Kliti Shentolli
Biomedical Ethics
9/30/2018
Moral argument essay #1
In the case of Mr. S, the 43 year old patient who’s requesting a prescription of Viagra during his annual wellness visit, I will be opposing the idea of the attending physician to fulfill Mr.S request. More specifically, this argument will focus on the autonomy as effective deliberation and autonomy as authenticity while supported even further by short vs. long term beneficence and beneficence as a primary duty of a medical practitioner.
According to “Concepts and Cases in Nursing Ethics”, beneficence is defined as promoting a person’s welfare by preventing or removing harm[1]. Promoting a patient’s welfare does not include just the solution to their evident problem but also takes into consideration any underlying issue(s) as well. At first glance, prescribing low- risk medication like Viagra seems to be the appropriate solution for Mr.S, as it resolves his evident issue of poor sexual performance, while respecting his beneficence and promoting both physical and mental boost. However, for about a year, Mr.S has been on low-dose SSRI medication to treat his mild depression that could potentially be associated with sexual dysfunction as a side effect as stated by the attending physician. Being aware of this information, it raises concerns for a more serious underlying issue. Although the patient himself denies any incidents of sexual dysfunction, the fact that he feels uncomfortable when asked more detailed questions and a sudden request for Viagra should at least raise some concerns. Prescribing Viagra will just “sweep under the carpet” the potential risk of suffering from sexual dysfunction and provide only short-term beneficence. As medical practitioners, it is our primary duty to provide beneficence and best possible care for our patients. Both the attending physician and myself suspect that his poor sexual performance may be linked with the side effects of the SSRI drug that Mr.S has been taking. Prescribing him Viagra just to not waste clinical time is in violation with beneficence, instead we should spend more time with Mr.S and investigate further for any potential side effects of the SSRI drug that might have on Mr.S. In this case, prescribing Viagra to Mr.S shows the attending physician and myself are not performing at the full capacity of our abilities but only providing a short-term solution to a problem which could potentially can cause more harm in the future rather than beneficence.
According to “Concept and Cases in Nursing Cases”, autonomy is defined as the right of a person to make personal decisions without outside influences[2]. It’s Mr.S’ autonomous decision to request and use Viagra, however that autonomy can be questioned when approached from the effective deliberation prospective. I believe Mr.S is confused on how to accomplish his end goal which has led him to make false assumptions due to lack of information. His current thought of process might’ve been influenced by multiple factors such as; his friend at the gym, the social norms of “feeling less of a man” because of his poor sexual performance, and on top of it, his mild depression might’ve also amplified all of these factors leading him to think Viagra will be the solution. Mr.S has a good physical examination, he’s well nourished and has a fitness routing which means he’s active. Given all these factors, it could potentially mean that his poor sexual performance is probably due to the side effects of the SSRI drug. However, with lack of information and outside influences, Mr.S has false reasoning based on false premises and therefore not able to make a appropriate autonomous decision. Exploring autonomy as authenticity is one more reason Mr.S shouldn’t be given Viagra. The decision of Mr.S requesting Viagra is not consistent with his previous visit. Over the year, Mr.s has been in a good health, reports no changes in his sexual health and that’s also clinically backed up during the visit. The sudden request of Viagra shows this is out of his character and something more important may be going on. Before prescribing, we need to make sure he understands the potential underlying issues that may be going on.
After the principles of autonomy and beneficence were applied in the case of Mr.S, we can conclude that it’s unethical to prescribe Viagra to him.
Reference:
[1] Yeo, Michael et al. (2010). Beneficence. In M Yeo et al. (eds.). Concepts and Cases in Nursing Ethics. [3rd edition] Ontario: Broadview Press, pp. 103-116.
[2] Yeo, M et al. (2010). Autonomy. In M Yeo et al. (eds.). Concepts and Cases in Nursing Ethics. [3rd edition] Ontario: Broadview Press, pp. 91-97, 103-109.
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