Jamilah: The Principle Of Respect For Autonomy

782 Words 4 Pages
Jamilah diagnosed as heart attack which is an acute and irreversible situation. Her medical condition is not a terminal but emergent. It is not terminal situation and treatment is available.
The goal of current treatment is to prolong the patient’s life.
Only if the patient signed an advance directive with DNR(Do Not Resuscitate), the medical treatments are not indicated.
The probability of success of various different treatments is relatively low due to patient’s age and comorbidities.
This patient can be benefited from not being died immediately if treatment is given. If the patient is under no intervention, the patient will likely die.

PATIENT PREFERENCES
The patient of Respect for Autonomy
The patient have language barrier to understand
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If she receive properly treatment, she probably will return to normal life. However, due to her advanced age and multiple comorbidities, she will recovery longer than others with no such prognostic factors.
Her sons may judge her situation and believe that she will not return to the normal quality of life due to her advanced age and multiple chronic problem. So, he decided for her to comfort care.
The provider may evaluate the patient quality of life differently according to her existing diagnosis and age. Further consideration may be the patient resided in long term care facility and admitted due to collapsing at the side. There is a question about her quality of life in the long term care facility.
The ethical issue is the autonomy. It is questionable if her quality of life can be improved after her treatment.
The quality of of life assessment depends on the decision if the surgery or no intervention. It really depends who is going to make the decision.
Her son plan to forgo life sustaining treatment. He also believed that her mother aged and comorbidities will seriously affect Jamilah’s quality of life. However, the delay of treatment also put Jamilah at risk of
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All parties want to determine who is really able to make the medical decision.

CONTEXTUAL FEATURES
The Principles of Justice and Fairness
There are no professional and business interests that might create conflicts of interest in this situation.
The family members are interest in clinical decision. Bashir had requested to no intervention and comfort care to his mother. Other two sons have not involved or mentioned any opinions on the medical decision.
Since Jamilah still in conscious and capable to talk, the facility should ask the permission from Jamilah before starting to discuss about her medical situation.
The cost for the long term care facility have certain impact on the decision. Since Jamilah stated in the extended care facility for years. The financial support on paying the bill will create conflict. In addition, Bashri may benefit financially from her mother’s die.
There are no problems of allocation of scarce health resources that might affect clinical decisions. Coronary bypass surgery or cardiac catheterization is very common surgery for heart attack.
The major issue will be Turkish culture and norms that the sons able to make all decision on behalf of Jamilah. Jamilah may obey her son's

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