Health Ethics

Jan 26, 2016 | 0 comments

Jan 26, 2016 | Miscellaneous | 0 comments

Health Ethics Discussion Questions

Question 1: Moral Claims on Clitoridectomy

Previously, scholars have seen cultural relativism as an essential antinode to ethnocentrism. That is a perspective that assesses and judges other people’s practices based on the standards and sensitiveness of one’s culture. Professors of history and philosophy of science have argued that clitoridectomy violates the rights of women whom it is performed. According to her, it is an operation that men use to control women and keep them unequal. However, Elliot Skinner, a professor of anthropology accuses feminists in the need of abolishing clitoridectomy of being ethnocentric. She observes that women themselves want to participate in the practice that works like a male initiation, transforming girls into adult women (Tobin & Jaggar, 2013). Under medical science, clitoridectomy is an offense. Welsch and Endicott, (2006) indicate that it should be described as a mere circumcision, and instead, it takes off a loose fold skin and removes a rudimentary organ of exquisite sensitiveness that is adequately supplied with blood and nerves. Therefore, medical scholars argue that clitoridectomy is scientifically unsound as a medical therapy. Likewise, it violates medical ethics.

Question 2: Telling the Truth Truth-telling and Withholding Information


            Every patient appreciates a bright perspective, most so in grim circumstances. Observing honesty in communication between patients and doctors is an important way to foster trust and show respect for the patient. In most cases, patients invest their full trust in their doctors and may feel that their trust is misplaced in case they find out or perceive a lack of honesty and candor by the physician. Besides, O’Rourke (2000) finds that telling truthful information helps patients become informed subjects needed in healthcare decisions. As such, it is prudent to tell patients all relevant aspects of their illness with a reasonable range of ethical practices. However, in some situations, especially in cancer patients telling the truth may have a terrible impact on the occasional patient. Research outlines that many physicians often worry about the brutal effects of disclosing extreme information to patients. While the disclosure should follow an appropriate tact and sensitivity, little research supports the fear. In medical ethics, if the physician has a compelling reason to believe that the disclosure would result in a predictable and real harmful effect on the patient; it may be prudent to withhold truthful information (O’Rourke, 2000).  Therefore, the doctor was within the ethical dimensions by refusing to disclose to John that he cannot deal with the news of his lung cancer and expected living days.

Question 3: Patient-Physician Relationship

The relationship between a physician and a patient is of significance in the overall healthcare delivery model. The relationship is unique that depends on trust and confidence between the parties for the provision of fare. Often, physicians enter into a relationship with patients to show commitment to providing quality health care. While the relationship depends on trust and confidence between the parties for care provision when the circumstances affect the ability of the physician to achieve quality healthcare, the physician has the ethical freedom to end the relationship. In some circumstances, it may be the patient that decides to end the physician-patient relationship. The healthcare policy entitles physicians to end the physician-patient relationship under specific circumstances. While good clinical judgment is required, the core principles of ethics of beneficence, patient autonomy, nonmaleficence, and justice must be given specific considerations. In a nutshell, physicians are expected to establish a relationship of primary importance in the overall delivery of health and care (Shelp, 2009). However, in circumstances such as the breakdown of trust and unmanageable large patients then the physician can end the relationship.

Question 4: Vegetative State versus Minimally Conscious State (MCS)


            An accident that leads to severe brain injury causes a change in consciousness. Perrin, Schnakers, Schabus, et al., (2006) defines consciousness as awareness of the self and environment. Brain injuries may lead to a wide range of disturbances of consciousness. The state of extreme unconsciousness characterized by no eye-opening is known as coma and the state of complete unconsciousness with periods of weakness and some eye-opening, and sleep is called a vegetative state. Individuals who experience a slow recovery of consciousness continue to have a reduced level of self-awareness and awareness of the world around them. As such, they have inconsistent and minimal ability to communicate and respond (Perrin et al., 2006). This condition is referred to as a minimally conscious state. Characteristically, the minimally conscious state (MCS) sometimes follows simple instructions. Besides, they may communicate yes or no by gesturing or talking and may speak understandable words or phrases. People in MCS share similar characters with the vegetative state, that is, they can both open eyes, and have wake cycles. However, MCS is inconsistent with object recognition, communication, command following, and contingent emotion while the vegetative state lacks such characteristics.

