Health Ethics Autonomy and Paternalism

Added on - 28 May 2020

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Health EthicsAutonomy and Paternalism, confidentiality and consent(Student Details: )
Health EthicsEthics are the values which guide the actions of the individuals, and are based on the morals ofsuch individual. These morals and values channel the acts undertaken by the people. These ethicstranslate in the daily lives of people and decide upon the manner in which a person acts.Naturally, these also shape the manner in which the work is done by the individuals (Smith,2008). When it comes to healthcare, the role of the individuals, in adhering to the ethical valuesin enhanced. This is because the relationship between the patients and the healthcareprofessionals is one of trust and care; and due to the dominating position of the healthcareprofessionals over their patients and the ones related to the patients, it becomes utmost importantthat the ethics are properly followed. This is particularly due to the patients having certain rightsin the kind of treatment they get and the duty of the healthcare professionals to respect thehuman rights of their patients. One of such rights is autonomy, where it is stated that the patientsneed to have the freedom of deciding upon their lives, which includes the medical treatment theyget, and the like. However, a controversial issue in this regard is offered through the concept ofpaternalism. This concept provides that there should be the right with the healthcareprofessionals to interfere in the liberty of actions of an individual owing to their welfare,happiness, interests, values, or good (Murgic, et al. 2015). The difference between the two, interms of healthcare ethics is elucidated below. Along with the clash between the two concepts,the discussion would also highlight the significance of consent and confidentiality in context ofhealthcare. The overall purpose here is to highlight the key points which are related to healthcareethics.Consent, or is aptly known as informed consent, in context of healthcare industry, is referred tothe permission given by the individual, after they come to know about all of the facts of the caseand the possible consequences of undertaking such actions. In doctor-patient relationships,Page2
Health Ethicsinformed consent holds major significance as the patients are required to be given the entire factsof their case and the possible results of their treatment, in order for such patient to given theirinformed consent to a particular treatment. This allows the patients to analyse all the facts andweigh in the pertinent risks, before they opt for a particular treatment suggested by the healthcareprofessional (Wear, 2012). This consent is based on the clear understanding, as well as, on theappreciation of factual background, its implications, and the consequences of going forward withthe proposed action. Particularly in context of ethics, a proper and informed consent has its rootsin the dignity of any individual. This means that the people need to be provided with theadequate reasoning facilities for them to give their consent on the basis of the facts which arerelevant to them (Brown, 2011).The concept of consent is based on the basic human rights and on the ethical principle of patientautonomy. The patients have all of the freedom in order to make a decision on what happens totheir body and for gathering the relevant information before a surgery, test or procedure isundertaken. A patient cannot be coerced in any manner; the doctors simply have to act as thefacilitator of the decision making of the patients. Consent is not only stemmed in ethicalprinciples, but in the legal ones as well. Where the informed consent of the individual is nottaken, and the patient is touched by the doctor, it would be treated as battery, which is a physicalassault in legal terms, and is also punishable. This makes taking of the consent very crucial in thedaily physical examinations. This makes the mutual communication between a patient and doctorinstrumental in context of the choice, authorization or permission of the former for acting thelatter in a specific manner (Rao, 2008).Another crucial element related to consent is the difference between an implied and expressconsent. The implied consent, as the name suggests is one which is implied through the conductPage3
Health Ethicsof the patient; and the express consent is the one procured expressly from the patient. Thedifference between the two can be better elucidated through respective examples. When a patientgoes in the chamber of the doctor and they express their problems to the doctor, there is animplied consent to the doctor for undertaking the general physical exam and for carrying theroutine investigations. However, when it comes to the express consent, the same is needed forintimate examinations. For instance, where an invasive test or a risky procedure is to beundertaken, a specific express consent has to be taken from the patient, which can take form ofwritten consent or oral consent (Snyder and Leffler, 2005). It remains preferable to take writtenconsents in such cases where long term follow up is required, in addition to the procedure beinghigh risky intervention, surgery or cosmetic procedure. In order to gain the informed consent ofthe patient, crucial information has to be disclosed which involves the need for further testing,the condition of patient, results of treatment, different available options, possible complications,expected outcome, duration and cost of treatment, and the possible benefits and risks of suchtreatment (Heywood, Macsakill and Higgins, 2010).The concept of consent is also aligned based on the ECHR, i.e., the European Convention onHuman Rights. Under article 3, it is specifically provided that a forced treatment which is givenagainst the wishes of an individual would be deemed as the breach of this article, as this article isrelated to the inter alia inhumane and degraded treatment (Byrne, 2012). In Ireland, the patientdoctor relationship is deemed as a privileged one and is dependent on the trust of the patient inprofessional conduct of the doctor. This is the reason for issuing a Guide to Professional Conductand Ethics by the Medical Council for the registered medical practitioners (Medical Council,2018).Page4
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