Running Head: Balancing the Rights of Patients and Medical Professionals In the medical field, law and ethics play a vital role in the relationship between patients and medical professionals. Violation of these laws results in liability of the offender. Ethics considers the best interest of an individual and society. It establishes and maintains a nature of obligations and duties. Biomedical ethics plays a significant role in guiding medical personnel on how to treat their patients. Medical [G1]
professionals offer a critical service to the public and, as a result[G2]
, it is required of them to maintain certain principles and establish grounds for their own protection. The practice of ghost surgery goes against the ethical principles of the medical profession and, [G3]
ethical and legal consequences. Ghost surgery occurs whenever the contracted medical doctor is not the one who carried out the actual surgery. Patients are usually unaware of the substitution due to being in an unconscious state. Medical institutions use this practice as a method of training medical students. This is done without the patientâ€™s consent. The legal doctrine of informed consent stems from fundamental principles regarding individual autonomy and the fiduciary doctor-patient relationship (Kocher, 2002). It may also be used as protection for medical professionals. The practice of ghost surgery has raised great concerns to the public, and also in the legal and medical sector as to who is to be held liable for mishaps due to this practice. Key features of biomedical ethics are beneficence, non-maleficence, patient autonomy, justice, and veracity. Beneficence [G5]
conveys the idea that healthcare professionals have a duty to act in regard to the benefits of patients. Non-maleficence questions the possible harm to the patient. In making decisions, the benefit to the patient should outweigh the harm. Patient autonomy is also important. Patients have the right to make their own decisions in respect to treatment and to have their confidentiality protected. Biomedical ethics establishes [G6]
accepted standards of which medical professionals should uphold. Professional negligence of a medical professional committed whether by oversight or an act may result in unfortunate outcomes such as injury or death of the patient. Such negligence is termed as medical malpractice and is usually due to failure to uphold these standards. Some of the most common and difficult ethical issues to navigate arise when the patientâ€™s autonomous decision conflicts with the physicianâ€™s beneficent duty to look out for the patientâ€™s best interests (Pantilat, 2008). Legal cases such as Tunkl V. Regents of University of California and Shorter V. Drury illustrate scenarios in which some ethical issues between patient and medical professionals are contested. They illustrate examples of the conflicts that arise between patients and medical professionals. The case of Tunkl V. Regents of University of California attempted to establish grounds on which it is valid to release a charitable research hospital from being liable for future negligence. Hugo Tunkl was a patient who sued the hospital in an effort to redress the damages of personal injury due to the medical malpractice of two physicians employed by the hospital. Tunkl later died before the end of his case and was therefore substituted by his wife. The hospital had Tunkl sign a release stating that they are not liable for the medical malpractice of its employees. Upon signing this release, Tunkl was under sedation.
The defendant stated that they are a charitable organization and was in no position to compensate any damages. The[G7]
court ruled in favor of the Regents. [G8][G9]
Another example of a case that challenged the ethics of phisicians and their responsibility to patients is the case between Shorter and Drury. This case was tried in the Supreme Court of Washington in 1985. This case involves a patient, Doreen Shorter who sought the medical attention of a medical practitioner Dr. Robert E. Drury. Doreen Shorter and her husband, Elmer Shorter were Jehovahâ€™s Witnessâ€™ who were prohibited by her religion to have blood transfusions. Dr. Drury examined Mrs. Shorter and discovered that she had a missed abortion. There were three possible methods of pursuing the require treatment for Mrs. Shorter. Two of these three methods would put her at a lower degree for the risk of bleeding. Without considering the principles of beneficence, non- maleficence and autonomy, Dr. Drury chose the method that placed Mrs. Shorter at a higher degree of bleeding. Upon experiencing persistent bleeding, Mrs. Shorter was adamant on not having a blood transfusion. Mrs. Shorter refused the recommendation of a blood transfusion and signed a contract that released the medical professionals from liabilities in the case mishaps. Mrs. Shorter died as a result of the medical malpractice, coupled with her religious belief. Her husband sued Dr. Drury for malpractice. The court ruled that Dr. Drury was held liable for his negligence. However, the court acknowledged that the death of Mrs. Shorter was not the sole cause of Dr. Drury. The court stated that seventy-five percent (75%) of the damages were due to the refusal of the deceased to have a blood transfusion. The plaintiff was awarded twenty-five (25%) of the verdict costs. In administering service to their patients, medical professionals should practice certain ethical principles to maintain the integrity of their profession and to assert respect and protection for the rights of their patients. Agreements or informed consent are adopted by healthcare providers as a method of protection. Informed consent doctrine has guided medical decision making by setting boundaries or the doctor-patient relationship.... (Insert citation - page 206 of text).
