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1. This case is complex and multilayered, as the speakers say. It touches upon several major bioethical issues include respect for patient choice, otherwise known as the principle of patient autonomy. The case also addresses the important issues surrounding physician bias, as well as the lack of competencies in physician communication and physician awareness of diversity issues. Although the diversity issues in this case pertain to same-sex couples, it could just as easily have been a case involving culture or any other diversity variable. Although the speakers did not mention medical paternalism, that is something that comes up in this case. Even had the couple been straight, it is possible the doctor would have disregarded the advanced directive, which would have indicated medical paternalism.
The speakers also did not mention the doctor’s point of view, or that of the hospital, both of which are important to take into consideration when analyzing the ethics of the case. Doctors operate under the broad parameters of the Hippocratic Oath, with its stipulations to do whatever it takes to save lives. This directive does come into direct contact with the more modern principle of patient autonomy, which is why medical paternalism can prove problematic. Even when a doctor thinks he...
That obligation is covered under the rubric of deontological ethics, like the speakers indicate. Bioethics have shifted to elevate the status of patient choice over the desire of a doctor to preserve life at all costs. Sullivan (2003) calls this normative shift “the new subjective medicine,” in which the patient—not the nurse, doctor, or anyone else—decides whether they want to be intubated, whether they want to be on life extension, or whether they prefer to let nature take its course. Of course, this mode of ethical thinking overlaps with discourse related to patient autonomy when it comes to euthanasia and physician-assisted suicide, too. A refreshing resolution to the ethical dilemma posed by cases like these is offered by Quill & Brody (1996): the “enhanced autonomy” model, which “encourages patients and physicians to actively exchange ideas, explicitly negotiate differences, and share power and influence to serve the patient's best interests,” (p. 763). The matter of physician bias is a separate one, and does need to be addressed more thoroughly in hospital policy as well as iin medical school education.
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References
Entwistle, V.A., Carter, S.M., Cribb, A. et al (2010). Supporting patient autonmy. Journal of General Internal Medicine 25(7): 741-745.
Pappagallo, M. & Heinberg, L.J. (1997). Ethical issues in the management of chronic nonmalignant pain. Seminars in Neurology 17(3): 203-211.
Nursing Role Roles and responsibilities "A nursing job demands great dedication and commitment from the learner." (Johnstone, 1999). The practitioner of this field is required to have the ability to work under great pressure as well as being able to remain calm under extreme circumstances. There are many responsibilities for any nurse and here we will look at some of them. Firstly, nurse is supposed to be the one who provides care
Nursing Home Report on Conditions at Brighton and Sussex University Hospitals NHS Trust The following report is based on extensive observation of the conditions for patients living at the Brighton and Sussex University Hospitals NHS Trust. While some patients received moderate care, overall, the quality of care in this facility was appalling. All patients -- all people -- deserve to be treated with dignity, and this was far from the case. The
My attitude has changed resulting from the information I learned about business communications quite dramatically. Business communication in my opinion was always something that was important to people working as managers or administrators, but I never fully understood how critical business communication is to all people regardless of the field they work in. The components of business communication most important to my field include learning how to translate one's
It is also possible that Jane could ask for psychological assistance for the Patient in order to ensure greater chance for compliance. What are Jane Martin's responsibilities with regard to respecting Mr. Tate's autonomy and right to self-determination? The State of Nevada both acknowledges and supports a sane, adult Patient's right to self-determination as long as that is not harming others. That does not mean, though, that Jane should ignore the
The strengths of this design are related to the ease of application and usage. The design of the survey was easy to administer and self explanatory. While the weakness was related to the willingness of the participant to Chapter Three 5 participate complete the survey and provide truthful responses. An additional weakness is relative to the age group that was present for the survey and their relationship to the use of
Nursing Ethics While most hospitals seem to be well-run and most situations and scenarios are planned for in advance when it comes to what nurses should be doing, should not be doing and why, this is not always the case. Just one example of this would be situations where palliative care is probably or definitely called for in a given situation but there is not a defined or clear protocol as