As a adult male at the age of 29, I do not have any biological children. I do however have a 9 year old step son, whom I adore. Being a parent has been rewarding and challenging at the same time. I find myself not wanting to go out as much and declining invites to parties and outings because he has a football game the next morning or has friends staying over, and I want to make them snacks as they play video games. Having said all of that, I think that despite the cost, the patient, Greg X and the doctor have much to discuss. I, for one, can attest to feeling a certain way about important life issues in my early 20's that if asked again today, I most certainly would feel different. At such a pivotal age, most are just figuring out what they want to do with there life and making such a huge decision will affect the patient. I am not aware of the risk of reversing the procedure but as a healthcare worker I would urge the patient to think long and hard. From my perspective, Dr. H wants to provide a service for his patient, despite how he may personally feel about the procedure. I think he should weigh the cost with the patient and base his decision on the mindset that the patient is in during the consultation. In doing so, a clear indication or judgment could be made as to the mental capacity and full understanding of the ramifications of such a procedure. Patients do have the right to change their mind but procedures such as they should be made with as much information as possible, not from the perspective of "flying by the seat of one's pants" From a moral stand point, the Dr. also should provide information that having said procedure will eliminate the chance of conceiving off spring but also potentially increase the chance of acquiring an STD, with the anticipated lack of use of contraceptives. All these calculated risk factors mitigate and elicit a wildly important decision, whose consequences would ultimately effect not only the patient, but also a woman he may encounter in his future whose wants children.
Paul, I agree with you on the fact that when you are at a younger age your values change so the fact that the patient is 25 makes him on the younger side but our choices define us and if someone were to make this choice of a vasectomy at such a young age but later change their mind they will have to deal with that it will only be up to the individual who made that choice. I understand that you have found fatherhood an amazing experience (Sounds like and awesome family!) however, Gregory could feel the same way he does now at 25.
Another thing to keep in mind is that some vasectomies today can be reversed. However, not all are reversable ad Gregory should be educated about this. So although he is 25 and wants one now, he could quite possible e able to go back and reverse his decison. Gregory needs ot be informed about this fact as well and understand that there is no garuntee that hs decision can be reversed is he wants it reversed in the future. i think patient education of all the options and the postivves and negatives of each option should be fully addressed before the procedure is done.
If the doctor does not feel comfortable performing a procedure based on the fact that he does not agree with Gregory X decision because the doctor has a different value system that is not right. As a health care worker i cannot pass judgement on a patient for their choices or for other things like religion i still have an obligation to help them. Now in Gregory's case this is an elective procedure so the doctor does have the right to denis him of this procedure. Gregory will only have a moral problem when he receives the vasectomy if he lies to his partners about wanting children or lying to his future wife that he one day wants children when he cannot physically have them. If he is honest with his choice with his partners then he should not have a moral problem. We all make choices throughout our lives if Gregory decides to have a vasectomy at 25 and decides 5 years laters that he might want children he will have to deal with his choice. All our choices have some type of repercussions in this case his choice would effect his future child bearing. The doctor surely does need to give Gregory all the information possible to help him consider his decision more. If doctor H does not feel comfortable performing the surgery on Gregory then he should be denied a patient. If Gregory is serious about the vasectomy then he will find another doctor and another hospital that he can do the procedure for his price range. No healthcare worker should perform something major and life altering if they are not comfortable with it protects both the patient and healthcare worker.
I agree with what you said regarding Dr. H. I also like the fact that you pointed out that this was an entirely elective procedure, that's a fantastic observation. Gregory could also have a moral dilemma as soon as the procedure is over. After he gets the operation done, he has taken away his own ability to create life. For anyone who is Pro-Life, this definitely creates an issue of morality.
I think it is refreshing to see how all of our post have to do with patient education in some varying degree. In so many cases the patient or family are given information on such an advanced level that it at time must be hard to make tough decisions. I think fully explaining the patient what the risk are on both sides of the argument is essential.
I agree paul! It is awesome to see the power of education be used as a tool when deciding these tough situations. Many people often forget that once a patient is fully educated it will help them make a more accurate decision. With the hustle of hospitals there is little time for education which is so important and in many cases with proper education ethical problems can be solved easier.
Honesty is key here in this situation. If Gregory is honest with his future partner about his vasectomy then there shouldn't be a case of right or wrong. This is a choice that Gregory has decided to make. You stated something about making choices and regretting them later. While this is a big choice for Gregory, if he decides that he longer wants it later he has to live with that. This goes along with a lot of things in life.
I believe that Dr. H shouldn't perform the procedure on Gregory X. As a health care worker, I know that I will be faced with my ethical and moral decisions but I have a strong moral background and I am not willing to compromise my beliefs for a patient. With that being said, I believe that patients have the right to make their own decisions and I will not judge them for their decisions, even though I might not agree with them. Yes, there is something morally problematic about Gregory X wanting to get a vasectomy. Gregory is a young man, I believe that it is too early in his life for him to make that judgment to sterilize himself. Gregory isn't married yet, if Gregory proceeds with this vasectomy it isn't fair for his future wife who may want more children. I think Gregory should wait until to make this life altering decision.
I agree that Gregory should wait, but I also agree that he can choose whatever he feels. It's not necessarily a given, however, that Gregory will be getting married. He may not ever want to get married, we don't know. I do agree that it is morally unacceptable for Gregory to have this procedure done. There is no way for him to read his own future, so how does he know that this is the best choice for himself at this juncture in his life. His life (statistically speaking) isn't even halfway over! But regarding Dr. H, I think that he shouldn't interject his own beliefs in this particular case. Even if he doesn't agree with the decision by the patient, he should operate (as long as it isn't too outlandish).
