The Bioethical Principle of Respect for Autonomy - Essay Example

Ethical Dilemmas in Nursing Ethical Dilemmas in Nursing Ethics helps people adjudicate everyday decisions and choices that involve a clash between interests and duties. The need for ethics is especially emphasized by the diversity of values, beliefs, and practices of people in pluralistic and multicultural societies. Moral guidelines have to be widely acceptable among people across cultures, ethnicities, and religions. However, moral guidelines cannot be considered as absolutes and they vary with situations and settings. Clinical contexts are open to many ethical dilemmas that are unique to individual patient, disease or intervention cases. This paper discusses an ethical dilemma involving physicians’ order for childcare and parents disapproval citing the moral issues involved. The paper discusses two bioethical principles and relates them to the aforementioned case. The document closes with a discussion on a value of personal morality and relates it to the morality of the larger group and society. An unnamed woman in Canada gave birth to six babies and physicians warned of their ill health and recommended blood transfusion for them. Two of them died before physicians in the hospitals where they had been born convinced their parents of how urgently the babies needed blood transfusion. The parents refused physicians to carry out the intervention and went to court seeking to stop officials forcing their way with the said intervention. The court then ordered some social workers who had taken custody of some babies seeking to secure treatment for them to return them to their parents (Birchley, 2010). The ethical dilemma in the case involved the decision on whether to assume physician’s moral obligation to ensure health of patients, in this case the infants, or whether to respect moral requirement of parents’ autonomy regarding actions on their children’s lives. Legal aspects of human rights to autonomy further complicated the case as the law supported the parents’ opinion that was based on their religious beliefs. The parents refused their babies to receive blood transfusion because their faith was against it. They were followers of Jehovah’s Witness and they remained adamant that they would have allowed any other treatment intervention as long as it did not involve blood. Jehovah’s Witness believers have strongly rejected any medical treatment including surgery that involves blood loss or reception. These believers have been proposing to have machines that can help recycle patient’s own blood to eliminate the need for a blood transfusion. The Canadian parents’ was an ethical dilemma for physicians because they were torn between saving the lives of the babies and respecting the religious belief of their children (Bjarnason et. al., 2009). The dilemma underscored the potential clash between nursing and religion. Physicians have to reckon that patients come to the medical setting with their cultural and religious beliefs and have to be expedient in adjudicating emergent conflicts. Physicians have a duty, for example in the Canadian parents’ case, to protect the lives of their patients. This is especially so with children who cannot make competent decisions about their treatment. Such a dilemma calls physicians’ attention to the importance of the values and beliefs that parents cherish and how these can affect the effectiveness of their prescriptions and recommendations about childcare. This translates in to a moral issue as physicians are confronted with the temptation to use their interventions forcefully. Forceful use of interventions would be tantamount to a violation of patients’ faith and that of their significant others such as parents. Watching the babies die for lack of blood and doing nothing their lives would be equally gross. Other moral issues that arise in the case relates to the beneficence doctrine. According to the doctrine, a physician has moral obligation to protect people from harm but actions into such an obligation may conflict with moral and legal environment of operation. The first of these issues is protection of people’s rights and the physicians were faced with the decision of whether to protect the infants’ lives by implementing the intervention or to protect the parents’ right to autonomy. This is further consistent with the issue of preventing occurrence of harm to a person. Elimination of conditions that threaten a person’s safety, in this case the infants’ low blood level, and the need to rescue a person from an imminent threat are other issues that arose in the case. There are two bioethical principles that relates to this ethical dilemma (Murray, 2010). The bioethical principle of respect for autonomy holds that the parties involved in treatment decision are rational and that they make informed and voluntary decisions. This principle requires physicians to assess whether the patients have the capacity to make sound decisions about their care and it brings about the need for informed consent. In the above case, the babies could not make a decision about their treatment and as such, their parents were the legitimate parties to make that decision on their behalf. Respect for autonomy required the physicians to inform, compassionately and respectfully, the patients’ parents of the need for the blood transfusion and the predictable outcome of forfeiting the intervention. The physicians would then respect the parents’ decision on the subject, whether they agreed with it or not (Robert, 2010). The principle of beneficence provides that a physician has a duty to ensure maximum good of a patient by benefiting the patient and by preventing and removing harm from a patient. This duty is rational and self-evident and is generally accepted as the proper goal of medicine. The principle implies that a patient can contract a physician for medical care with the trust that the physician’s chief goal is to offer help. In the case, the moral principle required the physicians to make rational decisions and to take necessary actions for the maximum benefits to the infants. Transfusion would be the rational decision because of the potential that it had in saving the infants’ lives. The doctrine however identifies conflict with respect for autonomy doctrine. The physicians of the Canadian parents’ case were confronted with the urge to give priority to saving the lives of the babies over respecting their parents consent. This urge was especially aggravated by the urgency with which these children a blood transfusion (Birchley, 2010). Respect is a value I cherish in my personal morality. Respect helps me to recognize the interconnectedness of life and people and accord its due regard. Respect helps me abide by my society’s emphasis for service and help to people. This value also fits in well with the society’s values including forgiveness, tolerance, and compassion. My society underscores the need not to hurt others and applauds peaceful co-existence with respect as its core. Members of this society hold adults and the elderly in high esteem and expect the young to treat them with care and respect. This society has many societal and cultural beliefs that emphasize the need to conduct one’s self with responsibility and discipline. There is immense awe for nature and the environment and the society frowns upon any conduct that violates their condition and functionality. In conclusion, ethical dilemmas are an everyday aspect of healthcare and they vary in nature and degree. Patients bring cultural and religious beliefs to the clinical setting that can sometimes conflict with medical practice. The situation is complicated when the clash is between religious beliefs and childcare and prudence is necessary in the resolution of such dilemmas. Informed consent helps vindicate physicians from blame of forceful or inconsiderate treatment intervention. Bioethical principles help in resolving physicians’ ethical dilemma about childcare but they are not absolutes. Respect is a value of personal morality that is consistent with lager group’s morality. References Ariga, T. (2009). Refusal of blood by Jehovah’s Witnesses and the Patient’s right to self-determination. Legal Medicine. 11(1), S138 - S140. Birchley, Giles. "What Limits, If Any, Should Be Placed On A Parents Right To Consent And/Or Refuse To Consent To Medical Treatment For Their Child?." Nursing Philosophy. 11(4): 280-285. Bjarnason, D., Mick, J., Thompson, J., & Cloyd, E. (2009). Perspectives on transcultural care. Nursing Clinics of North America, 44(38), 495 – 503. Effa-Heap, G. (2009). Blood Transfusion: implications of treating a Jehovah’s Witness patient. British Journal of Nursing. 18(3), 174-177. Murray, J.S. (2010). "Moral Courage in Healthcare: Acting Ethically Even in the Presence of Risk" OJIN: The Online Journal of Issues in Nursing. 15(3). Manuscript 2. Robert MacDougall, D. (2010). "Rawls And The Refusal Of Medical Treatment To Children." 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