Should the medical team allow this delay in informing the mother of her daughter’s death?
Respect for autonomy means respect for the decision-making capacities of a person. An autonomous decision is made when there is intentionality and understanding and when there are no controlling influences.The patient acts based on their own values, beliefs and desires. This shows how significant informed consent and patient’s confidentiality is in patient care (Phipps 2016). A patient has the right to obtain truthful information about their health because their health is intricately linked with their sense of self or to decide how to proceed with treatment. Based on the case, our patient is Ishraq. She is underage so her parents have parental autonomy to make treatment choices and give consent on her behalf. When she passed away, Ishraq mother’s has a right to know about the medical status of her child while Ishraq father’s has his right to prevent medical information from being disclose, which he believes is in the best interest of his wife.
Beneficence means to act in your patient’s best interest, that is by providing a good therapeutic outcome and by preventing harmful outcomes. This ethical principle is interrelated to medical paternalism. A doctor do not feel obligated to tell the patient their diagnosis and prognosis if they feel it isn’t in the best interest of the patient . Non-maleficence, on the other hand, is to do no harm, be it in the form of physical, psychological, emotional, long term, short term or culturally (Phipps 2016). The doctor may not want to inform Ishraq’s mother on the death of her daughter as they think that is better for her mental health which can also affects her physically. This is because the news might overwhelmed her and affects her pregnancy. They would also practice non-maleficence as they try to not inflict any emotional harm although it might only be momentarily.
There are three elements in justice. Firstly, the fair distribution of healthcare resources, benefits, risks, and costs. Next, right-based justice and also legal justice (Niselle 2013). Justice looks at how we treat individual patients in relation to the other population of whether a treatment they may have autonomously consented to ought to be provided for them by the State (Phipps 2016). It is applicable as the medical services are accessible to everyone regardless of their culture, race, nationality and gender. Ishraq is able to access better treatments in the United States without being discriminated. Doctors should be just and not discriminate against a particular gender in respecting their autonomy. However, there may be a cultural difference. Bangladeshi men usually take the lead to in making decision on what or when to inform their spouse but the cultural norm may also only apply to Ishraq’s father as we cannot assume whether the mother wants to know.
I will inform the mother of her daughter’s death if she ask about it. This is because I believe that the principle, autonomy far outweighs beneficence and non-maleficence in this particular case. Ishraq’s mother has her right to know about the condition of her daughter and we, however experienced, cannot predict how she would react in the situation based on all our previous patients. She is her own person and has her own views, beliefs and values. She, herself will know what is best for herself and the continuous worrying about her daughter’s condition will also affect her pregnancy. I think that she is entitled to grief for the death of her daughter. I also feel that I did exercise beneficence as, in my perception, informing her of the news might be what is best for her in the future. She may be able to accept the news of her daughter’s death and find peace with it. The father will not have to frequently visit the hospital. Instead, he can rest and look after his wife and unborn child. However, I did not practice non-maleficence as breaking the news about it would definitely caused pain to her emotionally and psychologically. Nevertheless, if she did not enquire about it, I would not inform her. This is because they are from a different culture and a language barrier also exist. The interpreter might not be able to break the bad news well in comparison with the father. I also have to take into consideration their ways of life. The principle, justice is applicable when treatment is provided to Ishraq impartially and when both parents’ autonomy are respected without discriminating based on gender. To overcome the language barrier, the hospital even employ an interpreter to communicate with the family.
References
Niselle, P. 2013, ‘ Essential learning: law and ethics’, New Doctor, vol. 6, no. 1, viewed 18 May 2016, http://www.medicalprotection.org/uk/casebook-and-resources/new-doctor/vol-6-no-1-2013/essential-learning-law-and-ethics
Phipps, ME 2016, ‘An introduction to ethics and biomedical ethics’, MED1011- Ethics Module, Lecture materials, Semester 1, 2016, Monash University.
