Reviewing Ethics and Common Controversies in Medicine
Part of the Medical Ethics For Dummies Cheat Sheet
Ethical principles are fine in theory, but putting them into practice is more difficult. Every situation is different, and ethical issues in medicine should be approached on a case-by-case basis. These are some common controversies, and how principles of medical ethics are applied to help solve them.
Abortion: Autonomy and nonmaleficence come into conflict in this issue. How much right does a woman have over her body, and how does that right balance with the rights of the fetus? Are there some cases when a therapeutic abortion is ethically mandated?
Physician-assisted suicide: If we respect autonomy, can we deny a patient’s request to die? Should doctors, traditionally committed to prolonging life, be involved in assisted suicide? How can providers honor the conflicting requirements of nonmaleficence, beneficence, and autonomy at the same time with this issue?
Conflicts of interest: For informed consent and patient autonomy to mean something, providers must tell patients what matters to their decision, including the potential for conflicts of interest, such as provider relationships with drug companies. Here, truthfulness is a primary ethical issue.
Relief of suffering at the end of life: To honor the principle of beneficence, providers should try to relieve suffering at to the best of their ability. However, some of the drugs that relieve suffering at the end of life can also hasten death. The double-effect rule helps you make decisions in these difficult situations.
Medical mistakes: Mistakes happen in all walks of life. But medical mistakes have the potential for hurting people and thereby violating the principle of nonmaleficence. Learning how to prevent mistakes, openly reporting mistakes, and learning from mistakes help you to respect the principles of nonmaleficence, justice, and beneficence.
Confidentiality: All four principles play a part in this issue. Can a patient’s medical information be kept confidential in the electronic age? When can confidentiality be breached? And who is allowed access to confidential information?
Healthcare rationing: Justice is the principle that applies in this issue. How can we fairly allocate limited healthcare resources to as many people as possible, without limiting resources to those who currently have them? Is it possible to reach a bare minimum of care for all?
Stem cell and genetic research: The frontiers of medicine exist in research. How can we balance beneficence and justice if embryos must be destroyed to perhaps find cures for devastating diseases? Should a patient know everything there is to know about his health and potential health risks? And can research be harmful to some in order to benefit many?