Patient autonomy and IGT

[Guest guest]

I feel this topic begs a discussion regarding numerous factors of medical

ethics, including patient autonomy, beneficence, and paternalism.

Definition: Autonomy is the " personal rule of the self that is free from both

controlling interferences by others and from personal limitations that prevent

meaningful choice. "

The promotion of autonomy also serves the concept of self determination.

Definition: Beneficence is action that is done for the benefit of others.

Beneficent actions can be taken to help prevent or remove harms or to simply

improve the situation of others.

There is very marginal room for the use of paternalism with fully functioning,

healthy, cognizant mothers. There are times when I work with a patient who is

less than fully functioning or autonomous meaning they may have compromised

intellectual impairments etc. and in that regard I am working with their

extended family support system and other professionals to develop a feasible

plan. The concept of appropriate use of paternalism in healthcare is more often

associated with end of life issues and people who are cognitively effected.

It's very unclear to me how the deliberate withholding of information is

considered appropriate in circumstances where it is highly evident that the

person whom we are serving as an IBCLC has an evident condition that is likely

to effect their circumstances.

To make the discussion more clear, I'm limiting the circumstances to women who

have the most marked, evident cases of hypoplasia. No, I don't have a crystal

ball but I would bet my house that in these cases, with what I see, (or don't

see, glandular making tissue) those women are not going to have full supply.

There are cases that fall upon other points of the spectrum that I struggle

with....those are tougher.