FinalCase Analysis: Paternalism vs. Autonomy (Dax Cowart)
FinalCase Analysis: Paternalism vs. Autonomy (Dax Cowart)
Patientautonomy is a situation when an all person can clearly make theirhealthcare decisions while the paternalistic approach is when theclinician wholly gives the choices regarding the individual’schoices. The ethical obligation of a health care provider is to letthe patients practice their rights of self-determination (Pozgar,2012). However, they are always faced with the dilemma of anintertwining concept of “doing good” for the benefit of thepatients (beneficence) (Pozgar, 2012). The practice of paternalism isimportant in areas where the patients are functionally illiterate inmost cases, the healthcare provider’s direction on an individual’shealthcare goes unopposed. Considering Dax Cowart’s case study,this paper will focus on the ethical dilemmas presented, thestakeholders’ perspectives, personal assessments, and potentialsolutions for resolving the issue.
Thehealthcare providers were faced with the ethical dilemma of patientfreedom versus the clinician’s control. The healthcare providersare trained, and therefore, are aware of the appropriate clinicalcourse of action to take. The real issue comes in when the patientdeclines the treatment or makes a decision with least optimaloutcomes. Healthcare providers are bound by the promise of devotingto the best patient care and live up to the guidelines of theprofession (Pozgar, 2012). In the case study scenario, the healthcareproviders face the dilemma of whether to continue treating Dax orcomply with his wishes to die. Dax was in a lot of pain during hisstay at the hospital, he begged with the nurses to end his life, hefelt like death was the only way out of the extreme pain. Dax feltlike the doctors practiced paternalism on him since they did not lethim make his decisions regarding what he wanted to do with his life.
Thestakeholders included the healthcare providers who were tasked withthe responsibility of taking care of Dax. Their main responsibilitywas to choose the best course of action for the patient from themoment he was brought in an ambulance. However, they also had toconsider the patient’s self-determination rights. The healthcareproviders were more inclined to continue treating him since theybelieved that the decision made by the patient was detrimental to hiswell-being. The other stakeholder was the patient. His decisions weremostly influenced by the fact that he felt he would not continuefunctioning normally by being a physically challenged person. Theexcruciating pain he felt also influenced his decision to end hislife he felt like the doctors failed to let him practice his rightto determine his options.
Thetheory of consequentialism ethics has the view that the appropriatemoral response closely links to the outcome or consequence of the act(Gallagher & Hodge, 2012). When Dax was in the hospital, he feltlike the doctors should have ended his life however, after gettingwell he led a healthy and happy life. Nonetheless, Dax admits that ifhe was put in the same situation he would still choose to die. Thedecision chosen by the healthcare providers closely relates to theend results achieved. The theory contradicts the patient’sperspective if the healthcare providers complied with his request,the outcomes would be negative. The theory of principlism emphasizeson autonomy, beneficence, non-malificence, and justice (Gallagher &Hodge, 2012). The patient’s view is that he was denied his right toself-determination. Therefore, that contradicts with the principalshighlighted by the theory. The legal issue arising from the casestudy scenario is consent. The patient felt like he did not giveconsent for the surgery and continuation of treatment. He felt likethe healthcare providers ignored his views and rights. The healthcareprofessionals in such cases face conflicts between ethics and thelaw.
Inmy view, I consider the doctors made the right decision to continuewith Dax’s treatment. The patient was blinded by pain and the factthat he felt he would not function like before, being a previouslyable-bodied person. The patient lacked information on facts such asthe different functions the challenged people still perform. Isuppose the patient also lacked guidance from a psychiatrist he hadjust become disabled and lost his father at the same time. Whenconfronted with a case such as that of Dax Cowart, I would not lethim die. As a physician, I would opt to reason out with him on hischoice and ask why he wants to die then introduce to him the optionsavailable for physically challenged persons out there. If the namedstrategy does not work, I would consider bringing him professionalcounselors. For future cases, the healthcare providers should helpthe patients understand their options with the help of counselingprofessionals.
Insummation, patient autonomy is a situation when an ill person canclearly make their healthcare decisions while the paternalisticapproach is when the clinician wholly makes choices regarding anindividual’s preferences. Considering Dax Cowart as the case study,the healthcare providers were faced with the ethical dilemma ofpatient freedom versus the clinician’s control. The two mainstakeholders were the patient and the healthcare providers. Thetheories related to the dilemma from the patient’s perspective werethe consequentialism and the principlism. Consequentialism theory hasthe view that the appropriate moral response closely links to theoutcome or consequence of the act. The hypothesis of principlismemphasizes on autonomy, beneficence, non-malificence, and justice. Ibelieve that the healthcare professionals’ decision was correctthe patient’s choice could not be considered as sound since it wasinfluenced by factors such as pain. I would not let Dax die if I washis physician since I believe he was not thinking appropriately.
Gallagher,A and Hodge S. (2012).Ethics,Law and Professional Issues: A Practice-Based Approach for HealthProfessionals:New York: Palgrave Macmillan.
Pozgar,D. G. (2012).Legaland Ethical Issues for Health Professionals:New York: Jones & Bartlett Publishers.