I agree that Gregory is at a very young age to be making such a life changing decision. However, Gregory has made his decision and I don't think that Dr. H can't allow his moral beliefs to get in the way of a procedure that Gregory wants done. Dr. H may not agree with it, but I don't think there is any way that he could say no. In my eyes there is no moral or ethical issues legally, even though I may have a problem with it.
I completely agree with you. The docotr is not obligated to preform the procedure for Gregory. Dr. H should not have to sacrifice his moral beliefs to serve the patient. The doctor can still respect the patien's wishes but tell the patient that he does not feel comfortable with doing the procedure and will refer him to another docotr in the same hispital that can do the procedure for him. This happens all the time at obstetric clinics with abortions. Some doctor do not believe abortion is morally righ so they will not do the abortion, but will tell the patient to find another docotr or refer them to another doctor who will do the abortion.
The fact that you have a very strong belief in your morals is awesome. However, being in the healthcare profession is all about compromise for patients. Using the example that Dr. Kate described in class where you're an EMT and are responding to a hostage situation where one of the kidnappers has been wounded and needs immediate attention. MY morals would say "no, don't help him/her because they're the reason this whole thing happened, they deserve whatever happens to them." But as an EMT, your whole job is to save lives no matter what. Sometimes you can't just shove the problem off on someone else.
Michaela, With the situation you have presented I feel you are obligated to give "immediate attention" to the kidnapper and you're right, "Sometimes you can't just shove the problem off on someone else". But in Gregory's case, because this is an elective procedure, this is the other half of the sometimes, where you can shove the "problem" onto someone else. If Dr. H feels that Gregory is not taking the right factors into consideration for his future, then he has the choice to not perform the procedure
We must act as patient advocates therefore in this particular case I find the argument of its not fair to the future wife invalid. Because now we are discussing the in and outs of their relationship which is completely and medically unrelated to this particular case. There are a lot of what if's. Why do people act as if the young cannot make well informed decisions? Sometimes that line "the older the wiser" is not always the case. Also if the argument is rooted in a religious angle related to contraceptives then you better also disagree with the use of condoms because although it is not a procedure it is the same thing in the eyes of the church.
I think that Dr. H should operate. As long as Dr. H has properly informed Gregory of all possible consequences and outcomes, then he has done the best he can to dissuade Gregory, personal opinion aside. If Gregory still wants the procedure, then Dr. H's duty is to perform the surgery (barring outlandish requests). Even if Dr. H doesn't agree with this patient's decision, he should proceed with the procedure since that is what Gregory truly wants. Gregory has the power to decide what's best for himself and live his life the way that he wants. Speaking morally, however, Gregory's request is problematic for me. I personally believe that Gregory should wait until he knows whether or not he's going to meet the love of his life. There is no way for him to know; he has no crystal ball. Gregory can choose to abstain rather than take his own ability to procreate away from himself. Abstaining from anything sexual will ensure that he does not have a child just as well as having a vasectomy. So, taking this into consideration, yes, I do think that Gregory is making a brash decision that should definitely be re-contemplated, morally speaking that is.
I agree that before Dr. H should operate he much completely inform Gregory of the precautions and side effects that could affect him as well. I agree that Dr. H may not agree with the decision or with the surgery, but he must follow through with the requests of his patients.
I believe that the docotr must follow the request. No health care professional is required to follow the requests of the patient. The health care professional is not the slave to the patient's request. A doctor, or anyone fro that matter, should not have to sacrafice theri moral beliefs and at the expense of just doing whatever the patient wants them to do. It is necessay for the doctor to respect the patient's wishes and not judge him, but the docotr can choose to not preform the procedure. However, other avenues should be taken by the doctor to help the patient. The docotr can refer the patient to another docotr in the same hospital that will be comfortabl preforming the surgery. This is a great option to help both parties involved in this situation; the dotor does not have to sacrafice his morals and the patientcan still get his procedure done.
Dr. H should perform the procedure but because he does not feel comfortable with the situation he should not perform the procedure. If i went into an elective procedure and the doctors was not confident in what he/she were doing i would not want them to operate on me. Yes, Dr. H reason might be personal and as healthcare providers we are taught not to pass judgements upon our patients and he is wrong for doing this but since he does not have 100% confidence for the procedure he should not do it.
I would have to agree. If Dr. H has properly educated Gregory X, then he is capable of deciding how to live his life, whether that means changing his mind or following through with the procedure. I also like the whole "abstaining" argument that you made. I didn't consider that.
I believe the doctor should allow Gregory X to have his wishes fulfilled. When forming my opinion I thought of many different components. I thought of his future spouses, his family, and his friends. In many situations I am sure that his parents, friends, and other family would want him to have children. His parents would want grandchildren. Another component that I think about is, is Greg old enough to make this decision and would him finding a soul mate change his decision in the future. After considering all of these components, I came to the conclusion that in the end it is Gregory X's decision no matter what. He is a 25 year old man that it perfectly capable to make his own decisions. At this point in life he is an unmarried man and has every right to make his own decision. He doesn't have to consider the decision or opinion of a significant other. I believe the only time he would be running into morality issues is if he lied to a future spouse about having children. If he never mentioned that he had a vasectomy then that would be running into morality issues.
