Retrieved from https://studentshare.org/social-science/1650300-katarian-respecting-patients-autonomy
https://studentshare.org/social-science/1650300-katarian-respecting-patients-autonomy.
Respecting Patient’s Autonomy I.D. of the Respecting Patient’s Autonomy Introduction In this paper, both the medical and ethical dimensions of the case of Miss Jenkins will be explored. Miss Jenkins is a patient of hypertension. She is very untidy and completely reluctant to clean herself. In such a scenario, Miss Downs seeks to intervene but possibility of medical paternalism on the part of the community healthcare system looms.2. Suggested Course of Action The suggested course of action for Miss Downs, the community health nurse, can be serially summarized in the following 5 points:1.
Although the 72 years old patient in question is in good health conditions, she has a recent history of hypertension. Therefore, Miss Jenkins (the patient) needs constant attention with regard to her hypertension, which may even result into unpredictable blood pressure fluctuations at a latter stage (Mayo Clinic Staff 2014). Consequently, a hypertension care plan must be drafted at first.2. Next, Miss Downs must pay more frequent visits to the patient and consistently labor to build confidence and engage in dialog.
Miss Downs must tell her about cleaning herself. She must show firmness over the issues regarding proper sanitation.3. After the initial counseling, there is less likeliness of a discernable effect. The reason is that Miss Jenkins has already got very much habituated in her appallingly untidy way of life. So, it should be clearly understood and elucidated at this stage that Miss Downs cannot come to see Miss Jenkins again and again and do the things like clearing her bedpan and mending her footwear.4. Next, Miss Downs must first collect necessary feedbacks and reports from the neighbors of her patient.
Then, she should utilize community care manpower for removing Jenkins from her place. This is to be done by force if necessary in the presence of a qualified gerontologist. 5. Finally, Jenkins would be referred to the community fiduciary. Psychiatric intervention will be immensely necessary at this stage. Medics experienced in handling psychiatric cases can figure out if Miss Jenkins is suffering from any mental disorder that makes her reluctant to clean herself. In sum, Miss Downs will have to act in a planned manner before it is too late.3. Justification The matter of cleaning oneself cannot be left to one’s sole personal discretion.
If there is an outbreak of a communicable disease (for example, influenza), then an old, untidy person is highly vulnerable. Moreover, Miss Jenkins lives alone and she won’t be able to take care of herself if she develops problems like skin disease or severe dysentery due to untidy living. She may also fall prey to food poisoning if she does not wash her hands before taking her meals. Instead of high level philosophical thinking, some practical work has to be done in this scenario. Experts like Bondeson and Jones (2002) oppose the idea of medical paternalism.
However, in extreme cases, patient’s good becomes interwoven with social good. In such situations, community health professionals have both the duty and power to act as deemed necessary. Miss Jenkins has developed a very unusual way of living in dirt. This will not only harm her but may also adversely affect her neighbors in one way or other.4. Conclusion Although disregard to a patient’s autonomy cannot be justified at any cost, medical situations may sometimes prove to be extremely demanding.
In Miss Jenkins’s case, the gravest possibility is that the patient is not only suffering from hypertension but may also having some kind of mental problems. A holistic intervention along with guardianship in an old age home or fiduciary is both ethically and technically justified in this scenario.ReferencesBondeson, W.B. and Jones, J.W. (2002). The Ethics of Managed Care. New York and Heidelberg: Springer.Mayo Clinic Staff (2014). High blood pressure (hypertension) Risk factors - Diseases and Conditions - Mayo Clinic.
Retrieved from http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/risk-factors/con-20019580 on 21st June 2014
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