Autonomy allows patients the right to make decisions of their medical treatment, therefore is important in the role of a Physician Assistance to respect her patients decisions as well as to “promote health, safety, welfare, and dignity of all humans.” In this case Mrs. Smith declines to hear any medical information from her cancer specialist, but would rather hear it from her Physician Assistant (PA) making it my own decision to view what must be evaluated with the patient, and my role in her treatment.
Therefore, I will talk to my patient and walk her through options in her treatment since she wants me to “direct her.” As stated in PA Code of Ethics it is my role to “Supervise ongoing communication between the physician and the physician assistant regarding the care of all patients.” Informing Mrs. Smith know that oncology is not my specialty, however I will be reviewing medical procedures done with the referred specialist.
2. The questions should be formulated to the patients in a manner that to obtain answers that will help improve the patients’ health such as, “Would you prefer to choose a specialist rather than me referring you to one?” This gives the patient options to choose where she prefers to be treated; maybe there are reasons why she didn’t want to speak with Dr. Billings, being male or just knowing a loved one was also treated in the referred facility. Another question will be, “Do you understand why treatment options need to be explained to patients?” Since the patient trusts me as a caregiver I will use the ethical consequentialism by explaining why her treatments and side effects to the medication she will be receiving is important, as well as the effects of no treatment if she chooses not to continue therapy.
3. The ethical concepts highlighted in this case is self-determination, withholding treatment, and non -compliance to informed consent, due to the patient refusing to hear procedures by the cancer specialist “I do not want to hear all the details.” The patient is in this case prefers not to the listen to the tending specialist, therefore, creating a legal requirement of explicit consent prior to treatment. Ethical concepts are placed on the Physician Assistant to respect the patient’s decision autonomy, as well as informing the patient what will be the outcomes if she decides to continue with her treatment as well as avoiding her treatment.
Beneficence also plays a role in this case since we want to conserve, “the well-being of others.” As a healthcare provider I will recommend the best treatment for Mrs. Smith, and explain to her that by her stating, “just do what you have to” puts any doctor in the position to not starting treatment. I will be willing to work with my patient as long as her interests are within my expectations, standards and knowledge to promote and respect her decision.
4. Autonomy plays a critical role in this case, since it deals with a patient not co-operating with the specialist information. As a professional I must maintain my role as a Physician Assistant code of ethics to, “maintain and increase the quality of individuals,” and not go beyond my scope of practice to initiate treatment.
The outcome to solving this dilemma is to explain the course of treatment to her in layman’s terms in order for her to continue her treatment, illustrates autonomy, informed consent and consequentialism. Another option will be to give her a list of specialists and let her choose one who she can feel comfortable with and letting her know I will work with who ever she chooses, “Physician Assistant Code of ethics.” Giving the patient these options will increase the likelihood to continue her treatment, this includes continuation of treatment or refusal of treatment, any of these decisions must be respected and followed