The realm of medicine is a domain of enterprise that frequently encounters moral quandaries. These quandaries span from interactions with patients to instances where the healthcare system conceals information from the general public, which could tarnish their reputation. One such moral dilemma in medicine revolves around enforcing chemotherapy on patients. Though not a pervasive issue, it undeniably exists and is entwined with the distrust of authority and the potential misuse of power through influence.
Chemotherapy: Exploring the Moral Dilemma
Consider the case of Cassandra C., a 17-year-old residing in Connecticut, who made a profound decision to decline further chemotherapy for her Hodgkin's Lymphoma (Ruth Macklin, 2015). This choice poses an ethical quandary with two conflicting principles. The first principle asserts an individual's right to self-determination, allowing a patient to refuse medical treatment, even if it means foregoing a life-saving option. The second principle concerns hospitals and their staff providing the best care for patients, optimizing benefits while minimizing harm.
A significant complication arose when Cassandra was legally a minor at the time of her decision, necessitating parental involvement (Joyce Frieden, 2015). Fortunately, Cassandra's mother did not contest her daughter's rejection of treatment. However, there are instances where patients and their parents disagree with medical decisions. Courts still possess the authority to overrule parents when the chosen medical course jeopardizes the offspring's life. In this case, the Connecticut Supreme Court determined that Cassandra must undergo chemotherapy. Despite efforts from Cassandra's lawyers to have her considered a 'mature minor,' granting her the right to refuse treatment, the court did not concur. Medical judgment indicated an 85% chance of survival through chemotherapy for Hodgkin's lymphoma. An ethics committee at the Albert Einstein College of Medicine affirmed that parents are typically decision-makers for their children, except when their choices clearly go against the child's best interests (Frieden, 2015). While this may hold for medical decisions concerning infants, it raises questions about teenagers' capacity to make decisions for themselves.
The decisions made by the patient, her parents, the hospital, and the court all come under scrutiny (Macklin, 2015). If the treatment were a one-time event, providing more benefit than harm despite potential discomfort, then forceful treatment might be justifiable. However, chemotherapy is a prolonged and uncomfortable process lasting up to six months. Forcing Cassandra into treatment and confining her to a hospital room after her mother's refusal seems ethically unjustified. While children under seven lack the mental capacity to make decisions, those over fourteen are generally considered capable. Forcing medical treatment on Cassandra while she was sedated and restrained appears excessive (Frieden, 2015). Although the primary aim was to eradicate cancer, broader implications suggest a potential monetary benefit for the hospital. Nonetheless, Cassandra's perception of the treatment as poisonous may be deemed unreasonable considering its short duration and high success rates (Frieden, 2015). Physicians supporting the compulsion of treatment on young patients must weigh the measures they take, as exemplified in this case.
Addressing the ethical issues between business and society, chemotherapy is an established and effective treatment for cancer patients, having saved thousands of lives (Riccardo Gionvanniello, 2019). It is not an experimental product posing potential danger to animals, which would raise an ethical dilemma. It is unlikely that the hospital compelled Cassandra to undergo chemotherapy for monetary gain. She was informed of the treatment's effects. From the hospital's perspective, providing the treatment to save her life is preferable to allowing her to perish due to a lack of intervention. Failure to administer the drug would tarnish the hospital's reputation and concern its shareholders. These ethical dilemmas extend beyond medicine and manifest in various aspects of business marketing. If the hazards of a product are concealed from buyers, an ethical dilemma arises. Similarly, if a company sells products using subpar materials while falsely claiming high quality, an ethical predicament emerges within the organization. Ethical dilemmas permeate numerous professional fields, and medicine is just one among many. These dilemmas impact companies, stakeholders, employees, and consumers (or patients in the medical context). Both consumers and companies have the potential to present ethical quandaries.
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