Conflicting Principles: A Medical Dilemma

The assignment content describes the scenario where Sophie was admitted to hospital and asked for her consent before undergoing surgery. The doctor, Dr. Lin, ensured that Sophie understood the treatment and gave her consent. In my opinion, the doctor would not stand liable as Sophie was in a lucid state and gave her consent. Two principles relevant in this scenario are the principle of respect for autonomy, which emphasizes the patient's right to make decisions about their own body, and the principle of beneficence, which requires healthcare providers to benefit patients and remove any harm that might inflict on them. These principles may conflict when a patient's autonomous decision is not in line with what a doctor believes is best for the patient.

Running Head: Health and law
HEALTH AND LAW

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If Joseph and Cindy decided to sue Dr Lin, what type of legal action would that be? What
are the elements of the offence that Joseph and Cindy need to prove for the action to be
successful? What is the standard of proof required in this case?
As it is rightly said that "No doctor knows everything, there's a reason why it's called ‘practising'
medicine.' Doctors are seen as God, and people believe that they would be healed and cured of
any disease but even the doctors do make mistakes which in cases cause a loss or damage to the
patient. The legal action to be taken here is of Medical negligence which is also denoted as
medical malpractice and is improper and negligent treatment by the doctor or healthcare
professional (Griffith, 2017). It occurs when the proper standard of care is not recognised. It is
one of the most unreasonable threatening practice and involves the foreseeing of an adverse risk
involved.
Negligence is the omission of doing something which should have been done by a reasonable
and prudent man. In one of the famous case of King v. Philips [(1953) 1 QB 429], it was held
that the negligence arises when there is a direct harm to the plaintiff and the injury was
foreseeable, thus making damage an important part to bring negligence under the law of torts. A
person claiming to sue in negligence must prove the three fundamental requirements namely that
there was the legal duty to take care by the defendant, there has been a breach of legal obligation
by the defendant and that the violation caused him damage (Chesterman, 2017). In the present
case, Joseph and Cindy need to prove the elements mentioned above.
The burden of proof is on the claimant to show that there has been a breach of duty on the part of
Doctor and also to show what is to be considered reasonable and to what extent has the conduct
of doctor below this level (Kale, 2015).

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Describe the defence that Dr Lin could raise. This includes describing the elements of a
valid consent (with supporting case law and legislation), and the process for obtaining
consent in those circumstances when an adult cannot provide it themselves.
A doctor cannot be held liable in all the cases if the patient has suffered damage due to the
operation, and now the burden of proof shifts to the doctor to prove that he has taken reasonable
care and there has been no breach of duty. The errors can be classified into two broad categories
as the error of judgment due to negligence or mere error of judgment. A mere error of judgment
cannot be taken as the breach of duty to take care, but it occurs when a decision which has been
made by a doctor and then it turns out to be wrong. A retrospective view is put forward in this
regards to say that it was an error and at the time of making a decision it did not seem that
something wrong might happen. The error of judgment occurred when due considerations of all
the factors were not taken.
As per the law, the consent is found to be a full defence pleaded in extreme situations. In cases
where the claimant either impliedly or expressly accepts the risk associated with the treatment
then his claim could easily be defeated by the defence of violent non-fit injuries as seen in case
of Administrators of the Estate of Tan Ah Hock v. Low Beng Hai. Secondly, the doctor would
not stand liable if it is shown that the claimant had full knowledge of the risk that is involved in
the treatment and still agrees to assume the risk that later materialized.
Here in the given case, the consent has been provided by Joseph regarding the proceeding of the
operation since Sophie was not in a state to provide her consent. In conditions like the one
mentioned in the case where Sophie has contracted forgetfulness in such situations, the decisions
are to be taken by her husband.

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The process for obtaining consent in those circumstances when an adult cannot provide it
themselves is informed consent. For a valid consent of the patient, it is important that she is
considered competent for making decisions and the approval so provided should be voluntary. If
the decision-making capacity of the patient varies on a day to day basis, then her consent in the
lucid state should be taken into count ("Ch.20 The Law of Negligence", 2017).
What are the possible outcomes of this case?
The possible results of the present case could be that doctor is not held liable for the state Sophie
gets into as ample consent has been obtained from Sophie and if any doubt persisted by Joseph
then he should look at the instance when the approval letter was not signed, shouldn't have
proceeded with signing the papers. Secondly when Sophie was in her lucid state as to why she
got admitted to hospital and again she was asked reading the surgery to which gave her consent
and hence, in my opinion, the doctor would not stand liable.
Identify two principles that are relevant in this scenario and describe how they apply to the
facts in the scenario.
Major as well as minor ethical choices confront the individuals in daily parlance with regards to
the regulations of medical care. The bioethical principles are non-hierarchical, i.e. to say no one
rule or law wins over another.
The principle of respect for autonomy would be apt in the present case and involves the notion of
making a decision which is moral as well as assuming that rational agents are participating in the
decision-making process which being voluntary (Beauchamp et al., 2016). In all the acts of

