Nursing Essays Autonomy

Nursing Essays Autonomy-10
There is research about how patients and family members think medical decisions should be made and which values they consider important. Barelle as she counsels Dave in hopes of achieving a treatment plan in accordance with Dave’s stated wishes while maintaining his close family relationships. [6] surveyed patients and family members about who should receive medical information and make medical decisions and how disagreements should be resolved.Ninety-three percent of respondents felt that both patients and family members should receive medical information; 70 percent of patients felt that family members should have a role in decision making, but only 54 percent of family members felt that they should.In the case of undue influence from family members, Dr.

There is research about how patients and family members think medical decisions should be made and which values they consider important. Barelle as she counsels Dave in hopes of achieving a treatment plan in accordance with Dave’s stated wishes while maintaining his close family relationships. [6] surveyed patients and family members about who should receive medical information and make medical decisions and how disagreements should be resolved.Ninety-three percent of respondents felt that both patients and family members should receive medical information; 70 percent of patients felt that family members should have a role in decision making, but only 54 percent of family members felt that they should.In the case of undue influence from family members, Dr.

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It is both common and socially acceptable for a patient to consult family members in order to aid in decision making.

Focusing on the strict definition of autonomy and failing to recognize an individual as part of a family leads to an incomplete understanding of decision making for informed consent [2].

When he’s been in and out of the hospital for four months or visiting clinic for lab tests and treatments, he’s often accompanied by his wife Jessica and one or both of his two children, Christine and Alex.

Dave’s family has remained optimistic, confident, and encouraging; they fully expected him to pursue aggressive treatment.

Dave’s physicians, however, now want to transition his care and incorporate hospice and palliative approaches to managing his illness. Barelle, sits down alone with Dave to discuss his end-of-life wishes.

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Dave insists on pursuing aggressive acute care for his prostate cancer, but he also seems exhausted. Barelle continues to describe what aggressive acute care would entail over the next months and begins to probe deeper into Dave’s goals of care, Dave slowly confesses that he worries about aggressive treatment, states that it isn’t what he wants, and also says, “I’m not the hero type.” He goes on to express that he particularly values his independence and that he fears pain, suffering, impending loss of functioning, and loss of his autonomy.

Expressing respect for patients’ autonomy means acknowledging that patients who have decision-making capacity have the right to make decisions regarding their care, even when their decisions contradict their clinicians’ recommendations [1].

Beauchamp and Childress remind us that autonomy requires both “liberty (independence from controlling influences) and agency (capacity for intentional action)” [2] and that liberty is undermined by coercion, persuasion, and manipulation [1].

American bioethics circumscribes the role of others who might influence the patient to make a choice that does not put his own wishes or best interests first.

Although this emphasis is intended to prevent patients from being coerced, especially by medical professionals, it ignores that a patient is part of a family.

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