Reference no: EM133991171

Question

Rita has been involuntarily committed to a psychiatric hospital because she was considered dangerous to others, in particular to her adult son, due to severe paranoid thinking. Her violent behaviour could be controlled by digestible psychotropic pills. She refuses to take any form of medication due to her paranoiac tendencies; she is afraid the nurses are trying to poison her. The nurses suggest administering a new experimental drug against her will by mixing the pills into her foods. Being ruled mentally incompetent, her adult son, who possess guardianship and medical power of attorney, authorises and consents to the use of this novel experimental psychotropic medications in her foods. However, some of the nurses are uncomfortable about deceiving the patient, despite having obtained informed consent from the patient's guardian.

Considering the concepts of autonomy, non-maleficence, beneficence and justice, discuss the following questions in relation to the scenario above in the forum "Applying the principles of bioethics".

1. Do you think the ends justify the means? In other words, does the goal of controlling the patient's violent behaviour justify deceiving her? Explain your reasoning by using the bioethical principles.

2.  Do you think it is ever ethically permissible to deceive patients? Under what circumstances? Which bioethical principles will be challenged? Why or why not?

3. To what degree should family members or legal guardians have full capacity to make decisions or give consent on behalf of those under their care? Explain by keeping the bioethical principles in mind.

4. Do you think severely mentally ill people retain any rights to determine what shall be done with their own bodies? Why or why not? Use the principles to guide your reasons.

5. Are there risks in surreptitiously medicating a paranoid patient with experimental drugs? Would this confirm the patient's delusions of being 'poisoned' by others or escalate her resistance to treatment? Are these risks worth taking in view of the potential to dramatically improve her mental functioning and reduce her suffering?

6. Since psychiatric patients have the right to treatment, does the strategy to surreptitiously administer medications serve this goal? Do you think this is ethically justifiable? Why or why not?

7. Does the history of the forcible treatments of persons with disabilities and other powerless populations affect how you view this case? Explain.