Ethics

There are many ethical issues to be considered in the field of medicine where treatment of a patient is concerned.  We are encouraged to seek out advanced medical directives, do not resuscitate orders, and pre-planned funeral arrangements at the advice of well paid attorneys on television at every turn.
The problems concerning medical ethics do not usually present until we find that we are the patient.  Our level of competency becomes questionable as does our true understanding of what is transpiring, once we disagree with a doctor.  However, it is still my right to refuse medical treatment.
   
As a patient, I have encountered innumerous medical problems.  Most were minor and related only to simple infections, colds, coughs, and flues.  I have never been faced with other diagnoses that were unexpected like cancer, diabetes, or a brain tumor.  In Ms. Welshs case, she was relatively independent until undergoing her first brain surgery to treat ependymoma.  Following surgery, Ms. Welsh was left without full bodily functions.  Physical therapy was needed in order to regain some use of her functioning.  With these factors considered, does this mean that Ms. Welsh is without the ability to make an informed and rational decision concerning her own medical directives for treatment  I think that Ms. Welsh was perfectly able to make any decision concerning her medical treatment before or after her first surgery.  Her autonomy may be shaken due to fear, pain, or shock but this does not render the individual delusional.  In her detailed description of the events leading up to her surgical procedure and the events that followed shortly thereafter, she demonstrated to me that she was well within her abilities to know and understand what was going on around her.
   
I think that every doctor has a duty to uphold the oaths that they took to practice medicine.  It angers me to think that I could end up being challenged where my competency is concerned if I should choose to disagree with them.  Doctors should be encouraged to educate their patients of
risks, side effects, and options when devising a treatment plan.  It is essential that a doctor attempt to develop a form of rapport with me as this would serve to gain my trust. Given the circumstances of Ms. Welshs case, it was never clarified that she wished to discontinue or refuse medical treatment.  If however she did have a change of opinion in the matter, I think the doctor should have been bound to accept her wishes.
   
We too often put doctors and members of the medical community upon a pedestal.   If I were Ms. Welshs doctor, I would certainly have taken whatever treatment direction that she was comfortable with.  After all, she was the one recovering from the surgery and who better to know her body than her.  Some delays and problems were defined by Welsh as being setbacks from the recovery process.  This is no way suggests that she was never in a competent state of mind to make a rational decision.  Other medical issues can circumvent a situation and make unforeseeable complications appear to be a violation of an ethical view.  Drug interactions and complications following surgery are not preventable in most cases.  In other words, sometimes circumstances can arise that may give the impression of being incompetent when in actuality it is due to a reaction to treatment.  I believe that her doctor was ethical in supporting her choices.
   
Ethical dilemmas will continue to plague the medical community from here to eternity.  We should be assured in knowing that we do have the right to refuse medical treatment.  Our doctors are legally bound to respect and follow our wishes concerning treatment.  There are instances whereby a doctor can seek out a legal authorization to override our directive, but this is rarely pursued.  If we continue to talk and work together with our doctors, then it is in all probability that our medical needs and choices of treatment will always be made a top priority.