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Part of Western Governors University

August 20, 2019

Nursing & Healthcare

Healthcare ethics in modern medicine.

Stethoscope on paper

What are ethics and what are ethics in health care? Ethics are guiding moral principles that direct an individual's behavior in his or her activities, and the term "ethics" is frequently used in reference to professional conduct.

Health care technology advances bring with them countless benefits and expanded capabilities, but they also bring with them increased obligations when it comes to ethical issues.

It is essential for health care professionals, and especially those aspiring to be in healthcare management to understand not only health care regulation and compliance, but medical ethics as well. Healthcare professionals should want to provide the best care they can for their patients — which involves care driven by a solid moral compass.

Definition of ethics in medicine.

It is a medical professional’s responsibility to hold him or herself to the highest medical ethics standards. If you are seeking a nursing degree, or hope to become a physician, you must understand medical ethics before being ready to provide care. 

Medicine requires some challenging judgment calls, and holding yourself up to high medical ethics standards may help minimize errors and foster trust, accountability, and respect between you and your patients.

Four ethical principles in medicine.

The textbook titled “Principles of Biomedical Ethics” (orig. 1979) by Tom Beauchamp and James Childress provided an early foundation for medical ethics and values for physicians and others involved with practicing medicine. This textbook has provided the compass for increased discussions about ethical issues at the clinical level for hears.

In addition to the following four basic ethical principles that Beauchamp and Childress define, most professional medical societies/organizations have established medical ethical guidelines for their members in regard to every patient’s human dignity, privacy, confidentiality, and patient rights.

The four main health care principles that Beauchamp and Childress discuss are:

Respect for autonomy.

Respect for autonomy is a norm in medical ethics that requires the respect for the decisions of adults who have the ability to make sound decisions (self-determination). 

A determination of someone’s decision-making ability can be gauged by their:

  • Intentionality (Is it believable he or she will follow-through with a decision?)

  • Understanding (Does he or she understand the situation and the consequences and implications of different options?)

  • Absence of controlling influences that determine their action (Is he or she being influenced somehow against choosing reasonably?)

In health care, it's vital for patients to have the right to make their own medical decisions after getting information from their doctor. Physicians must respect the ability that patient's have to learn about their health care, and make their own choices about what to do with regards to their medical care. Doctors, nurses, and physicians learn about the healthcare ethics of autonomy, and this should lead them to respecting the decisions and autonomy of their patients every day.

Beneficence.

The principle of beneficence embodies the concept of the moral obligation to act in the best interests of others.

This can be done either by:

  • Providing benefits

  • Balancing those benefits against potential risks/harms

Beneficence calls for the commitment to:

  • Protect and defend the rights of others

  • Prevent others from harm

  • Remove conditions that might cause harm

  • Help those with disabilities

  • Rescue others in danger

Physicians must practice this in a clinical and medical setting every day by making choices and judgment calls about how to benefit their patients. This element of healthcare ethics is usually vital to medical schools, hospitals, and every place where medicine is practiced. The idea that physician's main goal should be to benefit others shouldn't be surprising, but it is a principle that can sometimes prove to be an ethical issue when the unique settings of health care come to light.

Doctor holding clipboard

Non-maleficence.

Non-maleficence requires a commitment not to harm others in any way, based on the Latin maxim primum non nocere (first do no harm) which is in the Hippocratic Oath that every doctor must take. 

A non-maleficent obligates one not to:

  • Kill

  • Cause pain or suffering

  • Incapacitate anyone

  • Cause anyone offense

The idea to "do no harm" is a vital element of medicine. Physicians face the ethical dilemmas of how to avoid doing harm every day as they work. They must rely on resources to help them understand the best way to proceed forward and hep patients using their medical education, and their gut instincts.

Justice.

Justice calls on us to fairly distribute benefits, risks, costs, and resources as best we know how.

To each individual, justice, ideally, should proffer:

  • An equal share

  • According to need

  • According to effort

  • According to contribution

  • According to merit

The principle of justice means that every single person should be treated in the best possible way by their doctor. Advocacy for patients who may have less than others is an important part of justice. Ethical theories about justice in health care help doctors and nurses be prepared for what could await them as they treat patients on a wide scale of wealth, education, and health.

Doctor sitting at desk

Modern ethical dilemmas and considerations in healthcare.

The landscape of health care tech is evolving, and ethics will have to continue being part of the healthcare discussion.

Any reputable nursing program or health care administration program will emphasize maintaining the highest standard of ethics in modern healthcare, especially as medical technology marches forward and introduces new ethical dilemmas. If you have your heart set on a nursing degree or on becoming a healthcare administrator, you will most likely take healthcare ethical training/courses. These will help you be prepared for the future that awaits medical professionals.

As medical technology has advanced and change the landscape of health care tech, more and more ethical dilemmas continue to be identified, making it necessary for modern standard ethical practices to include:

  • Informed consent: A process for being granted permission before performing any kind of healthcare procedure or intervention on a patient who has been advised of potential consequences. 

  • Confidentiality: Maintaining confidentiality regarding patient information is critical in the delivery of healthcare and in developing a relationship with your patients.

  • Cultural understanding: The ability of healthcare providers and organizations to understand and take into account cultural differences and needs in their delivery of healthcare (e.g., someone from another culture or religion may not believe in a certain procedure being performed). 

  • Humanitarianism: An active belief in the inherent value of human life, leading providers to practice benevolent treatment and provide assistance to patients, with an end goal of bettering humanity.

The ethics of new medical practices will have to be taken into consideration as innovations in medicine and technology continue to evolve, in order to understand the benefits and negative impacts these innovations may entail.

Ethical decision-making in healthcare.

Although a healthcare provider may have his or her own sense of morals, there are some circumstances where ethical conflicts in healthcare may get in the way of caring for patients. For example, a patient may refuse care due to cultural/religious views, or may want an unnecessary treatment which may not be in his or her best interests; euthanasia is another example of a provider's sense of morals conflicting with his or her ethical obligations. 

As new medical technologies come along such as medical biotechnology, the ethics of using medical practices will continue to be evaluated, updated, and taught. The role of modern health care administrators and executive leadership in hospitals is at the intersection of caregiving, technology, and ethics. 

Executive leadership in health care systems is tasked with creating an environment that enables ethical decision-making while continuing to advance caregiving in modern medical practice.

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