Bioethical Deliberation

The questions of bioethics have always been connected with human practice in medicine. The principles of Human Dignity and Human Rights, Human Vulnerability, and Personal Integrity, and the others serve for providing sound resolutions of major bioethical problems. However, being the basis for bioethical deliberations they could not provide any universal decision that can be applied by any physician.

The case with Mr. Smith is sealing with a 22-year-old male having moderate learning disability and Type 1 diabetes. Despite his learning disability, Mr. Smith prefers to be as independent as possible. However, he relies on the assistance and practical support of his mother. The cases when Mrs. Smith assisted Mr. Smith’s motivation to attend appointments on a day-to-day basis are highly valued by Mr. Smith’s GP, Dr. Saeed. Nevertheless, Mr. Smith had an argument with his mother, which resulted in his strong will for his mother to be not involved in his care. Consequently, the patient misses the required appointment. Moreover, during reappointment it turns out that the patient has been binge drinking. The following has been a warning sign because it never happened before. Dr. Saeed attempts to influence the patient towards the importance of Mrs. Smith’s assistance. Nevertheless, Mr. Smith strongly disagrees with his GP and shares his intentions to be assisted by friends, whose place he has been staying recently.

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The above described case has a strong connection with bioethical principles of Respect for autonomy and Beneficence. The principle of Respect to autonomy argues on the person’s freedom for self-determination. According to it any patient has the right for choosing his ways of treatment, the conditions of treatment, medicine, and ways of surgery and so on. The following means he or she takes a responsibility for one’s decisions being informed about all options and consequences of proposed treatment. Regarding the case of Mr. Smith an ethical dilemma arises. The reason for it is connected with the patient’s unwilling to maintain the connection with his mother, which supports his treatment. Dr. Saeed highly values Mrs. Smith’s impact on her son’s treatment. The result of her assistance is that Mr. Smith is aware of the dosage of insulin and never misses appointments. On the contrary, there is strong evidence that his friends have a bad impact on the patient. As a result of the broken connection with the mother the patient is at risk of missing treatment procedures. Regarding his diagnosis, the repercussions of such behavior may lead to the development of a critical condition. Thus, it is a physician’s duty to ensure the patient’s appropriate care and assistance. However, the physician has no moral right to pressure the patient towards the sound decision. According to the principle of autonomy, the patient is sure in his decision being in sound mind, which should be respected. Nevertheless, Dr. Saheed attempts to maintain the principle of beneficence maintaining the principle of Autonomy. The following means that if a physician knows the procedure or action that would benefit the patient’s condition, he or she should take this action. There is a strong evidence that for the doctor that the best way of treatment for Mr. Smith is under the guidance of his mother. Consequently, he uses a tactics of persuasion to balance between the principles of Autonomy and Beneficence. However, the GP fails to ensure Mrs. Smith’s crucial role in Mr. Smith’s treatment.

Summarizing the analysis of the presented cases one can assume medical staff is required to have enough skills to balance between the principles of Autonomy and Beneficence. The physician should respect the patient’s choices of treatment according with the principle of Autonomy. However, he or she should sound a method of treatment that would benefit the patient’s condition. It is a physician’s duty to attempt to influence towards the decision providing better condition. If the patient makes one’s choice based on logical thinking being sane, the physician has to respect such decision even if it tends to harm the patient.

Among the case scenarios involving the problem of balancing between Autonomy and Beneficence, one may refer to surgery. For instance, with a patient, having pneumonia and awaiting surgery rejects antibiotics. In such case, the autonomous decision of the patient clashes with the beneficial obligation of the surgeon. In this situation, the surgeon’s choice between the mentioned bioethical principles may critically influence the patient’s condition. The strong point of such cases is that if the patient makes a deliberate choice on the basis of all presented information, it should be followed by the physician. Moreover, even the choice that might lead to the development of the patient’s critical condition should be respected. Thus, in case of the patient’s refusal from taking the necessary drugs, the physician has to inform about all the choices the patient has. It is a physician’s duty to describe the consequences of any of the patient’s choices and provide better solution for the patient. In case the patient chooses the worst option the physician should ensure the patient’s ability for rational thinking. If nothing is inferior to the patient’s sanity and his or her decisions are deliberate, the physician has to follow them.

The case of Muna, a female migrant from Kuwait aged 38 being infected with HIV involves ethical problems of Human rights and Human Vulnerability. Living in the UK with parents, she undergoes the required treatment. Muna has a daughter Amina aged 9, who should be tested for HIV. However, her mother is having problems with the acception of her diagnosis.Thus, any Dr. Jegede’s attempts for persuading Muna her daughter has to be tested for HIV are non-productive. Moreover, Amina has never been tested for HIV despite being conceived after Muna’s contact with HIV. Muna also fears of stigma towards HIV infected people. That is why she is protecting her daughter from possible upheaval the diagnosis is about to bring to her life.

From the one hand, the described case involves the bioethics obligation of Human rights. This ethical principle in medicine argues that every human has a right to be examined and treated in case he or she is exposed to illness or an injury. In accordance with it Amina should be examined because there is a high possibility of her being HIV infected. In case the examination discovers the infection, it is Amina’s right to undergo the required treatment. Moreover, Muna’s position can be regarded as a result of her vulnerability as an immigrant. It is clear from the case that the mother is having cultural prejudices, which have to be vividly explained. Moreover, she is not aware of the duties of her daughter, which are guaranteed in the EU on the legal basis. According to the principle of Human vulnerability there are various factors which influence one category of people being socially disadvantaged in terms of medicine and caring. One of them is the lack of information about the society and the rights of immigrants. Muna got used to the fact that people with HIV infection were stigmatized in Kuwait. However, she is not aware that the attitude towards the HIV infected is more democratic in the UK. Moreover, she puts her daughter in vulnerable position because in case she is HIV infected, she requires undergoing appropriate treatment.

The above discussed case involving migrants might be compared to another one of this type. A pregnant woman has been an immigrant to the country with free access health care. She has been never examined being pregnant. The patient has been taken to the hospital by the husband during delivery. The birth was premature and the child needed intensive care and ventilation. At the same time the woman was discovered to have kidney and liver problems. Consequently, a statistic research showed that the amount of baby mortality in the hospital was higher with babies from immigrants. The discussed case refers to the immigrant patients having equal human rights but being vulnerable because of unawareness of procedures in the countries they go. Thus, the principle of Human Vulnerability should be applied to ensure the maintenance of the principle of Human rights when treating immigrant patients. The discussed issue is provided by performing targeted education about the healthcare and social conditions for immigrants in the host countries. By this means the required access to the diagnosing would ensure the absence of fatal delays of life-saving medical procedures. Therefore, the principle of Human rights would be practiced among the medical staff more efficiently. Summarizing the discussed cases involving the principles discussed in the paragraph one may conclude that Human rights and Human vulnerability are one of the most important ethical principles. Any person has a right to be diagnosed and treated, especially in the case of being suspected to contact with HIV infection. Certain social groups are particularly vulnerable because of lack of information about the provided services. However, it is their fundamental right to be healthy and to be treated.

Sep 22, 2019 in Informative
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