In this reflective essay, I will explain a moral framework which will guide my first few years of clinical practice based on the reasons I decided to become a Physician Assistant, and the ethical principles of autonomy and beneficence, which I foresee will be important elements of practice to me, as they support the importance of spending time with patients and building trusting relationships with them in clinical practice.

         Ever since elementary school, I have always been especially interested in my science classes; as my classes became more advanced, I became more and more interested in the intricacies of how the body works and how diseases are identified, diagnosed, and treated. In addition, throughout my high school and college years, I have had various opportunities to build relationships and help people in various contexts, both within and outside the healthcare field. From volunteering in an organization for teenagers with troubled backgrounds, to working in homes for children with special needs, I fell in love with the opportunity to meet and help people in various ways, and deeply value the relationships I have been able to build as a result of these opportunities. I have chosen to become a Physician Assistant because I believe that this career will allow me to perfectly blend my love for science and medicine with my desire to build relationships with and help others.

         As I really value helping others through building relationships, I believe that the aspect of clinical practice that will be most important to me will be the time I spend with the patients and building proper patient rapport. As a PA, I will hopefully have the opportunity to spend more time with patients, and through this, I will be able to deliver better and more focused care. Furthermore, I hope to be able to establish trusting relationships with my patients, so that they feel comfortable opening up to me and discussing all their needs with me, both physical and emotional. Emotional and psychosocial needs of a patient are very crucial aspects to focus on, and I hope to be able to help patients with these needs in addition to their physical needs, and send them home feeling wholly cared for.

         One ethical principle that I anticipate will play an important role in my clinical decision making will be the principle of autonomy. Autonomy can be defined in four ways- the most classic definition of autonomy is autonomy as free action, similar in meaning to liberty, or freedom to do as the patient wishes, and not do what he does not wish to do. Autonomy can also be defined as effective deliberation, or going through a rational thought process to make a decision. A third way to define autonomy is as authenticity, meaning acting in line with a person’s character and how one normally acts, and a fourth way to define it would be autonomy as moral reflection, or in line with the person’s values that one has thoughtfully examined (Yeo et al., 2010.)   Since I recognize the importance of the emotional and psychosocial needs of the patient, I understand that there is more that goes into a patient’s decision than the medical facts and the physical ramifications that clinicians often tend to focus on. As long as my patient demonstrates decision making capacity, I will assume that the patient is effectively deliberating based on every aspect of his life that the decision affects, and I will give my patient the time and attention he needs to help him make a proper decision keeping all of these aspects in mind. I will then stand by my patient’s decision and honor his liberty, allowing him to do as he wishes, even if I do not necessarily agree with the choice from a clinical perspective. Furthermore, in my efforts to build a trusting relationship with my patient, I will attempt to be supportive of his wishes in general, and supportive of his autonomy pertaining to these wishes. This will hopefully build a stronger relationship that I can maintain with my patient even after the decision is made, and continue to be there for all his needs as he is dealing with the potential ramifications of his autonomous decisions.

         Another ethical principle that I believe will be crucial in my clinical decision making will be the principle of beneficence. Beneficence can be defined as a decision or action that promotes the good of the patient, or is in line with the goals of care of the patient. When making decisions based on beneficence, the physical, psychological, social, and emotional benefits should all be considered (Yeo et al., 2010.)  In my efforts to spend time with patients and build genuine and trusting relationships with them, I will be there for the patient as he discusses whatever he wants to discuss with me. Through this, I will attempt to understand all of the goals of care of the patient, including his physical, emotional, and psychosocial goals. Once I spend a good amount of time listening to my patient and understanding every aspect of his goals of care, I will make sure to honor these goals, in line with the principle of beneficence. Not only will this be the best for the patient, but it will also help further increase patient rapport and trusting relationships, since if the patient knows that I want to do what is most in line with his goals of care, he will feel more comfortable discussing these goals with me and trusting me with confidential information both related and not directly related to these goals.

         In this essay, I drafted a moral framework for my first few years in clinical practice as a Physician Assistant, explaining the reasons I decided to become a PA and using the ethical principles of autonomy and beneficence to support the value I find in spending time with patients and building trusting relationships with them in clinical practice.

         Yeo, M., Moorhouse, A., Kahn, P., & Rodney, P. (Eds.). (2010). Concepts and cases in nursing ethics. Broadview Press.