Autonomy Of The Patient

Introduction

I will give three cases. Following the three cases I have explained the justification of overcoming the autonomy of the patient. This is done under the principle of beneficence. Then I conclude with my own thoughts and views.

The Three Cases

Case 1:

I am working on a patient who is unstable in the intensive care unit. She was in an accident and all her children were killed. I know that any further emotional trauma would be disastrous for her and could cause her to die. She does look at me in a lucid moment and asks me, "How are my children?"

Question:

What would be the most appropriate answer for the patient and is this an instance when therapeutic privilege seems reasonable?

Answer:

The appropriate answer would be "I do not know, but when I have got you taken care of and can leave your side, I will go find out for you." This is a very good example of where therapeutic privilege would be reasonable. The reason why is because this is a situation where this horrific information could pose serious harm to her. It could even prompt her to suicidal behavior. The principle of beneficence involves a positive obligation, the duty to actually do something good, or to actively move to prevent or remove harm.

A positive obligation to protect the woman we are stabilizing, the duty to keep her safe, and actively removing harm by not telling her about her children at this time. All these obligations and duties follow the principle of beneficence. Basically if one cannot do good without also causing harm, then one should not act at all. Autonomy is the ability to take charge of, take responsibility for, or control over my own learning. What autonomy involves is people's possession of abilities or attitudes that they can develop to different degrees. I have to take charge, responsibility, and control over this situation. If I don't then we could lose this patient as well.

Case 2:

I am working late and I enter a patient's room to find that she has climbed out on the window ledge. It appears that she is crying and tells me to leave her alone.

Question:

Indicate whether you think it would be justified under the principle of beneficence and why.

Answer:

Yes it would be justified to overcome the autonomy of the patient because this is a suicidal attempt. This patient is need of some help even though she thinks she doesn't. She has put herself into an unsafe position and I have to now fix this problem. I would grant her wishes for the time being and ask her if there is anything I can get for her or if she needs to just talk I am here. With the principle of beneficence I have the obligation to respect her wishes. I have the duty to protect her from harm and to remove harm and if that is leaving her alone right now then so be it. I have to take charge, responsibility, and control over this situation. If I don't