From the Guidelines
The ethical consideration in this scenario prioritizes patient autonomy while ensuring the healthcare provider's duty of beneficence and nonmaleficence, necessitating a balanced approach that respects the patient's preferences and values while minimizing harm. When a patient wishes to continue a medication despite experiencing side effects, the provider should engage in transparent discussions about the nature and severity of these side effects, potential long-term consequences, and available alternatives. This process involves assessing whether the side effects pose serious health risks that might outweigh the benefits of continued medication use.
Key Considerations:
- The patient's right to make informed decisions about their care must be respected, ensuring they fully understand the risks and benefits involved 1.
- The provider should evaluate whether the side effects are manageable and not life-threatening, and if the patient values the symptom relief they are experiencing, continuing the medication with close monitoring may be appropriate.
- If the side effects present significant dangers, the provider has an ethical obligation to strongly recommend alternatives, respecting the patient's preferences within the context of shared decision-making.
- Patient factors, including preferences, comorbidities, and changes in treatment goals, should guide medication adjustments, as highlighted in the management of conditions like diabetes 1 and hypertension 1.
- The goal is to maintain therapeutic benefits while minimizing adverse effects, which may involve adjusting the treatment regimen based on individual patient needs and responses to therapy. Given the most recent and highest quality evidence, the approach should prioritize shared decision-making, emphasizing patient-centered care that balances the benefits of treatment against potential risks and side effects 1.
From the Research
Ethical Considerations
The patient's insistence on continuing a medication despite reported side effects raises several ethical considerations, including:
- The patient's autonomy and right to make informed decisions about their own care 2
- The potential benefits of the medication in managing the patient's symptoms, weighed against the potential risks and harms associated with continued use 3
- The importance of ongoing monitoring and evaluation to minimize the risk of adverse effects and optimize treatment outcomes 4
Patient-Centered Care
A patient-centered approach to care involves:
- Respecting the patient's autonomy and involving them in decision-making about their care 5
- Providing education and support to help the patient understand their treatment options and make informed decisions 6
- Collaborating with other healthcare professionals, such as pharmacists, to ensure comprehensive and coordinated care 2
Medication Management
Effective medication management involves:
- Regular review and monitoring of the patient's medication regimen to minimize the risk of adverse effects and optimize treatment outcomes 2, 3
- Simplification of the medication regimen, where possible, to improve adherence and reduce the risk of errors 5
- Ongoing evaluation and adjustment of the treatment plan as needed to ensure that the patient's needs are being met 4, 6