Mr. G's Case Study: Bioethics By Megan Jane Ho

Practitioners in the health-care field are constantly faced with moral conflicts. These conflicts often arise from trying to uphold the ideals of the basic ethic principles; justice, beneficence, autonomy and non-maleficence. Although, what these terms mean are contextually and culturally dependent, as discussed in the case of Mr.G which is presented in “Bioethics” by Megan Jane Johnstone. Specifically related to this case are autonomy and non-maleficence, which bring up multiple debatable points. Ultimately, while it’s important and necessary the patient is informed to an extent, one’s culture must be considered when making impactful decisions.
Before being able to analyze Mr.G’s case it’s important to understand the moral principles from
Mr.G’s Greek heritage, rural upbringing and mindset have predisposed him to having an irrational perspective and lingering taboo revolving around cancer. While cancer is infamous for its mortality rates, some rural Greek populations that didn’t have access to the healthcare that was required to “cure” cancer had the idea deeply engrained that cancer is a death sentence. In addition, Greek culture highly values family involvement and support in most contexts, and healthcare isn’t an exception. Also, the notion of the nocebo effect should be taken into account—what if the knowledge of the diagnoses alone caused for worsening of his condition or premature death? Therefore, the fact that Johnstone believes the decision making in terms of disclosing information to Mr.G should be left to the family isn’t absurd wholly. Although, it’s probable this wouldn’t be the most ideal situation for the sake of Mr.G’s health, considering the family would have the option to not transfer any information revolving around his condition at all. Yet, the belief that “not recognizing the protective authority of Mr.G’s family…undermined rather than promoted Mr.G’s autonomy” is eluding. When thinking about the definition of autonomy in this circumstance, Mr.G having a decision as to how the information was relayed- either by the practitioner or his family- would be the most autonomous option for him. The scenario in Johnstone’s book implies that the practitioner should go directly to the family without consulting Mr.G of his preferred method of communication, which in itself entirely undermines his autonomy. Is a practitioner who identifies as culturally competent supposed to assume that a geriatric patient from some perceived cultural background favors that only their family be told of the diagnoses? While solely informing the patient and not taking cultural relativism into account can be harmful, so can withholding