The aim of this assignment is to consider whether mental health patients have autonomy or do staff and the healthcare environment merely allow them a measurable quantity of autonomy based on legal, ethical and moral restrictions, if this is the case, is this autonomy at all? Placement experiences will be given in relation to patient autonomy and related ethical, legal and professional issues will be supported and/ or contrasted by relevant literature. Patient autonomy and capacity, consent, compliance, coercion and paternalism with are considered. In an attempt to show a deeper understanding and ability to apply theory to practice, the moral theories of liberal individualism, utilitarianism, Kantianism and communitarianism will be discussed in relation to patient autonomy. Attitudes, values, assumptions related to patient autonomy, implications for practice and care provision will also be reviewed.
[...] This principle can also apply to mental health patients' in a healthcare setting where it can be asked to what degree, if any, does the patient have autonomy or do staff and the healthcare environment merely allow them a measurable quantity of autonomy based on legal, ethical and moral restrictions, if this is the case, is this autonomy at all? Paley (1996) argues that the concept of autonomy is vague and needs clarity, as it is open to interpretation and ambiguity. [...]
[...] The NHS is utilitarian as it provides care for all patients at their time of need, not reserving care only for those who can pay for it (Tschudin 1994). It is also paternalistic, valuing patients mental health well being over their right to be autonomous. However, it believes that for patients' to have autonomy this is a common good as it benefits the maximum amount of people. The consequences of not respecting autonomy could result in moral chaos and unprofessional practice. [...]
[...] Had she been mentally well staff believed she would not have wanted to die. In contrast, Szasz (1983) opposes healthcare professionals' decisions to act paternalistically and disregard the patients' autonomy, even if this means the patient may be at risk. Staff may select choices on the behalf of the temporarily incapacitated patient by asking, “what would the patient decision be in normal circumstances?” however, this question will always be based on preconceived assumptions and may not reflect the patients true wishes. [...]
[...] Just because a patient is mentally ill does not mean to say they do not have the capacity to act autonomously as they may have. In this case, had she been able to make an autonomous choice regarding her care she may have been able to opt for a medication which she knew suited her and would not result in unpleasant side effects. This shows how patients know their illness and should be able make autonomous decisions relating to their care (Bunting 1993). [...]
[...] Whilst patients have a right to autonomy, it would appear that complex issues including capacity, consent, compliance, paternalism, staff duty, staff beliefs, attitudes, values, judgments, differing ethical approaches and the healthcare environment merely allow patients' a measurable quantity of autonomy based on legal, ethical and moral restrictions, if this is the case, is this autonomy at all? As a result of this inquiry it would appear that there is no cut and dry answers only a deeper understanding towards the complex issues of patient autonomy. [...]
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