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What are the ethical theories that support making a treatment decision for a patient even when he or she does not want treatment?
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While respecting patient autonomy is crucial in medical practice, there may be instances where healthcare professionals must make treatment decisions for patients who do not want treatment. In such cases, various ethical theories provide a justification for overriding patient autonomy in favor of the patient’s best interest. This answer will explore three ethical theories that support making a treatment decision for a patient even when they do not want treatment.
Consequentialism is an ethical theory that focuses on the outcomes or consequences of actions. According to this theory, the moral rightness or wrongness of an action is determined by its overall consequences. In the context of medical decision-making, consequentialism suggests that if the consequences of not providing treatment are likely to result in severe harm or death for the patient, it may be morally justified to override the patient’s refusal and proceed with treatment. The immediate and long-term well-being of the patient becomes the primary consideration, outweighing the value of patient autonomy.
The principle of beneficence emphasizes the moral obligation to act in the best interest of others and promote their well-being. In healthcare, this principle entails the duty of healthcare professionals to maximize the benefits and minimize harm for patients. Therefore, if it is believed that treatment is necessary for the patient’s overall health and well-being, even if they refuse it, the principle of beneficence supports making a treatment decision on their behalf. This is based on the understanding that healthcare professionals have specialized knowledge and expertise that enables them to assess the patient’s condition more accurately and make decisions in their best interest.
Paternalism is an ethical theory that justifies intervention in a person’s actions or choices for their own good, even against their expressed wishes. In the medical context, paternalism involves making treatment decisions on behalf of patients when it is believed to be in their best interest, even if they resist or reject the recommended treatment. Paternalistic interventions are typically justified when patients lack decision-making capacity due to cognitive impairment or when their refusal of treatment poses significant risks to their health or life. The underlying principle is that healthcare professionals have a responsibility to protect and promote the welfare of their patients, even if it requires overriding their autonomy.
It is essential to note that while these ethical theories provide a justification for making treatment decisions against a patient’s wishes, they should be applied cautiously and within ethical and legal frameworks. The ultimate goal remains to respect patient autonomy as much as possible while ensuring the promotion of overall well-being and a duty of care.