Question

James, age 14, is afflicted with a cleft lip and palate and needs a common operation that promises to improve both his appearance and his speech significantly. Due to his appearance, James has had tremendous difficulty finding acceptance among his peers and has few friends. The boy’s father, a believer in mental healing, refuses to permit the operation or even discuss it with the physician. The physician explains the operation to James, who expresses a desire to try harder to close the cleft palate “through natural forces.”

Question 1: What ethical principles related to autonomy, informed consent, beneficence, or nonmaleficence lend support to James’s refusal of surgery? What ethical principles override James’s refusal of surgery? Is James competent to consent for or refuse treatment?

Question 2: Based on your above analysis, must the physician respect their refusal of the surgery? If not, what ethically appropriate options are available to the physician?

Answer 1

Q1: Ethical principle of Autonomy respect patients and provide the opportunity for the patient to have decsions for their consent. providing choice to accept their wish to respect patient decsions. it supports James' refusal of surgery for their choice. Beneficence override James refusal of surgery to act as the best advocate for the patient that may conflict with Autonomy. Patient father has a strong desire to refuse the treatment.
Q2, As a physician they should act best for the patient. providing Autonomy as a basic ethical principle that physician has to follow but the same time doing best for the patient as a responsibility they have to be an advocate for the patient. when patient lack and their parents lack with decision making power someone should be as a surrogate decsion making. surrogate decision maker appointed by the patient or court-ordered guardian with the best interest to patient can make decision for behalf of the patient.