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medical treatment, the autonomy of the patient should be given respect which in turn implies that
patient has the capability to operate with understanding, voluntarily and intentionally in making
decisions. In the case mentioned Sophie was asked several times for assurance in furtherance of
the treatment as Dr Lin also could not proceed if the consent by the patient is not given. To the
curiosity of Joseph regarding the operation it was again asked Sophie if she wished to proceed
with the process or not, she was still very bright regarding it, and hence the treatment
commenced.
The second principle is the principle of Beneficence where the healthcare providers are entrusted
with the duty to benefit a patient and remove any harm that might inflict on the patient (Blais et
al., 2015). In this, the doctor stays duty bound to help his patient. The very principle is given a
position of the principle of respect for autonomy. In the present mentioned case reasonable care
has been taken while Sophie was undergoing an operation and since she was one of the oldest
patients of Dr Lin so but naturally special care and attention would have been given to her. There
could have been no chance that proper treatment was devoid from Sophie.
(Depts.washington.edu, 2017)
Describe where a conflict between these principles may arise by considering the different
values of stakeholders in the scenario.
The principle of beneficence has always conflicted with the principle of autonomy and is one of
the most ethical and challenging issues to navigate. It usually happens when the physician’s
beneficent duty is in regards to the patient’s best interests comes in conflict with the patient’s
autonomous decision (Byrd et al., 2014). So far the criteria for making a choice is autonomous,
the physician should convince the patient otherwise thereby respecting the decision of the

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patient. It in a way seems intervening for the patient but is very much useful, and still, it breaches
the autonomy of the patient by not regarding the rights of her decision in undergoing treatment.
In situations which require the critical analysis of the healthcare professionals have in mind the
risks as well as the benefits associated with the decisions made by them, in the entire process of
making the best choices along with the consequences for each choice which should undergo
discussion as well as planning for promoting maximum beneficence and minimum harm with
regards the autonomy.
Apply the Kerridge et al. (2013) model for ethical problem solving to address the conflict
Self-rule, determination, dignity, individuality, knowledge etc., are the various meanings for
autonomy. It is also identified as one with the qualities of actions that are intentional and are free
from controlling influences. Respect for autonomy is considered as a fundamental principle in
the medical ethics. It is important in many aspects for maintain a safe and healthy life and
staying independently. It is the integrity view that allows people with dementia for constructing
their lives in accordance to their values as stated by Dworkin.
A derived set of conclusions, as well as recommendations, have been presented for summarising
the theory and the practice of Interprofessional ethics which in turn includes inter-professional
ethics discourse and as an emerging field as well as the importance of framework.
Conclusion
It cannot be said that the doctors are all the time irresponsible while performing their duty which
requires a lot of patience as well as care but it has often been seen that they either fail or breach

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their responsibility towards their patient. One of the noblest profession is the medicine which
sets a realm benefitting the victims of various diseases. Many things of paramount importance
are often neglected by the doctors which could have been easily avoided, and in such
professional negligence, the focus is required with regards to the laws as well statutes. Hence it
demands setting up of an independent and unique legislation to stop this malpractice by the
doctors.

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References
Medical Negligence - The new legal test in Singapore to determine the standard of a doctor's
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test-in-singapore
Depts.washington.edu. (2017). Bioethics Tools: Principles of Bioethics. [online] Available at:
https://depts.washington.edu/bioethx/tools/princpl.html [Accessed 21 Aug. 2017].
Anon, (2017). [online] Available at:
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21 Aug. 2017].
Kale, K. (2015). Medical Negligence: Issues and Response. SSRN Electronic Journal.
Ch.20 The Law of Negligence. (2017). Singapore law.sg. Retrieved 21 August 2017, from
http://www.singaporelaw.sg/sglaw/laws-of-singapore/commercial-law/chapter-20
Beauchamp, T. L. (2016). Principlism in Bioethics. In Bioethical Decision Making and
Argumentation (pp. 1-16). Springer International Publishing.
Chesterman, S. (2017). The Fall and Rise of Legal Education in Singapore.
Blais, C. M., & White, J. L. (2015). Bioethics in Practice-A Quarterly Column about Medical
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Byrd, G. D., & Winkelstein, P. (2014). A comparative analysis of moral principles and
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informatics, and the health professions. Journal of the Medical Library Association: JMLA,
102(4), 247.

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Griffith, R., & Tengnah, C. (2017). Law and professional issues in nursing. Learning Matters.