It protects patients from unwanted medical treatment and the credits the medical professional written. Informed consent in the written format, along with stipulated conditions, is a good method of maintaining a [G10]
balance between the rights of the patients and the needs medical community. In signing any medical agreement, as in the case of contractual agreements, certain conditions should render the agreement valid or void. One such condition that should be considered is if the parties involved (especially the patient) are of a stable state of mind. In the case of Tunkl V. the Regents, the patient was in a fragile mental state and therefore,
the agreement signed for the Conditions of Admission should not have be considered valid by the medical professionals to proceed with any medical procedure. The Regents should have ensured that the Conditions of Admission was signed when Mr.Tunkl's mind was more stable rather than when he was influenced sedation.[G11]
Such condition would be beneficial to the Regents given that they are in no position to offer redress to patients in the event of mishaps.[G12]
The medical agreement in case of Shorter V. Drury may be considered valid as the parties involved were of a stable state of mind. The Shorters were adamant in refusing blood transfusion as treatment due to their religious beliefs. The doctors were not in any position to help save her life and as such, cannot be solely blamed for her death. The partial responsibility of her death is due[G13]
to the malpractice of Dr. Drury. In this case, the judgment and ruling of the Supreme Court of Washington are understandable and may be considered fair[G14]
. Dr. Druryâ€™s failed to consider the harm of his choice of treatment for her initial condition of missed abortion. He failed to inform her of the other methods of treatment that would lower the severity of bleeding she would experience. As a result of this, Mrs. Shorter could not fully access her autonomy. The bioethical principles of autonomy and beneficence often pose conflicts in the relationship between patients and medical professionals. Examples of these conflicts are demonstrated in the cases of Tunkl V. The Regents of University of California and Shorter V. Drury. Patients, [G15]
as well as medical professionals, have a right to protection. [G16]
Upholding medical principle and the implementation of agreements enables this protection. Failure to perform medical duties in accordance with these agreements should be evaluated in an effort to release or hold the medical professional(s) liable. Conditions that validate any legal contract; such as parties being of a conscious mind state, should also be used to validate the medical agreement.
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Bhopal, R. (2002). Natural History, Spectrum, Iceberg, Poplulation Patterns, and Screening. In Concepts of Epidemiology
(p. 138). Oxford University Press. CDC Global Noncommunicable Diseases (NCDs)
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(2011, June). Retrieved from Delaware Health and Social Services: http://dhss.delaware.gov/dhss/dph/files/directindtranspi.pdf Diseases and Conditions - Communicable Diseases
. (n.d.). Retrieved from Wisconsin Department of Health Services: https://www.dhs.wisconsin.gov/disease/index.htm
Kocher, S. M. (2002, January). Ghost Surgery: The Ethical and Legal Implications of Who Does the Operation. The Journal of Bone & Joint Surgery
. Pantilat, S. (2008). Autonomy vs. Beneficence
. Retrieved from UCSF.edu: http://missinglink.ucsf.edu/lm/ethics/Content Pages/fast_fact_auton_bene.htm Quarantine and Isolation.
(2014, January 15). Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/quarantine/ What is Chronic Disease?
(2011). Retrieved from The Center for Managing Chronic Disease: http://cmcd.sph.umich.edu/what-is-chronic-disease.html WHO: Noncommunicable diseases
. (2014). Retrieved from World Health Organization: http://www.who.int/mediacentre/factsheets/fs355/en/
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