scholarly journals THE GROWTH OF PATIENT AUTONOMY IN MODERN MEDICAL PRACTICE AND THE DEFINED LIMITATIONS UNDER THE SHARĪ’AH

2014 ◽  
Vol 22 (2) ◽  
Author(s):  
Puteri Nemie Jahn Kassim
Keyword(s):  
Decision Making ◽  
Medical Practice ◽  
Patient Autonomy ◽  
Medical Decision Making ◽  
Self Determination ◽  
Medical Decision ◽  
Legal Cases ◽  
Modern Medical Practice ◽  
The Right ◽  
Islamic Values

The concept of patient autonomy or self-determination is one of the dominant ethos in modern medical practice. The demands by patients to be given respect, independence and dignity in medical decision making have been heeded and mirrored in many ethical codes and judicial decisions. The development of the law relating to informed consent, euthanasia, confidentiality, and reproduction issues have clearly reflected the reinforcement of patient autonomy in which patients’ choices should be free from coercion and unwanted interference. Paternalistic infringement in these areas have been regarded as outmoded and are disfavoured, as respect for a patient’s right to determine his own destiny is given precedence.  The escalating medico-legal cases have further emphasised the salience of this concept in the provision of medical services. Nevertheless, while the importance of patient autonomy is duly recognised, the advancement of this concept is not without its limitations; it accordingly has to evolve within the perimeters of one’s religious and cultural precepts. For Muslim patients, the right and ability to make their own choices and decisions about medical care and treatment must be within the defined limitations of the Sharī’ah. The emphasis on individualism, personal gratification and the denial of faith in medical decision making is inconsistent with Islamic values. Therefore it is necessary that principles relating to the concept of patient autonomy be developed within the sphere of the Sharī’ah, in order to ensure their coherence with the doctrinal requirements stipulated in Islam.

Prudence in Shared Decision-Making: The Missing Link between the “Technically Correct” and the “Morally Good” in Medical Decision-Making

2020 ◽  
Author(s):  
Paul Muleli Kioko ◽  
Pablo Requena Meana
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Patient Autonomy ◽  
Intellectual Ability ◽  
Medical Decision ◽  
Shared Decision ◽  
Physician Patient Relationship ◽  
Good Healing ◽  
The Right ◽  
Physician Patient

Abstract Shared Decision-Making is a widely accepted model of the physician–patient relationship providing an ethical environment in which physician beneficence and patient autonomy are respected. It acknowledges the moral responsibility of physician and patient by promoting a deliberative collaboration in which their individual expertise—complementary in nature, equal in importance—is emphasized, and personal values and preferences respected. Its goal coincides with Pellegrino and Thomasma’s proximate end of medicine, that is, a technically correct and morally good healing decision for and with a particular patient. We argue that by perfecting the intellectual ability to apprehend the complexity of clinical situations, and through a perfection of the application of the first principles of practical reason, prudence is able to point toward the right and good shared medical decision. A prudent shared medical decision is therefore always in keeping with the kind of person the physician and the patient have chosen to be.

Implications of the patient self-determination act: Guidelines for involving adolescents in medical decision making

1996 ◽  
Vol 19 (5) ◽  
pp. 319-324 ◽  
Author(s):  
Mary Ann McCabe ◽  
Cynthia H. Rushton ◽  
Jacqueline Glover ◽  
Melinda G. Murray ◽  
Sanford Leikin
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Self Determination ◽  
Medical Decision ◽  
Patient Self Determination Act

Exceptions to the Legal Requirements: Emergency, Waiver, Therapeutic Privilege, and Compulsory Treatment

2001 ◽  
Author(s):  
Jessica W. Berg ◽  
Paul S. Appelbaum ◽  
Charles W. Lidz ◽  
Lisa S. Parker
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Consent To Treatment ◽  
Health Related ◽  
Consent Requirement ◽  
The Right ◽  
Therapeutic Privilege

