Topic Definition Patient Preferences
According to judicial opinion, patient preferences are protected by U.S. law, such as Schloendorff v Society of New York Hospital and Natanson v Kline (Jonsen, Siegler, & Winslade, 2015, p. 50). It is considered illegal battery to administer medical procedures and treatments on an individual without informed consent (Jonsen, Siegler, & Winslade, 2015, p. 50). Physicians who engage in unethical informed consent practices open themselves up to Tort liability under the charge of negligence (Jonsen, Siegler, & Winslade, 2015, p. 50).
Providers who engage in patient-centered practices have a greater likelihood of patient compliance (Jonsen, Siegler, & Winslade, 2015, p. 51). Six questions must be asked to analyze if patient preferences and ethical dilemmas, which include
- Has the patient been informed of benefits and risks, understood this information, and given consent?
- Is the patient mentally capable and legally competent, and is the evidence of incapacity?
- If mentally capable, what preferences, about treatment, is the patient stating?
- If incapacitated, has the patient expressed prior preferences?
- Who is the appropriate surrogate to make decisions for the incapacitated patient?
- Is the patient unwilling or unable to cooperate with medical treatment? If so, why? (Jonsen, Siegler, & Winslade, 2015, p. 51).
Providers must utilize multiple strategies to aid in patient comprehension of medical therapies. This is particularly important with vulnerable populations who may not be literate or have certain learning disabilities. Some strategies include clear explanations in the form of print materials, video or electronic devices, and educational programs (Jonsen, Siegler, & Winslade, 2015, p. 55).
Decision-Making for the Mentally Incapacitated
Failure to Cooperate in the Therapeutic Relationship
What I find interesting is the group of parents who are refusing vaccines are primarily comprised of individuals who are university educated (Even, 2013; Adams, 2010). Educated parents are reading the product inserts and circumventing therapeutic privilege, which is then resulting in refusal of informed consent of vaccines. I am encouraged by the new patient care model that is patient centered and respects individual autonomy and freedom of choice. This is replacing the old paternalistic model where you have providers at all costs shoving unwanted and often unwarranted treatment strategies down the throats of their patients. There is an ethical basis for providers to fire patients, and even an ethical basis for physicians to force vaccines on children; however, there is just recourse. We as parents can vote with our dollars who should benefit financially from providing care to our families. If a practice does not respect our individual autonomy, then they should be boycotted. If a physician should take the liberty of removing parental rights and force vaccinate then, they should be sued for negligence that resulted in the battery of the child.
Of course, the physicians who engage in this sort of hard-line tactics believe in the theory of vaccine derived herd immunity (debunked) and that the risk of the vaccine does not outweigh its benefit (questionable). These providers not only lack the accessible knowledge that is easily accessed regarding vaccination, they are militant in their belief system and should be identified and avoided by those who are concered about the safety and welfare of their children.
Even, D. (2013). More Israeli parents refusing to vaccinate their babies according to state regulations: Health ministry responds to trend with committee to study possibility of public input on inoculation policy. HAARETZ. Retrieved from http://www.haaretz.com/print-edition/news/more-israeli-parents-refusing-to-vaccinate-their-babies-according-to-state-regulations.premium-1.527622
Jonsen, A., Siegler, M., Winslade, W. (2015). Clinical ethics a practical approach to ethical decisions in clinical medicine (7th ed). New York, NY: McGraw Hill
Veatch, R. (2012). The Basics Of Bioethics (3rd ed). Upper Saddle River: Pearson Education, Inc.