Over the last fifty years, the methods in which doctors and physicians approach medical decisions have changed significantly. The medical choices for many generations have always been left exclusively for doctors and patients if they chose to be part of it, but they still had little say in the final decision. There was a change in this paternalistic process of decision making from the late 1960s to the 1970s where there was a campaign for patient empowerment in regards to the ethical care of patients by medical ethicists.
Respect for the patient is one principle that has gained traction among physicians over the years. Another belief that has dramatically influenced medical practitioners is the patient-doctor relationship which is the concept of respect for a person’s autonomy. The idea of autonomy means that patients have the right to make their own decision and go against what the doctor wants. This essay takes the position that it is right for patients sometimes to be protected from their own decision making.
There are some instances when the decision about a patient’s treatment or health can be made without their consent mainly because there are patients who cannot make a fully informed decision resulting in their choice causing more harm than good. The law has always demanded that physicians should do as the patient requests out of respect for their dignity but at times this could cause severe consequences for the patient.
An instance when the patient does not meet the demands of specific health care decisions, then it is fair that the decision is made for them. Doctors usually find out if their patient has the sufficient ability to make a capable, meaningful, and specific decision in regards to their health given the particular circumstances that they are facing. Sometimes a patient may make a choice that is medically unsound for example a patient may refuse to go through routine medical care or a life-sustaining treatment which is viewed as ordinary care and a medical procedure that is a must to have it.
Such a decision is alarming because it raises the question of whether the patient knows exactly what they are doing or want. Doctors and loved ones always have a reason as to why they hide some decisions from their patients’ one being their psychological characteristics and how they may be affected by it. Depression is one of the reasons as to why sometimes a patient cannot be involved in their healthcare decision making. An excellent example of this is when a patient who used to be happy begins to make statements that they want to stop their treatment and have a natural death.
This shows that the patient cannot be able to make any sound decision. Patients are usually excluded from decisions mostly when the best possible options for them are uncertain. In such a situation of uncertainty, this burden of coming up with a choice can cause severe anxiety and confusion to both the patient and the family. An autonomous decision does not always mean or reflect the wellbeing of a person especially when the patient exercises it by saying no to treatments that are life-sustaining. A patient’s refusal can cause severe medical consequences which can have more significant challenges for physicians. There are some refusals by patients that are solely based on their religious beliefs, and this signifies they are not entirely competent to determine what is best for them and to make genuine autonomy.
Another situation where a medical decision might be made without involving the patient is when they have a history of schizophrenia with a curable condition, but life-threatening and refuse treatment because they have voices in their head telling them to reject the recommendations of the clinician and this may lead to them avoiding treatment. The autonomous decision for such a patient is not founded on any grounds, and they are mentally incapable of making a decision that will promote their well-being.
Another reason as to why an autonomous decision does not reflect the well-being of a patient is because it might fail to represent what the patient truly wants because the effects of the treatment and illness might have distorted their judgments. In such a case the patient’s capacity to make an informed decision might be compromised to the point of viewing them as being incompetent, but they might reject a treatment that in their actual self would have said yes to it. In such a case it will be difficult for a clinician to accept their autonomous decision because of the consequences of respecting what they want.
An instance like this is when the importance of a healthy doctor-patient relationship comes into play because the doctor might be able to act on behalf of the patient’s values and be able to override the wishes that they have expressed. When a clinician does this, it is because they are hoping that they will receive retroactive consent from their patient. But still, this does not give a doctor the right to act contrary to what their patient wants and imposing their values on them. When the doctor feels the autonomous decision is not for the best interest of their patient, the doctor should provide evidence that what they are asking for is not what they truly want or they want the treatment that they are rejecting.
A patient’s autonomy is an ethical principle that is very important in medicine, but it is crucial that it is neither used as a conceived value that overrides all others nor as a directive that should adhere to the wishes expressed by the patients. The insistent conviction in individual rights is one of the most significant strengths that America has, but it is also its greatest flaw. Most of the time individual rights trump the common good. We as humans have that natural nurturing instinct and always take pride in helping others. Too much consideration being given to individual rights has encouraged greed and rejection of our maternal instincts.
An individual can never sustain themselves as there is always a time when the need for help of the common good will crop up. People have created a world of convenience where there are individuals who believe that they do not need help from any other person to prosper yet there very existence is a result of another person’s life, work, and pain. Individualism has its advantages, but there are certain situations such as the right to get treatment that it should not be applied. This does not mean that a person should entirely give up their autonomy and do whatever the system dictates. It means that one should learn to look beyond their selfish interests and needs.
Balancing between the common good and individual rights will result in the development of a better society. Individual rights should not overshadow the common good that we forget the people around us a good example being when a patient decides to stop treatment because they know they have right to without considering their loved ones. The Act Utilitarianism theory support the opinions shed in this essay as it dictates that an individual should act in a manner that will produce a significant amount of good over evil and one that considers everyone who will be directly affected by the action. The action that is ethically correct is the one that results in the most pleasure and the least pain to a large number of people.
The theory dramatically puts consideration on the impact to others. A good example is when the family of a patient does not support their decision to stop or reject care even though the reasons for their decision are very compelling. In such a case the patient would be morally be obligated not to go ahead with their choice because of the grief and discomforts that it would cause in the majority of people who are involved.
In conclusion, there are medical decisions that when shared with the patient can cause more harm to them psychologically because of the stress and uncertainty that comes with it. There are other cases when the autonomous decision of a patient will work against their well-being and only puts them at risk of severe consequences. In such cases, I believe that it is right for the decisions regarding their treatment or health should be made without involving them. It is not wrong to observe individual rights, but it should not be implemented in a manner that trumps the common good.