Correct, he is 25 and able to make his own decisions. There could be plenty of women who do not want to have children that Gregory could find in the future if he were to ever want to settle down and get married. Some women might like the fact that they do not have to worry about another form of contraceptives in their relationship, though Gregory needs to make sure to tell his partners about his previous procedure.
Krista, I agree with you in saying that Gregory is an adult and is able to make decisions on his own. This is something that we have a problem with realizing in the real world. If we don't agree with something we want the rest of the world to agree with us. Sometimes we need to take a step back and just let people make decisions on their own.
I think that the Doctor should respect Gregory's decision. The procedure is totally elective, and it is Gregory's right to decide whether or not he wants the surgery. Also in presetnday, sometimes vasectomies can be reversed.
Also, as a health care professional, Dr. H should not pass judgement on Gregory's chouce. However, with that being said, the doctor does have th right to inform Gregory on all the possible complications of the surgery. I think that it is the Dr.'s responsibiltiy to full educate about the procedure.
With that being said, i do not think that Dr. H has to preform the procedure. The task can be passed off to a docotr who feels comfortable with preforming the procedure. The hospital is not a tiny clinic. The case said tat it is a "large city hospital". This implies that there are other docotrs who could preform the procedure. This kind of situation occurs more often than people think. In states where abortion and physician assisted suicide are legal, all doctors do not have to preform these procedures. If someone does not beieve in what the patietn is doing or does not feel cmfortable doing the procedure, they can still respect the patient's decision and refer them to another doctor in the hospical who will do the desroed procedure.
I think the only time there could be a moral problem about Gregory's requeset is if he lies to a furture partner about getting a vasectomy. In addition, a moral problem could arise if the doctor just flat refused Gregory and did not refer him to another doctor in th hospital that can do the procedure for hm. While the doctor does not have to do the surgery, they cannot outright refuse the patient an elective surgery. The patient's wishes still need to be respected and the doctor should ever insert or push his own opinion on the patient.
Tonya, I would have to agree with you. The doctor should set his own beliefs aside, but he does have the right to refer Gregory to another physician that feels more comfortable. One of the most difficult things that are faced in the medical field is that of trying not to push ones own beliefs while also trying to help them.
I agree with with you on passing the procedure to another doctor that is comfortable with performing the procedure. Like you said, it states that it is a "large city hospital" and there are probably plenty of other doctors that would be more comfortable with the procedure. I also agree with you on the moral problem if the doctor denies to perform the procedure and doesn't refer him to another doctor. Also that a doctor or other health care provider should never push their own opinion on a patient because they disagree with what they are doing.
I agree with with you on passing the procedure to another doctor that is comfortable with performing the procedure. Like you said, it states that it is a "large city hospital" and there are probably plenty of other doctors that would be more comfortable with the procedure. I also agree with you on the moral problem if the doctor denies to perform the procedure and doesn't refer him to another doctor. Also that a doctor or other health care provider should never push their own opinion on a patient because they disagree with what they are doing.
Tonya, I agree that the doctor should refer the patient to someone else who feels more comfortable to perform the procedure. The issue of lying to a potential future partner is were I think I huge moral concern can arise. The doctors personal feeling should be set aside in order to provide for our patients. I will, however, say that can be more challenging at certain times, but still remains a responsibility of any health care worker.
I believe the doctor should follow Gregory X's request to perform the surgery. As a health care worker, it is Dr.H's responsibility to set his own beliefs and thoughts aside. If the patients request is within your range of practice it is your job to complete the request, though it is also Dr.H's responsibility to inform his patient on all of the consequences and advantages of a procedure of this extent. After the surgery is performed, the aftermath would fall into the lap of the patient and he would have to live with his decision. Their would be nothing wrong with Gregory X's decision morally as long as he informs future partners and his future wife if he were to ever get married that he had a vasectomy and will not be able to have children.
I also agree with you on after the surgery is performed, the aftermath falls on the lap of the patient. If he were to get a vasectomy that could be reversed and he tries, but it doesn't work then it is on him. Not every surgery can have a guarantee and he will have to live with it, if the reverse procedure does not work. I also agree that nothing is morally wrong with Gregory's decision as long as he doesn't withhold, or lie about, the information about his procedure from future partners/wife.
I also agree with you on after the surgery is performed, the aftermath falls on the lap of the patient. If he were to get a vasectomy that could be reversed and he tries, but it doesn't work then it is on him. Not every surgery can have a guarantee and he will have to live with it, if the reverse procedure does not work. I also agree that nothing is morally wrong with Gregory's decision as long as he doesn't withhold, or lie about, the information about his procedure from future partners/wife.
The only struggle I have with your perspective is the idea that the doctor should perform the surgery despite his beliefs. Because this is all about morals, in my opinion, I just don't believe that it is morally acceptable to make a doctor put aside his own beliefs because it is his duty to perform such a surgery. However, I strongly agree with you that it is Dr. H's responsibility to inform the patient of possible consequences.
Similar to my comment regarding the discussion about terminally ill children, I ask you: Some of you are saying that a young adult shouldn't be allowed to make decisions that potentially impact the rest of his/her life. But what about having unprotected sex or join ing the military? Young adults do that all the time, and they have potentially big consequences for one's future.
I believe that Dr. H shouldn't perform the surgery. As a health care worker I know there will be times I will feel uncomfortable and not agree with what the patient is choosing to do. If it is truly what they want after being educated fully about the procedure then they should be allowed to do what they want with someone comfortable performing the procedure. Dr. H can educate Gregory X on all of the consequences of his procedure and if Gregory still wants to continue then refer him to another doctor in the same practice that is comfortable performing the surgery. I believe there is nothing morally wrong with Gregory's decision as long as he tells any future partners about his surgery. There are some major complications that can occur if he doesn't inform them about the surgery and the future wife/partner wants to have children.