In the preceding chapter we spoke of the requirement for informed consent in absolute terms, as something that was an invariable component of medical decision making. Over the years, courts have come to recognize that there are a number of situations in which physicians are permitted to render treatment without patients’ informed consent. Even under the earlier simple consent requirement, consent to treatment was not required in all situations. There are different kinds of situations in which requiring disclosure and obtaining consent could be detrimental to the patient, such as in an emergency or when the disclosure itself would harm the patient, and therefore in these situations informed consent is not required. Patients may also waive, or give up, the right to be informed and/or to consent. Here the concern is not with promoting health values but with promoting autonomy. Informed consent may also be dispensed with in a fourth set of cases, those of legally required treatment, in which the harm from requiring informed consent is not necessarily to the patient (or the patient alone) but to other important societal interests (e.g., civil commitment of the dangerous mentally ill—see Chapter 11—or forced treatment of patients with infectious disease). In addition, informed consent requirements are modified when a patient is incompetent (see Chapter 5). Each of these exceptions contains the potential for undermining the values sought to be implemented by the informed consent doctrine: self-determination and informed decision making. Exceptions that are too broadly defined and applied are a threat to these values. On the other hand, these exceptions are an important vehicle for the interjection into the decisionmaking process of another set of values, society’s interest in promoting the health of individuals. When judiciously defined and applied, the exceptions accord health-related values their due. However, the exceptions can be, and sometimes have been, defined so broadly as to dilute, if not dissolve, the fundamental duties imposed by the doctrine and to undermine its essential purpose of assuring patient participation in medical decision making (1).

scholarly journals Covid-19: Refracting decision-making through the prism of resource allocation

2020 ◽  
Vol 88 (2) ◽  
pp. 97-101
Author(s):  
Richard WM Law ◽  
Kartina A Choong
Keyword(s):  
Decision Making ◽  
Resource Allocation ◽  
Critical Care ◽  
Clinical Judgment ◽  
Patient Autonomy ◽  
Medical Decision Making ◽  
Resource Constraints ◽  
Medical Decision ◽  
History Of ◽  
Care Decision

Medical decision-making has, across the history of the NHS, made a transitional journey from a model characterised by paternalism to one which places emphasis on partnership and patient autonomy. This article assesses the extent to which the circumstances generated by the Covid-19 pandemic affect the mode of critical care decision-making. It observes that clinical judgment influenced by protocols, algorithms and resource constraints do not lend themselves to full identification with either of the two frameworks familiar to the NHS. The unique mode of decision-making engendered can only be understood on its own terms.

scholarly journals The Protection of Children's Right to Self-Determination in South African Law with Specific Reference to Medical Treatment and Operations

2018 ◽  
Vol 21 ◽  
pp. 1-34
Author(s):  
Hanneretha Kruger
Keyword(s):  
Decision Making ◽  
Child Care ◽  
Medical Treatment ◽  
South African ◽  
Medical Decision Making ◽  
Self Determination ◽  
Medical Decision ◽  
Maturity Assessment ◽  
Consent To Medical Treatment ◽  
Surgical Operations

The Children's Act 38 of 2005 provides that children over the age of 12 years can consent to their own medical treatment or that of their children, provided they are of sufficient maturity and have the mental capacity to understand the benefits, risks, social and other implications of the treatment (section 129(2)). The predecessor of the Children's Act set the age at which children could consent to medical treatment at 14 years, and no maturity assessment was required (Child Care Act 74 of 1983 section 39(4)). Children over the age of 12 years can consent to the performance of surgical operations on themselves or their children, provided that they have the level of maturity described above and they are duly assisted by their parents or guardians (Children's Act section 129(3)). Before the Children's Act came into operation, the Child Care Act allowed children over the age of 18 to consent to their own operations (section 39(4)). Neither a maturity assessment nor parental assistance was required. (Note that when the Child Care Act was in operation the majority age was still 21 years.) In this article the question is considered if the relaxation of the limitations on children's capacity to consent to medical treatment and surgical operations in the Children's Act recognises the right of children to make independent decisions without the assistance of their parents or guardians or other substitute decision-makers. Firstly the article investigates the theoretical foundations of the protection of children's rights, particularly their autonomy rights. Secondly the meaning of the concept "competence" in medical decision-making and the related concept of "informed consent" are discussed. Thirdly some developmental and neuroscientific research on children's decision-making capacities and how they influence children's competence to give consent valid in law are highlighted. Fourthly possible legal foundations for the protection of children's right to self-determination in medical decision-making are sought in the Constitution and international and regional human rights treaties. Finally the relevant provisions of the Children's Act are examined in order to ascertain whether children's right to self-determination is sufficiently protected in South African law    

Influence of Illness Script Components and Medical Practice on Medical Decision Making.

2005 ◽  
Vol 11 (3) ◽  
pp. 187-199 ◽  
Author(s):  
Paul van Schaik ◽  
Darren Flynn ◽  
Anna van Wersch ◽  
Andrew Douglass ◽  
Paul Cann
Keyword(s):  
Decision Making ◽  
Medical Practice ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Illness Script
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