Monica Benjamin

Biomedical Ethics Essay #1

In this essay, I will argue why I will not prescribe Mr. S the unindicated drug, as it is not ethical and violates both beneficence and autonomy.

Prescribing Mr. S would beneficence as it is likely to cause harm to the patient, yet benefit myself rather than Mr. S. It would also fulfill a petition that cannot be deemed autonomous on the part of the patient.

Simply put, “beneficence” is the state of doing good and not doing bad, even when it is against what we as clinicians desire to do (Yeo et al.). In prescribing Mr. S the Viagra, I would likely not meet these two essential principles of beneficence, by possibly not doing good and doing bad, only fulfilling my own desires. Mr. S is not in need of this medication, thus in an overall sense, prescribing this medication would not be doing good. There is a suggestion that the medication may boost his self-esteem and his sex life.  However, this “good” is not even guaranteed or likely as it is founded on a “rumor.” Mr. S’s friend is likely speaking from personal anecdotal experience, possibly having the subjective feeling of “manliness,” resulting from other concurrent circumstances or a placebo effect. Now that I have established the improbability of the Viagra benefiting the patient, I will discuss the possible harms.  It is not within reason to subject a patient to the unnecessary side effects from the drug, or even an allergic reaction, for the sake of an unlikely benefit. There is also the harm to the patient resulting from the medication not making him feel “more of a man” (Kirk). Mr. S may think,  “Why did it work for my friend and not for me? Is there something wrong with me?” Now, in prescribing, I may have damaged my patient’s self-esteem, while still not providing any good. By not prescribing, although it may be contra to the desire of the patient and myself, I may actually be fulfilling the concept of beneficence (Yeo et al.). As my attending physician suggested, in order to further examine the underlying issues, I would have to spend “valuable clinic time” (Kirk). In the interests of my own convenience, I could just give him the prescription. However, it would be irresponsible of me to not investigate the matter further for the sake of not “wasting” time. Prescribing him this medication only promises to benefit me and has a high likelihood to disservice the patient.

“Autonomy” is the right of the patient to make decisions to accept or refuse things that directly relate to themselves, as long as it agrees with the four principles of personal liberty, a logical thought process, is a reflection of their true selves, and does not violate their own moral code (Yeo, Moorhouse, & Dalziel). In this case, Mr. S’s decision cannot be seen as fulfilling his right to autonomy, as it violates at least two of the core principles of autonomy: a logical thought process and correctly reflects the person’s identity and beliefs. According to Yeo, Moorhouse, & Dalziel, a thought process cannot be deemed logical if it is founded on “false assumptions or lack of information.” This case fulfills both those discrepancies: his friend’s claim is likely false and there is no empirical evidence or other reliable sources that support such a claim. Thus, Mr. S is utilizing his supposed autonomy by making a decision based on what is likely a myth. Furthermore, as his clinician, I ought to investigate why he feels the need to take something to make him feel more manly during sex. Is his depression causing him to search for anything to give him happiness or pleasure in his life? Does he have existing feelings of not feeling masculine enough? These potential sentiments and his friend’s advice could be labeled “a momentary influence,” which is not reflecting the true decision that he would make under normal circumstances (Yeo, Moorhouse, & Dalziel). Denying him the medication may seem to be a violation of his autonomy, however the circumstances make it clear that giving it to him would be the true violation.

I have just shown why both the two different principles of beneficence and autonomy both are fulfilled in my refusal to prescribe Viagra to Mr. S. In not prescribing, I have protected him from both mental and physical harms resulting from medication without a promised benefit and not allowed a decision that is not reflective of the patient’s identity.