Abstract
The ethical dilemma I have chosen to investigate is the tension between paternalism and informed consent within the medical profession. This conflict arises when physicians and healthcare providers must choose whether to make a decision for a patient or determine with the patient what decision should be made. It becomes essential to overcome the dilemma as it directly concerns patients’ freedom of choice and self-determination in medical decisions. Without the proper inclusion of patient perceptions and choices, healthcare interventions may derive from the patients’ values, leading to patient dissatisfaction, lack of compliance with the therapy course, and the fate of the desired results. Throughout regular visits and even in emergency rooms, this problem is common in all areas of the healthcare profession. Besides, it becomes fraught with moral and ethical concerns as it initiates a conflict between healthcare providers’ duty to put the patient’s interests first and patients’ autonomy coupled with the right to decide what should be done to them. This complication carries a high moral weight when patients might be deemed incompetent to give informed consent or their decisions go against the provider’s recommendations.
From different sides, the dilemma of paternalism vs. autonomy can be seen as a conflict between traditional medical paternalism, characterized by the priority of the physician’s experience and authority, and the contemporary style of care in which the patient authority is emphasized(Fisher). Certain participants could propose paternalistic tactics, asserting that patients cannot be left to the mercy of uncertainties and potential harm, among other reasons. However, others suggest informed consent, arguing for respect for the patient’s autonomy and medical decision transparency. Beyond all these, cultural, religious, and socio-economic issues may augment humans’ frame of reference regarding the inherent problem. Concerning this issue, the options based on critical thinking are the key. The literature that has been learned by the healthcare providers, alongside the W.I.S.E. Approach, will help them to navigate the perplexity between paternalism and informed consent, making them weigh the relevant information, consider the alternatives, evaluate the consequences of different courses of action and produce decisions that prioritize the autonomy of the patients. Consequently, this leads them to beneficence and non-maleficence(Fisher). Also, patient satisfaction can be rebuilt through open communication, developing trust, and employing collaborative decision-making, leading to treatment plan adherence and desirable outcomes of the health service.
Introduction
Paternalism in healthcare can be defined as the act where healthcare service providers make decisions for the patients without fully consulting them. It has been shown for the philocal roots that professionals are the ones who know better about the health of their patients(Holcomb). Nevertheless, fairly recently, there has been a tendency for the patient’s needs to be considered primary compared to the clinical decision-making roles of doctors. Ethical aspects are the main forces that change it because they strongly affirm the respect for patients’ decisions and desire to participate in deciding about their care. Consequently, the challenge of how paternalistic procedures and informed consent line up has become one of the important ethical dilemmas for healthcare settings. This article discusses wisdom-paternalism vs. informed consent in health care(Holcomb). It centers on the argument that conflict can develop when healthcare professionals make decisions over patients without fully disclosing such decisions to them. Such an approach can result in the raising of ethical concerns that relate to the freedom of the patient and the right to self-determination. The paper focuses on the ethical issue of multiple interests and how these may affect patient-centered care. This paper also presents several ways in which this problem can be addressed.
Literature Review
The issue of paternalism and informed consent in healthcare is raised along with the fact that patient autonomy and shared decision-making are the two main ingredients in ensuring healthcare delivery is ethical and effective. Liang et al. pointed out that not only the abuses of power by the doctors that restrict patient autonomy but also the paternalistic practices, in which the doctors make decisions on behalf of patients without their complete involvement, and the outcomes of care are dissatisfied. However, free consent allows patients to decide about their healthcare independently. This, in turn, serves as the foundation of the patient-centered care system. This approach offers the benefit that patients are well-informed of treatment choices, risks, and benefits, with active participation by the parents in making decisions regarding their health.
Lastly, this value is further emphasized and supported by highlighting the paramount idea that doctors should respect patients’ autonomy in medical ethics (Varkey). By this, they suggest that doctors and medical workers must give informed consent first and treat patients equally in the decision-making process. It guarantees that patients control their lives and uphold their values. Furthermore, the research works demonstrate the patient’s involvement in decision-making (Elwyn et al.). It is reported that the patient who has taken part in the decision-making process shows better clinical outcomes and treatment adherence. The findings of these studies exemplify the advantages of teamwork in medicine. This issue highlights the significance of considering the needs of patients and their role as participants in their healthcare. The theoretical aspects of paternalism and informed consent are not only two separate spellings, but they have great ethical consequences for the patients/clients’ wellness(Holcomb). The literature accomplishes this by systematizing ethical principles at the foundation of the concepts and providing evidence of linkage between the suitability of these approaches and the directedness of patient outcomes in healthcare decision-making. The review of research is about completely understanding the issue and why it is worth patient-oriented care and ethics in health facilities.
