Virtuous physicians always asses the decision making capacity and the competence of their patients to make sure they have adequate capacity to make their own decisions, especially for patients who refuse specific treatment, have mental illness, or have specific factors that impair their ability to make decision( _1).
What make a patient competent to make a decision? , and do depressed people lose their competence and their decisional capacity? . Depression is a common side effect of cancer (2), and cancer treatment require a lot of important decisions that patients need to make which are very significant in determining their future, and respecting patient will is fundamental in term of autonomy, but what if the patient refuse the treatment, if the doctor consider him as non-autonomous he also will think about his duty in non-maleficence and about his responsibility in supporting and respecting patient wishes.
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If a patient refuse the treatment in reflection to his desire of death, low self-esteem , thinking that life is not worth living, in that case we can say depending in autonomy definition that they are non-autonomous.(3) in addition Depressed patients usually undervalue the future risks from refusing the treatment, so they lose the ability in reasoning process and according to ucsd reasoning is one of the main elements for decision-making capacity (4) .However , addressing them as non-autonomous come with high price , because first we will ignore patient Preferences , and the harm of enforcing the patient to take medications against its will , might exceed the harm of the patient without medications. (5) that is why deciding if a patient is competent or not should be evaluated in proportion to
In some cultures, family members make treatment decisions on behalf of their loved-ones. Provided the patient consents to this arrangement and is assured that any questions about his/her medical care will be answered, the physician may seek consent from a family member in lieu of the patient.”
The concept and ideology behind Physician-Assisted Suicide within the contemporary generation has become an exceptionally sensitive and controversial issue as multiple factors conglomerate to define if Physician-Assisted Suicide is justifiable within the grounds of ethical understanding and moral principles. The idea concerning PAS is based on the grounds of rational and irrational thinking as in if death is a rational choice above all other alternatives (Wittwer 420).
In doing so, doctors also disregarded the patients’ autonomy in their decision to have themselves committed for their altered mental state. Invalidating the patients claim and affecting their trust, which is the pinnacle of the patient-doctor relationship. With psychiatric patient even more so because there must be a level of trust in the person’s claim and in their determination, that they might be having a breakdown. A beneficial scenario for the parties involves would have been if the doctors’ actions promoted more good, or beneficence, and gave Jessie better tools to cope with his PTSD. Instead, of taking an inactive approach, which allowed the situation to escalate to the point he became a danger to himself and others.
The last argument that this paper will look at is the argument of double effect. In the context of terminal illness physician assisted suicide could instead be seen as a vital form of care for someone who is suffering, instead of the failure of medicine. Physician assisted suicide seems to oppose the pro-life view, but on closer examination, its purpose is instead to relieve suffering in imminently terminal cases where it is thought that no other treatment could reasonably hope to do the same. Even though traditionally the role of the doctor is seen as extending life, that role may also encompass the assistance in PAS.
A patient’s decision-making capacity is variable as their medications or underlying disease processes ebb and flow. You should do what you can to catch a patient in a lucid state - even lightening up on the medications if necessary and safe - in order to include her in the decision making process. Delirious patients have waxing and waning abilities to understand information. However, if a careful assessment is done and documented at each contact, and during lucid periods the patient consistently and persistently makes the same decision over time, this may constitute adequate decisional capacity for the question at
Dilemmas are situations in which a difficult choice has to be made between two different options which can be taken. The Mental Capacity Act 2005 outlines a legal framework for making decisions on behalf of those who lack the mental capacity to make specific decisions on their own. All those working with and caring for an adult who may lack capacity to make particular decisions must comply with this Act when making decisions or acting for the individual, when the individual lacks the capacity to make that decision for themselves. This applies to life changing matters as well as every day matters. The Act firstly looks at whether an adult over the age of 16 has the legal capacity to make decisions for themselves, unless they show signs of
The thesis of this chapter states that in certain situations, it is crucial to listen to a medical professional, however, in others, it is very important to listen to yourself and also to do what you feel is right. The author of Complications," Atul Gawane, has written this specific chapter to persuade the reader of his thesis. If the choice you make is incorrect, then it could potentially be a matter of life and death. Atul Gawande gives multiple examples of patients that have made wrong and right decisions to prove his point. He uses the personal anecdotes of four different people, with four decisions to prove his point.
