Introduction
The values and customs of a person, as well as, a group are studied by a major branch of philosophy, which is known as Ethics. The concepts such as good and evil, right and wrong, and various other concepts are employed and analyzed by this philosophical branch. Three primary areas have been comprised by the Ethics. The concept of ethics is studied in Meta-Ethics, while the determination of the ethical values and their methods are studied in Normative Ethics, and lastly, the implementation of these ethical values and their methods are studied in the branch of Applied Ethics. (Gregory, pp. 20-26, 2003).
The concept of ethics
For many decades, Ethics has been defined in the most common way of distinguishing right and wrong. Several rules, such as the Golden Rule, the Ten Commandments, etc. have been created for the determination of ethical and moral values by philosophers and experts. In this way, acceptable and unacceptable behavior is analyzed, determined, distinguished, and studied by the norms of conduct that are the foundations of Ethics. (Thompson, pp. 54-59, 2001) In this regard, it would be better to say that some common ethical norms and values are recognized by almost all people. However, analysis, interpretation, and application of these ethical rules are done by different individuals based on their different perspectives, as well as, according to their different and contrasting experiences of life. (Erwin, pp. 30-33, 1994).
In this regard, ethics can be defined, determined, analyzed, and discussed in various perspectives based on the culture and practice of different societies. For example, a method and perspective that is used for the analysis and decision-making of complex and difficult issues by a medical ethicist can be defined as Ethics. Because, in medicine, ethical standards are studied by medical ethicists, and therefore, they must implement these standards in their daily practice, which becomes unethical, if not implemented properly and by ethical means. (Thompson, pp. 81-88, 2001).
An important practice issue has been emerged worldwide regarding the consent and the presence of families of patients before, as well as, during the medical process. This has sparked a considerable controversy regarding its acceptance in the medical society, as there are various pros and cons of the informed consent of families related to the medical practices around the world. In this regard, experts and doctors are trying to come to a decision, which may be beneficial to the patients, their families, and the medical society. However, a change has been observed in the attitude of early advocates by the researchers, regarding the allowance of families to be informed, as well as, present near the patients at the time of their revival. Little or no scientific research in the earlier days can be one of the reasons and causes that used to gain the resistance from the former advocates. (Gregory, pp. 98-102, 2003).
The lived experience of family members
In the past fifteen years, the conduction of several studies, surveys, and scientific research related to ethics has been taking place, to provide more scientific research results for the families, doctors, and nurses, who are associated with the process of clinical practice. Especially, descriptive surveys have played a vital role in supporting the ideas of informed consent during the treatments of the patients. The lived experience of family members, who were informed before the treatment has also been explored by the qualitative researchers. We will also try to review the literature, to comprehend and discuss some of the main pros and cons that are associated with informed consent concerning clinical practices.
In this regard, family members were also keenly observed who went through a mental trauma due to the loss of one of their family members during the clinical process without their informed permission. During the study, it was found that eighty percent of the sample family members would have preferred to be informed about the treatment if they would have been given that chance. (Erwin, pp. 48-53, 1994).
In other studies, the family members who were informed before the resuscitation of one of their family members showed their hundred percent preferences over acquiring their consent in future cases also. Family members were seen asserting emphatically on getting their right to participate in the process. It was observed that both patients and their family members found the permission of family during the medications helpful and important for them.
An advantage of informing the family members during the medications is that they come to know that every single thing and step had been taken to save their family members, and the seriousness of the condition of the patient is understood by them during their presence. Hence, grieving is eased by their consent and it has been observed that family members feel satisfied and sometimes, even happy that they were present with their family member at his/her last moments.
Interestingly, family members who were informed about the treatment were found to be having no traumatic memories, as compared to the family members who were not informed at the time of resuscitation after passing at least two months from the event. In another retrospective survey, it was observed from the survey results that acquiring permission for the treatment would have been appreciated by most of the bereaved family members, even if they had not accepted the proposal at that time. (Veatch, pp. 50-51, 1997).
A non-traumatic code of adult
In another descriptive survey, two or more symptoms of acute stress were reported by almost a quarter of the staff after a non-traumatic code of adult. However, no difference was found between the codes with the informed consent of family members, and without their consent during the medication process. Another reason for this stress that generates in the hospital staff members is that there is a chance of fear in the public as they are generally not aware of equipment and procedures that a patient goes through during the clinical process. As a result, psychological trauma can be lead to the family members of the patients due to the informed consent of medical procedures and various other painful techniques.
Another disadvantage of acquiring the consent of family members is that family members may feel offended by the aggressive behavior of the staff members during their different performances of the code. However, any litigation has not been indicated by any evidence so far that would have arisen from the informed consent of the family members. In this regard, different choices have been given to the staff members, family members, and patients regarding the permission of family members to perform the treatment process. From the abovementioned facts, it has been observed that positive effects have been noticed from the abundant literature that is available for the research and analysis for the experts.
To identify the ethical points of view, staff responses and their views were examined during the study, which came out to be beyond the researcher’s perspectives. Healthcare professionals, nurses, doctors, and physicians were examined in the research by the experts during the analysis. It was observed by the results that concern was shown by the staff members regarding their moral duties, and regarding the consequences that may lead by the permission of family members regarding the clinical process of the patients. (Brody, pp. 39-44, 2000).
Summary
To summarize the aspects and effects that affect the patients, their family members, and the staff members, there are some negative and positive aspects of the family’s informed consent. In this regard, as mentioned previously, it is very positive from the point of view of patients’ family members that they can be informed of every single thing and step that takes place for the safety and treatment of their loved ones, which is a very advantageous aspect for the families. Secondly, family members can also help the trauma team at the time of the decision-making process regarding the continuation of the treatment of a patient, with the help of the wishes of the family members. Thirdly, family members are also allowed to speak and say anything to the patient during his/her last moments, which may be the cause of satisfaction to the both, patients and their family members. (Veatch, pp. 62-64, 1997).
In this regard, there have been ethical laws created regarding informed consent, as well as, the presence of family members. In the case of an incompetent patient, a guardian plays a role as a legal surrogate decision-maker on behalf of his/her loved one. In the absence of a designated member, spouse, adult child, parent, or any relative is allowed to take the place and make the decisions with the staff members on scientific findings. Conclusively, it has been found from the various researches and studies that took place by the experts and healthcare professionals that the preference of the majority of the family members favors their informed permission during the clinical process. As it may give them a chance and opportunity to revive their last memories with their loved one and to show their love and care to the patient at the time of his/her treatment. (Brody, pp. 69-72, 2000) Lastly, we have tried to comprehend, understand, and analyze the different positive and negative ethical aspects that generate due to the informed consent of family members at the time of the clinical process of their loved ones. We hope that this study will help the experts and other associates who are connected with this field.
References
Ian Gregory. (2003). Ethics in Research. Oxford University Press.
Andrew Thompson. (2001). Ethics, Medical Research, and Medicine. Springer.
Edward Erwin. (1994). Ethical Issues in Scientific Research. Taylor & Francis.
Robert M. Veatch. (1997). Medical Ethics. Jones and Bartlett Publishers.
Baruch A. Brody. (2000). Medical Ethics. BNA Books.