In this case, the director of the Nursing Home uses the authority of her role to take away the right of her patients to decide whether or not they choose to be part of a research study about an Alzheimer’s drug. It is of note that by making this choice, she is exercising her own autonomy while denying all her patients their own autonomy. The study itself has been deemed ethical by several review boards. Indeed, even to my own sensibilities, it appears to me that the three types of consent, from the patient, a relative, and finally from the director herself, thoroughly ensure that only voluntary, competent patients become a part of the study. A striking point made in the case discussion, “if a reasonably competent patient consents but the family member does not, does it not seriously violate the autonomy  of the patient? ” shows that even these safeguards reduce the patient’s autonomy (Thomas and Waluchow 113).  However, this reduction in the patient’s autonomy, in my opinion, is trivial compared to the complete removal of personal choice from each patient under the director’s decision to not allow the study at her institution.

After reading the case and considering the case discussion, another salient point to me was the roles of the common good versus the rights of the individual. In this case, the director is disregarding the common good (that of those who might benefit from a successful Alzheimer’s treatment) for what she considers the rights of her patients (the right to live an unbothered, peaceful life). The director is using her own individual morality to over ride a study deemed ethically sound by other institutions. Perhaps, in this case, the morality of the individual should bend to fit into the ethics of a study that could help many in society.

Another point the case discussion brought up is the role institutions have on our autonomy. In general, most people are part of institutions, such as schools and workplaces, at some point in their lives. Almost by definition, institutions must provide some types of regulation to ensure that chaos does not occur. However, social institutions that are able to provide individuals with the biggest sense of autonomy are the most successful (Reeve and Assor 111). In my opinion, if studies have shown that this is the case, then the ethical thing to do is to allow as much autonomy as is possible in social institutions. In this case, therefore, allowing patients to choose whether or not they should be a part of the study would reinforce and rebuild a perhaps lost sense of autonomy in elderly persons and therefore result in a better quality of life. In the case discussion, it is presented that patient’s seeking to find meaning in life by contributing to the study would be an unwanted outcome. However, to me, it seems like a result that further supports allowing patients to participate in the study. Indeed, many people who are fully competent and healthy participate in studies so that they can contribute to society. If contributing to society makes these patients feel more fulfilled and happy, then I argue that it is the director’s moral obligation to allow the patients and their family’s to make such a choice.

 Works Cited

Thomas, John and Waluchow, Wilfrid. Well and Good. Canada: Broadview Press, 1998. Print.

Reeve, John and Assor, Avi. Do Social Institutions Necessarily SuppressIndividuals’ Need for Autonomy? The Possibility of Schools as Autonomy-Promoting ContextsAcross the Globe, ‹http://johnmarshallreeve.org/yahoo_site_ad min1/assets/docs/Reev e_ Assor2011_Chapter.1051322.pdf>