Medical Ethics of Amputations - Essay Example

?Medical Ethics Under normal circumstances, medical operations are carried out on individuals with medical conditions like injuries or diseases. These conditions prompt the performance of medical procedures in order to treat the disease or correct a situation hence saving the life as well as the quality of life of the person. Other operations like amputations require very serious considerations before they can be done. This means that the physician will have to make a thorough analysis of alternative forms of treatment and if the amputation is unavoidable, the patient is made aware of this in advance and in the most understandable way. Forceful circumstances that can dictate the amputation of limbs include stopping the spread of a certain condition like malignant cancer to other parts of the body, serious diabetes or an extensively fractured/damaged leg. However, some people may demand such a medical operation despite their perfect state of health. An example is a person with a rational desire to have one of their perfectly healthy limbs amputated. In such a case, serious issues in the field of medical ethics have to be considered before the physicians can go ahead with the amputation or reject this request. The aim of this paper is to give an argument that physicians have a moral reason to permit the individual to go through with the amputation. The second part of the paper gives an objection to this argument followed by a justification of the stronger argument. Argument in support for the amputation as a moral duty One of the critical ethical issues to be considered in the case of such a request is patient autonomy. First of all, it is very true to say that every person has the right to do whatever they want with their bodies. This is because the issue of personal autonomy has to be respected. In fact, it is one of the ethical principles in the medical field. Despite this, any request concerning medical procedures that comes directly from the patient has to indicate some rationality behind it. In this case, the patient has expressed a rational desire to have their perfectly healthy limb amputated. Despite being a rational desire, the request has higher chances of being granted if it expresses the person’s autonomy. In order to arrive at a good conclusion regarding this case, it is important to make a thorough examination of the concept of rational desires and how they relate to personal autonomy. Savulescu made a distinction between desires and rational desires. According to him, a rational desire is a desire that a person expresses while in possession of all relevant facts while "vividly imagining" what its consequences would be for them. At the time of its expression, the person should not commit any relevant error of logic as well (Savulescu a 121). Savulescu goes ahead to explain that a desire must be a rational desire or satisfy a person's rational desires for it to be treated as an expression of the person's autonomy. The principle of autonomy has a big role in the medical field hence it is a general requirement that physicians should respect the autonomous choices of their patients. According to Beauchamp and Childress (99), autonomy can be described as self-rule, that is, free from limitations such as limited understanding, that may prevent rational/meaningful choices, and controlling inferences from other persons. From this description, it is clear that autonomy is complete if the person is in a position to make meaningful or rational choices. These choices are later expressed as rational desires. In other words, the expression of rational desires is the practice of personal autonomy. On the other hand, autonomy is the expression of such rational demands. This means the concepts of rational desires and autonomy are inseparable. Instead, they are an expression of each other. This means any decision made within the boundaries of informed consent is a guided by both a respect to the rational autonomy of a person and their rational desires. Going against this informed consent will therefore constitute displaced decisions in the healthcare system. The expression of rational desires is a sign of self-determination. Rebecca (342) states that basing on the view of rational autonomy, a positive respect of a person’s autonomy is a focus on the capacity of person as a rational decision-maker in the processes of self-determination. This means the role of healthcare providers in relation to the autonomy of patients or other people is obtaining informed consent. A failure to obtain this informed consent may prompt the rejection of some requests, in this case, the amputation o the healthy limb. An informed acceptance or refusal of treatment is normally the beginning of a dialogue aimed at respecting the autonomy of the patient. This also means that informed consent is very critical in the performance of medical procedures that are not represented in the standard medical practices. Objection to amputation The amputation can be done as respect to the person’s rational desires and autonomy. This is because they will have given a thorough thought of a future life without a limb, have accepted it and gone ahead to demand for the amputation of their perfectly healthy limb. However, it is also important to note that there are many psychological mechanisms that operate in a person’s life. These psychological mechanisms could prevent a person from making a rational evaluation of their future life, in this case, how living in a disabled state would be like. Savulescub (29) explains that in the event that psychological mechanisms prevented a person from making a rational evaluation of their future life, the amputation could lead to serious personal problems. It will result in serious regrets in the near future yet the operation is such an irreversible one. This means that although the respect of patient autonomy is very important, a critical evaluation has to be made on the context, manner and the extent to which the principle is applied. At the same time, rational arguments and persuasions on the right contexts is a respect to individual autonomy and not an interference of this autonomy (Gert et al). This means it is not only the moral duty of medical practitioners to respect the autonomy of patients but also, to make rational arguments against some decisions made by their patients. This means that physicians will also have to make an objection to this request basing on theories like utilitarianism, deontological and principles like non-maleficence. In utilitarianism, the end justifies the means though what is right is most useful. In this case, the end seems to be such a bad one, then that is enough reason not to perform the operation. As for the deontological theory, the action should have a good moral reason and it should not go against the outlined morality for it to be accepted. It should consider the safety and the good of the person and other as well. In this case, a deliberate amputation of a healthy limb is not ethically or morally accepted. Such a person might turn to be such a burden to the society in terms of provision of care and meeting their financial needs. According to the principle non-maleficence, an action can only be considered ethical if it does not bring harm to self and others. Though the limbs belong to one person, the amputation should result to greater social benefits or social good. These reasons are logical and enough to advocate for a rejection of the person’s request. The respect of rational desires goes hand in hand with the respect for rational autonomy. I therefore support the idea of having the limb amputated as requested by the person. This argument is stronger because in case of some future regrets, the patient will not be in a position to sue the physicians involved. The physician’s will be defended by all the reasons and facts presented by the person in defense of their rational decision. Basing on this, the physicians will make a claim that they were respecting the rational autonomy of the person as required by the existing ethical principles in the medical field. It is also better to accept to do it professionally because the person might go and use some crude objects like a knife to do it. This will result to great loss of blood and death. Conclusion The concept of rational evaluation is not very easy and it has to be treated with much more seriousness and care, especially, where it relates to human life or the quality of human life. The respect of the principle of personal autonomy in the medical field may force physicians to perform medical procedures that should not have been done under normal circumstances. However, the rule is operates here is that this autonomy can only be respected if at all the action is an expression of the person’s rational desires. This means the person has made thorough consideration their future state of live and they are ready to become accountable for how it will be and how it will impact on them . Works cited Gert Bernard, Culver Charles and Clouser Danner. Bioethics: A Systematic Approach. New York. Oxford University Press. 2006. Rebecca Walker. “Respect for Rational Autonomy.” Kennedy Institute of Ethics Journal. (4) pp. 339-366. 2009. Savulescu Julian. “Rational Desires and the Limitation of Life-Sustaining Treatment.” Bioethics. (3) pp 191–222. 1994. Savulescu Julian. Autonomy, the Good Life, and Controversial Choices. In Blackwell Guide to Medical Ethics, ed. Rosamond Rhodes, Leslie P. Francis, and Anita Silvers. Oxford, UK: Blackwell Publishing. 2007 Tom Beauchamp and James Childress’s. Principles of Biomedical Ethics. (6th Ed). 2009. Read More