In the health care system, disabled individuals find it difficult to move. That is a very intricate and ethically complicated process. While international human rights instruments like the CRPD recognize the right to health, the actualization of this principle in healthcare decision-making faces numerous obstacles. This paper discusses the ethical dilemmas surrounding healthcare decision-making for disabled persons and examines how to balance respecting autonomy, promoting best interests, and ensuring inclusion ( Funk, 2020).
It must be understood that different kinds of disability exist within this community to manage their various experiences and cognitive abilities. Different levels of support or communication strategies are required for those engaging in healthcare decisions by people with intellectual or developmental disabilities, for instance. Hence, understanding this range is necessary when developing individualized decision-making processes.
Autonomy, which means having an informed choice about one’s health, is an ethical axiom that applies universally to all people, including persons with disabilities( Smith et al., 2022). In an ideal situation, personal autonomy should always be followed when all is well regarding the health choices made. This includes using readily available information, simple and straightforward communication techniques, and meeting any possible barriers with assistive technology or supporting persons. Nevertheless, because of varied cognitive capacities or communication difficulties, some disabled people may not satisfactorily understand the consequences behind healthcare decisions and consent on their own. This presents an ethical dilemma: respecting individual autonomy and the obligation to work in their best interest.
When a person cannot make decisions for self, the SDM or surrogate decision-maker can be used. This is achieved by appointing a statutory deputy, usually a family member or health care professional, to decide on behalf of an individual based on what he/she would have wanted and act in his/her best interest if sane. Such advantages include ensuring that in every circumstance, depending on the case, a particular can be out rightly represented or owned proper representation. It can protect people from injury and abuse. Finally, it provides prompt medical interventions at critical moments.
Conversely, this ethical problem has pros and cons, among which there is a possibility of misinterpreting individual wishes or preferences, accentuating the value external to one. Furthermore, failure to protect the autonomy of temporarily disabled employees who lose their duty status is infantile. First of all, when relatives are biased, existing imbalances in power get even more aggravated.
SDM is a different way of doing things by following- not being directly individual autonomy and supportive care. The strengths and weaknesses of this are that it allows persons with a disability to participate in decision-making processes without regard for the extent of their capacity. Some supportive facilities use SDM facilitator systems like electronic communication, family involvement, and peer advocacy. Finally and not least importantly, it highlights shared decisions informed by personal preferences within supported environments. However, supported decision-making has several cons. For this to be achieved, sufficient resources and well-trained facilitators are needed. Additionally, the process may be time-consuming and call for patience from medical practitioners. Supported decision-making still depends upon interpreting individual desires; thus, it may contain bias risks.
A multifaceted approach, such as altering attitudes, is required for ethical decision-making involving persons with disabilities. They are moving away from paternalistic models while acknowledging individuals’ capacity and right to participate even though they require support. Training and Education: Skilling healthcare personnel with the right communication skills, disability awareness, and supported decision-making. Inclusive Decision-Making Tools: Using understandable formats, persuasive speech aids, and involving the support of people in it. Empowering Individuals and Communities: Advocating for self-advocacy and bringing disability organizations to create ethical frameworks and decision-making plans ( Ahmed et al., 2022).
In conclusion, maintaining balanced and ethical healthcare decision-making regarding people with disabilities proves a dynamic issue. Acknowledging this diversity, valuing the autonomy and decision-making of each person, and adopting collective ways such as shared or supported decisions are important transformations leading to inclusive and ethical healthcare for all. This ethically complicated space demands constant dialogue, research, and unwavering dedication to defend the health rights of people with disabilities.
References
Funk, M., & Bold, N. D. (2020). WHO’s QualityRights initiative: Transforming services and promoting rights in mental health. Health and human rights, 22(1), 69.https://doi.org/10.3389/fpsyt.2020.571722
Smith, J. B., Willis, E. M., & Hopkins‐Walsh, J. (2022). What does person-centered care mean if you were not considered a person anyway: An engagement with person-centered care and Black, queer, feminist, and posthuman approaches. Nursing Philosophy, 23(3), e12401.https://doi.org/10.1111/nup.12401
Ahmad, S., Islam, M., Zada, M., Khattak, A., Ullah, R., Han, H., … & Araya-Castillo, L. (2022). The influence of decision making on social inclusion of persons with disabilities: A case study of Khyber Pakhtunkhwa. International Journal of Environmental Research and Public Health, 19(2), 858.https://doi.org/10.3390/ijerph19020858
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