Dr. Gawande’s Respect for Patient Autonomy in Whose Body Is It, Anyway?

Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment

Atul Gawande in his article “When the Doctor Makes Mistakes” exposes the mystery, uncertainty and fallibility of medicine in true stories that involve real patients. In a society where attorneys protect hospitals and physicians from zealous trials from clients following medical errors, doctors make mistakes is a testimony that Gawande a representative of other doctors speak openly about failures within the medical fields. In this article, Gawande exposes those errors with an intention of showing the entire society and specifically those within the medicine field that when errors are hidden, learning is squelched and those within the system are provided with an opportunity to continue committing the same errors. What you find when you critically analyse Gawande, “When Doctors Make Mistakes essay is how messy and uncertain medicine turns out to be. Throughout the entire article you experience the havoc within the medicine field as the inexperienced doctor misapplies a central line in a patient.

In a particularly morbid display of irony, Huyler, an emergency room physician who has pledged to serve the health of humanity, wishes his comatose patient was dead. In “A Difference of Opinion,” Huyler is treating a patient who has been in the Intensive Care Unit (ICU) for over a month and showed little sign of improving. Due to the

The concept of autonomy in the medical practice brings many different views. Autonomy is the ability individuals have to be self-governing. In these different views there exist two schools of thought, one is the belief that people are born with the ability to do what they want their body and no organization can tell them what to do with their body, like the government. On the other hand, some people believe that it is more complicated and conditional on mental competency so that person can make rational decisions. However, the majority of people seem to advocate for autonomy. A particular largely uncontroversial discussion arises with the case of Dax Cowart, who had his right to autonomy taken from him in a tragic accident and is

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

In his essay, The Refutation of Medical Paternalism, Alan Goldman states his argument against a strong doctor-patient role differentiation, in which the doctor may act against a patients’ immediate will in order to carry treatment in the patients’ best interest. Goldman frames his entire argument around the single assumption that a person’s freedom to decide his future is the most important and fundamental right as he claims “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.”[1] He claims that the majority of people would agree that they are the best judges of their own self-interest

To begin with the person is the centre of the plan, to be consulted with and their views must always come first: It should include all aspects of their care, and every professional should work together to provide it. (Leathard 2000) Autonomy refers to an individuals’ ability to come to his or her own decisions and requires nurses to respect the choices patients make concerning their own lives (Hendrick 2000).However Gillon Argues that the principle respect for autonomy may need some restriction, otherwise we may be morally obliged to respect an autonomous course of action with unthinkable consequences.( Gillon 1986) Every human being has an intrinsic value, they all have a right to well being, to self-fulfilment and to as much control over their own lives as is consistent with others (British Association of Social Workers 2002).Professional Judgement and patient preference cannot be suspended if practice is to be safe and effective rather than routine(DOH 2005) Alex had to attend this session as it was within his Timetable, how could it have been effective?, he was unhappy and

Patient’s decisions may sometimes be affected by various factors i.e. Their surroundings, they are often vulnerable and out of their normal environment. A conventional health care setting may be in a hospital environment where patients are most likely feel sensitive and insecure. Matiti and Trorey (2008:17) conducted interviews involving 102 patients in 3 different hospitals across the United Kingdom, over a period of 18 months. The purpose of these encounters was to annotate what was being said and also the fundamental meaning of how patients believed that their dignity was being put in jeopardy. One of the key aspects of patient dignity is making choices. Whilst conducting these interviews Matiti and Trorey (2008:17) discovered that despite the fact that patients accepted the loss of a little independence within the hospital surroundings, they wanted the freedom to participate in the decisions about their healthcare. Patients’ understanding in terms of choice, authority or participation in care and autonomy varied extensively. A number of patients were grateful that they were given the option to make decisions and that these were acted upon. On the contrary others considered that their right to making choices was contradicted and often their

“An ethical dilemma exists when a choice has to be made in which the consequences may have a potential positive or negative outcome.”("Topic 4: Contemporary Ethical Dilemmas (How do managers evaluate beginning-of-life dilemmas?). ", n.d.) The given scenario presents a patient named Jamilah Shah, who is of Turkish descent, 90 years old and collapsed at the side of her bed in the extended care facility in which she resides. The patient suffers from Chronic Pulmonary disease and diabetes mellitus. The patient was rushed to the ER were the EKG and lab tests revealed she suffered a heart attack and she was started on anticoagulants. The patient has no advance directives and a communication barrier exists, the ER department contacts the emergency contact, one of the patient 's sons Bashir. The patient 's family arrives at the hospital and her son states that he makes the decisions and the wants a do not resuscitate order for his mother and no medical intervention other than comfort care. The social worker handling Jamilahs case is concerned by her family 's lack of support and that the family 's wishes are at odds with the patient 's request for help and her expressed desire to live. Furthermore if the patient does not receive a cardiac catheterization or is considered for a coronary bypass, she will surely die.

There comes a time in any health care worker’s life where they have to make difficult decisions. Many physicians have to make tough calls when they try to do what is in the best interest for the patients, and sometimes there are points where the physicians have to ask for help from the patient’s family members and ask what the is in the best interest for the family. This example shows up in the case of Dr. Benitz, the chief neonatal physician at Stanford University which explains that some of the children that show up in his clinic have a very slim chance of surviving he then goes on to explain that one baby that was in the clinic on the day of this interview was born pre mature and “weighed only 13 ounces. This is where Dr. Benitz says he

Traditionally, the physician was expected to use all of their talents and training in an effort to save the life of their patient, no matter the odds. More recently, the physician’s role has been redefined to preserve the autonomy of the patient. Now physicians must give life saving care only in so far and to the degree desirous of the competent patient.

In conclusion, Person introduces two conflicting opinions of the main message, medical ethics. However, there is a bias towards Jenna’s initial view, and the opinions of Lily and Alleys. Overall, the author uses this book as a way of showing us the ever-more relevant debate of medical ethics, but wants us to make our own decision of what view to

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

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:

Autonomy applies to the profession of nursing because the patient should always be allowed to make decisions regarding their care while being treated with respect and dignity; however, autonomy can serve as a limiting agent when the patient decides to refuse care that would be of benefit to them. Autonomy is a sensitive issue because it allows the patient to choose to die and all health care can do from that point is allow the patient to do so comfortably. With healthcare always being one step ahead, it allows a surrogate to serve as a voice piece for that patient when they are unable to make decisions. However, that surrogate can end up making decisions they think is best for the patient ignoring the patients’ will. The responsibility of the nurse and interdisciplinary team is to inform and educate the patient and patient’s surrogate on all aspects of care to include medical diagnosis, treatment, and care plan so that the patient and