Biomedical Ethics (Randomized Clinical Trials)

Question 1:

“Freedom, true freedom, not only gives us the right to make the correct choices; it also has to give us the right sometimes to make the wrong choices” (Cowart, 72). Each individual is entitled to freedom. Autonomy allows for this freedom, but when our autonomy is reduced, our freedom is reduced. Our society has claimed this legally valid since the 1891 Supreme Court ruling, and reaffirmed it recently when it ruled “a competent person has a constitutionally protected liberal interest in refusing unwanted medical treatment” (Diekema, 87). However, this conflicts with a fundamental belief of many physicians – the Hippocrates belief that physicians have an obligation to act in the best interest of the patient. Does best interest mean preserving the autonomy of the patient or the well-being of the patient? This stems to our society’s roots in dying free is better than living under oppression. Therefore, physicians have a moral obligation to secure informed and voluntary consent in order to respect the patient’s autonomy.

Each individual is rightfully allowed their freedom to make decisions and be happy. John Stuart Mill’s On Liberty explains each person is the best judge of how to use their freedom (O’Neil, 54). Therefore, a fully ‘competent’ patient has the freedom and right to make a decision on which treatment to use without coercion or deception. A physician treating a patient without informed consent disregarding her will is not acting in the best interest of the patient, and therefore not fulfilling his duty. Free will is preserved by requiring informed consent.

Securing patient consent involves ethical and non-ethical obstacles. Consent is opaque; acquiring it can also be express or tacit, but is often somewhere in between (O’Neil, 55). Patients are often inexperienced in medicine, and do not understand various treatments. Therefore it lies with the physician to offer complete valid knowledge – no biased advice - on all alternatives so as to...