Constraint of a person’s autonomy is permissible when the person’s choices and actions infringe on the rights and welfare of others.8 Public health officials have detained patients with infectious tuberculosis to prevent spread of the disease.9 More controversial was the holding of more than 200 non-infectious people because they were noncompliant with treatment for periods of up to two years as late as 1993 in New York.9

The intentional limiting of patients’ autonomy “for their own good” is the definition of paternalism.5 This is the old-fashioned “doctor-knows-best” attitude of physician to patient. One form of paternalism is benevolent deception, in

The debate about forgoing life-sustaining treatment also falls within the category of nonmaleficence. Caregivers may view the act of withdrawing life-sustaining treatment as making them responsible for the patient’s death and therefore different from the act of never starting the life-sustaining treatment. Caregivers, patients, and families may worry about the distinction between withholding and withdrawing treatment because they think a therapy once begun cannot be stopped. But in some cases it is only after a treatment has been started that a proper diagnosis and prognosis can be made.1

which the clinician purposely withholds information because, in his or her judgment, the information may be too upsetting for the patient.5 Physicians in the 1970s made unilateral decisions to not treat deformed newborns without consulting the parents because they thought they were saving the parents from the emotional burden of decision. But public outrage when this practice was exposed led to including parents and others in the decision-making process.4

Just allocation. To be just, health care resources should be allocated fairly. Several methods for the fair apportionment of resources have been proposed. These include age-based rationing, such as not providing certain treatments and procedures for those over a certain age.1 A cost-effectiveness method measures dollars per quality-adjusted life years (QALYs) to define health benefits related to the costs of a specific medical intervention.14 Another method is rationing through priorities. The Oregon Health Plan is one example. It attempts to apply the principle of justice by providing a certain basic minimum of health care for all Oregon residents.5

Some topics in this essay:
Dorrence Darling’s, Oregon Oregon, , Health Plan, Assisted Suicide, Rockville Md, Follow-Through11 Respect, health care, Nurses Association, School Medicine, Memorial Hospital, terminally ill, physician-assisted suicide, life-sustaining treatment, principle beneficence, benevolent deception, principle respect, principle respect autonomy, quality life, unconscious mentally, respect autonomy, health care resources, terminally ill physician-assisted, standard due care, allocation health care,