Medical Ethics or Healthcare Ethics or Biomedical Ethics is a field of ethics applied to the fields of medicine and health care. In addition to doctors, nurses and healthcare professionals, many other people are frequently requested to give their judgments and opinion on various issues and cases that arise within the medical field or health care ethics. Philosophers, ethicists, hospitals healthcare administrators, healthcare insurance officials, theologians, ecologists, economists, family planners, legislators and politicians, lawyers, jurists, and many others are also involved.
Fundamentally, medicine and health care deal with human health, life and death. Medical ethics deals with ethical norms for the practice of medicine and health care and how it must to be done, so the concerns of medical ethics are among the most important and consequential in human life. Importance of medical ethics comes from the fact that members of the medical and healthcare professionals are granted powers and privileges that are not granted to non members. Surgeons and doctors have the right and duty to cut open the human body if they are convinced that by doing so they can improve or aid the health of the person being cut. Medical professionals get to determine or decide, at least sometimes, who will live and who will die. They can prescribe powerful drugs and chemicals that would or could be poisonous or otherwise harmful if administered improperly. They make decisions about the use and allocation of large amount of money and scarce resources. They decide how patient care is to be delivered, which patient should get which resources, how much, and what patients should be told about their situation, what kind of doctor patient interaction will occur, and whether the information given to them by patients will be kept confidential and if not, how and to whom it will be shared.
Problems of health care ethics rises for numerous reasons such as:
The power of physicians over human life and death and the potential for physicians and other health care workers to misuse this power or to be careless with it.
Healthcare development and growth of health care technology.
Doctors keep patients technically alive by hooking them up to various machines that are both expensive and invasive. Who would decide how to do and when to offer life support? When to let a brain dead patient die, is a potentially gray area.
Suppose there is a disagreement among the family members of a comatose patient. In such circumstances, whose opinion or desires or interest should take precedence? Suppose the medical professionals have one opinion but the family members have a different one, whose opinion should be followed then?
Doctors have the means to do organ transplants such as kidney, lungs, liver and heart transplant. More and more people need such organs than the organs available for transplanting. Which patient should get the available organ and what criteria should be used to make the decision?
Is healthcare a positive human right, so that every person who needs it or would benefit from it should have equal access to the most expensive forms of health care regardless of the ability to pay? Is it ethically permissible for a hospital to overcharge its paying patients as much as $100 for an aspirin to recoup the cost incurred by non paying patients?
All these are tough questions that medical ethicists carefully consider, from all vantage points.
Principles of medical ethics:
Ethicists and philosophers suggested many methods to help evaluate the ethics of a situation and to provide principles that health care professionals, doctors, nurses and administrators of medical institutions should consider while making decisions.
Thomas Mappes and David DeGrazia proposed a number of principles that they suggest will help solve problems of biomedical ethics. Six of the principles commonly included are:
1. Beneficence: A practitioner should act in the best interest of the patient.
2. Non-maleficence: First, do no harm.
3. Autonomy: The patient has the right to refuse or choose their treatment.
4. Justice: Concerns the distribution of scarce health resources and the decision of who gets what treatment.
5. Dignity: The patient (and the person treating the patient) has the right to dignity.
6. Truthfulness and Honesty: The patient should not be lied to, and deserves to know the whole truth about their illness and treatment (though certain exceptions are made for the proper use of placebos).
These principles serve to guide doctors on what principles ought to be applied in actual circumstances. Ethical dilemmas arise when one principle contradicts the other. For example, the principle of autonomy and beneficence clash when patients refuse life saving treatment. Bernard Gert, a philosopher of medical ethics reconciled the conflicting principles by promulgating a theory that would require the doctors to advocate their action publicly should they violate any basic moral principles (e.g. break a promise in order to save life).
Even today, the Hippocratic Oath is taken by doctors swearing to practice medicine ethically. This reveals that Medical Ethics were focused upon from centuries. Medical Associations all around the world provide guidelines and principles of medical ethics for healthcare professionals obliging them to practice their profession in the right manner for the benefit of their patients and humankind. Medical ethics are always under fire since many questions lie unanswered such as a patient's information confidentiality, what if this patient is going to harm a third person seriously; in that case should the professional break the confidentiality agreement? If yes, what procedure should be followed? This is just one question, you cannot fathom how many questions still lie unanswered related to medical ethics.
Compiled by Juliet Coutinho
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