NoBlood

<p>Medical ethics can be defined as the discipline of evaluating the merits, risks and social concerns of activities in the field of medicine.&nbsp; Many in the healthcare field have suggested various methods to help evaluate the ethics of a medical situation.&nbsp; These methods provide basic principles that doctors should consider when making decisions about care given to patients in regards to death and dying, reproductive medicine, medical research and alternative medicine.</p><p>These principles include:</p><ul><li>Beneficence- what is in the patient’s best interest</li><li>Non-maleficence –“first, do no harm”</li><li>Autonomy – patients have the right to refuse or choose their treatment</li><li>Justice – scarce resources then who gets what treatment</li><li>Dignity – the patient and practitioner have the right to be treated with dignity</li><li>Truthfulness – patients deserve to know the whole truth about his/her illness and treatment options</li></ul><p>In light of bioethical issues, some important questions need to be raised concerning the case of the women in <place st="on"><state st="on">Iowa</state> </place>whose guardianship has been awarded to her father, not her husband.&nbsp; The patient is an adult female who has been unconscious since <date day="31" month="7" st="on" year="2006">July 31, 2006</date> , when she collapsed because of a bad reaction to a diet drug.</p><p>Points about this case include:</p><ol start="1" type="1"><li>Husband of patient is a Jehovah’s Witness.</li><li>Father of patient requested guardianship of daughter, so he can consent to a transfusion of blood if necessary.</li><li>Patient is “stable and improving”, but still unconscious.</li><li>Five years ago, the patient signed consent forms for “no blood transfusions.”</li><li>The patient has no <i>Advance Directives</i> formulated.</li></ol><p>There are also some things that are alleged about the patient’s current thoughts about blood transfusions. &nbsp;An Aunt has stated that the patient verbally acknowledged at some point in time that she would accept a transfusion for herself and her son.&nbsp; The husband has stated that the patient allegedly signed a card identifying herself as one of Jehovah’s Witnesses, but the card has not been produced for review.&nbsp; The patient has been affiliated with Jehovah’s Witnesses as an interested person or a Bible student.</p><p>The facts and the possibilities lead us to ask some interesting ethical questions about the determination of the courts to award guardianship to the father.</p><p>Questions to ponder:</p><ul><li>What is the patient’s blood count?&nbsp; Why put the “cart before the horse” by considering ordering a procedure (blood transfusion) in advance of the fact that it might never be necessary?</li><li>What is the principles in regards to the rights of relatives to make healthcare decisions for a patient?&nbsp; Is their a “cascade” of qualified relative, who by law, should be able to make healthcare decisions for a patient?&nbsp; Priority in most states reads this way: <ol><li>the patient’s spouse;</li><li>the patient’s reasonably available adult children:</li><li>the patient’s parents; or</li><li>the patient’s nearest relative.</li></ol></li><li>Is the legal system, and as in the case of Terri Shiavo- the political system, taking precedence over the medical system who are the experts concerning medical interventions? </li></ul>