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Principlism In Health Care

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Principlism is an ethical theory applied particularly in relation to bioethics, divided in four prima facie: respect for autonomy, non maleficence, beneficence and justice. Respect for autonomy results in freedom to make choices without external control which is expected to be both accepted in binding in others (McLean, 2009). In this essay i am going to discuss the person’s autonomy and the role of the health care professional regarding the implementation of an advanced care directive including the features of a valid consent and how that relates to an advanced care directive, the importance of respecting a patients choices and the exceptions to this, when paternalism is ethically justified. These concepts will all be analysed from the perspective …show more content…

In a healthcare setting obtaining consent is essential before beginning a procedure or treatment (Koutoukidis & Hughson, 2012). In order for consent to be obtained it must be given voluntarily, cover the intervention about commence, the person must have legal capacity, and they must be sufficiently informed about the intervention. Consent may be withdrawn at any time, and if a health care practitioner acts without the consent of the patient, they may face assault and battery charges. (Koutoukidis & Hughson, 2012). An advanced care directive is a a legal document used by someone to dictate to others what choices they would like made in the event that they lose their ability to make these decisions themselves, or to appoint a nominated person to make these choices for them; if for example they are in a motor vehicle accident and suffer serious cerebral injury. These decisions include those relating to future health care, end of life care, personal arrangements and living arrangements, but not financial matters. In the event of a serious health issue, if the person has signed the advanced care directive, dictating that they refuse health care and it is directly relevant to the situation, then it is legal binding. All other aspects of the advanced care directive are only recommendations to the nominated person and/or the health care team (Advanced Care Directives - SA …show more content…

The patient then proceeded to become confused and disorientated. He was then discharged to a nursing home facility until he was cleared by his psychiatrists. After he was discharged, he failed to keep taking his antibiotics to eliminate the infection. He returned to the hospital several weeks later with a grossly purulent knee. The surgeons concluded that the only way for the infection to be controlled, was for the components of the knee replacement to be removed. J.s refused this because he didn’t want to lose the replacement knee (Capozzi & Rhodes, 2000). Therefore in this situation it would be ethical to override his decision. This is an example of the ethical theory of paternalism which is defined as ‘personal freedom and autonomy of a person (or class of persons) with a beneficent or protective intent’ (Britannica Academic, 2015). An example of a healthcare situation in which a nurse may use paternalism is for example; an elderly woman is incontinent in bed and is covered in her own body waste, but she is embarrassed and refuses to be washed. The nurse could go against the patients wishes because her intent is beneficent and the positive outweighs the negative in this

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