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John Hardwig - What about family.docx

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University of Toronto Scarborough
Kelin Emmett

John Hardwig: WhatAbout the Family? • Hardwig talks about how family member’s interest should be taken into a consideration and sometimes override the interest of the patient. He believes it is sometimes the moral thing to do for a physician to sacrifice the interest of their patient to those of non-patients, such as to those of the other members of the patients family • Family according to hardwig doesn’t necessarily mean immediate family members. It also includes people who are close to the patient • To be part of a family is to be morally required to make decisions on the basis of thinking about what is best for all concerned, not simply what is best for yourself (referring to patient) • Only when the lives of family members will not be importantly affected can one rightly make exclusively or even predominantly self-regarding decisions • Patients too have moral obligations, obligations to try to protect the lives of their families from destruction resulting from their illness • It is an oversimplification to say of a patient who is part of a family that “it’s his life” or “after all, it’s his medical treatment”, as if his life and his treatment could be successfully isolated from the lives of the other members of his family. It is more accurate to say “it’s their lives” or “after all, they’re all going to have to live with his treatments” • The way we analyze medical treatment decisions by or for patients is plainly abnormal to the way we think about other important decisions family members make  In terms of the dynamics of the family, the patient is not always the weakest member, the member most in need of protection  Instead of designing policies that would increasingly shelter family members from the adverse impact of serious and prolonged illnesses, we are sill attempting to shift the burden of care to family members in our efforts to contain medical costs  It’s important to recognize that the lives of family members could not be sheltered from all the important results of medical treatment decisions by an set of public policies  The emotional inability or principal refusal to separate ourselves and our lives from the lives of the ill or dying members of our families is not an unfortunate fact about the structure of our emotions. Therefore it becomes important to take into considerations the inputs of family members • Loyalty to the interest of the patient has been a cornerstone of both traditional codes and contemporary theories of medical ethics. There are to competing paradigms:  Benevolence model  Patient autonomy model • The medical and non-medical interest of both the patient and other members of the patient’s family are to be considered. The interests of patients and family members are morally to be weighed equally; medical and non-medical interest of the same magnitude deserve equal consideration in making treatment decisions • The patients interest may often outweigh the conflicting interest of others in treatment decision is no justification for failing to recognize that an attempt to balance or harmonize d
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