Conclusions and Recommendations
The quandary of paternalism as opposed to informed consent in healthcare is a situation embedded with complex ethical issues that necessitate the implementation of strategic critical thinking abilities to handle it effectively. Having examined the literature and research results using the W.I.S.E. approach and other critical thinking techniques, some suggestions can be made to improve the quality of care and meet the patient’s needs. Primarily, it is acknowledged that patient autonomy and collaborative decision-making processes form the pillars of ethical practice in healthcare. Mongering practices with healthcare providers result in patients’ decisions being made on their behalf, with them not fully participating, engendering censorship of patient autonomy and dissatisfaction with the care results(Holcomb). While informed consent regarding the procedure is the basis of patient autonomy, it gives patients all the power in the decision-making process for treatment by ensuring that they possess the right information and having it discussed with the providers about the treatment options, risks, and benefits (Varkey). For that reason, medical professionals need to focus on patient autonomy rather than consider patient autonomy as one of the tools alongside other important factors and, thus, involve patients in the deliberation process.
Next, critical thinking skills are widely regarded as the first order of the business in addressing the dilemma of paternalism and consent. The W.I.S.E. Approach, as described by (Liang et), provides the instrument for a systematic framework concerning problem analysis and decision-making based on patient autonomy. Through detailed consideration, we are looking for different options, recognizing the impacts, and acting in a way that may help the art of decision-making for health workers and good patient outcomes. Furthermore, other components of critical thinking like empathy, perceptual thinking, and ethical reasoning are important for appreciating individual opinions, earning patients’ trust, and facing inevitable moral dilemmas confidently(Holcomb).
Healthcare institutions need to strike a balance between paternalism and informed consent while practicing. Several ways might be adopted to do so. Firstly, healthcare providers should focus on patient education and informed consent. This includes providing patients with all the necessary meaningful information about the pros and cons of the treatment modalities they are being considered for. Through this, patients can now choose wisely by getting all the necessary information needed to make better decisions concerning their health. This leads to increased autonomy as well as a more profound patient-physician relationship(Holcomb). To sum up, it is essential to to revise decision-making processes by involving the society more. The proactive participation of patients in decision-making process regarding their treatment options and taking their opinions into consideration by healthcare providers can lead to rooting of the collaborative decision-making, as the case plans will be in line with the patient’s values and goals and the trustworthiness and mutual respect will be present. On the other hand, caring for cultural and ethical diversity, confidence in the relationships and appearance, and ongoing professional development are the attributes that are important for ethical health care service which preserves patient autonomy and contributing to positive patient outcomes.
Finally, the challenge of paternalism versus informed consent in healthcare demands that providers apply critical thinking and make the right decisions, in order to have patient-focused care. Recognition of the patient’s autonomy through shared decision making, respecting different cultures, fostering a credible relationship, and continuous presentation in the professional sphere can help healthcare providers successfully handle this dispute and improve the patients’ outcomes. Given tremendous convergence between health, technology, and society, it is essential that healthcare professionals resolve themselves to ensuring that they follow moral principles and guard the best interest of their patients at any time and in all circumstances.
References
American Medical Association. “Ethics.” American Medical Association, 2016, www.ama-assn.org/delivering-care/ethics.
Elwyn, Glyn, et al. “A Three-Talk Model for Shared Decision Making: Multistage Consultation Process.” B.M.J., vol. 359, no. 359, 6 Nov. 2017, p. j4891, www.bmj.com/content/359/bmj.j4891, https://doi.org/10.1136/bmj.j4891.
Fisher, St. “Part of the Medicine and Health Sciences Commons Recommended Citation Recommended Citation Consadine.” Journal of Undergraduate Research Soaring: A Journal of Undergraduate Research, vol. 2023, 2023, p. 3, fisherpub.sjf.edu/cgi/viewcontent.cgi?article=1017&context=soaring. Accessed 17 Sept. 2023.
Holcomb, Lola. Ethical Considerations Regarding Paternalism in Medicine Ethical Considerations Regarding Paternalism in Medicine. 2020.
Lazcano-Ponce, Eduardo, et al. “Communication Patterns in the Doctor–Patient Relationship: Evaluating Determinants Associated with Low Paternalism in Mexico.” B.M.C. Medical Ethics, vol. 21, no. 125, 10 Dec. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7731770/, https://doi.org/10.1186/s12910-020-00566-3.
Liang, Zhanming, et al. “Patient-Centred Care and Patient Autonomy: Doctors’ Views in Chinese Hospitals.” B.M.C. Medical Ethics, vol. 23, no. 1, 8 Apr. 2022, p. 38, pubmed.ncbi.nlm.nih.gov/35395761/, https://doi.org/10.1186/s12910-022-00777-w.
Varkey, Basil. “Principles of Clinical Ethics and Their Application to Practice.” Medical Principles and Practice, vol. 30, no. 1, 2021, pp. 17–28, www.ncbi.nlm.nih.gov/pmc/articles/PMC7923912/, https://doi.org/10.1159/000509119.
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