It is worth noting that the problem of medical ethics is becoming increasingly relevant. Modern technologies can prolong a person’s life, as well as interrupt it, and this is a person’s choice which decision to make (Scher & Kozlowska, 2018). Nevertheless, the case of each patient is unique, which does not always allow adhering to a certain pattern of behavior, hence, ethical dilemmas arise. The purpose of this paper is to discuss an ethical dilemma related to handling a request for no further cancer treatment of a woman with developmental delay.
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Importantly, handling patients who experience terminal conditions is quite challenging due to a variety of accompanying factors. If a client suffering from a deadly disease also has developmental delay, this poses an additional degree of responsibility on the healthcare provider. This is related to their inability or limited ability to make autonomous decisions (Scher & Kozlowska, 2018). In addition, it is a frequently observed situation that patient cases cannot be processed through a proper legal framework. This is a setting when various ethical dilemmas may arise, and the specialist needs to consider those along with differing legal, mental, and psychological factors.
It is the direct responsibility of the healthcare provider to make an adequate decision while securing the rights of the client and ensuring minimal risks for them. When dealing with such patients, it is crucial not only to be compassionate but also to act professionally and within the scope of one’s practice. Every medical professional should possess sufficient knowledge and critical thinking skills to able to act in the best interest of a patient.
Statement of Dilemma and Author’s Position
In the provided case, a 41-year-old woman with advanced breast cancer wishes to stop her cancer treatment. The complexity of the situation lies in the fact that she is developmentally delayed since birth and may not be autonomous fully. Moreover, the core of the ethical dilemma is that the specialist needs to either act or not to act on the woman’s request for terminating her treatment (Di Nucci, 2018). The author of this paper believes that it is ethical to carry out the desire of the patient for several reasons.
Justification, Refutation, Alternative Option
Autonomous decision-making and independent health-related choices are two of the main principles of healthcare, which should be ensured for all patients. This means that every patient should be given an opportunity to make health-related decisions without persistence or indifference from the side of the healthcare professional (Di Nucci, 2018). Any choice made should be treated with respect if it meets the criteria of an ethically and legally valid decision. That is, the fact that the woman is developmentally delayed cannot undermine or affect these ethical principles.
It is crucial to note that, previously, patients with developmental delays were treated differently, and a specialist could execute control over certain decisions. At present, a completely different approach has been practiced, assuming that the patient is a client whom the medical staff serves. Consequently, the healthcare provider may perform only those activities on which they have agreed with the client and those which the family has approved (Di Nucci, 2018).
Any person is a free individual regardless of their condition, and medical ethics should stem from this understanding. A developmentally delayed client has the same rights as all other people (to the maximum degree of feasibility). The woman is developmentally delayed since childhood, but she has the right to appropriate medical care and treatment as well as the right to refuse it.
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Nevertheless, in order to form an objective opinion of whether it is ethical to stop the woman’s treatment at her request, it is necessary to have a wider context. It is important to understand the degree of developmental delay and how autonomous the woman is intellectually, emotionally, and legally (Erickson & Payne, 2016). The doctor needs to know if the consent of the guardian is required to stop treatment and how immediate family can be included in this process of care to achieve maximum benefit for the client.
Despite the conditions of the limited context, the specialist is obliged to provide their client with information about their rights not only in terms of receiving medical care but also if they want to refuse it. The administration of the medical institution and the attending doctor are to provide each patient with information about their health, different treatment options, and the consequences of rejecting/stopping treatment (Erickson & Payne, 2016). Thus, the specialist needs to create the conditions for the execution of the rights of the woman and that of her legal representative (if any).
Golden Rule Approach
The author of this paper believes that the golden rule approach is the most suitable and adequate method of solving ethical dilemmas. It implies that a person should be treated the way the individual making a decision would prefer to be treated. The writer would prefer to be handled with respect in regards to personal freedom and choices made. By respecting the choice of the woman, the healthcare specialist would feel self-respect as well (Bodenheimer & Grumbach, 2016). In addition, by following the golden rule principle, the medical professional would build emotional goodwill.
Many experts in the field would argue that the fundamental principles of autonomy and informed consent may be violated when caring for developmentally delayed patients. In the situation of the 41-year-old woman, it can be assumed that the patient’s right to refuse medical care is one of her fundamental rights and the doctor’s actions to respect this right, even if they lead to the death of the patient, are quite ethical (Tucker King, 2017). The woman has breast cancer, and this condition implies that the woman will die inevitably. Nevertheless, this is her basic right to choose whether to continue receiving treatment or not, and it should be respected and protected.
In such a setting, the author of this paper would prefer to be well-informed on the consequences of canceling a treatment, get an opportunity to discuss the matter with the immediate family/guardian, and be provided with autonomy for decision-making (Tucker King, 2017). This way, the compromise between rights, justice, and utility will be achieved. The woman refusing treatment and her legal representative should be explained the possible consequences of stopping treatment, but it should be up to her to make the final decision.
Thus, it can be concluded that ethics is an important aspect of healthcare. Ethical issues related to moral dilemmas arise from conflicts in duties or obligations to patients and their families. The ethics of a decision is inextricably linked with the principles of autonomy, beneficence, and justice. In the case of the woman, the moral dilemma arose in the context of patient autonomy and the fundamental principles of informed consent. Ethics concerns choices, decisions, and actions in the interests of the patient. Therefore, the healthcare provider should ensure the woman’s rights are protected even if treatment cancellation is not recommended.
Bodenheimer, T. S., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw Hill Professional.
Di Nucci, E. (2018). Ethics in healthcare: A philosophical introduction. Lanham, MD: Rowman & Littlefield International.
Erickson, J. M., & Payne, K. (2016). Ethics in oncology nursing. Pittsburgh, PA: Oncology Nursing Society.
Scher, S., & Kozlowska, K. (2018). Rethinking health care ethics. London, England: Palgrave Macmillan.
Tucker King, C. S. (2017). The rhetoric of breast cancer: Patient-to-patient discourse in an online community. Lanham, MD: Lexington Books.