Headlines (Friendship Never Ends)

The Spice Girls were the biggest girl band of the mid-90s, around the time I was a mere preteen going to the early teens. Whoever have not heard this name in one way or another must have come from a whole different universe. Really! They were the biggest group of popstars that everybody adores. Their music was the anthem and their dance moves were imitated in every school program I could remember back then. But after 2 explosive albums and even a movie, they disbanded. Sad but true. I think it was around 1998 that fans went in mourning the world throughout because Geri Halliwell a.k.a Ginger Spice left the group and made out for a solo career. The remaining four, Mel C (Sporty Spice), Emma Bunton (Baby Spice), Mel B (Scary Spice) and Victoria Adams-Beckham (Posh Spice) continued on with the group, although each carried on with their own solo careers later on. Music videos from both camps showed the severance from each other....who could forget Geri's video "Look at me" with a depiction of Ginger's death? And the quartet's "Goodbye" and "Let love lead the way" could only mean sending off Geri with their love.

Fast forward to nine years later, mid 2007, headlines blared that the Spice Girls are reuniting and going on a world wide tour. I could just cry. I guess my blog entry's several months late in keeping with the hot topic but hey, I always didn't have the luxury of time to blog and think of great topics to post. But I few hours ago I saw on TV their first public performance before kicking off their tour, and that was when they performed at the Victoria's Secret fashion show. I almost cried. Call me whatever but it's really like meeting an old friend whom you haven't seen in years. It's good that their back. And I guess their new song tells it all--friendship never really does end!

assignment # 9

Differentiate state paternalism from personal paternalism.

State Paternalism refers to certain actions of the state or government in which they act in a "fatherly" manner towards the citizens even without consent or even to the unwillingness of the citizen. In line with this are paternalistic legistation that are made for the benefit of the people, for their own good and even to protect them against themselves. These include the following: riding a motorcycle without a helmet, gambling, homosexual sodomy, prostitution, polygamy, making and selling pornography, selling and using marijuana, practicing certain professions without a license (law, medicine, education, massage, hair-styling), purchasing blood or organs, suicide, assisting suicide, swimming at a beach without a lifeguard, refusing to participate in a mandatory insurance or pension plan. Paternalism protects people from themselves, as if their safety were more important than their liberty. (ref: http://www.earlham.edu/~peters/writing/paternal.htm)
Soft Paternalism is a political philosophy that believes that the state can “help you make the choices you would make for yourself".

Personal Paternalism refers to your own paternalistic actions over your loved ones, like a father-figure to your younger siblings and making important decisions in behalf of them, especially if they are still underaged.

assignment # 8

What is paternalism? Why is the physician given the authority to practice paternalism? What are the situations wherein paternalism supercedes autonomy?

Paternalism refers usually to an attitude or a policy stemming from the hierarchic pattern of a family based on patriarchy, that is, there is a figurehead (the father, pater in Latin) that makes decisions on behalf of others (the "children") for their own good, even if this is contrary to their wishes. (ref: http://en.wikipedia.org/wiki/Paternalism)

The physician is given the authority to practice paternalism based on the fact that the physician really knows more about the human body and its illnesses (though not all) than the ordinary patient (as opposed to other doctors who might become your own patient). Hence, the physician can make decisions in terms of treatment modalities for the patient, though the patient can actually refuse any intervention if it violates his/her own beliefs and principles. Bottomline, the physician can make the decision for the patient for the patient's own good, especially if to save his/her life. This holds true for certain situations wherein paternalism supercedes autonomy like emergencies or minor patients whose parents or guardian are unavailable to decide, or even those who are mentally incapable of making their own decisions (ex. retarded, comatosed patients with no relatives, ignorant patients). In these cases, the physician is permitted to make decisions for them, like a father who knows better for the good of his children.

assignment # 7

Truth telling and confidentiality

Telling the truth to your patient wholly depends on whether you trust your patient to be able to handle the truth especially if his/her condition lies on the extreme end of the spectrum. While telling the truth is always preferential to lies or even half-truths, we should also take into account the condition of the patient, on whether knowing the truth is beneficial or harmful to his/her overall condition. Sometimes, we overlook the inner strength of the patient by concealing the truth in order to "spare" him/her of unnecessary pain, worry or anxiety. Still, it's all in the delivery of the information. Soften the blow, so to speak, so as not to create more tension and ill-feelings. However, if you think that the mental condition of the patient is very fragile and could hardly handle knowing the truth, as supported by their family, then supplying only half-truths to the patient may be acceptable but still, the whole truth should be given to the family members or preferentially to the elder of the family or the financial supporter.

Confidentiality, on the other hand means disclosing classified information only to those authorized to have access. This would mean that unless a person is the legal guardian of the said patient, he/she cannot access the patient's records unless with a signed consent. This holds true to any members of the family. Other doctors not part of the treatment team or hospital staff are also not permitted to obtain information about a patient record. However, if a patient information is such that it can be harmful to the general public, then in the physician's better judgment it should be disclosed but only to appropriate authorities only. Otherwise, any breech of confidentiality in the part of the physician, or other unauthorized persons should be lawfully dealt with.

ref: http://www.providence.org/everett/Patient_Resources/HIPAA.htm

assignment # 6

You have a patient whose religious belief does not allow blood transfusion. In your medical opinion the patient will die if he or she is not given a blood transfusion. What will you do?

The question is not so much as what will you do but will you do it? Afterall, as the physician, you can actually "have your way" in order to save the patient. But the patient's decision should be placed above my own because it is afterall his life in question. And also, it is stipulated in the patients' bill of rights that they can refuse medical treatment. However, the patient should be duly informed of the consequences of his decision. This is not to say that I am "washing the responsibility off my hands" but I would let the patient sign a waiver stating his refusal of the treatment and the knowledge of possible outcomes of his actions to avoid any legal implications of neglect as most malpractice suits are made of. It pains me to have a patient in my care die but if it is his decision to refuse the only life-saving intervention available, then his life is out of my hands.