can decide which is best for him. An important condition to remember in this conclusion is that all of this is assuming that no other individuals are being harmed or put at risk by the actions of these people. Under this condition I have come to the conclusion that there do exist certain circumstances where the government has a right to legal paternalism. These circumstances include times when an individual is unable to make a rational and logical decision for himself either because he does not fully understand the issue or because he is unable to logically assign value to specific possible consequences of a decision.
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
Autonomy means that an individual has the right to make choices about their life (Burkhardt et al., 2014). Any individual of legal age with full mental capacity has the right to refuse treatment. The individual’s choice must be respected even if it is not what the healthcare provider has recommende...
These incorporated ethical convictions touches on treating individuals as autonomous agents and providing protection to persons that possess diminished autonomy. Therefore, respect to person calls for a requirement of acknowledging autonomy as well as protection of persons with diminished autonomy (U.S Department of Health & Human Services, 1979). An autonomous individual possesses the capability of deliberating about personal goals as well as taking action regarding the direction that such a deliberation calls for. Respecting autonomy calls for deep considerations of persons’ opinions as well as choices and also abstaining from any actions that hinders the will of such persons unless they prove detrimental to others. Individuals with diminished autonomy fail to possess self-determination maybe as a result of age, illness or mental disability as well as other circumstances that severely restricts the liberty of such
In his essay, “The Refutation of Medical Paternalism,” Alan Goldman discusses his argument against differentiation in the roles between physicians and patients. He says the physician may act against a patient’s will in order treat the patient in their best interest. Goldman makes his whole argument around the assumption that a person’s right to decide his or her future is the most important and fundamental right, saying, “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.” His claim is that most people agree that they are the best judges of their own self-interest and there is an innate value in the freedom to determine their own future. On these principles, Goldman starts by discussing conditions under which paternalism may be justified.
The concept analysis of autonomy will be analyzed according to the Walker and Avant method of concept analysis. Walker and Avant (2005) present a strategy for analyzing concepts in a comprehensive manner to present new theories and a common definition for different concepts. The current as well as historical meaning is an important aspect to analyze the concept of autonomy, as one must understand how one simple four syllable word grew into such a powerful concept. Definitive attributes drawn from the concept mapped for future use as well as case study as outlined by Walker and Avant (2005). The necessary attributes are then plugged into model, borderline, related and contrary cases so that full concept involvement and understanding is determined. Antecedents as well as consequences of the concept are also discussed for positive and negative connotations can clarify the meaning of the concept of autonomy. Finally the empirical referents of actual phenomena can be realized as Walker and Avant (2005) strive to explain and simplify the concept analysis.
In the words of Bertrand Russell, “Fear is the main source of superstition, and one of the main sources of cruelty. To conquer fear is the beginning of wisdom” (Russell). Fear causes many problems in our lives. Fear influences many of a person’s actions and decisions. However, people usually regret the decisions or actions they made out of fear. Also, these actions and decisions can cause problems for those people in their future. Fear is a harmful emotion, for it clouds people’s judgement, disables them from taking action, and causes them to make decisions that they will regret later.
Respect for autonomy was created to acknowledge and respect the patient by giving them a voice and involving them in the decision making process, by ultimately leave the final decision up to them (depending on the situation/circumstances and within the rules/laws). By involving the patient in the decision making process, it allows them the freedom to act according to their own personal and moral beliefs/views/and traditions, without being influenced by other opposing ideas. The problem with respect for autonomy is determining whether or not a patient is physically and mentally capable of making these decisions or if someone else should, and if that is the case who that person should