Bioethics and Aging - Assignment Example

Bioethics and Aging Define and explain informed consent. Please explain the three elements of informed consent and their components. Informed consent is a doctrine stating that the physician have the obligation to disclose to his or her patient concerning potential medical treatment, so that the same patient can make knowledgeable choices (Ketler, 2001). By and large, there are four key components of an informed consent: First, the patient must have the competency to participate in the informed consent process; Second, the medical provider must disclose necessary and vital information (e.g., type of procedure) to the patient; Third, the patient must fully comprehend the relevant information in question; And fourth, without coercion or force, the patient must voluntarily grant or express his or her consent (Ketler, 2001). The three elements of informed consent are almost similar to its four key components. The only difference is that the former does not include the second part of the latter: that is, it disregards the duty of the medical provider to disclose information to his or her patient. Apparently, the three elements of informed consent focus solely to the patient’s capacity, voluntariness, and degree of comprehension. The doctrine of informed consent is basically based on the premise of patient autonomy. 2) Explain the purpose of a surrogate decision maker and the three types of surrogate decision-making. Please illustrate examples for each type of decision making which clarify its application. The main purpose of a surrogate decision maker is for the incompetent patient to have a voice concerning his or her desires in life. There are three types of a surrogate decision-making: (1) the projection of informed consent; (2) the projection of personal values; and (3) the projection of personal relationships (“Advance planning,” 2006). First, the patient is himself or herself the surrogate decision maker; this usually occurs when a competent person makes a “living will.” For instance, a mentally competent patient expresses a decision on whether or not he wishes to have an immediate surgery should a biopsy reveal a malignancy. Second, a person might express or inform in advance to others about his or her own view of what constitutes a “life of sufficient quality” (“Advance planning,” 2006). Here, the surrogate decision-maker is someone (e.g., the patient’s brother or sister) other than the patient. And third, the competent patient designates a decision maker for health care matters, coupled with guidance concerning the choices that such proxy might face in future time (“Advance planning,” 2006). 3. Explain the Doctrine of Double Effect. Please explain the four key elements of double effect with examples. The Doctrine of Double Effect states that there is a difference between one’s direct intention and one’s indirect intention. This doctrine permits an action that has good intention, although there is an embedded foreseen bad consequence. Thus, it is considered wrong to perform an action having bad intention for the sake of foreseen good consequence (Singleton & McLaren, 1995). There are four elements of the Doctrine of the Double Effect: First, the act of removing a fetus from the mother’s cancerous uterus is acceptable if such action possesses good intention; Second, the intention is the good effect (e.g., saving the mother’s life) and not the evil one (e.g., the crushing of the fetus’ skull); Third, the good effect is not produced through the evil effect; And fourth, there is a “proportionally grave reason” for allowing the foreseen evil effect (Stanford Encyclopedia of Philosophy [SEP], 2009). 4) Explain the difference between active killing and letting die. Please provide an example case for each to clarify the differences. Active killing is morally unacceptable. Letting die, on the other hand, is morally permissible (Mayo & Gunderson, 2002). Both are similar with regard to the cessation of life, but they are different in the process or way of ending one’s life. Active killing can be compared to physician-assisted suicide. A terminally-ill patient dies with the aid of lethal medicine or the termination of life-sustaining equipment. Letting die, on the other hand, is permitting one to die in the natural way. A patient dies without human interventions. References Doctrine of double effect. (2009). In Stanford Encyclopedia of Philosophy online. Retrieved from http://plato.stanford.edu/entries/double-effect/ Ketler, S. K. (2001). The rebirth of informed consent: A cultural analysis of the informed consent doctrine after Schreiber V. Physicians Insurance Co. of Wisconsin. Northwestern University Law Review, 95 (3), 1029+. Mayo, D. J., & Gunderson, M. (2002). Vitalism revitalized: Vulnerable populations, prejudice, and physician-assisted death. The Hastings Center Report, 32 (4), 14+. National Academy of Engineering. (2006). Chapter 3: Advance planning, surrogate decision making, and assent or objection. Online Ethics Center for Engineering. Retrieved from http://onlineethics.org/Topics/RespResearch/ResResources/nbacindex/mindex/8942.aspx Singleton, J., & McLaren, S. (1995). Ethical foundations of health care: Responsibilities in decision making. St. Louis, MO: Mosby. Discussion 5: Inoperable Carcinoma of the Prostate 1) What are your thoughts about this case? I think that the story is about the old man and his physician. As I understand the story, these two individuals know each other for quite some time. The 69-year-old man, in fact, routinely visits his physician for a medical examination. In the course of time, the physician builds an impression as to what kind of character or mental state his patient has. The physician knows that his patient, following the death of the old man’s wife, has a history of psychiatric disease. It is a wonder to me -- despite the physician’s knowledge of his patient’s medical and family background -- as to whether or not the doctor made a right decision: that is, whether or not he should inform his patient’s inoperable carcinoma of the prostate. The doctor may have ideas concerning his patient’s neurotic behavior; however, this patient still functions well in the society and has the ability to think rationally. 2) Do you believe that the physician’s response was justified? Explain your reasoning. I believe that the physician’s response to the old man’s query can be justified in two respects: (1) If the physician has valid proofs that his patient is incapable of thinking clearly; and (2) If the physician knows his patient very well. First, the physician’s data -- from which his decision is based -- must be scientifically grounded, and not merely his impression or personal opinion. If necessary, the physician must consult other practitioners who are much competent in the field of cognition or mental state. And second, the physician must constantly have an open communication with his patient so as to monitor the old man’s true mental framework. The physician knows or should know, to my mind that the old man has the right to know concerning the patient’s true medical condition. However, the question that arises is: how far and how much information should a doctor informs the old man about his patient’s medical situation? Read More