Goldman 's Critique Of Medical Paternalism

Katz states, “the conviction that physicians should decide what is best for their patients, and, therefore, that the authority and power to do so should remain bested in them, continued to have deep hold on the practices of the medical profession “(214).

Cassandra’s case is unique based on her experiences, and therefore a simple norm of autonomy vs. beneficence can not be created, and instead must be weighed differently based on the circumstances of each case. Cassandra should be able to make the erudite decision, and it should be superior to the doctor’s own plans for the course of action. Cassandra should be able to decide what the best course of treatment is for herself, and, if she does not want chemotherapy, then her sentiments should be respected and followed rather than her being forced into treatment and having to live with severe side effects. While doctors are charged with with the necessity to help patients, they must also care about the individual’s own desires - Cassandra’s beliefs should be compromised with rather than trampled

In the current situation, a physician is withholding a portion of information about the treatment that is used to treat the patient melanomas (10% of those whom survive can contract a form of leukemia) from his/her patient because the doctor is afraid that if he/she disclose the truth of the 10% to her patient, it may unduly alarm her. After, it may causes her to deny the treatment and thereby, spoiling the patient's chance for long term survival. However, in this situation, the patient is deciding a decision for his/her patient, without taking into considerations of the patient's right of autonomy and of self determination. Higgs also brought upon the "Principle of Ethics", which mentioned one part: that a physician at all time, deal honestly with his/her patients or colleagues. Therefore, i believe that Higgs would recommend the physician to tell his/her patient about the downside of the treatment and perhaps, let the patient decide whether or not he/she want to continue with the treatment or

Rarely any physician intends to harm patients when he or she provides treatment to them. Patients see physicians and specialists in full faith that they will get help with a condition. What complicates the patient-doctor relationship is that the outcome of each patient’s treatment is different because of individual health conditions and the course of treatment chosen by the doctor. Problems arise when a patient is not satisfied with care provided by the doctor or in extreme cases when a patient dies. Since most of the time it is hard to clearly determine whether the outcome was solely a result of the course of treatment chosen by the doctor or whether other factors played a role too, quite often patients take their

Another issue with the implementation of Informed consent arises when the patient waives the right to Informed consent and leaves the right to make the decision on the physician. Though legally correct, this can cause psychological stress for the physician especially when the decision is about a life threatening medical condition. Moreover, this also makes the patient vulnerable to abuse. (Manthous, DeGirolamo, 2003)

Autonomy includes three primary conditions: (1) liberty (independence from controlling influences), (2) agency (capacity for intentional action), and (3) understanding (through informed consent) (Beauchamp & Childress, 2009, p. 100). According to Beauchamp & Childress (2009) to respect autonomous agents, one must acknowledge their right to hold views, to make choices, and to take actions based on their personal values and beliefs (p. 103). Respect for autonomy implies thaturges caregivers to respect theassist a patient in achieving? Heed? the autonomous choices of their patients. From there, patients can act intentionally and with full understanding when evaluating medical treatment modalities. Autonomy also includes a set of rules, one of which requires that providers honor patient decision-making rights by providing the truth, also known as veracity (Beauchamp & Childress, 2009, p. 103). In this case, several facets of the principle of respecting autonomy, specifically veracity, informed

To argue the first premise, he appeals to common knowledge that doctors hold their occupations because they are more knowledgeable in a medical context on the options for improving health and longevity. With this in mind, he then establishes that individuals who consult physicians do so in order to prolong their life and improve their well-being. By establishing these foundational premises for paternalism in a medical context, Goldman can now argue that given a patient that is determined to be acting out of line with his true values and his actions might result in harm that is severe, certain, and irreversible, it is the physician’s professional to override the patients’ immediate rights in order to preserve that patients’ more long-term desires. But how can the physician determine whether the patient is acting in line with his true values in the case of withholding medical information from the patient?

Every patient has a right to decide on their own course of treatment and freely consent to that treatment. In order to make an educated decision they must be provided with the proper information to make an informed choice (Opinion 8.08 - Informed Consent, 2006). It is the physician’s legal and ethical obligation to provide this information when making their recommendation on treatment. The choices given must be in accordance with good medical practice (Opinion 8.08 - Informed Consent, 2006). The informed consent is the legal policy, either written or verbal, that gives full disclosure of all the information including potential risks that is applicable to the patient’s condition and treatment being offered (Kazmier, 2008).

