If it isn't the consequences of your own actions.. (or is it?)

 Making decisions in a healthcare setting seems more or less straightforward. Yes, I want this procedure done. No, I do not want this procedure done. It is made evident to us as future healthcare providers that patient autonomy and beneficence are of the utmost importance in patient care. 

Let’s say a low-income family comes to the dentist because their child has a cleft lip. The child does not have any other health complications related to the cleft lip but the parents are concerned with their appearance as they grow older. The child is old enough to say that they do not want any surgery and like how their lip is different from other kids. The provider states that surgery can be done to repair the cleft but the child has a very negative reaction to that option. The parents ask the provider, “Well, what would you do?”

Theoretically, the provider may be able to pay off the surgery more easily, their child does not like the way they look and the child wants the surgery. So what are they supposed to tell these parents? 

Providers will provide information to the patient who will or will not give their informed consent. But oftentimes, the patients are hesitant to make a decision and ask the provider what they would do. This makes it difficult for the provider as what they would do is not necessarily what would be the most beneficial for that patient’s specific case. The parents in this case may also be confused about what the right decision is. Patient’s have the right to autonomy but often look at it as more of a burden rather than a benefit (Welie, 2019). The weight of decision-making can often be passed back to the provider and being able to evaluate on a case-by-case instance of what is the most beneficial to the patient is key to providers, especially in scenarios like these. 

So, what would you do in this case if you were the provider? The parents?

Welie JVM. Patient autonomy as a necessary but limited ethical principle in shaping the dentist-patient relationship (*). J Forensic Odontostomatol. 2019 Dec 1;37(3):34–41. PMCID: PMC7442962.