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Background reading material for Year 1 Semester 1 Med PPSD Session on 20th August 2008 by Professor Omar Hasan Kasule Sr.
1.0 PATIENT AUTONOMY IN MEDICAL DECISIONS
No medical procedures can be carried out without informed consent of the patient except in cases of legal incompetence.
The patient has the purest intentions in decisions in the best interests of his or her life. Others may have bias their decision-making.
The patient must be free and capable of giving informed consent.
Informed consent requires disclosure by the physician, understanding by the patient, voluntariness of the decision, legal competence of the patient, recommendation of the physician on the best course of action, decision by the patient, and authorization by the patient to carry out the procedures.
The patient is free to male decisions regarding choice of physicians and choice of treatments.
Consent can be by proxy in the form of the patient delegating decision making or by means of a living will.
Consent is limited to what was explained to the patient except in an emergency.
Refusal to consent must be an informed refusal (patient understands what he is doing). Refusal to consent by a competent adult even if irrational is conclusive and treatment can only be given by permission of the court.
Doubts about consent are resolved in favor of preserving life.
Spouses and family members do not have an automatic right to consent. A spouse cannot overrule the patient’s choice.
Physician assisted suicide, active euthanasia, and voluntary euthanasia are illegal even if carried out with patient consent.
2.0 PHYSICIAN AUTONOMY
2.1 Professional freedom and professional independence
The physician as a professional should be free in the exercise of his profession and his work performance can only be reviewed by his professional peers and not managers or administrators outside the medical profession.
2.2 Refusal of medical procedures based on conscience
The physician should be free to refuse undertaking procedures such as abortion if he feels that they violate his personal values.
2.3 Torture or degrading punishment
The physician should not forced against his will to participate in cruel or degrading punishments or torture.