Bioethical Principle of Autonomy in Healthcare.

Posted: December 3rd, 2022

Bioethical Principle of Autonomy in Healthcare.

The memorable situation that I experienced as a nurse clinician involving incorporation of the preferences of my patient concerned the choice of dialysis modality for the patient who was in renal failure. This was a patient who was diabetic and hypertensive with progressive kidney failure, as evidenced by a steadily dropping estimated glomerular filtration rate or eGFR (Hammer & McPhee, 2018).Bioethical Principle of Autonomy in Healthcare.

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I had my own reasons for wanting to suggest peritoneal dialysis treatment for the patient, but he did not agree with me and wanted to choose a different modality – in-center day hemodialysis (three sessions of 4 hours each every week). Being a salesman, he is always up and about and felt that he could always take 4 hours of dialysis during the day before resuming his sales work. He ruled out peritoneal dialysis as he deemed it “cumbersome”. Home hemodialysis was out for him because of the associated costs of acquiring a dialysis machine. He also ruled out nocturnal in-centre hemodialysis because he worked during the day and needed to rest and sleep at night in his house. The patient decision aid My Life, My Dialysis Choice helped me allow him make this decision (DHRI, 219). As I was to realise later on, incorporating this patient’s preferences into the decision making for his treatment was a good idea as it facilitated compliance with the treatment by the patient. To allow patients to participate in decisions about their care is to respect the bioethical principle of autonomy (Karnik & Kanekar, 2016; Ringstad, 2016; Motloba, 2018).Bioethical Principle of Autonomy in Healthcare.

Including patient preferences impacts patients’ treatments because they feel that they own the process. According to Entwistle (2019), the patient has the right to decide how their treatment is done. However, they must be given the necessary medical information to make this decision correctly. This is the whole essence of informed consent. In my case, the patient chose standard in-center hemodialysis because they felt that that is what suited them and their work schedule. And because the patient felt respected and valued in deciding his care, he visibly improved tremendously and stuck religiously to his dialysis schedule of three times a week during the day (DHRI, 2019). Incorporating patient preferences as demanded by the bioethical principle of autonomy therefore positively impacts their treatment trajectory (Karnik & Kanekar, 2016; Ringstad, 2016; Motloba, 2018).Bioethical Principle of Autonomy in Healthcare.

The value of the decision making aid I chose is that it clearly outlines the patient category or audience to which it applies, and the available options. It is these options that made it easy for me to inform the patient about them so that he could make his informed decision. I could always use this decision making aid in my professional practice to guide the decision about dialysis modality of choice for each of my kidney failure patients.Bioethical Principle of Autonomy in Healthcare.

Patient Preferences and Decision Making

Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.Bioethical Principle of Autonomy in Healthcare.

What has your experience been with patient involvement in treatment or healthcare decisions?

In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.Bioethical Principle of Autonomy in Healthcare.

To Prepare:

• Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
• Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
  • Choose “For Specific Conditions,” then Browsean alphabetical listing of decision aids by health topic.

NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.Bioethical Principle of Autonomy in Healthcare.

In 1-2 pages

Write a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.Bioethical Principle of Autonomy in Healthcare.