In advance directives a person prescribes his/her treatment preferences to be used in future for his/her treatment in case of mental incompetence to make such decisions in that time. This is written when one is of sound mind and competent to describe the decisions to be made about their treatment in future, (Beauchamp et al., 2001). In cases where there are no advance directives the life partner can be involved in making the decision on behalf of the patient. This is where the patient has no prior treatment directives on there health matters and cannot make sound decision because of their illness.
In making the decision about the procedure it would be appropriate to ask the life partner the following questions.
1). Do you accept the procedure to be carried on the patient?
2). If yes, are you ready to accept the results?
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The strongest ethical argument for the procedure is that, all the decisions being made are for the best interest of the patient i.e. to save the life of the patient and therefore a patient cannot be left to die because he/she cannot make a decision.
The strongest ethical argument against the procedure is that, the patient is not directly involved in making such important decision about his/her life. There is no informed consent by the patient about the decision being made and therefore all the treatment is done without the knowledge of the patient.
If I were the patient I would wish the team to take time and look at the alternative methods of treating my illness. The team should also analyze carefully the most expected outcome of the procedure and consider the outcome of the similar procedures performed in the past. Finally the best decision should be arrived at, targeting to save my life.
Applicable medical ethical theories and principles
Beneficence is one of the ethical values in medicine, which emphasizes on taking the actions that serve the best interests of the patient. It governs the actions of the doctor in making decisions that aim at healing. The patients advance directives written or unwritten are taken into consideration before taking any medical measure. The final goal of any treatment should be meant to save the patient's life, (Brudney, 2009)
Autonomy, this is where one has the freedom and the right to accept or reject acertain type of treaatment according to his/her own views. The principle of Autonomy recognizes that individuals have the right to make decisions that concerns the treatment preferences give that one is of sound mind. It's based on the societys' for individual's liberty and capability to decisions that concerns their health matters, (Brudney,2009).
Individuals are often evaluated by Psychiatrists to ascertain their mental capacity when making high risky decisions about their health and treatment. Those found incompetent to make such decisions, their refusal to treatment is declined, unless they had provided an advance directive before their illness and in situations where one lacks mental capacity to make sound decisions about their treatment and no advance directive given ,the patient is treated to their best interest.
Non-Malfeasance, this principle refrains' medical professionals from causing more harm than good to their patients. This principle provides that doctors should evaluate their medications and analyse the extent of harm the prescription can cause to the patient before administering the treatment and in cases where the outcome of illness without treatment is fatal, risky measures of treatment may be prescribed as the risk of not treating is likely to cause more harm.
Informed consent; this refers to a situation where the patient is fully aware and understands the benefits and risks involved in their treatment preferences. The patient who makes uninformed decisions risks making wrong treatment choices which may have negative impact in their health.The patients can choose to make their own treatment decisions, or can be made by a third party on their behalf if the patient is incapable, (Brody & Baruch, 1988).
Individual autonomy is important in making decisions that concern one's health matters and therefore consulting competent patient about their preferences in treatment upholds personal dignity and incases where the patient cannot make such decisions, the treatment should be done for the best interest of the patient.
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