I believe that Dr. H shouldn't perform the surgery. As a health care worker I know there will be times I will feel uncomfortable and not agree with what the patient is choosing to do. If it is truly what they want after being educated fully about the procedure then they should be allowed to do what they want with someone comfortable performing the procedure. Dr. H can educate Gregory X on all of the consequences of his procedure and if Gregory still wants to continue then refer him to another doctor in the same practice that is comfortable performing the surgery. I believe there is nothing morally wrong with Gregory's decision as long as he tells any future partners about his surgery. There are some major complications that can occur if he doesn't inform them about the surgery and the future wife/partner wants to have children.
I like how you added your own perspective and put yourself in the doctors shoes. I definitely agree that I would not want to go along with something that I am uncomfortable with simply because it is my job. I think some doctors would no longer enjoy their jobs if they were required to go along with things they didn't agree with and that could lead to so many more issues.
I actually picked this case to write my paper about. I went back and forth on my opinion on this case as I was writing it. I always felt that as a health care professional you had to learn how to keep feelings about certain situations out of decisions that are being made. I was speaking with my roommate about this case and she brought up the issue about abortion and how I felt about that. I guess I never really looked at the case in this manner. These situations can be looked at in the same sense. A doctor may have mixed feelings about abortions but decides to perform the procedure anyways. I believe that the doctor could refer Gregory to another doctor that could perform the procedure. There has to be another doctor that he can afford. The situation is very sticky and would be helpful is discussed with fellow colleagues in the practice.
I agree with you, that the doctor should keep his feelings out of the decision but if the doctor feels strongly enough about not doing it, then he shouldn't. Instead, he should refer Gregory to someone else.
To me, there are no ethical problems with Gregory's request. However, Dr. H is not obligated to perform the procedure himself if he can get another doctor to do it. If Dr. H does not want to do it himself, however, he is obligated to find another doctor willing to perform the procedure. It is optimal for the doctor to be comfortable with his assigned operations, but as a doctor he must respect his patient's personal decision. If Dr. H cannot find another doctor to perform Gregory's vasectomy, I believe Dr. H should accede to his request. The doctor should not pick and choose which operations to perform based on his personal opinions.
Andrew, I too feel that there is not an ethical issue regarding Greg's request. But because this is an elective procedure, Dr. H is not obligated to perform it or to find another doctor for this patient. If he has a good practice and has recommendations and resources then I agree he should share them, but he is not obligated to. What if this patient was married and the wife wanted children as but he wanted the vasectomy? Would you still accede with his request? I feel that in some cases the doctor should be able to back out based on their own morals and personal opinions.
I believe that Dr. H should perform the procedure but only if he can accept the patient's decision. The doctor should not feel regret for doing a procedure even though the patient wanted it. Therefore, I would recommend Dr. H referring Gregory X to a doctor that would be willing to do the procedure regardless of his or her opinions. As for Gregory, if he feels strongly about doing this then he should and if he happens to later regret it, at least it won't be anyone's fault but his own because doctors tried to talk him out of it.
Gregory X may have questionable reasons for wanting a vasectomy, however even if Dr. H will not perform the procedure that will not stop Gregory X from searching for a doctor that will perform the surgery and eventually succeeding. As previously mentioned, if Dr. H doesn't feel comfortable enough with Gregory X's reasoning to perform the procedure, then maybe he can refer Gregory to another doctor. I hate to be cheesy, but the whole saying that "there's someone out there for everyone" applies in this situation. I'm assuming that there is a partner for Gregory X who is either incapable of having children, or doesn't want to have children, just like Gregory. As long as his partner is aware of his decision, then there are alternate paths to take (i.e. adoption) if Gregory X and his future partner change their minds.
To me, this is a question of whether Dr. H sees Gregory X's motive as appropriate to receive this procedure. Even though Greg has thought about getting this done for years, his only real motive is that his future love won't have to worry about the "hassle" of contraceptives. For this reason, as well as the fact that Dr. H began to question Greg's decision and asked him to consider a future wife who would not have any say in his choice, I don't think that Dr. H should perform the procedure. I do agree that as an adult it is his decision to have this procedure done, but it is also Dr. H's choice to perform it on a patient that he feels might be making a bad decision. There are other doctors out there that would do as he wishes despite his situation, and if not, then he could budget more money to have the vasectomy done.
From the information we are given, it seems to me that Dr. H is a virtuous physician who does not want to do the surgery. Because of this, I do not think he should accede with the request simply because Gregory X cannot afford it elsewhere. However, I do think he should refer the patient to other doctors who will. I don't necessarily think that the patient shouldn't recieve the surgery, I just think that this doctor in particular doesn't have to perform the surgery if he feels strongly against it.
In terms of virtue, I think the only moral issue is possibly Gregory X's character. He does not seem to be virtuous because he is only thinking of himself in his current situation and not his future partners. However, i believe he should be able to make his own decision on whether or not to have the procedure done.
