Ethics in Medical Practice

The world of medicine faces an increasing number of challenges in making decisions for patients, patients making decisions for themselves and considering both the implications to ethics that the decision-making comes with as well as the legalities involved. The concerns by health professionals in today's society are the growing need to make conscious and ethical choices that serve to promote the most benefit for their patients. A health professional needs to have the right amount of training and competency to manage the several challenges that affect their patients to provide the best solutions that will improve the health of the patient. In many instances, the course of action delivered to a patient may be characterized by some level of risk that may be beneficial or harm the patient. Despite the best efforts to ensure that the patient receives appropriate treatment, most patients are hesitant to pursue the recommendations of the health professionals to the point of rejecting treatment in other cases. These patients are either skeptical of the benefits of the procedure or would prefer a particular treatment different than the professionally suggested. In other words, it is common for some patients not to be willing to go through with treatment provided by health professionals. Health professionals have the mandate to provide services to improve their patient’s health by making ethical decisions that conform to the practice of medicine and abide by the law. At the same time, every patient is protected by legal rights that aid in preventing the patient from abuse by the health professionals and provides the patient with the power to make decisions on their choice of treatment. Mrs. G has the right to choose the treatment she desires and equally has the right to reject any course of treatment due to the implications that the treatment may have on her and her family. Ethics in medicine requires that the rights of the patient to be respected at all-time provided they be in the position to make conscious decisions (Pelto-Piri, Engstrom, K. and Engstrom, I. 49). Mrs. G is within her rights to reject the suggested course of treatment since she views that the consequences of the treatment would harm her lifestyle and also have a significant effect to her family since she is a mother. Mrs. G’s reason is valid, and as a medical professional there is need to consider her views since she is the patient and the recommended treatment will affect her daily life. Ethical medicine requires the respect for autonomy, which calls for the decisions made by the patient need to be respected since they can act deliberately because they understand the issues revolving around their treatment, and no controlling influences affect their judgment. Respect for autonomy requires that the healthcare professionals inform the patient of his or her options and the repercussions of the treatment to assist the patient in decision-making (Stirrat and Gill 128). Mrs. G has been made aware of her condition as well as the effects of the suggested treatment to be used on her per the respect of autonomy. Additionally, ethical practice in healthcare requires the principle of non-maleficence to be followed while attending to a patient for all health professionals. This policy protects the patient from harm and prejudice that may arise while being attended to by health professionals (Stirrat and Gill 128). Mrs. G is protected by this principle because the course of treatment that she is meant to receive may cause her harm. Being exposed to the risk of being crippled would hurt her lifestyle and affect her family since she will become a burden to them.  However, Mrs. G's refusal for the treatment afforded to her is in contradiction with the ethical principles of Beneficence. The health professional under the law of beneficence is required to provide the patient with the best possible treatment that prevents or removes harm to them (McCormick). Mrs. G's condition is critical, and the chances of her blindness or death are high, which presents the dilemma on whether to respect her autonomy or proceed to act on the principle of beneficence. The law requires that the facts of the case be predetermined to decide on matters of compromising the patient’s autonomy. For Mrs. G's instance, she has the right to autonomy since the effects to her life is more critical due to the significant risks in the course of her treatment she is advised to pursue. The odds of recovery for her case are rather slim compared to the odds of her death or becoming a cripple. The dilemma in odds in the medical practice is based on the identification that a patient may or may not survive a course of treatment provided to them. However, odds despite their low or high rationale, do not offer any guarantees to the patient. The patient's health is dependent on various factors that need to be accounted for each time they receive treatment; thus, no odds are suitable for a patient.

