Family or the Individual: Who Do We Work with?

Dani Romero Dr. mac carmine PHIL 3311 3/1/2013 Family or the item-by-itemist Who do we spirt with? Just as finis and souls, medical exam examination ethics varies around the world. In the westerly world medical ethics regarding consent is almost driven by the composition of separating the diligent from the family. As discussed in class and readings, horse opera bio-ethics, comp bed to other countries, goes to the extent in dehumanizing the family calculate when it comes to medical ethics, unless the uncomplaining is incap satisfactory(p) to make their throw decisions on their c be.This opinion is applied to most cases, redden unwrap to those pertaining to minors. In other countries, for example China, family is the first source a mendelevium goes to in order to to discuss the patient roles c ar and state before talking to the patient. The main question is, which coming should be used when it comes to consent? Is it punter to glorify the patients independence by getting rid of the family get in or is it better for the physician to go to the family first before bombarding a patient with overwhelming information?Of course, both sides of the argument have valid ideas defend their reasoning however, trying to draw close this as unbiased standard would be useless. In addition to making an insight to both arguments I leave al wizard also apply what I have experienced with regards to a family vs. various(prenominal) get alonging in my culture. First of wholly, we must understand that for severally one approach is based on a statistical analysis, meaning that its a summation of the most common come to the forecomes of each individual case.We approach each case like this because it would be impossible to remember each single(a) outcome for each individual case that is relevant. This doesnt mean that every single family is evil and tries to exclude the patient from their own choices however, it also doesnt mean that every family is a depiction of the Brady Bunch where everyone is happy, understanding and embraces each others flaws and quirks. In addition, we must also fully understand what the term family in truth means.According to the Oxford Dictionary a family means a group consisting of parents and children living unneurotic in a household. If you approach this finished a biologic point of view it means a principal taxonomic family line that ranks above genus and below order (Oxford Dictionary). In both descriptions a family is basically a group that shares similar qualities and characteristics, but unlike friends that share similar pertains, family members are joined by a blood line that holds together by, non plainly wager, but also biological need to win (e. . Propagation of their genes to future extensions) In Western culture in that location has been a desire to separate the patient from the family. It almost feels as if society sees the family figure as a source of unfair control or a dictatorship that silences the individuals phonation. In our modern society, bio ethics is driven by works for whats the surmount interest of the patient and what they, as an individual, say is better adapt for them.In this approach, the family plays a only a by default esthesis, meaning that the patient is incapable of acting on their own behalf and has failed to appoint a nonher individual to serve in their behalf and make decisions in the patients dress hat interest (Boisaubin, 2004 Cherry and Engel disenfranchisedt, 2004) Through the passing of the years, we as Ameri pottys have base up a object set that families are evil and should not be sended since we believe that no one knows better than what the individual wants but the individual himself.The ideas behind isolating the individual from the family is to protect their scoop out interest. By having the patient as the go to figure we are enforcing the authority the patient has over themselves thus assuring that they are the only one that have control on what should happen to them. The idea of self-sufficiency plays a great collapse in Western culture, thus by isolating the patient we are playing by what every Ameri dissolve is entitled to, which in this case, is the liberty to either accept or cross treatments offered by physicians.Also, as mentioned before, the main reason why an a patient is treated as an individual is in order to protect their best interest. As it can be easily seen, the family figure plays no quality in this approach. The families main manipulation is to play a historian in order to help the physician fill any gaps left by the patient. In this case families are suppose to be trusted, unless they show signs that they are incapable of being trusted. As mentioned in Ruiping Fans and Julia Taos Consent to Medical Treatment The Complex Interplay of Patients, Families, and Physicians,Western ioethics began as a troth against paternalism in order for the patient to gain auto nomy over themselves (Engelhardt, 2002). Bioethics was build up on the pillars of individualism and autonomy over ones own clay and decisions. Knowing this it doesnt seem strange that Western bioethics drive a wedge betwixt the family and the individual. Most would believe that the wedge driven in the midst of patient and family wouldnt affect paediatrics since children arent seen as a someone who is responsible and aware of their actions and their repercussions.However, in Western society the same idea is being applied to pediatric care. In todays society, under the Convention on the Rights of Children by the United nations minor children ought to be treated as self-possessed moral get on withnts, who are to undertake their own moral and life-style decision making as soon as possible and as far as feasible (Parental Authority and pediatric Bioethical, pg. 553). An example would be acceptance of allowing children as young as 14 years-old to get birth control and abortion with o ut parental consent.Even if, correspond to Englehardt, some isnt considered a responsible person in the sense that they are rational and are able to understand their actions money box the period of 18 (). It almost seems strange that children at such(prenominal) young era have the mental and moral capacity to make such drastic decisions with out parental consent. This all falls under the same idea of the individual being independent and free to make their own choice, even if the individual doesnt have full control over their impulses.Granted that parents and guardians are suppose to act in behalf of their childs best interest however, how is possible for Western bioethics to try to drive a wedge between the bond of child and parent at such an early age? On the other hand when we look at other countries such as China, we see that there is there is a more family orient approach to medical ethics. According to Yali Congs article Doctor-Family-Patient Relationship The Chinese Par adigm of Informed Consent a family member can either be the patients family or the representative of the patients entire family, ordinarily meaning the grandfather, father or elder son (pg. 52). The individual makes realm of the family, thus whatever causes harm to the individual causes harm to the family ( e. c emotionally, mentally, frugalally) therefrom the family should be with the individual in order to support them through the process. In most cases in China, the physician discusses the patients health with the family first and then they root how much the patient should be told or if they should be told at all.Even if this approach is family oriented, it doesnt mean that the individuals voice is ignored and all the decisions are do by the family and dont consider the individual. It means that if the individual isnt able to communicate or the family decides not fully disclose all the information to the patient, family members will act in the patients behalf and follow wha t the patient best interest is. This bioethical approach revolves around one central idea why should we separate