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I need a response to my classmates answer.
Forum
1: Conscience clause discussion
Question:–Contemporary
law and ethics protects the rights of medical professionals to practice per
their conscience. This has translated into clinicians refusing to
participate in medical procedures that they believe to be unethical or morally
represensible (such as terminating a pregnancy, performing a sterilization, or
refusing to dispense certain medications). While we do want clinicians to
be ethical and attuned to moral aspects of their professions, there is
controversy about the extent to which a clinician can refuse a particular
practice. Ethics is also concerned about paternalism –
individual or state decisions that limit patient autonomy (which can only be
limited in narrow and highly compelling circumstances, such as a patient
requesting medically inappropriate or unreasonable care, a patient being a
danger to themselves or others, etc.). This creates a conflict between
protected principles – the conscience of the practitioner directly conflicts
with the patient’s right of self-determination. Should a medical
professional be permitted to override a patient’s desire to obtain an ethically-controversial but medically-justified service
or procedure?
Classmates answer:—- I
believe that practicing medicine on any level requires focus on the science,
first. I know that every human struggles with the ethical dilemma of treating a
client with a controversial procedure that is medically justifiable. It
is also easy to say, “I will not practice that way, but you may find another
provider”. I don’t feel that any medical professional can override “a
patient’s desire”. At the point where the

clinician and the patient disagree,
the patient and the clinician have free will to part ways unless it is in an
emergency.
I think that much
controversy may lie in the rights of women to choose and men to choose to have
a vasectomy to not have more children. I practiced as a FNP in women’s health
for 7 years and ran a clinic for patients with Medicaid. Before I practiced
there, I can honestly say that many of my ethical views were set in stone.
Then, I was exposed to reality, where each situation is different and so
many factors do not allow for “a right or wrong “ethical or moral
decision. I think that the best clinician can allow themselves to
practice in the “gray area” and take all details into consideration before
overriding a patient’s desire for a medical procedure that is controversial.
It is critical that we
practice within our four major ethical principles of autonomy, beneficence,
nonmaleficience and justice unless in an emergency (Pierce & Smith, 2020).
We should practice veracity, fidelity and allow for patient privacy while
neuroethics practice under the idea that there is “one best solution to a
dilemma” (Pierce & Smith, 2020). Instinct and intuition will always be part
of clinical decision making as well as a fight between religion, state and
medicine. Paternalism (Stanford, 2020) has shifted to a shared decision
model with “repositioning’ authority to the patient (Pierce & Smith,
2020). Despite the relationship, the patient is the ultimate receiver of
care and has the right to make an ultimate decision to accept what the
clinician plans to provide.
I need a response to my classmate’s answer. I need a reference the iswithin the last 5 years, to
go with it.