None of the possible meaning of the distinction explains why the distinction should directly determine whether treatment is morally obligatory or optional. For example, a treatment that is statistically generally accepted or involves the use of low technology might be beneficial to an individual patient in specific circumstances. However, it may not be helpful or perhaps even burdensome to another patient in other circumstances. The correct understanding of the traditional distinction is the distinction between treatments that are beneficial and treatments that are overly burdensome (and useless) to the patient. Treatment is only excessively burdensome when the benefits it provides are insufficient to justify the hardship. Unlike other interpretations, this interpretation of the ordinary-extraordinary distinction marks a significant moral difference.
The assessment that a treatment is “extraordinary” places a label on a treatment already independently determined to be useless or unduly burdensome to the patient. Evaluation of the benefit – the burden of doing an independent job in evaluating the treatment, so can be justified. For this reason, many commentators have abandoned the ordinary-extraordinary analysis in favor of a clearer and more direct approach to assessing the benefits and burdens of treatment for the individual patient.
Thus, the considerations that guide physicians relate to their personal ethical standards, as well as understanding their patients. They can listen to their patients and include extraordinary therapy in treatment, even if it is illegal or inappropriate in a particular situation. At the same time, doctors may face criminal liability or be excluded from the medical community. No ethical basis can be applied mechanically to make simple and unambiguous decisions about taking extraordinary treatment. Even with the best implications and the clearest reasoning, many decisions remain ethically problematic and emotionally charged.
Within the framework of treatment, which can be called ambiguous, the doctor has many responsibilities. The patient’s comorbidities and other treatment must be considered first. The expression “taking everything into account” also emphasizes the need to balance all the obligations of the patient. It implies not only the impact on the person, but also on his family. At the same time, the doctor’s duty is to consider not only pain, cost and health benefits, but the meaning of life and quality of life, as the patient understands this.
Some decisions to take ambiguous therapy are not relevant and require more precise knowledge of the diagnosis. In this context, it should be emphasized that a physician, or other health care provider, cannot make such decisions, if only because the professional does not know all the circumstances. Moreover, the health care provider is not fully aware to assess the meaning and value of life for another person. A doctor recognized as informed consent must do what is medically required, which would do more medically good than harm. Formulated differently, the medical benefits must outweigh the medical burden for the patient.
Although the health care professional is not competent to assess proportionality, taking everything into account, it is his responsibility to have a professional role and competence in this area. The area is one in which the health care professional must evaluate the proportionality of the consequences. As far as physicians are concerned, they call the special formulation of the principle of mercy the principle of medical indications. Treatment is medically necessary unless the patient is dying of some other incurable disease, or unless the treatment would cause more harm than medical benefit.
The obligation of proxy-decisions makers to consent to or refuse treatment depends on whether the wishes of the once-competent patient are known. Moreover, it is being considered whether these wishes can be inferred. It is included whether the patient was not always incompetent, or whether his wishes are completely unknown. If the wishes of a once-competent patient are known (verbally or in writing), or can be easily inferred from the person’s actions and values, the surrogate should decide in accordance with the patient’s wishes. To invalidate those wishes would be a violation of human autonomy.
The principle of best interests requires that the surrogate act in the best interests of the patient, overriding the interests of others, including the interests of the family, society, and the surrogate himself. The principle of best interests, therefore, requires that only the good of the patient be considered and nothing else. The principle of rational choice requires that the surrogate choose what the patient would choose, being competent and having considered all available relevant information and the interests of all affected persons.
Opinions about extraordinary treatment in different categories of people do not coincide. Someone believes that this is a murder and such procedures are unacceptable, regardless of the severity of the situation in which the sick person is. Others believe, when there is no other way out, that this type of treatment will make the patient feel significant. My opinion is that extraordinary treatment is not possible under any circumstances.
One of the main precepts in medical ethics says not to harm the patient. However, with extraordinary therapy, this commandment is violated. In the situation with IVF in case of Octomom, the doctor violated this and planted 6 embryos in the woman, despite the fact that medicine advises to plant no more than two embryos (Gitlin and Einion 487). Thus, even when persuading a woman to plant more, the doctor had to refuse, as this could lead to health problems or death. In this case, I believe that the use of extraordinary therapy is impossible.
Work Cited
Gitlin, Susan, and Alys Einion. “Ethics in fertility and pregnancy management.” Fertility, Pregnancy, and Wellness. Elsevier, 2022. 479-492.