Taking Care of a Non-Compliant Patient.
Based on the ethical principle beneficence which means “to do what is good” I would not stop taking care of Mr. C despite his non compliance behavior and his angry feelings.
Since my primary duty is to provide helpful treatment to the patient rather than to inflict more suffering upon the patient based on Least Harm principle, I would work out a plan to deal with Mr. C’s non compliance and smoking.
The principle Respect for Autonomy states that people should be allowed to reign over themselves and to be able to make decisions that apply to their lives. This means that Mr. C should have control over his life as much as possible because he is the only person who completely understands his chosen type of lifestyle.
The ethical dilemma that comes up as I think of this scenario is that the patient prefers not to take medication. I may convince the patient and Home Care Agency to make the patient continue taking his medication because it will improve the symptoms. In this situation, I will deny the patient’s autonomy and ability to choose her treatment. However, it leads to an increased amount of beneficence.
In contrast, in the libertarian view, I can prioritize the patient’s wishes over the best interests. This means that the patient has control over his life availing the greatest amount of personal beneficence. Although this viewpoint is more mindful of the patient’s desires, it does not prevent the patient from making decisions that may be more harmful than beneficial.
My plan would involve enquiring from Mr. C in a problem-solving manner and nonjudgmental manner the reason for non-compliance. I would ensure that Mr. C and I have a common understanding of the medical condition he has, of the availability of effective treatments for this problem, and of the risks if the problem remains untreated or undertreated. I would then develop a shared understanding that Non-Compliance is a mutual problem whose solution is vital to effective treatment and finally build a more effective therapeutic alliance with the patient.
McDonald H.P. (2002) Interventions to enhance patient adherence to medication prescriptions: scientific review. Humana press. Totowa
Berlant J. (1975). Profession and Monopoly: A study of Medicine in the United States and Great Britain. University of California Press. California