Ethics Of Doctors

What was a Doctor's Job?
May 25, '07 3:11 AMby Mer Cedo for group circularrefuge
Some people don't accept some medical treatment even if when they are absolutely necessary to save their lives.
If a patient instructed a doctor not to do some particular treatments - for example, not to use some medicine or practice some medical treatment beside medical reasons, how a doctor ought to react?
If a doctor practiced some particular treatments when he judged that they are necessary and irreplaceable to other measures, then he did them deliberately with fully knowing the patient's wish of refusal to those particular treatments, and he successfully saved his life in consequence. Might he sue the doctor for not honouring his wish, or not?
It doesn't matter, because a doctor did what he had to do, this is a doctor's professional act within a range permissible by medical doctors. His first job is to save a life of patients. If he can do it within alternative treatments the patients allowed the doctor to practice, that'll be fine, too.
If the case involves in using the very treatments the patients directed him not to, his medical judgement ought to be prior to patient's wish. If you don't want particular measures when they're absolutely necessary, all he has to do is to leave a doctor. If he did so, the case will leave a matter a doctor concerns. That'll be fine, too.
Next case is even more troublesome. When a doctor judged a particular measure is necessary and irreplaceable to other measures, but he didn't it because he honoured the patient's wish and as a consequence, a patient died.
In this case, he might be questioned as murderer. He definitely honoured the patient's wish, but he not only violated doctor's ethics but also criminal code. Because he didn't do what he had to do enough in his job. The patient won't sue a doctor of course, if his family were understandable to the patient's wish, they won't sue him either. The problem was the third person like public prosecutors can sue the doctor for not fully responsible to his job. If the deceased were an influential person as company president, the company would have a possibility to sue the doctor.
If the patients leaves the matter to a doctor after he clearly states his wish not to accept a particular medical treatment, that'll be fine. My conclusion is that a patient cannot instruct a doctor not to practice some particular treatments as long as he is a patient of the doctor.

Comments:Chronological Reverse Threaded


ememalb wrote on May 25In my limited understanding of how this works...if a patient refuses a specific type of medical assistance, the doctor can have (and should) have the patient sign a form stating they are refusing said treatment.I don't believe it's up to a doctor to go against a patient's wishes, even if the doctor thinks the patient's wishes are stupid. (Obviously there is a gray area, where the patient might not be thinking rationally, but that's not the point of this post).


eglamkowski wrote on May 25I think the hard part is when children are involved. The child may be too young to understand what's going on and thus too young to make a competent decision of their own. Should the parents be allowed to risk the life of their child against the advise of a doctor? I do kind of want to say yes, it should be the parent's decision, but I am certainly sympathetic to the other side of the argument as well. It's a tough call.


ememalb wrote on May 25true, it is.However, there has been precedence for this before. i forget the version of (perverted) Christianity it is, but there's a subset who don't believe in modern medicine. So...is it their right to refuse medical treatment on behalf of their child? The courts say yes.I, of course, believe this is delusional and extremely short-sighted. But that's just me, I don't make the rules. (Damned if I shouldn't tho)


kshgoddess wrote on May 25iirc, it's jehovah's witnesses who refuse most medical attention.It's a patient's right to refuse any procedure, and I'm fairly sure as was said upthread, there is a form for it. Otherwise there would be no reason to have, say a DNR order (Do not resuscitate). It does get tricky when children are involved. It gets damned tricky when it's a lifesaving measure that's refused, like an epinephrine shot for someone who's throat is closing up, a transfusion for someone who's lost too much blood, etc.

siliconjesus wrote on May 25I believe he's actually referring to Christian Scientists.


mercedo wrote on May 25Now I changed my opinion as yours.


sillypixie wrote on May 25Hm. Methinks you are giving far far too much credence to the omniscience of the Doctors of the world...I know a woman who would have woken up from exploratory surgery with a radical (and unnecessary) hysterectomy, if the world worked the way you speak of -- the doctor was convinced that a hysterectomy was absolutely critical -- but it turned out that the doctor was just a decade out of touch with the types of fibroids that this lady had, and only her ability to think for herself and to do her own research saved her from listening to someone who was very authoritative, but dead wrong. Life-or-death situations are harder - but then I think they are also much less likely to involve contradictory commands from the patient of family. The only real cases like that would be the ones where certain medical procedures are against a patient's religion. Even in that case, I *still* think that the patient has a right to dictate their own treatment.


mercedo wrote on May 25, edited on May 25I'm now wondering how weaker it might have been my idea for the importance of the individual's right. Ten out of ten people say the patient's wish ought to be respected more than the doctor's opinion. In the end any patients go to see a doctor whom they want to have themselves see. Any patients have a right to choose a doctor or even not to go to see a doctor. A doctor can neither force patients to come to see him nor practice medical procedures the patients feel detested.Usually for the ordinary patients it's more important to live longer. But for people who have some belief, it might be much more important to live well in accordance with the way they are eager to pursue rather than just to live longer.

lpetrazickis wrote on May 25People have the right to refuse any medical procedure they desire.Conversely, parents and guardians can't kill their children. That notion went out with Rome's paterfamilias. It is the duty of the government to protect children from their parents, so it is my opinion that doctors should have the final say when it comes to children's medical treatment.


mercedo wrote on May 25Children usually try to follow the parent's decision. Doctors and government agencies ought to watch these particular cases closely and if the cases apparently might lead to a matter of life or death, the third person ought to have the proper right to intervene the parent's decision.
Reply deleted at the request of the author.


mercedo wrote on May 26, edited on May 26Reply deleted at the request of the authorI deleted my post because I mistakenly posted it in my article. I think I did the same thing in Slashdot two times before.Thanks to various replies, my idea was completely changed at before and after, now I knew my idea was a bit short-sighted. Now I want to delete my blog entry itself, though I don't of course.