A Choice Patients in Anesthesia and Surgery - Essay Example

? Topic: Do patients really have a choice in anesthesia and surgery? The patient still refused to agree. “Waiting longer may be dangerous for you,” the doctor informed her patient. It had been almost a week yet the patient would not agree for the surgery just because of the anesthesia she would be given temporarily. The doctor had tried to convince her that this was necessary or the pain could be beyond being bearable for her. “No, it scares me. Please find another way for my kidney failure,” her patient would not budge from her choice. The case highlights the issue regarding anesthesia faced by a number of patients. The mere condition of having sensation blocked or the nerves being desensitized is not accepted by many and there may be each to their own reasoning for it. The anesthesia is used to avoid the person undergoing surgery from pain or distress. For different issues, different kinds of anesthesia may be used. There is general, local, regional and dissociative anesthesia, each one used in different cases as each one has their own varying effects. Consent, is now an integral part of pre anesthetic consultation. Nowadays, given the evolved role within the health institutions, plus the legal and ethical issues, the patients are informed about the procedure they will be subjected to during the surgery. Disclosure of information seems to be the most legal and ethical discussion in the consent process. Given the function of any anesthesia, this consent is vital. This reinforces the idea that the given ‘consent’ to the patient before any surgery, is not actually being asked to accept a procedure but is being offered a range of options from which to choose. Any medical profession indeed respects the patient’s reasoned choice and their right in law to refuse treatments. As anesthetists, the consent process can serve more than one purpose. It protects the practitioner from any ethical or legal issues. It ensures that the patient has agreed to the given way of treatment. The consent is a representation of the choice the patients have today in this. (Slater. R, 2007) No matter what examination or treatment one has to undergo, one may ask their anesthetist if there is any choice in the anesthetic method. One should also understand that some surgeons are more content operating on patients who have received one form of anesthetic rather than another. This most often means that the patient has a general anesthetic, which involves temporary unconsciousness. The article on All about Anesthesia, Do you have a choice, talks about the surgeon not having to choose the type of anesthesia one will receive, unless there is no anesthesia involved in one’s case. (2012) However, the surgeon may discuss the choice with the patient and with their anesthetist. In the same way, ones anesthetist does not choose what operation one will have or how it will be carried out. Again, ones anesthetist may discuss the operation with the patient and the surgeon, particularly if one has special anesthesia problems. The type of anesthesia varies with the given situation. Example for a finger ligament being torn off or the finger’s bone being broken may allow for local anesthesia, this type of a surgery allows a choice from the range of anesthesia. On the other side, during a caesarian, spinal or epidural anesthesia can be used. This type of scenario may allow less choice for the patient because general anesthesia may be harmful to the baby. Another case may involve a heart surgery, which will involve the use of general anesthesia and confine the choice of the patient. Given the intensity of the situation like a heart surgery, a patient can not choose spinal anesthesia for their own good. This aspect suggests that a patient’s choice depends on the situation they are in. The beginning of this article stated a brief case where the patient would not agree to get their sensation paralyzed for a while, may be due to a range of reasons. These may involve the patient not approving the idea of losing control, issue of allergy, talking out the unconscious mind etc. Such factors may lead a patient to not agreeing to anesthesia. In certain cases, the patients are given the choice of using sedatives as an alternative. Yet again as mentioned above, the situation one is in plays a significant role for the patient to have a choice in getting anesthesia or not. Time is another contributing factor. Within the paradigm of the situation, time is held into account. There may be no time for choice from the patient as the top priority for any practitioner is the patient’s life, as per the Hippocratic Oath. (Tyson, 2001) But then at the other end of the spectrum, the Oath also states that the practitioner agrees to practice medicine legally. In such cases, often the choice or the consent is taken from the family of the patient. Taking the historical aspect into consideration, people did not have much choice back then. The medical industry was not evolved to the extent it has today and thus offered little or no choice to the patients. There were specified conditions for the anesthesia and they were carried out. Taking into account the evolved medical practices, there are now a range of the types of anesthesia available and furthermore, there is a choice certainly. Patient’s choice in surgery is another heated debate. The case at the beginning again, is an example to this. Due to the patient fearing anesthesia or its effects, she asked for an alternative. The choice of any patient for a surgery does exist, to an extent. Here once again, the consent comes in as per the ethical guidelines. Prior to any surgery, communication between the patient and the doctor is considered essential. This is so as to develop a patient practitioner relationship. This relation allows the patient to trust the doctor and seek him/her for any issues that might arise. The communication involves the doctor fully explaining to the patient what his/her condition is, what may be the consequences of the condition if not dealt with at the right time, why it occurs, what treatment for it and any options within the range of treatment. This communication furthermore allows the patient to express their views, whether he/she agrees to the treatment or not. If not, what are the alternatives? Now here, once more the situation or the intensity of the condition makes the difference. (Neale 2011) Say, a patient suffering from breast cancer, at the last stage will have less choice in having a surgery or not. Comparatively, the same patient if at an earlier stage, may resort to chemotherapies to cure the disease. Moreover, with the research within this issue, now women have a choice here too between conservation and