As a adult male at the age of 29, I do not have any biological children. I do however have a 9 year old step son, whom I adore. Being a parent has been rewarding and challenging at the same time. I find myself not wanting to go out as much and declining invites to parties and outings because he has a football game the next morning or has friends staying over, and I want to make them snacks as they play video games. Having said all of that, I think that despite the cost, the patient, Greg X and the doctor have much to discuss. I, for one, can attest to feeling a certain way about important life issues in my early 20's that if asked again today, I most certainly would feel different. At such a pivotal age, most are just figuring out what they want to do with there life and making such a huge decision will affect the patient. I am not aware of the risk of reversing the procedure but as a healthcare worker I would urge the patient to think long and hard. From my perspective, Dr. H wants to provide a service for his patient, despite how he may personally feel about the procedure. I think he should weigh the cost with the patient and base his decision on the mindset that the patient is in during the consultation. In doing so, a clear indication or judgment could be made as to the mental capacity and full understanding of the ramifications of such a procedure. Patients do have the right to change their mind but procedures such as they should be made with as much information as possible, not from the perspective of "flying by the seat of one's pants" From a moral stand point, the Dr. also should provide information that having said procedure will eliminate the chance of conceiving off spring but also potentially increase the chance of acquiring an STD, with the anticipated lack of use of contraceptives. All these calculated risk factors mitigate and elicit a wildly important decision, whose consequences would ultimately effect not only the patient, but also a woman he may encounter in his future whose wants children.
ReplyDeletePaul, I agree with you on the fact that when you are at a younger age your values change so the fact that the patient is 25 makes him on the younger side but our choices define us and if someone were to make this choice of a vasectomy at such a young age but later change their mind they will have to deal with that it will only be up to the individual who made that choice. I understand that you have found fatherhood an amazing experience (Sounds like and awesome family!) however, Gregory could feel the same way he does now at 25.
DeleteAnother thing to keep in mind is that some vasectomies today can be reversed. However, not all are reversable ad Gregory should be educated about this. So although he is 25 and wants one now, he could quite possible e able to go back and reverse his decison. Gregory needs ot be informed about this fact as well and understand that there is no garuntee that hs decision can be reversed is he wants it reversed in the future. i think patient education of all the options and the postivves and negatives of each option should be fully addressed before the procedure is done.
DeleteIf the doctor does not feel comfortable performing a procedure based on the fact that he does not agree with Gregory X decision because the doctor has a different value system that is not right. As a health care worker i cannot pass judgement on a patient for their choices or for other things like religion i still have an obligation to help them. Now in Gregory's case this is an elective procedure so the doctor does have the right to denis him of this procedure. Gregory will only have a moral problem when he receives the vasectomy if he lies to his partners about wanting children or lying to his future wife that he one day wants children when he cannot physically have them. If he is honest with his choice with his partners then he should not have a moral problem. We all make choices throughout our lives if Gregory decides to have a vasectomy at 25 and decides 5 years laters that he might want children he will have to deal with his choice. All our choices have some type of repercussions in this case his choice would effect his future child bearing. The doctor surely does need to give Gregory all the information possible to help him consider his decision more. If doctor H does not feel comfortable performing the surgery on Gregory then he should be denied a patient. If Gregory is serious about the vasectomy then he will find another doctor and another hospital that he can do the procedure for his price range. No healthcare worker should perform something major and life altering if they are not comfortable with it protects both the patient and healthcare worker.
ReplyDeleteI agree with what you said regarding Dr. H. I also like the fact that you pointed out that this was an entirely elective procedure, that's a fantastic observation. Gregory could also have a moral dilemma as soon as the procedure is over. After he gets the operation done, he has taken away his own ability to create life. For anyone who is Pro-Life, this definitely creates an issue of morality.
DeleteI think it is refreshing to see how all of our post have to do with patient education in some varying degree. In so many cases the patient or family are given information on such an advanced level that it at time must be hard to make tough decisions. I think fully explaining the patient what the risk are on both sides of the argument is essential.
DeleteI agree paul! It is awesome to see the power of education be used as a tool when deciding these tough situations. Many people often forget that once a patient is fully educated it will help them make a more accurate decision. With the hustle of hospitals there is little time for education which is so important and in many cases with proper education ethical problems can be solved easier.
DeleteHonesty is key here in this situation. If Gregory is honest with his future partner about his vasectomy then there shouldn't be a case of right or wrong. This is a choice that Gregory has decided to make. You stated something about making choices and regretting them later. While this is a big choice for Gregory, if he decides that he longer wants it later he has to live with that. This goes along with a lot of things in life.
DeleteI believe that Dr. H shouldn't perform the procedure on Gregory X. As a health care worker, I know that I will be faced with my ethical and moral decisions but I have a strong moral background and I am not willing to compromise my beliefs for a patient. With that being said, I believe that patients have the right to make their own decisions and I will not judge them for their decisions, even though I might not agree with them.
ReplyDeleteYes, there is something morally problematic about Gregory X wanting to get a vasectomy. Gregory is a young man, I believe that it is too early in his life for him to make that judgment to sterilize himself. Gregory isn't married yet, if Gregory proceeds with this vasectomy it isn't fair for his future wife who may want more children. I think Gregory should wait until to make this life altering decision.
I agree that Gregory should wait, but I also agree that he can choose whatever he feels. It's not necessarily a given, however, that Gregory will be getting married. He may not ever want to get married, we don't know. I do agree that it is morally unacceptable for Gregory to have this procedure done. There is no way for him to read his own future, so how does he know that this is the best choice for himself at this juncture in his life. His life (statistically speaking) isn't even halfway over! But regarding Dr. H, I think that he shouldn't interject his own beliefs in this particular case. Even if he doesn't agree with the decision by the patient, he should operate (as long as it isn't too outlandish).
