Ethics Case study
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Informed Consent or Not? Case 1
Informed Consent or Not? Case 1
University of Charleston
Ebony Hopkins
Health Ethics and Policy (HSCI-302-01N)
Professor: Kristi Barnett
October 22, 2023
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Informed Consent or Not? Case 1
Informed Consent or Not?
In the given scenario, a 64-year-old woman with multiple sclerosis (MS) is hospitalized,
and the team feels that she may need to be placed on a feeding tube soon to ensure adequate
nourishment. However, the woman's decision-making capacity fluctuates due to her medical
condition, and she expresses confusion and waffling regarding the feeding tube placement.
Therefore, the following questions arise: Has the woman given her informed consent?
Based on the given information, the woman initially agreed to place the feeding tube in the
morning when she was lucid and able to understand the information provided. Her decision at
that time can be considered informed consent as she met the understanding and voluntary
decision-making criteria. However, her confusion and disorientation in the evening raised
concerns about her decision-making capacity. Therefore, it is essential to evaluate her
competence comprehensively to ensure her final agreement is informed consent.
Should she be judged competent? A comprehensive evaluation is necessary. This
evaluation should consider her cognitive function confusion and waffling at various times.
Healthcare providers should assess whether she has medical power of attorney and whether she
can comprehend the nature, purpose, risk, and benefits of the feeding tube placement and any
available alternatives. The fluctuation in decision-making capacity due to her medical condition
suggests that the woman's competence may vary over time. Therefore, a comprehensive
evaluation of her competence is warranted to ensure that she can understand and process
information, weigh the risks and benefits, and decide based on that information. The evaluation
should consider the woman's cognitive function at various times, considering her confusion and
waffling. Involving an ethics committee or consulting with experts can guide evaluating
competence and ensuring that the patient's final agreement is genuinely informed consent.
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Informed Consent or Not? Case 1
Should her final agreement to the procedure be sufficient to establish informed consent, or
should her earlier waffling and confusion also be considered?
In cases where a patient's decision-making capacity fluctuates, it is crucial to address any
inconsistencies in decision-making. While the woman's final agreement in the morning, when
lucid, may be considered informed consent, it is essential to feel her confusion and waffling.
Evaluating her competence comprehensively and involving appropriate experts will ensure that
her final decision is genuinely informed consent, aligning with her true wishes and values.
In conclusion, informed consent is a cornerstone of patient-centered care, ensuring
individuals have the necessary information to make decisions about their health. However, in
cases where a patient's decision-making capacity fluctuates, such as in individuals with multiple
sclerosis, ethical dilemmas arise regarding informed consent. Assessing the patient's competence
comprehensively and involving an ethics committee or experts can guide the evaluation of the
fluctuating nature of decision-making capacity and ensure that the patient's final agreement is
genuinely informed consent. By taking these steps, healthcare providers can uphold the
principles of autonomy and beneficence, ensuring that the patient's best interests are respected
while respecting their autonomy. Maintaining the principles of autonomy and beneficence
requires a nuanced approach that respects the patient's autonomy while considering their
fluctuating decision-making abilities.
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Informed Consent or Not? Case 1
Reference
Informed Consent,”
Ethics in Medicine
(University of Washington School of Medicine),
http://depts.washington. edu/bioethx/topics/consent.html (17 November 2007).