Philosophy(Biomedical Ethics)

Biomedical Ethics

Introduction

Changes occurring in Health care delivery and Medicine are the result of social , economical , technological , scientific forces that have evolved in the 21st century . Among the most significant changes are shift in disease patterns , advanced technology , increased consumer expectations and high costs of health care . These factors have redefined medical practices to fit into the changing health delivery system . Thus , Medical Profession is `Accountable ' to the society . i .e . obliged to the laws regulating the professional activity . This `accountability ' is usually spelt out in Patient Care Documents

' established by hospital associations and medical associations or councils of every country (Suzanne , 2004 . In addition , medical profession has defined its standards of accountability through a formal code of Ethics

Thus , patient 's perceptions of health care , particularly disagreements and researches of various kinds with doctors have caught the attention of every one since 1980s .These disagreements have turned often into legal complaints (Ellen Annandale 1998 . These disagreements turned legal complaints lead to long medical litigations . Rights for advance directives and doctrines such as informed consent have created a new approach to medical litigations . With increased patient awareness of the health care delivery situations , media flare up and public opinions medical practice has become more accountable today and there is a radical departure from the traditional medical practice which draws upon the personal experiences , case studies and research of the physician and not the health care delivery system as a whole entity

The Case of 71 years old Ronald X , a widower , living alone in an apartment is classic case of a patient 's competence in giving informed consent . Informed consent refers to legal rules that prescribe behaviors for physicians in their interactions with patients based on the ethical doctrine rooted in the value of autonomy that facilitates patients right to self-determination . It is an interpersonal process whereby practitioners interact with patients to select an appropriate course of action . Informed consent means that tests , treatments and medications have been explained to the person , as well as outcomes , possible complications and alternative procedures before the treatment and his consent is documented . There is no second opinion on the fact that only a competent individual can give an informed consent . But the concept of competence is broad with moral , medical and legal implications . Since Ronald X suffers from arteriosclerosis , a condition that results in his experiencing periods of confusion during which he sometimes wanders purposelessly around the city , running some risks to himself , it is first important to determine his competence to give consent . It is important to see if he is competent or marginally competent or incompetent . This can be done by the application the classical 5 tests for testing the level of competence of this case . The 5 tests to determine the competence test the following

1 .Reasonable outcome by which the individual is declared competent if consent seeks a reasonable outcome

2 .Rational reasons by which the individual is declared competent if consent follows a rational process

3 .Ability...