Question 5: Personhood

Consciousness is a continuous concept that encompasses subjectivity, self-awareness, and the ability to appreciate the relationship between the environment and the self. The moral significance of phenomenal consciousness has been assumed that genuine vs. patient lack subjectivity whereas patients in MSC possess at least intermittently. Golan and Marcus, (2012) argue that from a philosophical standpoint, the talk of minimal consciousness is misleading since MSC patients have limited form is rather motivational and cognitive capacities (Golan et al., 2012). Moral consciousness is grounded in the moral significance of interests that include desiderative, hedonic, and objective elements. It is the connectedness and continuity that an individual’s mental state that underwrites personhood as a significant sense of the word of morality. Consequently, general remarks of personhood underlie the abortion debate. Some observe it is murder, dangerous, and it is irresponsible for skeletal muscles. In a study conducted by (), the findings indicated that HRT improves the functions of muscles in women to abort. However, these claims fail to explain why numerous skeletal muscles. In a study conducted by (), the findings indicated that HRT improves the functions of muscles in women seek abortion even in countries where it is illegalized. The concept of personhood significantly confers the rights of society. Personhood in MSC and abortion are relatively similar in that in moral community people define a person and draw boundaries on who is accepted and who is the moral in the community (Golan et al., 2012).

Question 6: Debating Death

The Oregon Death with Dignity Act, (ODDA) was adopted in 1994, and it allowed physicians to prescribe lethal drugs to ill patients considered terminally qualified. The act came under intense debate as numerous stakeholders argued that it permitted physicians to offer physician-assisted suicide or physician aid in dying. The rationale of the Act was to expand the control of patients over end-of-life decisions, yet it was subjected to enduring ethical and cultural scrutiny. ODDA aimed to end the ban of patient legality on refusals of virtually every form of treatment based on the ground that patient self-determination and choice (Hillyard & Dombrink, 2001). The 1994 and 1997 Oregon PAS campaigns lobbied the no and yes group who echoed their concerns. Proponents of the law provided that it has offered the world a model for how to give dying patients a real choice on how they could bid farewell to the world. Also, it is argued that the Oregon law forces people to examine the question of what is special about the life of a human. Therefore, according to Hillyard and colleagues, it is the autonomy and dignity inherent in people’s individuality in terms of making hard decisions for themselves and determining individual destinies. While the law grants civil and criminal immunity to physicians offering lethal prescriptions, most doctors report that they provide lethal prescriptions because of loss of autonomy, loss of dignity, and feeling of being a burden. Therefore, the practice creates a frightening “duty to die” and is against human dignity it purports to protect. 

References

Golan, O. G., & Marcus, E. L. (January 01, 2012). Should we provide life-sustaining treatments to patients with permanent loss of cognitive capacities?. Rambam Maimonides Medical Journal, 3, 3.)

Hillyard, D., & Dombrink, J. (2001). Dying right: The death with dignity movement. New York: Routledge.

O’Rourke, K. D. (2000). A primer for health care ethics: essays for a pluralistic society. Washington, DC: Georgetown University Press.

Perrin, F., Schnakers, C., Schabus, et al. (January 01, 2006). Brain response to one’s own name in vegetative state, minimally conscious state, and locked-in syndrome. Archives of Neurology, 63, 4, 562-9.

Shelp, E. E. (2009). The Clinical encounter: The moral fabric of the patient-physician relationship. Dordrecht: D. Reidel

Tobin, T. W., & Jaggar, A. M. (July 01, 2013). Naturalizing Moral Justification: Rethinking the Method of Moral Epistemology. Metaphilosophy, 44, 4, 409-439.

Welsch, R. L., & Endicott, K. M. (2006). Taking sides: Clashing views in cultural anthropology. Dubuque, Iowa: McGraw-Hill/Contemporary Learning Series.