hen Patient autonomy conflicts with professional autonomy or well being of a third party what should be done

Preferred language style: English (U.S.

).  Paper needs to be in Word for Medical Ethics class. Paper should analyze cases and issues using Kantian ethical theories. Must include following concepts in its analysis and specify them in the paper: Autonomy as the capacity for effective deliberationThis definition also considers rationality and freedom from coercion as necessary but insufficient components of autonomy.

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To these criteria, it adds a range of factors that could infringe on clear thinking: depression, grief, lack of full information, or exhaustion, to name a few that could be especially relevant in a medical scenario.So, if I am an HIV+ patient about to undergo outpatient surgery and I do not tell my doctor about my condition; Liberty Limiting Principles; Principle 5: Offense.  Exactly what it sounds like, this means denying someone’s freedom of action or thought because you find those actions or thoughts offensive, they bother you. This principle is often cloaked in language of public harm or even paternalism, i.e., individuals are suggested to constitute a danger to self or others due to their unconventional lifestyles; Negative rights: the right to be left alone. This is the right emphasized in the first definition of autonomy.

It is the type of right recognized repeatedly in the Bill of Rights. Confidentiality is an example of a negative right; it is the right to be left alone to divulge your medical information when and to whom you see fit. The right to refuse medical treatment is another example of an established negative right.The paper needs to reference relevant cases and philosophical arguments.

Citing is a mustAutonomy as the capacity for effective deliberationEvery patient in the health system has certain rights and obligations.  The healthcare professional and the healthcare organization should also know these rights, and should respect them.  Among the rights of the patient are the autonomy and the informed consent rights.  However, in the relationship between the patient and the healthcare professional (including physicians, specialists and nurses), the society also plays a very important role, which need to be recognized by the healthcare professional.  This relationship is like a triangle, involving the patient, healthcare provider and the society.

  Every adult who has a sound mind has the right to determine any action or objective done with his/her body.  The healthcare provider has the obligation of respecting this right.  Before performing any treatment/intervention, the healthcare provider would have to explain the details of the procedure, along with the risks, benefits, costs and viable alternatives.  The patient should be able to make a reasonable decision about the therapy which would be conducted.  The patient has the freedom to accept or reject any treatment, without assigning any reason.However, there are several complex issues concerning autonomy.

  Autonomy can be described to a form of deliberate choice making in which the patient is given all the respect and would able to make a more rationale decision.  The issue of autonomy involves several other rights including self-governance, privacy (including confidentiality), liberty, individual choice and actions, etc.  The patient had to act with self-governance due to self-determination.  Autonomy is a right to freedom and others do not have the right to interfere with the decisions made by the patient.   In all cases of protecting the patient’s right to autonomy, the healthcare provider should ensure that the patient is not treated against their will.

  Taking consent for one treatment and performing another or not performing any treatment at all would be considered to be a form of malpractice.  Leino-Kilpi et al (2000) considered patient’s autonomy to exist at three levels, namely:-·         At the physiological level – Independent from other autonomous processes·         At the personal level – Identifying the self and acting according to the will·         At the social level – This mainly involving constraining factors whilst exercising one’s right to autonomy (E. Sakellar, 2003)The information presented to the patient should be complete and sufficient to make a reasonable decision about their health.  IF the physician thinks that the patient’s decision-making is impaired, then the physician should consider using a surrogate to provide the decisions.  If the patient is legally not competent to make a decision about their health, and the physician considers such decision, then it could be considered as malpractice.

  In the US healthcare concept, Autonomy is given central consideration and all cases of malpractice are based on the right to autonomy.  In most Western countries, the right to autonomy arises naturally and out of the need to impose certain moral laws on oneself.  The cornerstone of patient’s autonomy is the informed consent process.  During the deliberation of autonomy, personal goals are frequently sought by the patient without consideration of the social issues.  Frequently, in a clinical situation, the patient’s right to autonomy and privacy would not be interfering with social issues.

  However, if there is a clash between the right to autonomy of the patient and the social interests, then the social interests would persist considering the greater number of people involved.A patient suffering from HIV/AIDS and who know their HIV/AIDS status should make all efforts to prevent from getting infected with their condition.  The patient should be aware of the methods by which the infection could be spreading including:-Unprotected sexUsing contaminated syringes during intravenous drug abuseBlood transfusion of contaminated blood productsThrough accidents during invasive surgical proceduresMother to baby (AIDS, STI.

2008, and E. Sakellar, 2003)A patient suffering from HIV/AIDS has the social obligations of protecting others from the disease and not spreading it through the above mentioned acts including unprotected sex, contaminated needles, blood transfusion, etc.  Besides, a patient who knows that he/she has been infected with HIV/AIDS, and has to undergo an invasive procedure in which the physician would be coming in contact with infected blood/body fluids, then the patient has the responsibility of informing the healthcare provider of their positive HIV status so that extra precautions can be taken.  There is a slight but significant risk of transmitting the disease.  Although the numbers of cases that have spread from patient to physician have been less, there are nevertheless the chances of transmitting the disease.  In the past, there has been the case of a dentist in Florida who had contracted the disease from one patient and later on transmitted it to a few patients.

  There was also the transmission of HIV/AIDS from one infected person to an orthopedic surgeon during the operation on the patient.  Several states have developed their own laws which specifically prohibit people with HIV/AIDS from deliberately performing certain acts which would result in infection of other people (Bradford McIntyre. 2004, & The Body. 2002).  This includes transmission of HIV/AIDS to the healthcare providers.·         In Section 22-11A-21 of the Alabama Code, a person who deliberately performs acts which can result in infection of other would be committing class C misdemeanor·         In the Arkansas Code, the person who would be deliberately spreading the disease would be committing Class A felony.  Besides, he should also inform the dentist or the physician of any HIV infection as he could be held liable under Class A misdemeanor·         Under the California Health and Safety Codes and Penal codes·         Under the Colorado Rev Status·         Under the Georgia Codes·         Other laws (The Body, 2002)When the physician knows about the HIV status of the patient, he/she should sufficiently inform the patient about their status, so that the patient can take adequate amount of steps to protect others from the disease.

  Besides, the physician should also inform the patient about the means by which the disease could spread to others and the way it can be prevented.  If the physician has a feeling that the patient is not going to inform the sexual partner of their HIV status, then the physician should take adequate steps in informing any other member of the public, even if it involves breaking confidential issues.  Confidentiality is a concept closely associated with autonomy.The physician would have to keep private all information of the patient’s health details.

  However, if the physician feels that the patient would be at the risk of causing harm to others due to their condition, then it is the duty of the physician to adequately inform the member of the public of the risk involved from the patient.  This issue of breaking confidentiality in order to protect the general public was first explained in the case Tarasoff V.s. Reagents of California.  If there is a clash between the rights of the patient and the need to protect the general public, then the needs of the general public would prevail, as it would involve a greater number of people, which is more important than the HIV patient.

  However, this disclosure has to be limited and ethically done, without excessive disclosure (Michael A. Gordam et al. 2001 and Bradford McIntyre, 2004).



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