Dr. Mack Cherry
Family or the individual: Who do we work with?
Just as culture and individuals, medical ethics varies around the world. In the Western world medical ethics regarding consent is almost driven by the idea of separating the patient from the family. As discussed in class and readings, Western bio-ethics, compared to other countries, goes to the extent in dehumanizing the family figure when it comes to medical ethics, unless the patient is incapable to make their own decisions on their care. This idea is applied to most cases, even to those pertaining to minors. In other countries, for example China, family is the first source a physician goes to in order to to discuss the patients care and state before talking to the patient. The main question is, which approach should be used when it comes to consent? Is it better to glorify the patients independence by getting rid of the family figure 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 defending their reasoning; however, trying to approach this as unbiased standard would be useless. In addition to making an insight to both arguments I will also apply what I have experienced with regards to a family vs. individual approach in my culture.
First of all, we must understand that each approach is based on a statistical analysis, meaning that it’s a summation of the most common outcomes of each individual case. We approach each case like this because it would be impossible to remember every single outcome for each individual case that is relevant. This doesn’t mean that every single family is evil and tries to exclude the patient from their own choices; however, it also doesn’t 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 really means. According to the Oxford Dictionary a family means “ a group consisting of parents and children living together in a household”. If you approach this through a biological point of view it means “a principal taxonomic category 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 same interests, family members are joined by a blood line that holds together by, not only interest, but also biological need to survive (e.c. Propagation of their genes to future generations)
In Western culture there 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 voice. In our modern society, bio ethics is driven by working for whats the best interest of the patient and what they, as an individual, say is better fit for them. In this approach, the family plays a only a “by default” sense, meaning that the patient is incapable of acting on their own behalf and has failed to appoint another individual to serve in their behalf and make decisions in the patients best interest (Boisaubin, 2004; Cherry and Engelhardt, 2004) Through the passing of the years, we as American’s have built up a mind set that families are evil and should not be trusted 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 “best 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 liberty plays a great part in Western culture, thus by isolating the patient we are playing by what every American is entitled to,...
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