Kliti Shentolli

12/8/18

Ethics- Reflective Essay

After taking a semester of Ethics at York College, I believe I’m now able to draft an ethical framework that can guide me during the first few years as a future Physician Assistant. Aspiring to soon become a surgical PA, I believe autonomy and informed consent will be the two main ethical principles that I can use to justify my future ethical decisions.

As a child, I was always impressed and fascinated how doctors knew exactly what was wrong with a patient and how to make their sufferings go away. I’ve always wanted to acquire such knowledge and be able to someday use it to help my family and those in need. I first heard of the Physician Assistant profession during my freshman year of college. During that time, I knew I wanted to become a middle/high-level medical practitioner but was not ready to commit to 4 years of medical school and 2 years of residency after college. When I started looking more into the PA profession, the idea of going to school for 2 years and half and being able to not only practice as a mid-level practitioner but also have the ability to switch specialties with ease, intrigued me.

After completing the PA program, I anticipate working as a surgical PA in the neurosurgery department. This preference came after I shadowed a surgical PA at Lenox Hill hospital for 8 months. The technology and science behind the process of literally getting into a patient’s head and able to identify and remove various size tumors, fascinated me. The medical knowledge required and the precision needed to perform a successful brain operation are what I hope to achieve in a near future through continuous studying and experience. With that being said, I also do not shy away from patient interaction and patient interviewing. I feel confident and comfortable enough to interact with patients and I do enjoy the process of eliciting important information about their medical condition so I can assist them better, however becoming a surgical PA is my end goal. Two ethical principles that I believe will play the strongest role during my time as a surgical PA are autonomy and informed consent. According to “Concept and Cases in Nursing Cases”, autonomy is defined as the right a person has to make independent decisions concerning themselves and their wellbeing. Autonomy is divided in four main categories: free action (ability for a person to do as they please), effective deliberation (ability for a person to make rational decisions with no lack/false of information), authenticity (making decisions that are consistent with previous past decisions/behavior) and moral reflection (same as authenticity but also take into account how those decisions can affect their loved ones). According to “Patient-Centered Informed Consent in Surgical Practice”, informed consent is defined as the process where patients are given full, detailed information concerning their health and the ability for that patient to comprehend such information and make an appropriate decision.

Before a patient makes any autonomous decision, they need to properly be informed, especially before a surgical or any other invasive procedures. By properly explaining the patient the detailed surgical procedure and making sure they fully understand such procedure, not only you ensure them safety, but also ensure them respect during the procedure. Going through the process of informed consent with the patient, acknowledges the fact that you, as a surgical medical practitioner, respect that patient as an autonomous person with dignity and basic human rights. Informed consent of a patient is also important when it comes to legal requirements before a surgical procedure. Medical practitioners are required to have legal documentations with the patient’s signature on them, as proof to show that the patient fully understood the surgical procedure and is aware of potential benefits and/or harms. By making an informed consent decision, the patient is also exercising his/her autonomy at the same time. Most specifically, they are using their autonomy as effective deliberation and free action. Being able to understand and comprehend the presented information and make an independent decision afterwards, shows that you have full decision-making capacity and your autonomous decision should be respected. Just like informed consent, not respecting or violating the autonomous decision of a patient who is fully capable in doing so, can have legal consequences to it. Especially in surgeries, where the procedures are more invasive therefore exposing patients to more risks, autonomy of a patient is absolutely needed and needs to be well documented as well. Working in a surgical department, is as close as I will ever get to a patient, literally, so I think its extremely important for my future patients to be fully informed and aware about the procedures and use that information, to make an independent autonomous decision.

Working as a surgical PA, autonomy and informed consent are the two main ethical principles that I can use to build an ethical framework and rely for future guidance.

Reference:

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.

Bernat, JL, Peterson, LM (2006). Patient-centered informed consent in surgical practice. Archives of Surgery, 14(1), 86-92.

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