I must be aware, as the patient’s advocate, of the choice of each individual patient regarding his or her medical management or, as in this case, the withholding of treatment.

Paternalism not so long ago was the model used in patient relations, it embodies two main ethical principles: beneficence—doing good- and non-maleficence—preventing harm. Dr. Fox could have prevented harm by considering the family’s wishes, and would have done

Quality health care is an issue in America for everyone, despite our numerous tests and advances in technology. In his article, “Overkill,” Atul Gawande argues against a common assumption that our healthcare system is the best because of these medical advances. In fact, Gawande claims that our health care provides much unnecessary care that often causes harm and that costs a lot . He follows that claim by redefining “low-value care” as “no-value care” and provides considerable scientific data along with his own experience with his own patients to support his claim. He also states logical reasons by referring to expert authorities who critique our health care by viewing it from an economic perspective: like talking about information asymmetry where a doctor is more informed than the patient, thus the doctor has more power over the patient. All of these emphases strongly defend his controversial claim. But what stands out most is how Gawande uses several stories showing vastly different outcomes, depending on how informed the patient and doctor are including offering non invasive treatments. We need to explore how his unusual storytelling strategy exposes how surgeons and patients should care more about quality than the mere quantity of tests and what alternatives are available to change the unnecessary over testing and over-diagnosis which prevent good health care.

You bring up a very good point regarding health care ethics, which maintains that providers advocate for the best care of their patient. Informed consent requires that healthcare workers provide patients with “reasonable” information on their options for treatment (DeBord, 2014). Healthcare workers who intentionally withhold information about a relevant treatment option or who minimize risks and exaggerate the benefits of a procedure to a patient are engaging unethical behavior. I believe physicians must strive to provide informed consent to patient so as to have the patient be an active participant in their care. Author Kass, believes that medical ethics must respect patient autonomy, and I agree (Kass, 2001). Informed consent and autonomy

Respecting autonomy is when a physician respects a patient’s wish when the patient makes a fully informed decision. (Rhodes, 77) Patients are expected to participate in their health care by understanding the risks and benefits of the procedures they agree to, and the physician are expected to provide necessary information and allow independent choice. Miller, in his essay “Cosmetic Surgery and the Internal Morality of Medicine”, argues that cosmetic surgery does not allow for true autonomy as deceptive advertising fails to properly inform patients of plastic surgery risks:

Michael H., a 68-year-old man, was admitted for exploratory surgery of his abdomen. He is frail, and his attending physician describes him as “emotionally labile.” Marcy R. is a social worker at BFL General Hospital, who is assigned to the unit that Michael H has been admitted. After Michael’s surgery, Marcy R. was approached by Michael H.’s daughter, Ellen B. in which Ellen has told Marcy that her father’s physician had just informed her that the lab report from the exploratory surgery shows that her father has terminal cancer. Ellen said that she and the family are in shock and they have decided that they not want the hospital staff to tell her father about the terminal nature of his cancer once he recovers from anesthesia. In this essay, I will discuss the ethical dilemma of “to tell Michael or not to tell him he has terminal cancer. He has the right to confidentiality by not withholding information from him when he has been diagnosed with terminal cancer, informed consent, and self-determination.

Written about the structure and culture of biomedical heath care and a society that is attempting to prolong aging, Medicare funding, funding and development of research, and today’s definition of standard care, Sharon Kaufman brings to light the many dilemmas posed to the American health care system. Her ethnographic story, Ordinary Medicine: Extraordinary Treatments, Longer Lives and Where to Draw the Line reveals the booming biomedical research and clinical trials industry, the power held by Medicare and private insurance, and a rapidly changing standard of care once a medical treatment is considered reimbursable. This leads to systematic changes in the standard of care result in a massive amount of pressure being placed upon doctors, patients and families to make an ethically and medically sound decision in refusing or accepting therapy. Kaufman exposes the driving forces behind the expansion of biomedicine, society’s response to the growing industry on a personal and bureaucratic level.