Question #2
In case number 2, the ethical issue is Karen’s refusal to take a mammogram in spite of the mass detected in her breasts. As a gynecologist, I ought to protect my patient’s health and one way to do that is to examine her and to identify the true cause of the mass in her breast. However, regardless of my genuine concern for her wellbeing, she still has the right to decide whether to go for or against any treatment or test that concerns her body. I have the responsibility to respect her autonomy.
McCormick says that the said respect is not measured through attitude; instead, it is measured through the way a person behaves in recognizing the independent yet informed decision of the patient (McCormick). In this case, Karen has every right to refuse a mammogram. However, I need to know her reasons. This is to identify if there are any religious or moral issues that she is considering in her decision. Also, the need to identify whether or not she has Alzheimer’s disease is of higher importance as Alzheimer’s disease can affect her intellectual capabilities. This can result in less credible decisions from her. If she is incapable of making sound decisions then I could probably seek a decision from her immediate family.
Any independent person has the right to choose freely, be it based on a religious belief system or in various values that may limit his or her other freedoms (Beauchamp). However, as the principle of beneficence suggests, as a health professional, I am accountable for my patient’s welfare. It is therefore my obligation to stop and to eliminate the impairment from my patient. Thus, I need to inform Karen, together with her husband, about the risks of the mass in her breasts. The consequences of her refusal to take a mammogram must be clarified to her. As a gynecologist, I need to strongly convince her to undergo a mammogram. When she and her husband are informed, she can then choose freely if she will accept my advice. According to McCormick (2013), the physician must communicate with patients in great compassion and respect for the patient’s beliefs and perceptions even at the expense of any medical intentions.
Question #7
For me, the doctor did not make an ethical decision in case number 7. The first come, first served basis should not always be applied, especially if the patients’ wellbeing are at stake. There should have been a fair and equal evaluation of the patients’ conditions before he came up with a decision. The Alzheimer Europe Organization reported that under the principle of justice, a fair judgment and settlement should be made between contending claims.
Under this principle is a category called distributive justice. According to the Alzheimer Europe Organization, this category pertains to the “fair distribution of scarce resources.” This does not only mean that the resources should be shared equally. This also means that the resources should be distributed in the fairest way possible. Since the alcoholic has serious health issues, it should have been considered by the doctor before deciding to give him the cornea. Since he has other health problems, he tends to benefit less from the corneal transplant than the attorney. As said in Alzheimer Europe Organization’s article entitled Justice, as we face a scarcity of resources, we are prioritizing those who can benefit more from the resources (Alzheimer Europe Organization). We should employ effective utility of the scarce resources. Also, according to Lawrence, in practicing the principle of beneficence and nonmaleficence, one should weigh the benefits (beneficence) and risks (nonmaleficence) of every action and do what gives the best result (Lawrence 35). In this case, the attorney has a higher moral claim over the cornea since the alcoholic has other diseases, which can harm him and potentially put the corneal transplant to waste.
However, social status should not be relevant in accessing medical healthcare. As stated in the principle of justice, people should be treated equally, regardless of their social position.
Question #8
First, both the physicians fail to consider the principle of autonomy. As said above, patients have the right to decide what to do with their body. Although the duty of the physician is to inform them and do what’s best for them, it is still the patient’s last call whether to have any health-related procedure performed on him or her (Lawrence 35).
. The physician who refuses to perform assisted suicide is the same as the physician who refuses to perform abortion because both consider the principle of non-maleficence. It is stated in the principle that any health professional should not do any harm to his or her patient. As such, killing a person, when he or she can be possibly treated, and killing an unborn child are harmful to the patient.
In some countries, a physician has the rights to refuse to perform procedures that may involve ethical issues such as abortion and assisted suicide. The physicians in both cases may also consider the principles of justice when refusing to perform such acts. It is because as stated in the principle of justice, one should respect and abide by ethically accepted laws.
Health professionals are confronted with ethical choices. In this regard, the four principles of bioethics guide health care workers in weighing morally conflicting situations and providing the best decisions. Not only do they consider the cultural and diverse backgrounds of
their patients, they also reflect on their own belief system.
Works Cited
Alzheimer Europe. “Justice.” alzheimer-europe.org. Alzheimer Europe, 2013. Web. 11 Nov.
2014 <http://www.alzheimer-europe.org/Ethics/Definitions-and-approaches/The-four-
common-bioethical-principles/Justice>
Beauchamp, Tom. “The Principle of Beneficence in Applied Ethics.” plato.stanford.edu.
Stanford University, 3 Oct. 2013. Web. 11 Dec. 2014
<http://plato.stanford.edu/entries/principle-beneficence/>
Lawrence, Dana. “The Four Principles of Biomedical Ethics: A Foundation for Current
Bioethical Debate.” Journal of Chiropractic Humanities (2007): 34-40. Print.
McCormick, Thomas. “Principles of Bioethics.” depts.washington.edu. University of
Washington, 1 Oct. 2013. Web. 11 Dec. 2014
<https://depts.washington.edu/bioethx/tools/princpl.html>
