DQ 1-1

DQ 1

-

1

First Response

“The

principle

of

autonomy

involves

recognizing

that

right

of

a

person

to

make

one’s

own

decisions”

(Pozgar

&

Santucci,

2016,

p.

40).

Autonomy

in

this

clinical

situation

is

relevant

because

the

patient

is

incapacitated

and

unable

to

practice

true

autonomy

for

himself,

nor

can

anyone

practice

it

on

his

behalf.

The

description

only

says

that

the

patient’s

mother

is

his

surrogate

and

does

not

mention

if

she

is

the

durable

power

of

attorney,

or

if

the

patient

has

a

living

will.

If

these

measures

were

in

place,

the

ethical

principle

of

autonomy

would

be

practiced

and

this

would

not

be

a

component

of

the

ethical

dilemma

.

“Beneficence

describes

the

principle

of

doing

good,

demonstrating

kindness,

showing

compassion,

and

helping

others”

(Pozgar

&

Santucci,

2016,

p.

40).

For

this

ethical

principle,

the

physicians

feel

that

they

are

showing

the

patient

beneficence

by

not

subj

ecting

him

to

harsh

and

aggressive

medical

treatments

and

procedures.

In

this

way,

their

perspective

is

that

they

are

showing

compassion

and

demonstrating

kindness.

From

the

perspective

of

the

patient’s

mother,

beneficence

would

be

shown

to

the

patient

by

making

every

attempt

to

treat

him

and

return

him

to

his

previous

level

of

functioning.

I

assume

she

feels

this

way

because

the

patient

is

young

and

has

a

high

quality

of

life

.

“Nonmaleficence

is

an

ethical

principle

that

requires

caregivers

to

avoid

causin

g

patients

harm”

(Pozgar

&

Santucci,

2016,

p.

40).

It

is

the

counterpart

to

beneficence,

and

would

reflect

similar

ideals

of

both

the

physicians

and

the

mother.

This

may

be

considered

the

most

subjective

ethical

principle,

and

what

“causes

harm”

to

any

ind

ividual

may

vary

greatly.

The

physicians

feel

aggressive

treatments

are

causing

the

patient

harm,

and

the

mother

feels

withholding

any

treatments

is

causing

the

patient

harm

.

“Justice

is

the

obligation

to

be

fair

in

the

distribution

of

benefits

and

risks”

(Pozgar

&

Santucci,

2016,

p.

41).

This

ethical

principle

is

applies

when

considering

the

state’s

laws

regarding

living

wills

and

DNR

orders,

the

specific

wording

of

what

withholding

treatment

and

palliative

care

means

(also

varying

by

state),

as

well

as

eu

thanasia.

Justice

for

the

patient

would

be

granted

if

the

patient

was

given

the

same

legal

rights

as

any

other

patient

in

his

state,

including

his

right

to

refuse

treatment,

have

a

living

will,

and

designate

a

power

of

attorney

to

make

healthcare

decisions

for

him.

In

the

ideal

medical,

legal,

and

ethical

world,

every

patient

in

every

type

of

healthcare

facility

would

be

given

the

same

treatments

because

living

wills

and

their

accompanying

terminology

would

be

clearly

defined

and

described,

but

this

has

not

been

the

case

.

Pozgar,

G.D.

&

Santucci,

N.M.

(2016).

Legal

Aspects

of

Health

Care

Administration

(12th

ed.).

Burlington,

MA:

Jones

&

Bartlett

Learning

.

DQ 1-1

First Response

“The principle of autonomy involves recognizing that right of a person to make one’s own decisions” (Pozgar &

Santucci, 2016, p. 40). Autonomy in this clinical situation is relevant because the patient is incapacitated and

unable to practice true autonomy for himself, nor can anyone practice it on his behalf. The description only says

that the patient’s mother is his surrogate and does not mention if she is the durable power of attorney, or if the

patient has a living will. If these measures were in place, the ethical principle of autonomy would be practiced and

this would not be a component of the ethical dilemma.

“Beneficence describes the principle of doing good, demonstrating kindness, showing compassion, and helping

others” (Pozgar & Santucci, 2016, p. 40). For this ethical principle, the physicians feel that they are showing the

patient beneficence by not subjecting him to harsh and aggressive medical treatments and procedures. In this

way, their perspective is that they are showing compassion and demonstrating kindness. From the perspective of

the patient’s mother, beneficence would be shown to the patient by making every attempt to treat him and return

him to his previous level of functioning. I assume she feels this way because the patient is young and has a high

quality of life.

“Nonmaleficence is an ethical principle that requires caregivers to avoid causing patients harm” (Pozgar &

Santucci, 2016, p. 40). It is the counterpart to beneficence, and would reflect similar ideals of both the physicians

and the mother. This may be considered the most subjective ethical principle, and what “causes harm” to any

individual may vary greatly. The physicians feel aggressive treatments are causing the patient harm, and the

mother feels withholding any treatments is causing the patient harm.

“Justice is the obligation to be fair in the distribution of benefits and risks” (Pozgar & Santucci, 2016, p. 41). This

ethical principle is applies when considering the state’s laws regarding living wills and DNR orders, the specific

wording of what withholding treatment and palliative care means (also varying by state), as well as euthanasia.

Justice for the patient would be granted if the patient was given the same legal rights as any other patient in his

state, including his right to refuse treatment, have a living will, and designate a power of attorney to make

healthcare decisions for him. In the ideal medical, legal, and ethical world, every patient in every type of

healthcare facility would be given the same treatments because living wills and their accompanying terminology

would be clearly defined and described, but this has not been the case.

Pozgar, G.D. & Santucci, N.M. (2016). Legal Aspects of Health Care Administration (12th ed.). Burlington, MA:

Jones & Bartlett Learning.