An analysis of Robert Schwartz “Autonomy, Futility, and the Limits of Medicine” reveals that physicians are not required to give patients treatment that has been proven to be effective, and they are not morally obligated to provide treatment that is not in-line with practice of medicine. Schwartz explains although our autonomy is respected, there are limitations on our request. We all enjoy our right to autonomy, the freedom to express what can be done to us, the right for self-determination. “Autonomy is based on a person’s ability make rational choices concerning their own life and choose for themselves.
They must be treated with respect without interfering with their ability to determine their own paths and make decisions for oneself” (Vaughn 9). The freedom of autonomy gives patients the right decide their healthcare decisions without the influence of the values of their physicians, their colleagues, or society (Schwartz 105). According to Schwartz there are a few restrictions placed on our autonomous decision making when it comes to healthcare treatments.
Often the physicians respect our autonomy, but can deny treatment to us if our values are not in-line with the physician values, and within the realm of medicine, therefore, we cannot ask for treatment that isn’t in the practice of medicine. “Patients are not entitled to be treated with nonmedical practices, or scientifically futile treatment, or treatments that are in-line with the scope of medicine” (105). Perdue Chaney 2 Schwartz suggest our autonomy is not denied by the healthcare system if they do not provide treatment that might be effective, but has no medical meaning, nor falls in-line with alternative medical treatments (105).
In other words, a stressed out mother can’t go to her physician, and expect her doctor to prescribe her, or even recommend her to spend a day at the spa, and then go out for drinks later with friends. Even though this experience might relief her of the stress for that day, and maybe well needed, but this treatment is not practiced in medicine, therefore, cannot be offered. Autonomous patients can only choose from reasonable medical alternatives, it must be proven and effective. Physicians are not obligated to provide futile treatments to patients.
We cannot demand to receive procedures that are inconsistent with the ethics of medicine. It’s not a clear understanding which proven scientifically and medical procedures are reasonable alternatives (105). So, if I decided I didn’t want anything protruding from my face at all. I just want a flat face. I doubt there would be any plastic surgeons lined up to remove my healthy nose, lips, and ears completely off. It’s my body, and I feel it’s a rational choice, so why I can’t find surgeons willing to do this procedure?
Because it would put their ethics into question for performing such taboo practices in the medical field that are not in-lined with the scope of medicine. If I had a flesh eating disease that was causing those areas to deteriorate, and there was a high chance it would spread to the rest of my face, than the removal of my nose, ears, and lips would be within the realm of medicine. Furthermore, patients cannot expect treatment that is beyond the limits of medicine. Even when the treatment is what the patent desires, is a medical procedure, and is not futile, can still be accepted, or denied by the healthcare providers, and/or the courts (108).
Schwartz argues the courts, and the hospital approach the Wanglie case at the wrong angle. Instead of focusing on the Perdue Chaney 3 “best personal medical interest”, they should have been concentrating on whether continuation of the feeding tube, and ventilator were within reasonable medical practices, and if it should have been offered to Mrs. Wanglie, or her surrogate (106). “After she has experienced severe irreversible brain damage, and is in a persistent vegetative state” (105). Schwartz goes on further and suggests, “Mrs.
Wanglie’s healthcare providers should have argued that medical practice simply did not include providing a ventilator and gastrostomy feeding under circumstances of this case, and that no surrogate decision maker-whether it be Mr. Wanglie or another substituted by the court-should be able to choose this option” (106). In closing, autonomy is the driving force for medical decisions, but the expectations of it must be in-line with the scope of medicine. “Any healthcare provider, who believes that the proposed course of treatment is within the realm of reasonable medical alternatives, that the patient will have access to that course of treatment.
It is only when a patient desires treatment that not one single healthcare provider believes to be within the limits of medicine that the patient will be denied that course of treatment” (107). Work Cited Page Perdue Chaney 4 Lewis, Vaughn. Bioethics: principles, issues, and cases-2nd ed. New York: Oxford, 2013, 2010. Print Schwartz, Robert. “Autonomy, Futility, and Limits of Medicine. ” Bioethics: principles, issues, and cases-2nd ed. Lewis, Vaughn. New York: Oxford 2013, 2010. 105-108. Print.