Do patients have the right to refuse life-sustaining treatment?
Ethically and legally patients have the right to refuse life-sustaining treatment, including artificial nutrition and hydration. The Patient Self-Determination Act (1991) is a federal statute that reinforces patients' rights to refuse artificial hydration and nutrition. This right was determined in constitutional law in the case of Nancy Cruzan.
What is an example of a right to refuse care?
A mentally ill patient who poses a physical threat to himself or others is another example. Most patients in the United States have a right to refuse care if the treatment is being recommended for a non-life-threatening illness.
Why is it important to protect the rights of patients?
Since the decisions to be made may concern patients’ family members and society as well as the patients, it is important to protect the rights, dignity, and vigor of all parties involved in the clinical ethical decision-making process.
What are the rights of a patient on life support?
A patient has both the “right to demand the termination of treatment” (e.g. the discontinuation of life support) and the “right to refuse treatment altogether”; the exercise of these rights is strictly dependent on the person.4,5AD can be updated yearly and/or prior to any hospitalization.9
Do patients have the right to refuse life sustaining treatment?
Under federal law, the Patient Self-Determination Act (PSDA) guarantees the right to refuse life sustaining treatment at the end of life.
What is the ethical principle of Nonmaleficence?
Nonmaleficence. The principle of nonmaleficence holds that there is an obligation not to inflict harm on others. It is closely associated with the maxim primum non nocere (first do no harm).
What is the principle of beneficence in health care?
Beneficence. The principle of beneficence is the obligation of physician to act for the benefit of the patient and supports a number of moral rules to protect and defend the right of others, prevent harm, remove conditions that will cause harm, help persons with disabilities, and rescue persons in danger.
What are the 4 principles of informed consent?
There are 4 components of informed consent including decision capacity, documentation of consent, disclosure, and competency.
What is beneficence vs Nonmaleficence?
The “Beneficence” principle refers to actions that promote the well-being of others. The duty of professionals should be to benefit a party, as well as to take positive steps to prevent and to remove harm from the party. Non-maleficence reminds you that the primary concern when carrying out a task is to do no harm.
What is autonomy and beneficence?
The four principles are: Respect for autonomy – the patient has the right to refuse or choose their treatment. Beneficence – a practitioner should act in the best interest of the patient. Non-maleficence – to not be the cause of harm. Also, "Utility" – to promote more good than harm.
What are the 4 main ethical principles?
Ideally, for a medical practice to be considered "ethical", it must respect all four of these principles: autonomy, justice, beneficence, and non-maleficence.
What is the principle of beneficence in nursing?
Beneficence. Beneficence is defined as kindness and charity, which requires action on the part of the nurse to benefit others. An example of a nurse demonstrating this ethical principle is by holding a dying patient's hand.
Why is Nonmaleficence important?
The principle of nonmaleficence requires that every medical action be weighed against all benefits, risks, and consequences, occasionally deeming no treatment to be the best treatment. In medical education, it also applies to performing tasks appropriate to an individual's level of competence and training.
What are the 5 basic ethical principles?
Moral Principles The five principles, autonomy, justice, beneficence, nonmaleficence, and fidelity are each absolute truths in and of themselves.
What is the principle of autonomy?
The third ethical principle, autonomy, means that individuals have a right to self-determination, that is, to make decisions about their lives without interference from others.
Which of the four treatment principles involves a patient making their own decisions?
The Principle of Autonomy. Autonomy is an American value. It is the ability to make decisions for oneself, also known as self-government.
What happens when a patient refuses life-sustaining treatment?
When a patient refuses initial life-sustaining treatment, respectfully explore the underlying reason for the refusal. This allows the healthcare team to identify alternative options that may be equally medically effective and also acceptable to the patient. In the end, the patient has the right to accept or refuse life-sustaining medical treatment.
Why do some people refuse blood transfusions?
Some patients may elect to refuse specific medical treatments, such as blood transfusions, because of religious beliefs, but will accept synthetic blood plasma expanders that aren't made of donor blood. When a patient refuses initial life-sustaining treatment, respectfully explore the underlying reason for the refusal.
What ethical dilemmas can a nurse face?
A: One of the greatest ethical dilemmas a nurse can encounter is when a patient refuses life-sustaining treatment—any procedure, medication, intervention, or use of medical technology that can postpone death. As healthcare providers, we're instilled with the primary objective to save lives. However, when treatment options are aimed ...
Can medical technology prolong life?
Medical technology can potentially allow the prolonging of a patient's life. However, these treatments carry risks and may also cause the patient physical, spiritual, or emotional pain. Many patients state that they would prefer their remaining life to be filled with family, friends, and enjoyable activities.
Is it illegal to force a patient to take medication without their consent?
Forcing treatment on a patient without his or her informed consent is illegal . Ensure that the risks and benefits of all treatment options are discussed with the patient so that he or she can make an informed decision that reflects his or her values and beliefs.
Can you stop curative treatment?
However, when treatment options are aimed at prolonging the patient's life, and no acceptable curative treatment option is available, patients may opt to cease medical treatment. Even when curative options are available, patients may not be willing to undergo the physical trauma, time involved, or associated emotional distress.
What is the dilemma of emergency medicine?
One of the greatest dilemmas for emergency physicians occurs when a patient refuses medical treatment that is necessary to sustain life and health. When patients in need explicitly refuse life-sustaining emergency treatment, the physician must choose between the undesirable options of forgoing beneficial treatment and forcing treatment on a competent but unwilling patient [1], both of which have potential ethical and legal consequences. The “emergency privilege” does not permit physicians to treat competent patients with emergency conditions who refuse treatment; but how does one assess an injured patient’s decision-making capacity?
