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Ethical Health Care Issues: The Refusal of Care
According to Emanuel Medical Center, Ethics in healthcare is defined as doing the right thing for the patient - providing care and treatment that deliver medical benefits, reflect what's important to the patient's well-being, and respect what the patient wants (Emanuel Medical Center, 2014). Health Care ethics is concerned with the implementation of well researched decisions while taking into cognizance the patients’ religious and cultural beliefs, and wellbeing in relation to the treatment that is rendered unto the patient. It is mandatory by healthcare professionals to abide by medical ethics principles, most especially when dealing directly with patients. Some professionals confront the ethical issues directly while others turn away (Colonel John S. Murray, PhD, RN, USAF, NC, 2014). How individuals respond to these ethical dilemmas depends on their previous experiences with unethical behavior, their individual personality traits, and their ethical values, as well as their knowledge of ethical principles (Clancy, 2003).
In this modern era, there are certain ethical issues that might arise in relation to a patient’s clinical management. A prominent medical ethical issue is the refusal of a patient for treatment, such as receiving blood transfusion because of his or her belief. The most renowned international religious group of people that refuse blood transfusions is the Jehovah’s Witnesses. Jehovah witnesses believe that blood transfusion "may result in the immediate and very temporary prolongation of life, but at the cost of eternal life for a dedicated Christian" (Jason Barker, 2000). In June 2000, the governing body of Jehovah’s Witness called the Watchtower Society changed its policy regarding members who choose to receive blood transfusion to denounce willfully themselves from the group, and consequently to abjure from the congregation ( Berend & Levi, 2009).
The belief system of the afore-mentioned religious group creates major conflicts with regards to the application and practice of medical ethical principles. Conflict in decision-making by healthcare professional becomes difficult when an adult patient refuses treatment that the health care team believed will save the patient’s life. However, the patient is also protected by if not all but some of the same ethical principles that govern the healthcare profession and professionals. These four (4) major ethical healthcare principles include autonomy, beneficence, non-maleficence, and justice. Patients exercising their autonomous rights should not be considered as having controlling influences but rather acting intentionally with the understanding of their healthcare rights as autonomy is the “personal rule of the self that is free from both controlling interferences by others and from personal limitations that prevent meaningful choice.” Patients visit doctors and clinicians for guidance and suggestions for informed medical choices and consents rather than clinicians imposing management plans on patients.
The principle or rule of beneficence refers to a normative statement of a moral obligation to act for the others' benefit, helping them to further their important and legitimate interests, often by preventing or removing possible harms (Stanford Encyclopedia of Philosophy, 2013). The four ethical principles are believed to be non- hierarchical, meaning no one principle routinely “trumps” another (Thomas R. McCormick, D.Min., 2013). The non- hierarchical belief of the ethical principles in the medical field is sometimes difficult to adhere to in the scenario of Jehovah Witnesses’ patients. The roles of the clinicians and medical doctors is to render excellent services to their patients for the patient’s benefits but in the instance of the refusal of blood transfusion by the patient because of his or her religious beliefs, then it could clearly be seen that autonomy automatically trumps beneficence.