Tag: autonomy

Blog Posts (9)

April 21, 2014

Being Wrong is Unacceptable: The Continued Saga of Justina Pelletier

by Theresa Spranger, Bioethics Program Alumna (MSBioethics 2012) Alright, as many of you certainly know I have developed an addiction to the Justina Pelletier case.  I promise someday I will write on another topic, but today is not that day.  If you haven’t been privy to my latest obsession please see: When Doctor’s Disagree. An opinion […]
April 11, 2014

What Price Immortality? Privately Funded Projects and the Prolongation of Life

By Richard Koo, Bioethics Program Alum (MS Bioethics 2011) and Adjunct Faculty Seemingly ripped from the covers of comic books, no less than three privately funded projects seeking the prolongation of human life have been publicized in the past year. The 2045 Initiative, dubbed “the Avatar Project”, is arguably the most futuristic and non-traditional of the […]
April 4, 2014

Whose Business Is It If You Want a Bee To Sting Your Penis? Should IRBs Be Policing Self-Experimentation?

by Michelle Meyer, Bioethics Program Faculty. You might think that the answer to the titular question is pretty obvious. Obviously, it’s your business, and yours alone if you want to induce a bee to sting your penis? Right? I mean, sure, maybe it would be considerate to discuss the potential ramifications of this activity with your partner. […]
April 1, 2014

When Doctors Disagree: Parental Rights and Disputed Pediatric Diagnoses

by Theresa Spranger, Bioethics Program Alumna (MSBioethics 2012) What happens when doctors disagree on a pediatric diagnosis? What are the parents’ rights in a diagnosis dispute? Do they have any? Many readers will be familiar with the story of Justina Pelletier, a 15 year old Connecticut girl diagnosed with Mitochondrial Disease by Dr. Mark Korson at […]
March 30, 2014

Rated NC-17: Why Voluntary Euthanasia of Children is Dead Wrong

by Dr. Patricia Mayer, Bioethics Program Alumna (2009) Belgium just became the first country in the world to extend the option of voluntary euthanasia to children under the age of 12.  Voluntary euthanasia of adults has been legal in that country since 2002, but the Belgian parliament has now decided to remove age restrictions from […]
August 3, 2013

The Problem with POLST - Physician Orders for Life-Sustaining Treatment

  The Problem with POLST Over the years, informed consent has been given short shrift. There is, however, a growing understanding of the importance of obtaining an actual and legitimate consent before  having a patient accept or reject m...
May 7, 2013

Waiting for medical records "after discharge" is of no help for decision making

  Medical records: Waiting for medical records “after discharge” is of no help.  Reviewing medical records  in the hospital allows the patient and/or a surrogate decision maker to obtain the greatest amount of information pos...
March 11, 2013

Autonomy: the Basis of Respect and Dignity

 

“Be a good girl and take your medicine.” Part 1

This statement was made to a 60 year old end stage leukemia patient who demanded to be discharged from the hospital. The patient refused the prescribed medications.  No attempt was made to discuss the risks attendant in not taking the prescribed medication. The patient was cogent and articulate - able to make medical decisions for herself. The physician walked out of the patient’s room in the ICU. No social worker, bioethicist had been called to assist. Patient Jane was merely told, “Be a good girl and take your medicine.”

What can we say about the physician who made this statement? One might speculate that perhaps the physician was elderly – old school, etc. He was not. Early forties, well trained, and well respected. Could it be a socioeconomic impasse in communication? Possibly, the pt was poor and black. There was family or friends to advocate on her behalf. Nevertheless the statement breached medical ethics and legal responsibilities. A patient has a fundamental right to determine what medical care she will accept. To ignore these requests constitutes battery and possibly false imprisonment. 

The patient reported that she never really spoke with her doctor. He would come into the room briefly, she said, early in the morning. He spent a short time examining her. Often he was interrupted by cell phone calls. He would say he had to run. The pt reported that the nurses were giving her little attention, save saying that she should take the medicine the doctor proscribed. She told the ICU nurses she was refusing meds and wanted to be discharged. She called me.

I found her curled up in a fetal position shivering with no blanket calling for help. She told me her wishes; her refusal of meds and request to be discharged. She had voluntarily admitted herself to the hospital and saw no reason that she should be kept “like a prisoner” and with her “Constitutional Rights violated." She implored me to help her; she said she had a brief time to live and did not want to remain in this hospital to wait out her days. She was feeling better and "wanted out." I contacted the primary treating physician who said she was not competent to make decisions. I recommended a psychiatric consult to confront this issue. The psychiatrist responded within a few hours and found that Jane was clearly competent to make decisions for herself, but placed her on an involuntary 72 hour hold because he found her to be paranoid that people would not listen to her.

This was a misapplication of the purpose of the 72-hour psychiatric hold statute, used for the protection of a who may cause harm to herself or others. I contacted then psychiatrist to inquire why he felt she might cause harm to herself or others. He did not think she would but did not want to cause "a problem" for the primary treating physician.

 

 

August 12, 2010

Slicin' and Dicin' Doesn't Work for BDD Sufferers

As shocking as this might sound, those who suffer from body dismorphic disorder (BDD) don’t feel better or improve on any indicators after having plastic surgery according to a recent study in the Annals of Plastic Surgery.…

Published Articles (16)

AJOB Neuroscience: Volume 4 Issue 4 - Sep 2013

Autonomy in Neuroethics: Political and Not Metaphysical Veljko Dubljević

American Journal of Bioethics: Volume 10 Issue 12 - Dec 2010

The Encompassing Ethics of Bariatric Surgery

American Journal of Bioethics: Volume 10 Issue 12 - Dec 2010

Stuck in the Middle: The Many Moral Challenges With Bariatric Surgery

American Journal of Bioethics: Volume 10 Issue 9 - Sep 2010

Deidentification and Its Discontents: Response to the Open Peer Commentaries

American Journal of Bioethics: Volume 10 Issue 10 - Oct 2010

Invited Commentary: ?Rethinking Research Ethics,? Again: Casuistry, Phronesis, and the Continuing Challenges of Human Research

American Journal of Bioethics: Volume 10 Issue 7 - Jul 2010

Review of The Ethics of Consent, eds. Franklin G. Miller and Alan Wertheimer

American Journal of Bioethics: Volume 10 Issue 3 - Mar 2010

The Secret of Caring for Mr. Golubchuk

American Journal of Bioethics: Volume 10 Issue 3 - Mar 2010

The Case of Samuel Golubchuk and the Right to Live

American Journal of Bioethics: Volume 9 Issue 12 - Dec 2009

Response to Open Peer Commentaries on ?A Duty to Deceive: Placebos in Clinical Practice?

American Journal of Bioethics: Volume 9 Issue 12 - Dec 2009

A Duty to Deceive: Placebos in Clinical Practice

View More Articles