What are the limitations of determining DMC?
In the emergency setting, there are limitations on determining DMC. When faced with medical emergencies requiring urgent action and decision making, the emergency practitioner does not have the luxury of time to consult psychiatric professionals, an ethics committee, or hospital legal counsel.
What is the emergency exception?
The emergency exception is based on the presumption that a reasonable person would consent to treatment to preserve life and health if he or she were able. Conversely, the patient who is alert, communicative, and comprehends the situation has the ability to direct his or her health care. The grey areas lie in between.
What is the right to refuse medical treatment?
The right to refuse medical treatment is grounded within the common law right to self-autonomy. This right is protected by the common law doctrine of informed consent, permitting a patient to make an informed choice, if competent to do so, to accept or forgo medical treatment. The doctrine of informed consent is rooted in the concept ...
What are the rights of competent and incompetent persons who choose to forgo life-sustaining medical treatment?
Competent and incompetent persons who choose to forgo life-sustaining medical treatment are protected by common law and by statutory and constitutional rights. Their right is not absolute, however, and must outweigh state interests of preserving human life; preventing suicide; safeguarding the integrity of the medical profession;
What is the right of a competent adult?
A Competent Adult's Right to Forgo Medical Treatment. In general, a court will uphold a competent adult patient's decision to forgo medical treatment even if that decision will result in a person's death. 9 – 11 This is because a competent adult has a common law, 9, 12, 13 statutory 14 and constitutional 15, 16 right to decline or accept medical ...
What does it mean when a court finds a patient incompetent?
A court that finds a patient incompetent must determine the patient's wishes by any means available, and must abide by those wishes unless there are truly extraordinary or compelling reasons to override them. 24 Two of the state's interests are clearly not evident here. First, this is not a case of suicide.
Is the input of a health care professional determinative?
While the input of a health care professional is important, it is not determinative. A court must independently assess an individual's abilities and limitations. In this scenario, a psychiatrist determined that TR was medically competent. She was also found to be depressed, yet the depression did not incapacitate her.
Does TR have to take dialysis?
Second, consistent with her ability to make a decision in accord with her preferences, she has often avoided dialysis. On two occasions, TR stopped going to dialysis for 10 days.
What is the ethical principle of respect for patient autonomy?
Respect for patient autonomy is the primary ethical principle to employ when a patient is able to make deci-sions for him/herself. It may appear to clinicians that the burdens of foregoing tube feeding outweigh the benefits.
What is the Patient Self-Determination Act?
The Patient Self-Determination Act (1991) is a federal statute that reinforces patients' rights to refuse artificial hydration and nutrition. This right was determined in constitutional law in the case of Nancy Cruzan. Thus, the recommendations of the ethics consultants were solidly based on both ethics and law.
Why do speech pathologists want to prevent aspiration?
The speech-language pathologist's wish to prevent aspiration and prolong life conflicts with the patient's wishes for comfort and avoiding life prolongation using tube feeding. Many speech-language pathologists are uncomfortable feeding a patient who aspirates, and may worry about legal liability.
What happens if speech language pathologists do not eliminate aspiration?
If treatment procedures do not eliminate aspiration, then the speech-language pathologist must decide whether or not to assist the patient in oral feeding. The concern of course is to reduce the speech-language pathologist's liability should the patient get pneumonia and/or die because of eating orally.
What are the rights of a patient who refuses treatment?
In addition, there are some patients who do not have the legal ability to say no to treatment. Most of these patients cannot refuse medical treatment, even if it is a non-life-threatening illness or injury: 1 Altered mental status: Patients may not have the right to refuse treatment if they have an altered mental status due to alcohol and drugs, brain injury, or psychiatric illness. 6 2 Children: A parent or guardian cannot refuse life-sustaining treatment or deny medical care from a child. This includes those with religious beliefs that discourage certain medical treatments. Parents cannot invoke their right to religious freedom to refuse treatment for a child. 7 3 A threat to the community: A patient's refusal of medical treatment cannot pose a threat to the community. Communicable diseases, for instance, would require treatment or isolation to prevent the spread to the general public. A mentally ill patient who poses a physical threat to himself or others is another example.
What is the best way for a patient to indicate the right to refuse treatment?
Advance Directives. The best way for a patient to indicate the right to refuse treatment is to have an advance directive, also known as a living will. Most patients who have had any treatments at a hospital have an advance directive or living will.
What is the end of life refusal?
End-of-Life-Care Refusal. Choosing to refuse treatment at the end of life addresses life-extending or life-saving treatment. The 1991 passage of the federal Patient Self-Determination Act (PSDA) guaranteed that Americans could choose to refuse life-sustaining treatment at the end of life. 9 .
How can a patient's wishes be honored?
Another way for a patient's wishes to be honored is for the patient to have a medical power of attorney. This designates a person to make decisions on behalf of the patient in the event they are mentally incompetent or incapable of making the decision for themselves.
What must a physician do before a course of treatment?
Before a physician can begin any course of treatment, the physician must make the patient aware of what he plans to do . For any course of treatment that is above routine medical procedures, the physician must disclose as much information as possible so you may make an informed decision about your care.
What are the four goals of medical treatment?
There are four goals of medical treatment —preventive, curative, management, and palliative. 2 When you are asked to decide whether to be treated or to choose from among several treatment options, you are choosing what you consider to be the best outcome from among those choices. Unfortunately, sometimes the choices you have won't yield ...
Why do patients make this decision?
Patients make this decision when they believe treatment is beyond their means. They decide to forgo treatment instead of draining their bank accounts. Those who live in a country with a for-profit healthcare system may be forced to choose between their financial health and their physical health.