Medical Paternalism or Patient Autonomy

Medical Paternalism or Patient Autonomy At issue in the controversy over medical paternalism is the problem of enduring liberty. Medical paternalism put up be defined as interfering with a long-sufferings freedom for his or her own wellbeing uncomplaining autonomy means being able to act and make a decision intentionally, with understanding, and without controlling influences (Munson, 38 & 39). The principle of certified bear has come to be essential to whatever philosophical analysis of the tightness between medical paternalism and persevering autonomy in healthc atomic number 18 decision- reservation.However, notwithstanding the obligatory duties physicians sustain to their patients, patient involvement and informed consent should be valued in certain medical incases. Consider, for example, the case of Monica, a 49-year-old muliebrity who was admitted to the hospital for acute respiratory insufficiency. As a heavy smoker, she had been experiencing dyspnea. Upon t esting it appe bed she had several abnormalities in the chest. Following this she became cyanotic and draw nearly lost all consciousness.Furthermore, a bronchoscopy revealed a large, tumor- wish mass in her trachea. Upon further examination it was determined by a multidisciplinary interference team that Monica was so advanced in the tumor, removing it would not be possible, either by surgery or laser. In addition, chemotherapy and ray of light therapy would not cede helped and implanting a stent would have been difficult. Monica had at most terzetto more months to live.With such occurrenceors taken into computeation, the team devised four possible alternatives call back life-sustaining measures, continue mechanical ventilation and heavy drugging without treating whatever complications, implant a stent without Monicas consent, or wake Monica and inform her on the diagnosis and possible alternatives while giving her the final choice. However, the team does not believe that Mo nica bequeath have the full autonomy to make a rational decision on her own.Furthermore, the team worry that reducing sedation while Monica is being intubated bequeath induce tremendous strong-arm pain in the ass. The forefront therefore remains whether they should wake her and inform her diagnosis and prognosis and deliver her to make the decision or make a medical paternalistic decision on her behalf. Because each possible alternative presented in this case have a similar unfortunate end result, it appears that the medical ethical motive issue at most concern is the failure to respect the patients autonomy.The principle of autonomy clearly dictates that Monica should have the opportunity to locate about her future. There are limits to imposing suffering on patients in order to grant them autonomy in decision-making, but only patients themselves rotter know exactly what those limits are. Therefore the caregivers must ask if Monica would prefer to be awakened from sedation at all. If so they must then consider whether she would want to participate in the difficult decision about her give-and-take options.But despite these considerations, Monica has a right to be informed to a class that she herself find outs her medical fate. Therefore, the team should wake her. The harm done to her by vigilant her, however, should be kept to a minimum. She should know her diagnosis and prognosis, and that she raft at any time delegate the decision-making power to another person and start out sedating medication. The question for Monicas caregivers, then, is whether autonomy becomes overvalued when it conflicts with other values.When the possibility was discussed of waking Monica so that she could decide what to do next, the multidisciplinary treatment team worried that she would not be in any gravel to make an autonomous decision on any possible issue when faced with physical suffering and a horrifying prognosis, Consider, however, Kants Metaphysical Principles of Virtue. In this article Kant states that everyone is worthy in making his or her own decisions as human beings (Korsgaard). Therefore, Kant would argue that Monicas physicians are obligated to let her make her own treatment decision.He would even go far enough to say that the caregivers are in no position to judge her level of competence. Accordingly, Monicas willingness to make a decision will calculate on her individual level of pain and ability to learn that she is near death it will not compute on the physicians judgments. Of course, not respecting Monicas autonomy would represent a decision that could be characterized as paternalism. Oftentimes, the word paternalism is associated with physicians grave patients what is good for them, without regard to the patients own needs and interests.In the bigger sense, however, the relationship between physicians and patients is a paternalistic, beneficent relationship the physicians are evaluate to do what is medically best for th e patient, according to Dworkin (Munson, 60). According to the principle of beneficence, physicians have a responsibility to act in ways that promote the well-being of their patients (Munson, 892). Monica faces so short a life expectancy, and the quality of that life can be presumed to be so miserable, that the caregivers may ask whether waking her salutary for the purpose of letting her choose among her horrible options will in fact cause more harm than good.So when deciding about Monicas participation in the treatment decision, the caregivers are right to be concerned about whether she will truly be competent when woken up. But if the underlying concern is competency, we can make the case that she is more than capable of making a treatment decision since there is no best alternative among the treatment possibilities, Monica will not be in a position of asking the caregivers to do something that will inflict harm upon herself, and thus will not have to prove her competency on the highest standards.Therefore, paternalism and beneficence from this perspective is essentially conflicting overall. The caregivers are not at a position to provide what is medically best for Monica because all options lead to about the same unfortunate outcome. In such case there is ultimately no reason wherefore the caregivers cannot respect Monicas autonomy at the very least. One valid argument against the respect for Monicas autonomy is that reducing sedation in an intubated patient like Monica in order to allow her to be informed about her situation and to communicate her preferences will induce significant physical pain.And learning in such a difficult moment that she is spillage to die soon of lung cancer is likely to be very pesky psychologically. However, as stated previously, Monicas willingness to accept this suffering will depend on her individual level of pain and her ability to cope with both pain and learning that she is near death. Perhaps even more importantly, it will depend on whether there are important things in her life that she would like to accomplish before she dies.Many patients would like at least to say arrivederci to their loved ones or clarify a relationship after a recent dispute. Monica might want to make a will or indicate how and by whom her affairs should be handled after her death. Such factors are extremely important to consider upon the last few months of a patients life. Works Cited Korsgaard, C. M. , Autonomy in Kants Moral Philosophy. 1990 Munson, R. interference and Relfection. Boston Clark Baxter, 2012. Wadsworth Cengage Learning.