The foundation for medical ethics consists of a pair of concepts. The first of the pair is active goodness or beneficence. That is choosing to do what is good for the patient. The second part of the pair is doing no harm, non-maleficence. While the latter is better known and more often talked about, without the former patients will not receive the most beneficial, quality medical care that they ought to receive. In prescribing care and treatment both concepts must be taken into account and balanced. Both need to be at the root of medical decision making.
On top of that foundation rise other prime considerations for medical ethics. Justice must also be weighed. Not justice in the legal sense, but in the sense of humane and equitable decision making and care. This value comes into play when considering apportioning scarce or expensive healthcare resources. It is also the basis of ensuring that even those without insurance and limited financial resources have access to necessary care. Justice also informs decisions when further care becomes futile.
Both patient autonomy, their right to self determination, and patient dignity argue against the more classical paternalistic model of the physician-patient relationship. Patients have the right to refuse care or specific interventions, whether that is based on personal religious convictions or other reasoning on their part. The only mitigating circumstance making autonomy not the prime consideration is when the patient is deemed incompetent to make their own determinations. This can be a temporary impairment, as with intoxication, or a permanent condition, as with dementia. Dignity is related to autonomy. Dignity must not only inform day-to-day care, but most particularly comes into play during end-of life treatment and related decision making.
Truthfulness is valued in ethical physician-to-patient communication. Communication must be open, occur in both directions, and be ethically honest. Forthright communication can mitigate against any number of ethical issues and is the best remedy for those that do arise.
Informed consent is an area in practice presenting potential ethical stumbling blocks. Here honest, forthright communication is key. The patient must have complete information regarding the risks and benefits on which to base their decision to agree to or decline a specific procedure or treatment. Misinformation here can lead to incorrect choices with their attendant consequences. Problems with this important part of medical practice can also have legal ramifications.
Confidentiality is very much a part of medical practice. It has become a statutorily reinforced ethical practice. Not only is confidentiality mandated in statute, but also several exceptions are mandated. Beyond the more general Privacy Rule of HIPAA are the more stringent confidentiality rules pertaining to those in mental health and substance abuse care. Examples of confidentiality exceptions include parental consent for certain procedures and reporting suspected child abuse or domestic violence to proper authorities.
Ethics in general and medical ethics in particular must walk a line between the benefits for the individual balanced with the benefits for the whole community. Many times these considerations are readily discerned, but at times these considerations must take place in committee or with expert input. An example of an action that would benefit from this input would be the use of treatment modalities considered experimental.
One more ethical issue is the possibility of influences from outside the patient-physician relationship affecting care decisions. These are brought to bear by such entities as business arrangements with testing facilities, pharmaceutical company influences (both physician gift inducements and patient-targeted advertising), and complimentary referral patterns.
Medical care is, at its most fundamental, caring. Ethics involves specifically valuing the patient, working to do what is best for the good of the patient, while ensuring that your actions (or inaction) do not harm the patient. Truthful communication ties all those efforts together.
Article Directory : http://www.articlecube.com
