I argue that informed consent is vital in securing the welfare and the self-determining will of patients. I consider the financial barrier of keeping terminally ill and comatose patients alive as not a primary consideration of hospitals and medical staff members. Those who recommend the financial barrier will object that keeping terminally ill and comatose patients alive will only waste the financial resources of the patient and of the patient’s relatives and friends. I respond to this objection by arguing that the primary task of doctors and hospital staff members is to secure the lives of the patients in their hands and not to destroy lives.
Informed consent should be treated as an inherent right of individuals, even patients who are suffering from terminal diseases or ailments and those in a state of irreversible comatose (Sankar, 2004, p. 441). The reason for this is because patients are human beings who have the natural right to self-determination. While doctors also have their self-determination, it does not necessarily follow that they can do whatever they like with the patient (Holmes-Rovner & Wills, 2002, p. 33). On the contrary, the fact that both patients and doctors have their own free will suggests that none of them can interfere with the will of the other (Karlawish, Fox & Pearlman, 2002, p. 16). Considering the patient-doctor relationship, however, it is the vested duty of the doctor to preserve the right of the patient at whatever cost. The primary role of doctors is to give patients the proper treatment which will prolong their lives.
One example that can be cited in order to illustrate the issue at hand is the case when a patient is in a state of comatose and cannot decide for himself. In the situation, both the doctors and several relatives of the patient want to put an end to the “suffering” of the patient by cutting-off his life support system. The relatives of the patient likewise consider the financial burden of having to pay for the life support of the patient for an undetermined length of time as per the advice of the doctor.
In the example given, the attending doctor should not decide about the fate of the patient. Neither the relatives have the natural right to make any decision for the patient. It is only reasonable to presume that had the patient been in a normal state he would be able to make the decision for himself. But since the patient is in a state of comatose, he cannot actually make the decision needed since seeking the consent of the patient will yield to no response. The normal course would suggest that the decision of the relatives should be sought. However, there is one objection that will arise from that proposition: how sure are we that the decision of the patient’s relatives is the same as what could have been the decision of the patient?
Apparently, there are no concrete ways to measure the extent of the similarities between the decisions of the patient and his relatives (Gray, 1998, p. 39). In order to resolve the difficult situation, it should be noted that the patient is still a patient; the safety of the patient should be the primary aim of the relatives and of the doctor. His life support system should not be cut off as this will contradict the right to life of the patient. One objection to this is that continuing the life support of the patient in a state of comatose is costly and is futile since the patient is already ‘brain dead.’ Even if the patient is allowed to continue receiving life support, it will not reverse the condition of the patient and bring him back to a normal state.
However, it should be reminded that financial arguments ought to be out of the question since the problem at hand is the preservation of a delicate life. The fact that the life of the patient is already delicate as to require life support means that his life should all the more be preserved instead of being destroyed. Had the patient been in a normal condition, he can decide for himself the proper course of action that the doctors can perform unto him. But since the patient is in a state of comatose, the immediate response of the doctors and relatives should be to secure the life and welfare of the patient. Not one of them other than the patient can make decisions for himself.
Gray, B. H. (1998). Complexities of Informed Consent. Annals of the American Academy of Political and Social Science, 437, 37-48.
Holmes-Rovner, M., & Wills, C. E. (2002). Improving Informed Consent Insights from Behavioral Decision ResearchImproving Informed Consent Insights from Behavioral Decision Research. Medical Care, 40(9), 30-38.
Karlawish, J. H. T., Fox, E., & Pearlman, R. (2002). How Changes in Health Care Practices, Systems, and Research Challenge the Practice of Informed Consent Medical Care, 40(9), 12-19.
Sankar, P. (2004). Communication and Miscommunication in Informed Consent to Research. Medical Anthropology Quarterly, 18(4), 429-446.