removal. If one considers the role of socio economic conditions of the patient to have a choice in surgery or anesthesia, here foremost the effect of climatic changes on one’s health status can be taken into account which varies from country to country. The article, Effects of global climate change on disease epidemics and social instability around the world’ talks about this aspect in detail. It mentions about developing countries versus industrialized countries. The article says that in developing countries the climatic conditions like rising temperatures and humidity result in spreading vector borne diseases like malaria or dengue. (Tsai, Liu 2005)6 Eventually, such factors contribute towards negative consequences and the conditions of extreme climatic events leave less time for recovery. Such a socio political climate affects the health of the people in its society. Thereby, in extreme situations, leading to surgeries where the patient has no choice! Be it for the surgery or anesthesia, they have to undergo the situation to live.  The same article6 furthermore discusses the other side, i.e. of industrialized countries that also face challenges from extreme climatic changes It talks about how the populations in industrialized countries are susceptible to mortality often due to temperatures. ‘Finally as climate changes allow for the spread of infectious diseases in the developing world, the ease of international travel facilities further spread of these diseases to the developed world.’ (Tsai, Liu 2005) Again, another side of the socio economic condition poses a threat to the victims of various diseases as stated. Here again, the situation plays its role thus ultimately, leaving very minute or no choice for the patients.  Economic conditions of the patient hold importance. Consider the socio political situation given earlier of a developing country. Families with low income may comprise of the majority. Now given the situation of their surrounding, they may suffer from diseases whose last resort is a surgery. In such cases, given the low incomes, there is again very less or no choice for the patient or his/her family members. Given a totally opposite case, where the patient belongs from socio economic class A with high income background, he/she may give a thought to the idea of a surgery or other alternatives like medicines or therapies. The person here can afford to make a choice and then choose between the alternatives. The profession of the patient is a worth noting affect in the fact whether they have a choice to choose between having a surgery or not and if yes than what type of surgery etc. Say a patient suffering from osteoarthritis may go for joint replacement if he/she is a breadwinner for the family. However, if the patient is a stay at home person with fewer responsibilities, he/she may have choice to resort to alternatives. The article ‘The cure and prevention of diseases: How to prevent disease’ states that the research within the medical field shows that physical therapy sessions work just as efficiently as surgery if one is concerned about relieving or subsiding pain.7In such means, the physical therapist can help the patient improve their mobility but the time factor is involved here. (2008)7. So, the social conditions of the patient at an individual level are vital in such choices. For any patient, to have lifelong precaution or learning in such matter, he/she needs to be aware fully. The branch of psychology that deals with the patient practitioner relationship talks about the rights of both parties. The stated ideas above cover the responsibilities of the practitioner; working legally, ethically, morally, seeking consent, striving for the best to save the lives. However, there are certain guidelines on the part of the patient too. They need to be fully aware about their condition themselves; they need to inform the practitioner about how they feel in detail because any missed out symptom may allow for a choice in surgery or anesthesia. They need to comply with the prescribed treatment and adhere to it completely.  Last but never the least, as the means to inculcate lifelong supportive measures, one needs to take precautions from the very beginning. The article ‘The cure and prevention of diseases: How to prevent disease’ talks about how one cannot avoid getting sick entirely, but one can certainly prevent major diseases that are not hereditary, or decrease the chances of getting diseases. (2012) One does this by taking care of the body and mind. Explicitly, this can involve: eating the healthy foods, exercising regularly, keeping one’s mind active, and getting regular checkups. There are plenty of other things one can do to prevent disease in the body, like maintaining healthy hygiene. This will not only ensure that one lives a longer life but also offers a complete choice in getting no surgery and no anesthesia. As the article displays every possible aspect considering a patient’s choice, be it in terms of surgery or anesthesia. A patient does have a choice in surgery, again given the condition or the situation. However, less choice is involved in the anesthetic decisions because anesthesia is a part of the surgery and the surgery itself is often seen as the precautionary or the last resort and in most cases the pain or distress is unbearable, thus allowing lesser choice in taking anesthesia. But the choice may also revolve around the type. The variables, anesthesia and surgery involve a choice as per the situation. References; Slater. R, (2007) Rethinking Anaesthetic Consent. Retrieved from; http://www.anzca.edu.au/resources/college-publications/books-and-publications/Australasian%20Anaesthesia/australasian-anaesthesia-2007/Slater.pdf (2012) All about Anesthesia, Do you have a choice? Retrieved from; http://allaboutanaesthesia.com.au/index.php?option=com_content&view=article&id=84&Itemid=117 (2008) Anesthetic choices for hip or knee replacement. Retrieved from; http://www.rcoa.ac.uk/docs/PI_achkr.pdf Tyson, P. (2001, March 27th) The Hippocratic Oath Today. Retrieved from; http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html Neale, T. (2011, March 17th) Choice of Surgery or Stenting Can Be Left to Patient. Retrieved from; http://www.medpagetoday.com/Cardiology/PCI/25377 Tsai, H-T. Liu, T-M. (2005, June) Effects of global climate change on disease epidemics and social instability around the world. Retrieved from; http://www.bvsde.paho.org/bvsacd/cd68/HTingTsai.pdf (2008, September) Move forward: Avoid Surgery. New England Journal of Medicine. Retrieved from; http://www.moveforwardpt.com/WhyTherapy/Surgery.aspx (2012) The cure and prevention of diseases: How to prevent disease. Retrieved from; http://www.amvtn.org/how-to-prevent-disease.html Read More