A Patient’s Right & a Physician’s Sworn Commitment: The Ultimate Balancing Act

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A great deal of the concept of autonomy stands on the grounds of a patient being mentally and emotionally capable of making decisions about their own well being; the ability to fully absorb and understand the information offered by healthcare professionals is also required to make an informed choice. In the case of a young child, one must realize that consent cannot be given if it is not informed. For example, cases of child abuse tend to walk the line between autonomy and beneficence. Healthcare providers feel compelled to report abuse and seek a remedy for it, but the child involved may be unwilling to do so out of feelings of shame or fear. In the defense of beneficence over autonomy in a case such as this, Tom Hay (1997) briefly states a few long-term negative effects of sexual abuse as significant reasons for abuse to be reported against the will of the victim. He describes those abused during childhood as individuals who often lack developed social skills and tend to have a higher rate of marital divorce. According to Burkhardt and Nathaniel (2002), healthcare workers have a duty to report cases of child abuse since the result of staying silent on the matter could have devastating long term effects or even create an opportunity for the abuse to persist.

Patient autonomy and physician beneficence are two extremely critical bedrocks in any healthcare setting. The question of which concept should be valued over the other is not as black and white as desired. As seen from the juxtaposition of these viewpoints creates a gray area where assigning precedence is no longer an easy task. This same gray area is not unlike the one that is at the very heart of any ethical discussion. There are countless examples on both sides, but ultimately each unique situation requires discretion from all involved parties in order to reach the most comfortable conclusion for all.

Bibliography

- Emery, A. E. "Hippocrates and the Oath." Journal of Medical Biography 21.4 (2013): 198-99.

- Stiggelbout, A. M., and W. Otten. "Ideals of Patient Autonomy in Clinical Decision Making: A Study on the Development of a Scale to Assess Patients' and Physicians' Views." Journal of Medical Ethics 30.3 (2004): 268-74.

- Bradford, Porcia T., Alisa M. Goldstein, Mary L. Mcmaster, and Margaret A. Tucker. "Acral Lentiginous Melanoma." Arch Dermatol Archives of Dermatology 145.4 (2009).

- Hay, Tom (1997) Child Sexual Abuse, National Clearinghouse on Family Violence, Ottawa.

- Burkhardt, M. and A. Nathaniel (2002) Ethics and Issues in Contemporary Nursing, 2nd ed., Delmar, Australia.