health services.case study 1
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Apr 3, 2024
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Case Study 1: The Principle of Autonomy
Bethel Tewabe
HHP:4040:0EXW
Dr. Gayle Walter
April 23, 2023
This scenario raises several ethical and legal issues. The woman’s right
to informed consent, autonomy and full participation of her own healthcare decisions, was violated and I don’t believe that there is any way the physicians actions could be justified. Ethically, the surgeons actions could be seen as an abuse of power since they overrode the patients wishes and made the decision for her. Furthermore, one of the primary reasons why patient autonomy is important that it recognizes the individual as a unique and valuable being and gives them a chance to assert their independence, exercise their freedom of choice and express personal values. This promotes a sense of self-worth and dignity, which can be very hard to feel for patients with sever illnesses or in dire situations. Legally, this could have caused a plethora of issues of the surgeon and the hospital. Performing the surgery without the patients consent could be considered battery, a type of intentional harm even if the surgeon believed they were acting within the woman’s best interest. This is simply because since no explicit permission was given, her right to bodily integrity was also violated. For the hospital, they could be held legally liable for this situation if it were to be looked into and determined that their supervising and training of staff was negligent considering lots of people had to make many decisions for the surgery to be done, it could also show that they are not training their staff to respect the wishes of the patients and to disregard their rights.
Although the physician believed she was not in her right state of mind, it does not look like he offered any alternative options or involved any other
medical professionals to determine her mental state, such as psychiatrists, in
the decision-making process. Understandably, time was of the essence but that wasn’t a decision that the physician can make solely on their own.
The only kind of situation that would allow the override of someone’s autonomy would be if the patient was incapacitated and requires immediate medical treatment to prevent death or harm. This is expressed in the term of implied consent, which primarily handles emergency like situations. For this specific situation, there was no emergency occurring so there would be no court order that would justify the actions of the physician.
If I were one of the health care professionals witnessing this take place in the emergency room, I would inform the physician of the possible implications that could arise from this decision, even though I’m sure they would already know. If the physician is non-responsive I would then notify the
proper upper management to stop the surgery from occurring, whether that be the administration or the medical ethics committee.
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References
Erlanger Medical Ethics Orientation Manual. (2000). Section 5. Principles of biomedical ethics
Gottesman, Sara. “Patient Autonomy in Direct Primary Care.”
Voices in Bioethics
, Colombia University Libraries, 20 May 2022, https://journals.library.columbia.edu/index.php/bioethics/article/view/
9679.