Life is never guaranteed and whether it is through an illness or an accident, we as humans are eventually going to die. Physicians Assisted suicide is one of the most controversial issues. The issue of doctor-assisted suicide has been the subject of the heated dispute in recent years. While some oppose the idea that a physician should aid in ending a life, others believe that physicians should be permitted in helping a patient to end his or her unbearable suffering when faced with a terminal illness. Furthermore, Physician-assisted suicide should be legal; it should be the patient’s right to decide when and how he or she should die.
But there continues to be adverse reactions concentrated towards the practice. After reading and comprehending the controversies of the topic, I have come to a firm belief that terminal patients should have the right to control their death through the use of assisted suicide when faced with
Most people would never contemplate whether or not to end their family pet’s suffering, so why can’t people be as sympathetic to their family and friends? In today’s society, the legalization of physician-assisted suicide is one of the most debatable topics. The debates on physician-assisted suicide go back and forth between whether or not patients, specifically terminally ill patients, should have the right to die with the aid of doctors. Opponents believe physician-assisted suicide is morally and ethically wrong for patients to end their lives, and they believe it violates basic medical standards. However, proponents of physician-assisted suicide believe it is a humane and safe way for terminally ill patients to resolve their agony.
Wednesday, October 22 Reading Response 2 “Living Will” by Danielle Ofri is about an author who is a doctor who came across a patient that is suicidal. “They All Just Went Away” by Joyce Carol Oates is about a young lonely girl who finds herself attracted in entering abandoned house and is entranced by other peoples lives and what they left by. Although these stories are very different, I believe both the authors share a similar idea, but different outlooks, of how the main characters in each essay struggle to do the right thing. “Living Will” gives us a better perspective of what doctors today have to face with their jobs. The author, Danielle Ofri, came across a severely ill patient, Wilburn Reston, which really makes her think.
But in Donald’s case it was the total opposite. He went to the hospital with his mind already made up to die, which goes against what the doctors have being taught to do, and the principle of beneficence. The doctors decided to reject his autonomy because they knew he had an immense possibility of having a happy live and not just simply acting in a paternalistic way. In the end the doctors decisions was the right choice, when Donald stated, “I am enjoying life now, and I’m glad to be alive” (Munson6).
The ethical principle of autonomy provides for respect for the patient’s autonomy to make decisions and choices concerning their life and death. Respecting the patient’s autonomy goes against the principles of beneficence and non-maleficence. There also exists the issue of religious beliefs the patient, family, or the caretaker holds, with which the caretaker has to grapple. The caretaker thus faces issues of fidelity to patient welfare by not abandoning the patient or their family, compassionate provision of pain relief methods, and the moral precept to neither hasten death nor prolong life.
He uses examples of cases in which people committed crimes involuntarily. Eagleman also cites examples of mental diseases in which the victims have no control over their impulses or actions. In other words, there are people who simply cannot stop themselves from making horrible or regrettable decisions. Therefore, this essay challenges the assumption that people have the power to choose how they live their lives and to make the right decisions at all times. Eagleman addresses the readers directly in order to be able to demonstrate that he understands that his readers will find his ideas radical.
Atul Gawande in his article “Whose body is it, anyway?” introduced couple of cases, which discussed a controversial topic, doctors dealing with patients and making important medical decisions. These are difficult decisions in which people might have life or death choices. Who should make the important decisions, patients or doctors? Patients don’t usually know what is better for their health and while making their decisions, they might ignore or don’t know the possible side effects and consequences of these decisions.