Case number 7 involves a 69-year-old female patient named Dorthea. Dorthea was healthy and active until roughly five years ago, when she was diagnosed with diabetes. Eighteen months ago, after some reoccurring fainting spells, her doctors found out that she had an intermittent transient heart block. Dorthea reluctantly consented and was given a permanent pacemaker to correct this problem. Three months ago, her kidney function was found to have decreased 10% to what was normal and could have possibly caused her diabetes. At first her doctors thought that she was going to need dialysis but her kidney function had improved since and dialysis would not be needed at this time. Dorthea consented to a colonoscopy which was preformed to see if she
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Another option would be for the physician to consider turning off her pacemaker but require her to go through grief counselling and see a therapist to make sure this is what she really wants to do. Although Dorthea is expressing her autonomy by using the capacity for rational self-governance and making choices about her health, she may not be in the right mental state to do so. The physicians on this case might take into consideration that paternalism may be necessary in this situation and they may choose to override Dorthea’s actions and decisions for her own good (Bioethics 9-10). Goldman did not believe physicians should practice full disclosure and that allowing patients full control over their decisions minimizes the risk of harm to patient’s health and lives. He believes that doctors should be better trained in psychology in order to be better able to judge the effects of disclosure on patients. Goldman’s approach would provide the physician with more knowledge about depression and grief and how to help Dorthea deal with those issues before making other decisions about her health (Bioethics pg. 106-109). This approach would also allow the physicians to not tell Dorthea about some of her medical issues because it encourages her think that her life will end sooner and that she is too sick to live …show more content…
This full disclosure and control caused negative risks and harm to her health. Dorthea put herself at risk for more health problems by refusing treatment for anemia, depression, and could cause more health problems in the future if she were to refuse dialysis. By refusing treatment, these issues can shorten and decrease the quality of her life. If the physician told Dorthea that they would consider turning her pacemaker off but she must go to grief counseling and therapy, she may still refuse to get treatment for her grief. Since Dorthea has said she wouldn’t take her own life and she is unable to turn off the pacemaker on her own, her only choice would be to attend the therapy and counseling or continue with life the way things
Another option would be for the physician to consider turning off her pacemaker but require her to go through grief counselling and see a therapist to make sure this is what she really wants to do. Although Dorthea is expressing her autonomy by using the capacity for rational self-governance and making choices about her health, she may not be in the right mental state to do so. The physicians on this case might take into consideration that paternalism may be necessary in this situation and they may choose to override Dorthea’s actions and decisions for her own good (Bioethics 9-10). Goldman did not believe physicians should practice full disclosure and that allowing patients full control over their decisions minimizes the risk of harm to patient’s health and lives. He believes that doctors should be better trained in psychology in order to be better able to judge the effects of disclosure on patients. Goldman’s approach would provide the physician with more knowledge about depression and grief and how to help Dorthea deal with those issues before making other decisions about her health (Bioethics pg. 106-109). This approach would also allow the physicians to not tell Dorthea about some of her medical issues because it encourages her think that her life will end sooner and that she is too sick to live …show more content…
This full disclosure and control caused negative risks and harm to her health. Dorthea put herself at risk for more health problems by refusing treatment for anemia, depression, and could cause more health problems in the future if she were to refuse dialysis. By refusing treatment, these issues can shorten and decrease the quality of her life. If the physician told Dorthea that they would consider turning her pacemaker off but she must go to grief counseling and therapy, she may still refuse to get treatment for her grief. Since Dorthea has said she wouldn’t take her own life and she is unable to turn off the pacemaker on her own, her only choice would be to attend the therapy and counseling or continue with life the way things