Case 2

It is vital to provide the patient with the complete information on their condition, which includes outlining the procedures for treatment, surgery, and medication before the patient makes a decision on the course of action they wish to pursue. The need to provide a patient with the full information on the facts of their conditions is an ethical requirement of the health profession and a legal requirement for all patients. This information provided by the health professionals is referred to as informed consent. An informed consent provides the patient with the necessary information on their condition and the treatment plan outlined for them, to provide the patient with the knowledge and option to agree or reject the treatment provided for them. A patient is at liberty to accept by signing, and equally within their rights to refuse by not signing to approve the consent forms. Patients who refuse to sign often raise concerns on the course of treatment and the repercussions it may have towards their health or beliefs. Therefore, health professionals are obliged both ethically and legally, to comply with the wishes of the patient and not to influence their decision-making, towards the signing of the informed consent. As disclosed by Hastie and Dawes, the choice of action to be taken on a patient lies within the patient's conscious capabilities or the decision by their respective decision makers (284). It is ethical practice to provide the prerequisite information to a patient for them to make proper judgments on the course of treatment they desire or wish to forego. The need for informed consent in medicine is vital since it helps the patients in decision-making as well as provides the medical practitioners with safeguarding from being sued or any legal actions being taken upon them. Informed consent requires the health professionals to outline the risks, benefits and additional options available for the patient that they can take up before any treatment is done on them. It does not require the patient to approve as it also provides the option for refusal if the patient is not in agreement with the outlined preconditions. Mrs. S is legally obliged to defer the determination of her requirement for surgery to treat her condition. Having been made aware of the possible risks and benefits of the treatment being offered to her, Mrs. S needs to decide whether to agree to the treatment being provided or not. However, Mrs. S's denial of her condition makes it difficult to acknowledge her decision to an informed consent since her state has already been medically determined to exist. The choice for informed consent for Mrs. S is challenging since she may not be willing to sign the consent forms despite the efforts of the physician to inform her of her preexisting condition and the treatment procedure that can provide her with optimal health. Ethics in medicine requires that a patient is informed of their condition and the treatment plans that can assist them with the most health benefit. Anderson and Funnell note that it is vital for a patient to be able to have the right amount of information for them to make concise decisions on matters of their health (279). Legally, the physician is obliged to accepting the decisions of Mrs. S since she is an adult and consciously capable of making health decisions for herself. The choice to be in denial about her condition that has been medically indicated is also a decision that Mrs. S is within her right to make despite the negative implications it may have towards her health. Providing an informed concept is, however, mandatory to make the patient aware of the preexisting ways that she could be assisted if she chooses to come around. Influencing a patient into signing a consent form before providing the informed consent information is an ethical wrong and violation of the rights of the patient that is an illegality. The patient needs to decide on the informed consent on their free will without the persuasion of any health professional since it exposes the physician to liability in the event the patient is not satisfied, or the medical implications are experienced. Despite the physician’s predetermination of the condition of Mrs. S and the awareness of the proper treatment she requires, it is up to Mrs. S to decide for herself based on her choices and preference. Legally, the physician is in violation of the code of conduct for the medical professionals that are liable to legal action. The patient is within her rights to choose to refuse or agree to treatment, provided they are consciously making the decisions. Unless Mrs. S is willing to accept her condition is existent, providing an informed consent may not prove useful; nonetheless, it is her right to receive information on her preexisting condition.

Work Cited

Anderson, Robert M., and Martha M. Funnell. ""Patient empowerment: myths and misconceptions."" Patient education and counseling 79.3 (2010): 277-282.

Hastie, Reid, and Robyn M. Dawes. Rational choice in an uncertain world: The psychology of judgment and decision making. Sage, 2010.

McCormick, Thomas R. ""Principles of bioethics."" Ethics in Medicine, University of Washington School of Medicine (2013), from: https://depts.washington.edu/bioethx/tools/princpl.html. 

Pelto-Piri, Veikko, Karin Engström, and Ingemar Engström. ""Paternalism, autonomy and reciprocity: ethical perspectives in encounters with patients in psychiatric in-patient  care."" BMC medical ethics 14.1 (2013): 49.

Stirrat, Gordon M., and Robin Gill. ""Autonomy in medical ethics after O’Neill."" Journal of Medical Ethics 31.3 (2005): 127-130.