write a clear, consistent, coherent, and comprehensive argumentative essay on the topic given below
Mrs. A’s refusal
Mrs. A is a 63-year-old, five foot tall, 315-pound woman.
Because of severe abdominal pain Mrs. A was admitted to the hospital where an ultrasound of the pelvis revealed an ovarian cyst. The consulting gynecologist recommended an immediate hysterectomy and removal of both ovaries. The surgery was done with Mrs. A’s consent. During the operation both the bladder and the sigmoid colon were injured. Mrs. A was put on post-operative antibiotics.
Six days later she again suddenly developed severe abdominal pain and became hypotensive (i.e., her blood pressure dropped dramatically). This occurred at approximately at 11:00am. She was transferred to the Intensive Care Unit where her blood pressure was raised with Dopamine and intravenous fluids. Because of her respiratory distress she was intubated (connected to a respirator, a machine that assisted her breathing). As the day progressed her blood pressure rose to 100 systolic, her condition gradually improved, but she continued to be maintained on a respirator. Mrs. A was experiencing continuing pain and she had a fever of 100 degrees (Fahrenheit).
A surgical consult was called, and the patient was examined by the surgeon at 6:30pm. Her examination revealed Mrs. A to be suffering from generalized peritonitis (i.e., a serious infection of abdominal organs) caused by leakage from the sigmoid colon. In spite of all this, her general condition reasonably stable. Her pain was being managed. She appeared to be alert and aware of where she was. She communicated by means of written notes that seemed reasonable and sensible.
After a discussion of the proposed surgical procedure, Mrs. A refused to give her consent. Even when it was explained straightforwardly and realistically that without another operation she would probably die, she still refused the surgery. Indeed, she threatened to have the police called If her wishes were disregarded and demanded to be released from the hospital. Her family was greatly distressed by her reaction, so the explanation for surgery was repeated in the presence of two family members. But Mrs. A was even more adamant about her refusal.
By 8:30pm her husband and four adult children had gathered in the waiting area of the ICU in deep distress. They wished to consent to the operation on Mrs. A’s behalf. It was explained that this could not be done since the patient was conscious and apparently had the capacity to make decisions. Her eldest son, J, arrived from a trip abroad at approximately 9:30pm. When he was apprised of the events that had taken place, he declared that his mother was behaving abnormally and insisted that she really did not understand the consequences of her refusal of surgery. When the surgeon again expressed her unwillingness to operate against Mrs. A’s wishes, J warned, “If you do not operate, you will be responsible for my mother’s death and you will hear further from me.”
Develop an argument wherein you take a position on whether it is morally justifiable to perform the recommended surgery on Mrs. A without her consent.
Sample Answer
Sample Answer
The Moral Justifiability of Performing Surgery on Mrs. A without Her Consent
Introduction
In the case of Mrs. A, a 63-year-old woman who has refused to give her consent for a life-saving surgery, a moral dilemma arises. On one hand, the surgeon is faced with the duty to preserve life and prevent further complications caused by the leakage from the sigmoid colon. On the other hand, Mrs. A’s refusal to undergo the surgery must be respected as an expression of her autonomy and right to make decisions about her own body. This essay aims to argue that it is not morally justifiable to perform the recommended surgery on Mrs. A without her consent.
Respect for Autonomy
Respect for autonomy is a fundamental principle in medical ethics that requires healthcare professionals to honor patients’ decisions regarding their own bodies, as long as they are competent and have been provided with adequate information. Mrs. A’s refusal to undergo surgery, even in the face of potential death, should be respected as an exercise of her autonomy. By disregarding her refusal and proceeding with the surgery without her consent, the surgeon would be violating this principle and undermining Mrs. A’s inherent right to control her own body.
Informed Consent
Informed consent is another crucial aspect of medical ethics that ensures patients have sufficient information to make decisions about their healthcare. Mrs. A’s refusal indicates that she has considered the potential risks and benefits of the surgery and has made an autonomous decision based on her own assessment. It is essential for healthcare professionals to provide patients with accurate information, answer their questions, and respect their decisions, even if they seem to go against medical advice.
The Principle of Beneficence
The principle of beneficence obligates healthcare professionals to act in the best interest of their patients and prevent harm. However, in this case, it is important to recognize that performing surgery on Mrs. A without her consent would violate the principle of non-maleficence, which states that healthcare providers must avoid causing harm. By going against Mrs. A’s wishes and conducting the surgery against her will, the surgeon would be inflicting harm both physically and emotionally.
The Role of Family
While the distress of Mrs. A’s family is understandable, it does not justify overriding her autonomy and making decisions on her behalf. In cases where patients are unable to make decisions due to incapacity or unconsciousness, surrogate decision-making can be employed. However, in this situation, Mrs. A is conscious and capable of making her own decisions. Therefore, it would be ethically inappropriate to allow her family to consent on her behalf against her expressed wishes.
Conclusion
In conclusion, it is not morally justifiable to perform the recommended surgery on Mrs. A without her consent. Respect for autonomy, informed consent, and the principles of beneficence and non-maleficence all support the argument that Mrs. A’s decision should be respected, even if it puts her life at risk. While it is understandable that her family is distressed and concerned for her well-being, it is essential to honor Mrs. A’s autonomy and allow her to exercise control over her own body and healthcare decisions.
