“Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine.”
The term medical ethics is incredibly broad. In general, the principles of medical ethics and there actual purpose is to uphold an optimal standard of patient care. However, in practice things are not so black and white.
There are four pillars of medical ethics:
- Autonomy – maintaining the patients capacity to think and make their own decisions as to their healthcare, even if it appears medically wrong.
- Beneficence – refers to doing what is best for the patient, coinciding with autonomy.
- Non-maleficence – not doing harm, however in most procedures there is always a certain amount of risk and almost always side affects.
- Justice – giving patients the care they deserve and treating them equally.
All doctors take the Hippocratic Oath before practicing medicine and adhere to patient confidentiality throughout treatment.
In an ideal world the four pillars mentioned previously would always be followed strictly. However there are times where doctors are unable to fulfil these standards, resulting in a violation of medical ethics. In most of these cases, the impact may be minor often resulting in a suspension of practice for a brief amount of time however in others the hospital may be sued and/or the doctor may lose his/her medical licence.
One of the biggest ethical issues in healthcare is end of life treatment. A patients family may choose to prematurely terminate aid or may be unwilling to turn off life support. In many cases the patients themselves may request to terminate all treatment in order to die naturally. Despite, the first pillar being autonomy often the medical professionals and family members of patients are forced to decide what is best for the patient if the patient is unable to do so. In some cases, family members do not respect the wishes of loved ones and often blame medical personnel for the decease of a loved one. In other cases, medical personnel make a decision based on their own understanding and knowledge of the patients situation and of treatment. However ultimately, end of life treatment rarely occurs in a manner which ensure everybody’s happiness.
In addition, the allocation of donor organs is another grey area in medical ethics. As you are aware, patients who are in need of a transplant organ are placed on a transplant list. However when an organ becomes available the organ may not go to someone who has been waiting 2 years, but instead to an emergency case. In these cases, the fourth pillar of justice is violated. Is it fair to give the donor organ to a patient who needs it critically when another patient has been waiting for it and has been told that they would be given the organ? Most people would agree that the emergency patient requires the organ as without it they would most likely die. However, denying the patient who has been waiting for the organ is a breach of justice as they have been promised a something that would change there life and standard of living for the better.
Finally, one ethical issue which is not always addressed is access to care. In many cases, millions of people living in third world country simply do not have access to the healthcare that we have in England or other first world countries. In England the healthcare system is free, provided you pay tax. A patient could have treatment worth £3000 without actually spending that much. However in a variety of countries people do not have access to basic healthcare such as the vaccinations given at birth in western countries, and regular health checks. In reality, despite being unable to control the flow of money, we are basing the right to live based on where a person lives and their assets. This is essentially a breach of human rights and injustice. However, in the real world a doctor working in England for example is unable to control the financial status of a country in Africa, and in extension whether there is adequate healthcare. This inability to change this violation of ethics has led to a variety of non-profit organisations such as the MSF, providing free healthcare to those who can not afford it in other countries.
To conclude, knowledge of medical ethics is a vital part of becoming a healthcare professional and without a code of conduct modern medicine would be vastly different from the high standard of patient care we receive today.
Through this post we have briefly discussed a range of ethical issues in medicine. For further information, please refer to:
- Top Five Ethical Issues in Healthcare
- Med Ottawa Medical Ethics
- Medical Ethics Overview
- Medical Ethics Committee; British Medical Association
- Good Medical Practice (2013); General Medical Council
- Beauchamp T, Childress J; Principles of Biomedical Ethics, 7th Edition. Oxford University Press.
- Antoniou SA, Antoniou GA, Granderath FA, et al; Reflections of the Hippocratic Oath in modern medicine. World J Surg. 2010 Dec;34(12):3075-9. doi: 10.1007/s00268-010-0604-3.
- Good Medical Practice – Explanatory Guidance; General Medical Council
- Managing a child or young person with suspected maltreatment; NICE CKS, March 2014 (UK access only)
- Confidentiality and information sharing; National Treatment Agency for substance misuse, 2003
- Consent guidance; General Medical Council