Question

Quality of Life What do we mean by quality of life? Who should be able to define the quality of life when making an ethical decision? What is your personal definition of quality of life and how might that affect your decision-making on behalf of patients?

Answer 1

Quality of life: The patient's ability to enjoy normal life activities. Quality of life is an important consideration in medical care. Some medical treatments can seriously impair quality of life without providing appreciable benefit, whereas others greatly enhance quality of life.

Doctors should be able to define the quality of life when making an ethical decision .Being an ethical physician is more important than making money or seeing as many patients as possible.

No single ethical principle predominates in this discussion of quality of life. Both principles that we have discussed in the prior topics, namely, Beneficence and Respect for Autonomy, are relevant to this topic. However, we may select one particular aspect of the Principle of Beneficence as most relevant to this discussion about Quality of Life. In Chapter One, we limited the very broad idea of Beneficence to one of its implications, namely, as a moral principle that directs persons to help others in need. In medicine that need arises from deficits in health, and the actions are those that correct those deficits and support the patient. In this topic, we focus on another aspect of the Principle of Beneficence, namely, acting in ways that bring satisfaction to other persons. Many moral philosophers have taken satisfaction or happiness as a significant element of beneficence. We propose that it is particularly relevant to clinical decisions. One significant feature of all medical interventions is the aim to produce a state of satisfaction for the patient who has sought treatment. He or she is not only made well, but feels well. Quality of life, then, refers to that degree of satisfaction that people experience and value about their lives as a whole, and in its particular aspects, such as physical health. The ethical dimensions of any case in clinical medicine must include not only appropriateness of interventions (Beneficence as Help) and respect for the patient's preferences (Autonomy), but also the improvement of quality of life (Beneficence as Satisfaction). When medical care fails to do so, ethical problems will arise, as this topic will demonstrate.

A principle of ethical decision making is that of Fidelity. Fidelity addresses a person's responsibility to be loyal and truthful in their relationships with others. It also includes promise keeping, fulfilling commitments, and trustworthiness . In healthcare, however, the implementation of this principle extends beyond the regular responsibilities of business or contractual fulfillment to the creation of relationship based upon trust: the trust the patient has that the professional will always operate in the patient's best interests and will always fulfill their professional obligations to operate in his or her best interests. Some authors have taken the position that fidelity, along with non maleficence, are the most legally salient moral principles (Bersoff and Koeppl 1993).

As applied to psychotherapy, fidelity forces the professional to orient toward the patient's needs and not his or her own. Thus, the therapist who allows a sexual relationship to develop in treatment would be violating this principle. Clearly such a relationship is designed to meet the therapist's needs and becomes exploitive. This principle also applies to patient abandonment since such conduct would violate the trust the patient places in the psychotherapist, trust that the therapist will see the patient through the treatment process. Finally, fidelity also applies to circumstances where professionals allow administrative factors, like benefits limitations, fee capitation, and contractual rebates to affect their treatment decisions.

Fidelity, as applied to healthcare, is a dynamic process: and the way in which a therapist maintains fidelity in treatment changes as treatment changes. Fidelity also blends with the other principles of ethical decision-making to require that the therapist be open and honest in the treatment relationship and to make sure that the patient's expectations are consistent with what the therapist can provide. Fidelity requires psychotherapists to make the best choices they can for those that they treat.

In my view, Quality of life is that all peoples must acquire all sorts of essential needs in a way which is given by all healthcare workers for the well being of the people.To me if all the healthcare workers does their job with perfection simultaneously there will be a upgrad of people`s health in their countries.