Ethical Implications of a Patient's Right to Refuse Treatment

Following the delivery of her child, a patient is bleeding heavily and her obstetrician proposed and received approval for a dilation and curettage to take out the piece of the placenta which had been retained. However the bleeding continued, consent was then sought to give the patient a blood transfusion and it was denied based on religious belief. After an emergency court hearing in which the procedure was approved by a judge, the patient received the transfusion, recovered and was discharged.
This is the case of Stanford versus Vega in Connecticut 1996. Person’s rights to refuse care or life saving treatment have been the paramount of autonomy, and great burden and moral conflict to health care personal who have sworn the oath of beneficence and nonmaleficence.
Melissa Ann Rowland in Salt Lake City is still in jail for criminal homicide with charges stemming from depraved indifference to human life and child endangerment because she refused c-section to save lives of her twin babies contrary to doctor’s advice. Although Melissa eventually consents to c-section but then it was too late, one of the babies died.
The possibility that a patient and people empowered by the patients to speak on their behalf, can refuse life saving treatment for themselves or the patient, and be allowed to do so is becoming dangerous ground for those who have taken personal and professional oaths to save lives. Most human beings are capable of making informed decisions if the are given the ability and knowledge to do so. These decisions are not always acceptable to everyone. In the case of the patient it may be a religious reason, or reason based on fear of the outcome of treatment or on a lack of consensus on the part of physicians. Whatever the reason may be, the number of patients choosing not to undergo treatment is on the rise, and mirroring that increase is the dilemma faced by healthcare providers. The underlying basis of beneficence is that a person should do right unto others and prevent harm. This principle is most sacred in a healthcare facility. However, a patient’s autonomy however crazy sounding or harmful to them is to be respected. Patient’s autonomy shall be upheld at all times. Patient consent is the principle that anyone over the age of 18 has the right to accept or decline all physical interventions, from operations and injections, to help with getting dressed. Providing that a person is competent (that they understand what is going on and the consequences of their actions) and that they are acting voluntarily, the decisions of adults about physical intervention cannot be overridden or ignored. Nurses and doctors can suggest treatment, but should answer the patient's questions and provide a balanced, full picture of the options and their consequences. In both two cases, patient’s autonomy has been severed, patient right was denied for good reasons. While there are laws that states what circumstances a person’s wishes should be respected irrespective of the outcome (permanent injury to invite all in or even death). Health care providers must battle not only their personal desires to save (or attempt to save) a patient’s life, but they must also contend with the legal parameters that govern healthcare operations. In the health care industry there is an ever increasing predicament as to a patient’s right to refuse life saving care. While the patient’s right to refuse treatment is not a new occurrence, nor is the resulting legal action that is usually taken when a patients requests are ignored. Despite the principles of deontology, kentanism and beneficence that guide health care provider, heath care providers should thrive to protect and respect patient’s right to refuse treatment.