the patient from the people they are there to support them?As explained, Chinese physicians would never directly guarantee the patient that they are misfortunate from a terminal illness. On the other hand they would approach the family and civilise them about whats going on and what could happen and then the family can decide what to do in regards of letting the patient know. Families usually tell their loved ones the diagnosis gradually in order for them to take in the news and learn to accept it little-by-little and allowing them to ad skillful to their state (Doctor-Family-Patient Relationship, pg. 155)Another similar approach to the family oriented consent is that of Confucian moral balance where not only is family integrity important but also pursuits a harmonious standard pressure where family members can cooperate and work harmoniously with one another in order to work for the patients best interest (The Family and Harmonious Medical finality Making, pg. 580). In the case of Tankai and her unfortunate death due a find to the head in an accident her parents had to become the figure of authority since Tankai couldnt possible act in her behalf. afterward her death, Tankais father decided to donate her organs in the hope that their daughters life could at least partially be continued in someone else (HEC Forum 2008, pg. 191). In this case, the family stepped in and acted on their daughters behalf and did what they knew Tankai would have decided on if she where to be of sound and mind before her passing. As shown by this case, the families job is to act in the behalf of the individual and do what they would have considered their best interest.In addition, it is understood that when the term best interest is used in this circumstance it doesnt mean the what the family may eudaimonia from but what a the individual of the family will ultimate ly benefit from. After understanding both sides of the argument, I can see that I lam more towards the family oriented approach. I was brought up in a traditionalistic Catholic home, in addition I come from a Mexican background meaning that I come from a very cautious household.Family plays a big role in the morals that have been taught to me through both my religion and culture. As I grew older I started to curve from some of the ideas that had been drilled into my head by my culture. However, I dont understand the Western obsession with separating the individual from the family as if they where to ignore the individuals voice and carry out their beliefs on them. Family is seen as the core of social and economic activity and therefore the locust of moral activity.Im not look that individuals choices should be manipulated by the families interest but the family shouldnt be take away from the picture since they are the source of the individuals moral and ethical reasoning. The individuals reasoning usually comes from elder family members that have been passed down from one generation to another, which makes the idea of cutting off the family seem even more irrational. As I grew up, I was taught that with out family you dont have anything. I was taught that family is the glue that holds all your life together and without it life would be hard and eventually fall apart.Of course, not all families are the same and there may be a reason why Western medical ethics have decided to remove the family figure, but for the most part family members tend to care more for the people they have a stronger association to thus making them one of the most reliable choice or else than a by default choice. However, if the family doesnt seem to be trust worthy (due to their actions, behavior, and decisions of care for the patient) or the patient has expressed that they dont wish to have to do anything with them, I believe that the family oriented approach is the better one.I trust that my parents, siblings or any other family member, can responsibly act on my behalf if Im not able to do so. Why wouldnt I trust the people that have been there for me through thick and thin, and have molded me to become the person I am today? It seems bizarre to think that some people cant trust their own family members however, I do understand that not everyone has the same luck with family members and experience. In my own personal view of the station I would prefer for my parents to be cognizant first about by condition, that is if its a horrble diagnosis.I would prefer for my parents to have their breakdown and promise out their feelings prior to me knowing the diagnoses. I believe this because when I am informed by the physician I would have my moment and would be able to look at my parents and have them be the shoulder for me to cry on, or else than them having a meltdown and me not have anyone to look up to and tranquilize me everything would be ok. Generally, its the families duty to comfort the ill family member, and having them cry and have a meltdown would be more stressful quite than comforting.I also agree with the Chinese ethical belief that when it comes to medical context it should com down to three different parties the patient, family and physician (The Family and Harmonious Medical conclusiveness Making, pg. 580) Another thing to think about when it comes to family oriented approach is the role parental and guardian supervision take place in pediatric care. Due to my upbringing in a catholic home its really hard for me to stomach the idea that children as young as 14 years-old can receive abortions and birth-control without parental consent.Yes, I understand the idea that its better for them to be sexually active with protection quite than having them have unprotected intimate relationship. However, this comes back to the idea of moral pluralism, that everyone is a secular individual and necessarily share the same beliefs. However, maybe its because it got beaten into my head that it wasnt acceptable to be intimate till marriage, but to me it seems that we are giving children the easy way out.Technically, Western culture is enforcing children to go behind their parents back and engage in such activities that they the child could place to consequences that they can easily be protected from or taken out of. My question is when is protecting the childs best interest gone(p) too far? Western culture is attempting to take apart the family figure by allowing children to be self-possessed moral agents (Parental Authority pg. 553). Overall, there is a definite connection between Chinese morals with hose that I have been exposed to, making it harder for me to understand the reasoning behind Western fight for the separation of the patient from the family. Family oriented and individual oriented approaches to medical cases have one thing in common that they both give for the patients best interest however, how you arrive at that is a long caterpillar track that has been twisted and turned by modern Western society. This makes is impossible for physicians to contract a default approach to all cases.Unless you live in a family and tradition driven society like China, one cant assume that everyone is comfortable with a family approach. However, since America is a melting-pot or cultures there really isnt a right answer for which approach should be the default one. Most individuals, and physicians, prefer the individual approach since its just easier to talk to the individual with out having 10 different people call at you giving different opinions.Regardless of whats easier, I believe that if the patient is to say that they prefer a family oriented approach as that the one used in China, their wishes should be respected and carried out since it is considered the patients best interest. As a prospective medical student I know I will have to understand and keep an open mind and do what the patients best interest is. Overall, I find that the family approach may be more relaxing to the patient however, if the patients family doesnt seem trustworthy or doesnt seem interested on the patients best interest