The Curious Case of the De-ICD: Negotiating the Dynamics of Autonomy and Paternalism in Complex Clinical Relationships
| Autor: | Daryl Pullman, Kathleen A. Hodgkinson |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Cardiovascular event
medicine.medical_specialty Psychotherapist media_common.quotation_subject medicine.medical_treatment Decision Making 030204 cardiovascular system & hematology Morals 0603 philosophy ethics and religion Paternalism 03 medical and health sciences 0302 clinical medicine Intervention (counseling) medicine Humans Ethics Medical Psychiatry Ethics Consultation media_common Negotiating Health Policy 06 humanities and the arts Implantable cardioverter-defibrillator Issues ethics and legal aspects Negotiation Dynamics (music) Personal Autonomy 060301 applied ethics Psychology Autonomy |
| Zdroj: | The American Journal of Bioethics. 16:3-10 |
| ISSN: | 1536-0075 1526-5161 |
| DOI: | 10.1080/15265161.2016.1187211 |
| Popis: | This article discusses the response of our ethics consultation service to an exceptional request by a patient to have his implantable cardioverter defibrillator (ICD) removed. Despite assurances that the device had saved his life on at least two occasions, and cautions that without it he would almost certainly suffer a potentially lethal cardiac event within 2 years, the patient would not be swayed. Although the patient was judged to be competent, our protracted consultation process lasted more than 8 months as we consulted, argued with, and otherwise cajoled him to change his mind, all to no avail. Justifying our at times aggressive paternalistic intervention helped us to reflect on the nature of autonomy and the dynamics of the legal, moral, and personal relationships in the clinical decision-making process. |
| Databáze: | OpenAIRE |
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