DeleteI agree that Gregory is at a very young age to be making such a life changing decision. However, Gregory has made his decision and I don't think that Dr. H can't allow his moral beliefs to get in the way of a procedure that Gregory wants done. Dr. H may not agree with it, but I don't think there is any way that he could say no. In my eyes there is no moral or ethical issues legally, even though I may have a problem with it.
DeleteLauren,
DeleteI completely agree with you. The docotr is not obligated to preform the procedure for Gregory. Dr. H should not have to sacrifice his moral beliefs to serve the patient. The doctor can still respect the patien's wishes but tell the patient that he does not feel comfortable with doing the procedure and will refer him to another docotr in the same hispital that can do the procedure for him. This happens all the time at obstetric clinics with abortions. Some doctor do not believe abortion is morally righ so they will not do the abortion, but will tell the patient to find another docotr or refer them to another doctor who will do the abortion.
Lauren,
DeleteThe fact that you have a very strong belief in your morals is awesome. However, being in the healthcare profession is all about compromise for patients. Using the example that Dr. Kate described in class where you're an EMT and are responding to a hostage situation where one of the kidnappers has been wounded and needs immediate attention. MY morals would say "no, don't help him/her because they're the reason this whole thing happened, they deserve whatever happens to them." But as an EMT, your whole job is to save lives no matter what. Sometimes you can't just shove the problem off on someone else.
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DeleteMichaela,
DeleteWith the situation you have presented I feel you are obligated to give "immediate attention" to the kidnapper and you're right, "Sometimes you can't just shove the problem off on someone else". But in Gregory's case, because this is an elective procedure, this is the other half of the sometimes, where you can shove the "problem" onto someone else. If Dr. H feels that Gregory is not taking the right factors into consideration for his future, then he has the choice to not perform the procedure
We must act as patient advocates therefore in this particular case I find the argument of its not fair to the future wife invalid. Because now we are discussing the in and outs of their relationship which is completely and medically unrelated to this particular case. There are a lot of what if's. Why do people act as if the young cannot make well informed decisions? Sometimes that line "the older the wiser" is not always the case. Also if the argument is rooted in a religious angle related to contraceptives then you better also disagree with the use of condoms because although it is not a procedure it is the same thing in the eyes of the church.
DeleteI think that Dr. H should operate. As long as Dr. H has properly informed Gregory of all possible consequences and outcomes, then he has done the best he can to dissuade Gregory, personal opinion aside. If Gregory still wants the procedure, then Dr. H's duty is to perform the surgery (barring outlandish requests). Even if Dr. H doesn't agree with this patient's decision, he should proceed with the procedure since that is what Gregory truly wants. Gregory has the power to decide what's best for himself and live his life the way that he wants.
ReplyDeleteSpeaking morally, however, Gregory's request is problematic for me. I personally believe that Gregory should wait until he knows whether or not he's going to meet the love of his life. There is no way for him to know; he has no crystal ball. Gregory can choose to abstain rather than take his own ability to procreate away from himself. Abstaining from anything sexual will ensure that he does not have a child just as well as having a vasectomy. So, taking this into consideration, yes, I do think that Gregory is making a brash decision that should definitely be re-contemplated, morally speaking that is.
I agree that before Dr. H should operate he much completely inform Gregory of the precautions and side effects that could affect him as well. I agree that Dr. H may not agree with the decision or with the surgery, but he must follow through with the requests of his patients.
DeleteI believe that the docotr must follow the request. No health care professional is required to follow the requests of the patient. The health care professional is not the slave to the patient's request. A doctor, or anyone fro that matter, should not have to sacrafice theri moral beliefs and at the expense of just doing whatever the patient wants them to do. It is necessay for the doctor to respect the patient's wishes and not judge him, but the docotr can choose to not preform the procedure. However, other avenues should be taken by the doctor to help the patient. The docotr can refer the patient to another docotr in the same hospital that will be comfortabl preforming the surgery. This is a great option to help both parties involved in this situation; the dotor does not have to sacrafice his morals and the patientcan still get his procedure done.
DeleteDr. H should perform the procedure but because he does not feel comfortable with the situation he should not perform the procedure. If i went into an elective procedure and the doctors was not confident in what he/she were doing i would not want them to operate on me. Yes, Dr. H reason might be personal and as healthcare providers we are taught not to pass judgements upon our patients and he is wrong for doing this but since he does not have 100% confidence for the procedure he should not do it.
DeleteI would have to agree. If Dr. H has properly educated Gregory X, then he is capable of deciding how to live his life, whether that means changing his mind or following through with the procedure. I also like the whole "abstaining" argument that you made. I didn't consider that.
DeleteI believe the doctor should allow Gregory X to have his wishes fulfilled. When forming my opinion I thought of many different components. I thought of his future spouses, his family, and his friends. In many situations I am sure that his parents, friends, and other family would want him to have children. His parents would want grandchildren. Another component that I think about is, is Greg old enough to make this decision and would him finding a soul mate change his decision in the future. After considering all of these components, I came to the conclusion that in the end it is Gregory X's decision no matter what. He is a 25 year old man that it perfectly capable to make his own decisions. At this point in life he is an unmarried man and has every right to make his own decision. He doesn't have to consider the decision or opinion of a significant other. I believe the only time he would be running into morality issues is if he lied to a future spouse about having children. If he never mentioned that he had a vasectomy then that would be running into morality issues.
ReplyDeleteKrista,
DeleteCorrect, he is 25 and able to make his own decisions. There could be plenty of women who do not want to have children that Gregory could find in the future if he were to ever want to settle down and get married. Some women might like the fact that they do not have to worry about another form of contraceptives in their relationship, though Gregory needs to make sure to tell his partners about his previous procedure.
