Under what circumstances, if any, are HCPs justified in overriding a patient’s autonomy or decision making?

Patient Adherence


While working at a health clinic at a homeless shelter, you discover

that F.C., a 64-yr-old man with tuberculosis (TB), has not been taking

his prescribed medications. He tells you that it is hard for him to get

to the clinic to obtain the medication, much less to keep on a

schedule. You are concerned not only about this patient, but about

the risks for the other people at the shelter, in the park, and at the

meal sites where he often visits.

Ethical/Legal Points for Consideration

• Adherence is a complex issue involving a person’s culture,

values, and beliefs, perceived risk for disease, availability of

resources, access to treatment, and perceived consequences of

failure to adhere to treatment.

• Advocacy for the patient and the community obliges you to

involve other members of the health care team, such as social

services, to aid in obtaining resources or support for the patient

to complete a course of treatment.

• Some cities and states have a stepwise legal process for managing

nonadherent TB patients.


• Legally the constitutional right to control one’s own body may be

limited by state and federal obligation to protect public health

and safety. Most of these laws have provisions for the protection

of constitutional rights, such as right to counsel, right to least

restrictive alternative in terms of confinement setting, and right

to prompt judicial review.

• The federal government and many states have provisions for

quarantine, detention, and treatment. With the threats of

bioterrorism and the globalization of exposure to highly lethal

infectious diseases, it seems unlikely that the government’s

power to detain will be removed.

Discussion Questions

1. What alternatives of care can we offer to F.C.?

2. Under what circumstances, if any, are HCPs justified in

overriding a patient’s autonomy or decision making?


find the cost of your paper

set up and solve a case-study example of the light-intensity distribution in a photochemical reactor.

Photochemical reactor modeling: a case-study problem. Although radiation is important in heat transfer, an analogous model can be used in the design of photochemical reactors. The modeling of these reactors….

Write a critique on this technique of secondary-emission measurement.

Secondary-emission measurement: a case-study problem. An indirect way of measuring of secondary emission from ponds or large bodies of water used in waste treatment is to measure the concentration and….

set up a mass transfer model and evaluate the variation of the local mass transfer coefficient at various locations in the plate.

Chemical vapor deposition (CVD) on an inclined susceptor: a case-study problem. An important application of convective mass transfer theory is in CVD processes employed to coat surfaces with thin films….