Dilemma Behind Using Doctors Counterfeit Notes – Legal And Ethics

A law 9Today, the Internet is rampant with several websites offering counterfeit doctor notes; and people are more than willing to use these notes to explain their absence from work or school. These websites are catering to an existing demand and whether they should held accountable is a different matter altogether.

People have no qualms about using counterfeit doctor notes and do not realize the risk they taking. Should the workplace or school figure out that the notes are fake, there would a lot of explaining to do. And, if the person has forged the signature of practicing doctor or physician, then he or she could be arrested for fraud. There have been instances where people have got caught using fake doctor notes and found themselves in the dock facing severe fines and jail time. Additionally, a professional will end up losing his or her job, while a college student could be expelled for using a fake doctor note.

Before a person resorts to using this note, he or she should consider all the pros and cons, ask legal advice from the experts of legalmedsolutions. There is legal and ethical dilemma of using counterfeit doctor note in play too.

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Refusal of Medical Treatment

Can a rational person possibly refuse treatment?
Until very recently, it was assumed that there was something wrong with people who refused medical treatment. It was believed that some irrational fear, incorrect judgment, or suicidal tendency was interfering with the patient’s reaching the conclusion that treatment was the only viable option. Only now has the medical profession become more open to the idea that refusing conventional medical treatment may be a reasoned and informed choice made by someone in full possession of his or her faculties. For example, although in the 1970′s this concept was addressed in the model patient’s bill of rights and implied in the principles of informed consent, it was in 1990 that the Association of American Physicians & Surgeons adopted a list of freedoms that should be guaranteed to all patients that included the freedom to refuse medical treatment even if it is recommended by their physician.

refuse treatmentUnderstandably, doctors find it hard to take when their treatment paradigm is challenged. Often, they are very troubled by the patient’s decision and will keep trying to get them to change their mind; others will be concerned to cover themselves in case the patient or the family later decides to sue for inadequate care.

Refuseniks are not a small fringe group
Treatment refusers (sometimes referred to as “refuseniks”) are often at the beginning of their illness, and the interventions they refuse are considered “active” in that they are intended to cure or control the illness, rather than “palliative” i.e., intended to just comfort the patient. While Christian Scientists relying on prayer or Jehovah’s Witnesses refusing blood transfusions are the ones that make the headlines, most people who refuse treatment are not doing so for religious reasons or out of a deep mistrust of modern medicine. In fact, many patients will accept part of a doctor’s recommendation – surgery to remove a tumor, for example – only to reject follow up therapy such as chemotherapy or radiation.

The cost/benefit analysis
These patients are doing a kind of cost/benefit analysis. For example, in the case of chemotherapy drugs, they cite that unlike most drugs, which provide the high possibility of benefit with the possibility of harm, many anticancer drugs, provide near certainty of harm with only a possibility of benefits. The therapies might prolong life — but for how long? And at what cost? There have been no studies — since withholding treatment from a control group would be unethical — but one survey comparing almost 800 patients who refused all conventional cancer treatment with those who accepted treatment found that refusal shortened the median length of survival by nine months. The survey was extremely broad: subjects suffered from 30 kinds of cancer at varying stages of the disease, and survival ranged from two months to more than six years. But the point is that sometimes treatment buys you a lot of time, and sometimes it doesn’t.

Older patients more likely to refuse treatment
It follows, therefore, and is borne out by the statistics, that older patients refuse treatment more often than younger patients. Often, they feel that they have lived their life, or that the chance of a bit more time alive does not justify the consequences involved in undergoing treatment. In one survey of women with breast cancer, 7% of women 65 or older refused treatment, compared with 3% of women under 65. Older men with prostate cancer often postpone surgery out of concern about adverse effects such as incontinence and impotence, and in fact such watchful waiting and monitoring PSA levels are sometimes a doctor-approved option. Usually, however, a patient is not given enough information nor time to deliberate, a complaint that is often cited by supporters of complementary and alternative medicine.

A value judgment
Generally speaking, refuseniks are intelligent, articulate and fully aware of the possible consequences of their decisions. They don’t use medical evidence as the only — or even the main — factor in their decision-making, although they report collecting lots of research about proposed treatments. Instead, they make choices based on their values, like the belief that the meaning of life is greatly diminished when the ability to live it normally is compromised. They don’t want to live as long as possible if that means a loss of bodily integrity and personal independence. Sometimes they rely on the personal experiences of friends who underwent similar treatments. They believe in the benevolence of the doctor’s intentions and often in the doctor’s skill as well, but in the end, they choose a route that they think will give them a better sense of control, quality of life and dignity.

Some Of The Ethical Issues In The Medical Realm

As an industry dealing with medical applications, technologies, and services to ensure human health, the health care industry must ensure that its practices are in line with medical, legal, and ethical standards to avoid compromises on the part of the health care practitioners. Specifically in medical practice, dealing with human lives is a serious matter and thus, careful considerations must be made when a decision is required.

Although the medical practice is such an objective science, ethical issues are not. The current status of medical practice in the US is such that practitioners are confronted with a highly dynamic setting in which precedents must be reviewed from time to time in order to come up with decisions or solutions for each problem. A patient refusing treatment, a doctor choosing not to disclose full information to a client, or a family deciding for an incapable patient are just some of the examples wherein decisions need to be carefully evaluated. Let us take a look at two of the prevailing ethical issues in medical practice.

The Patient Bill of Right and the Right to Refuse/Accept Treatment Based on an Informed Decision

A law 4Adopted by the American Hospital Association or the AHA, the Patient Bill of Right states that a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law. First, the concept of full disclosure has been advocated to ensure that the patient, as long as he or she is cognizant and capable of arriving at sound decisions, be accorded the power to decide on whether a medical option must be chosen. It is proper for practitioners to ensure that patients are provided all the necessary information to make a decision. For example, undergoing a gastric bypass surgery is risky so the patient must be informed of all possible consequences to ensure that his or her decision is an informed one.

The ethical issue here arises when the patient is deemed “incapable” of deciding for himself or herself which option is the best. This is true in cases wherein patients are senile, suffering from mental illnesses, or are comatose. Who gets to decide in such cases? Although patients are accorded the right to accept or refuse treatment, isn’t it true that doctors actually know better in terms of what could be the best decision for their patients? Such questions surround medical decisions resulting in a variety of ethical and moral considerations in coming up with a decision.

This is a classic dilemma pitting the notion of ensuring human health versus safeguarding the business interests of pharmaceutical companies. It is true that physicians and the pharmaceutical industry share a common interest in promoting medical knowledge; however, this common interest ends when the business interest of the pharmaceutical industry is factored in. Since a physician must operate under the principles of beneficence, non-malfeasance, and patient autonomy, they must, in the context of product promotion, ensure that these principles are upheld before considering the benefit of the pharmaceutical companies.