Krista, I agree with you in saying that Gregory is an adult and is able to make decisions on his own. This is something that we have a problem with realizing in the real world. If we don't agree with something we want the rest of the world to agree with us. Sometimes we need to take a step back and just let people make decisions on their own.
DeleteI think that the Doctor should respect Gregory's decision. The procedure is totally elective, and it is Gregory's right to decide whether or not he wants the surgery. Also in presetnday, sometimes vasectomies can be reversed.
ReplyDeleteAlso, as a health care professional, Dr. H should not pass judgement on Gregory's chouce. However, with that being said, the doctor does have th right to inform Gregory on all the possible complications of the surgery. I think that it is the Dr.'s responsibiltiy to full educate about the procedure.
With that being said, i do not think that Dr. H has to preform the procedure. The task can be passed off to a docotr who feels comfortable with preforming the procedure. The hospital is not a tiny clinic. The case said tat it is a "large city hospital". This implies that there are other docotrs who could preform the procedure. This kind of situation occurs more often than people think. In states where abortion and physician assisted suicide are legal, all doctors do not have to preform these procedures. If someone does not beieve in what the patietn is doing or does not feel cmfortable doing the procedure, they can still respect the patient's decision and refer them to another doctor in the hospical who will do the desroed procedure.
I think the only time there could be a moral problem about Gregory's requeset is if he lies to a furture partner about getting a vasectomy. In addition, a moral problem could arise if the doctor just flat refused Gregory and did not refer him to another doctor in th hospital that can do the procedure for hm. While the doctor does not have to do the surgery, they cannot outright refuse the patient an elective surgery. The patient's wishes still need to be respected and the doctor should ever insert or push his own opinion on the patient.
Tonya,
DeleteI would have to agree with you. The doctor should set his own beliefs aside, but he does have the right to refer Gregory to another physician that feels more comfortable. One of the most difficult things that are faced in the medical field is that of trying not to push ones own beliefs while also trying to help them.
I agree with with you on passing the procedure to another doctor that is comfortable with performing the procedure. Like you said, it states that it is a "large city hospital" and there are probably plenty of other doctors that would be more comfortable with the procedure. I also agree with you on the moral problem if the doctor denies to perform the procedure and doesn't refer him to another doctor. Also that a doctor or other health care provider should never push their own opinion on a patient because they disagree with what they are doing.
DeleteI agree with with you on passing the procedure to another doctor that is comfortable with performing the procedure. Like you said, it states that it is a "large city hospital" and there are probably plenty of other doctors that would be more comfortable with the procedure. I also agree with you on the moral problem if the doctor denies to perform the procedure and doesn't refer him to another doctor. Also that a doctor or other health care provider should never push their own opinion on a patient because they disagree with what they are doing.
DeleteTonya,
ReplyDeleteI agree that the doctor should refer the patient to someone else who feels more comfortable to perform the procedure. The issue of lying to a potential future partner is were I think I huge moral concern can arise. The doctors personal feeling should be set aside in order to provide for our patients. I will, however, say that can be more challenging at certain times, but still remains a responsibility of any health care worker.
I believe the doctor should follow Gregory X's request to perform the surgery. As a health care worker, it is Dr.H's responsibility to set his own beliefs and thoughts aside. If the patients request is within your range of practice it is your job to complete the request, though it is also Dr.H's responsibility to inform his patient on all of the consequences and advantages of a procedure of this extent.
ReplyDeleteAfter the surgery is performed, the aftermath would fall into the lap of the patient and he would have to live with his decision.
Their would be nothing wrong with Gregory X's decision morally as long as he informs future partners and his future wife if he were to ever get married that he had a vasectomy and will not be able to have children.
I also agree with you on after the surgery is performed, the aftermath falls on the lap of the patient. If he were to get a vasectomy that could be reversed and he tries, but it doesn't work then it is on him. Not every surgery can have a guarantee and he will have to live with it, if the reverse procedure does not work. I also agree that nothing is morally wrong with Gregory's decision as long as he doesn't withhold, or lie about, the information about his procedure from future partners/wife.
DeleteI also agree with you on after the surgery is performed, the aftermath falls on the lap of the patient. If he were to get a vasectomy that could be reversed and he tries, but it doesn't work then it is on him. Not every surgery can have a guarantee and he will have to live with it, if the reverse procedure does not work. I also agree that nothing is morally wrong with Gregory's decision as long as he doesn't withhold, or lie about, the information about his procedure from future partners/wife.
DeleteAmanda,
DeleteThe only struggle I have with your perspective is the idea that the doctor should perform the surgery despite his beliefs. Because this is all about morals, in my opinion, I just don't believe that it is morally acceptable to make a doctor put aside his own beliefs because it is his duty to perform such a surgery. However, I strongly agree with you that it is Dr. H's responsibility to inform the patient of possible consequences.
Similar to my comment regarding the discussion about terminally ill children, I ask you: Some of you are saying that a young adult shouldn't be allowed to make decisions that potentially impact the rest of his/her life. But what about having unprotected sex or join ing the military? Young adults do that all the time, and they have potentially big consequences for one's future.
ReplyDeleteI believe that Dr. H shouldn't perform the surgery. As a health care worker I know there will be times I will feel uncomfortable and not agree with what the patient is choosing to do. If it is truly what they want after being educated fully about the procedure then they should be allowed to do what they want with someone comfortable performing the procedure. Dr. H can educate Gregory X on all of the consequences of his procedure and if Gregory still wants to continue then refer him to another doctor in the same practice that is comfortable performing the surgery.
ReplyDeleteI believe there is nothing morally wrong with Gregory's decision as long as he tells any future partners about his surgery. There are some major complications that can occur if he doesn't inform them about the surgery and the future wife/partner wants to have children.
I believe that Dr. H shouldn't perform the surgery. As a health care worker I know there will be times I will feel uncomfortable and not agree with what the patient is choosing to do. If it is truly what they want after being educated fully about the procedure then they should be allowed to do what they want with someone comfortable performing the procedure. Dr. H can educate Gregory X on all of the consequences of his procedure and if Gregory still wants to continue then refer him to another doctor in the same practice that is comfortable performing the surgery.
ReplyDeleteI believe there is nothing morally wrong with Gregory's decision as long as he tells any future partners about his surgery. There are some major complications that can occur if he doesn't inform them about the surgery and the future wife/partner wants to have children.
Morgan,
DeleteI like how you added your own perspective and put yourself in the doctors shoes. I definitely agree that I would not want to go along with something that I am uncomfortable with simply because it is my job. I think some doctors would no longer enjoy their jobs if they were required to go along with things they didn't agree with and that could lead to so many more issues.
I actually picked this case to write my paper about. I went back and forth on my opinion on this case as I was writing it. I always felt that as a health care professional you had to learn how to keep feelings about certain situations out of decisions that are being made. I was speaking with my roommate about this case and she brought up the issue about abortion and how I felt about that. I guess I never really looked at the case in this manner. These situations can be looked at in the same sense. A doctor may have mixed feelings about abortions but decides to perform the procedure anyways. I believe that the doctor could refer Gregory to another doctor that could perform the procedure. There has to be another doctor that he can afford. The situation is very sticky and would be helpful is discussed with fellow colleagues in the practice.
ReplyDeleteI agree with you, that the doctor should keep his feelings out of the decision but if the doctor feels strongly enough about not doing it, then he shouldn't. Instead, he should refer Gregory to someone else.
DeleteTo me, there are no ethical problems with Gregory's request. However, Dr. H is not obligated to perform the procedure himself if he can get another doctor to do it. If Dr. H does not want to do it himself, however, he is obligated to find another doctor willing to perform the procedure. It is optimal for the doctor to be comfortable with his assigned operations, but as a doctor he must respect his patient's personal decision. If Dr. H cannot find another doctor to perform Gregory's vasectomy, I believe Dr. H should accede to his request. The doctor should not pick and choose which operations to perform based on his personal opinions.
ReplyDeleteAndrew,
DeleteI too feel that there is not an ethical issue regarding Greg's request. But because this is an elective procedure, Dr. H is not obligated to perform it or to find another doctor for this patient. If he has a good practice and has recommendations and resources then I agree he should share them, but he is not obligated to. What if this patient was married and the wife wanted children as but he wanted the vasectomy? Would you still accede with his request? I feel that in some cases the doctor should be able to back out based on their own morals and personal opinions.
I believe that Dr. H should perform the procedure but only if he can accept the patient's decision. The doctor should not feel regret for doing a procedure even though the patient wanted it. Therefore, I would recommend Dr. H referring Gregory X to a doctor that would be willing to do the procedure regardless of his or her opinions. As for Gregory, if he feels strongly about doing this then he should and if he happens to later regret it, at least it won't be anyone's fault but his own because doctors tried to talk him out of it.
ReplyDeleteGregory X may have questionable reasons for wanting a vasectomy, however even if Dr. H will not perform the procedure that will not stop Gregory X from searching for a doctor that will perform the surgery and eventually succeeding. As previously mentioned, if Dr. H doesn't feel comfortable enough with Gregory X's reasoning to perform the procedure, then maybe he can refer Gregory to another doctor.
ReplyDeleteI hate to be cheesy, but the whole saying that "there's someone out there for everyone" applies in this situation. I'm assuming that there is a partner for Gregory X who is either incapable of having children, or doesn't want to have children, just like Gregory. As long as his partner is aware of his decision, then there are alternate paths to take (i.e. adoption) if Gregory X and his future partner change their minds.
To me, this is a question of whether Dr. H sees Gregory X's motive as appropriate to receive this procedure. Even though Greg has thought about getting this done for years, his only real motive is that his future love won't have to worry about the "hassle" of contraceptives. For this reason, as well as the fact that Dr. H began to question Greg's decision and asked him to consider a future wife who would not have any say in his choice, I don't think that Dr. H should perform the procedure. I do agree that as an adult it is his decision to have this procedure done, but it is also Dr. H's choice to perform it on a patient that he feels might be making a bad decision. There are other doctors out there that would do as he wishes despite his situation, and if not, then he could budget more money to have the vasectomy done.
ReplyDeleteFrom the information we are given, it seems to me that Dr. H is a virtuous physician who does not want to do the surgery. Because of this, I do not think he should accede with the request simply because Gregory X cannot afford it elsewhere. However, I do think he should refer the patient to other doctors who will. I don't necessarily think that the patient shouldn't recieve the surgery, I just think that this doctor in particular doesn't have to perform the surgery if he feels strongly against it.
ReplyDeleteIn terms of virtue, I think the only moral issue is possibly Gregory X's character. He does not seem to be virtuous because he is only thinking of himself in his current situation and not his future partners. However, i believe he should be able to make his own decision on whether or not to have the procedure done.