Ethical Principles Affecting the Delivery of Healthcare - Essay Example

? Ethical principles affecting delivery of healthcare by the carer Introduction Ethics are defined as a set of self-regulated guidelines framed by society incorporating the various cultural and philosophical aspects aimed at preserving human dignity. Principles in ethics have been developed in diverse fields, be it in industrial practices, financial or in health services. They seek to preserve the facets on which a civilized society should function with regard to respect of the individual and the community. This paper seeks to address the ethical principles in healthcare and its impact on the care giver. What is medical ethics? Medical or health care ethics are guidelines that seek to find a common ground between the patient and the care provider. Healthcare, which was previously a more personal interaction between a doctor and a patient, has now given way to more commercial entity with lot of economics involved (Gabr, 2010). This is because it now involves the health service not just benefitting the patient but also providing valuable returns to the hospital financially. Limited resources also place a huge burden on the government, which is severely constrained to provide universal coverage for its people. Deficiencies in the medical system also cause ineffective treatment leading to wrong diagnosis and treatment. (Smith, Hiatt, and Berwick, 1999). In these aspects, ethical principles have evolved which seek to address healthcare as a basic fundamental right with the patient as the principal stakeholder. All efforts should be made to improve the condition of the patient and all institutions within the healthcare system should function in tandem to improve the quality of service. Ethical principles There have been a number of guidelines on ethics that have evolved which can be classified into four basic principles: 1. Autonomy deals with the right of the patient to take decisions for her/himself. This would require the health service provider to furnish all details of the disease to the patient and let him/her take a final call (Nelson, 2007). The shroud of secrecy that previously existed between the doctor and the patient should give way to a system in which the doctor makes the patient knowledgeable about the diseases, the pro and cons of resorting to a particular treatment and ultimately allow him/her to participate in taking a final decision. 2. Beneficence is a principle of providing a service which is beneficial to the patient and is provided by the care giver based on a sense of duty. The ultimate beneficiary should be the patient who should be able to get good treatment for the money he/she is being charged (Stewart and Chisholm, 1998). The carer should benefit from the services provided but not at the cost of the patient. 3. Non-malfeasance is an extension of beneficence as it urges those in the health sector not to take decisions or go for treatments that would adversely affect the patient or those who are in close proximity to the patient. Clinical freedom provides for the doctor to carry out treatments or administer drugs that, according to his/her sound medical knowledge, is best suited. (Stewart and Chisholm, 1998). However, if there is a disregard to the accepted rules of medical practice, then it would be trampling on patient rights. These areas of malfeasance would also include medical trials carried out on patients without their knowledge with drugs that have not been certified to use by the IMO. Administering drugs without fully disclosing the side effects to the patient or the impact it would have on ones that would come in contact with the patient also constitute malfeasance. 4. Justice is another ethical principle that constitutes the delivery of healthcare. Treatment and care should be given to all those who are availing it irrespective of caste, race, economic or religious prejudices (Stewart and Chisholm, 1998). The health sector cannot be compared to any other sector where a customer who is more economically well off is given access to the most benefits. The health of its people should be the prime concern of the government, and it has to strike a balance in allocating its resources in such a manner that all its people, young and old, the rich and the poor, have access to quality healthcare. Impact of ethical principles on the carer Following these principles of ethics which are paramount presents several challenges to the health carer or the service provider. The increasing cost of healthcare also poses a challenge to the hospitals in treating the patient at affordable cost. There are large overheads in running a hospital and also carrying out up gradations like Electronic Patient Record; installing new equipments like scanners; the costs which are ultimately offloaded to the patient. However, it is also important that hospitals try to modernise themselves to tackle diseases more effectively (Limentani, 2012). The ethical question would therefore be how far these expenses would be borne at the patient’s cost. Autonomy is another grey area impacting healthcare providers as providing all the information might sometimes prove to be harmful to the patient since it might lead to unnecessary tension and bouts of anxiety (Limentani, 2012). This would therefore severely hamper any further procedures that the doctor may have lined up for the patient. As stated earlier, these codes of ethics have evolved based on the respect to the individual, culture, philosophy and to an extent to the religious principles imbibed by the society. However, there are occasions when this medical procedure conflicts with the religious laws of the land. A recent incident of a woman in Ireland dying after contracting septicaemia because the doctors refused to terminate the pregnancy is a case in point. The reason given by the doctors was that abortion was against the Irish laws that were framed in line with the orthodox views of the Catholic Church. Doctors could be charged up to five years in prison if guilty of carrying out abortion (Suroor, 2012). However, the Catholic Church has vehemently denied this accusation saying that the doctors had misinterpreted the laws since the church is not against abortion when the life of the mother is at stake. These incidents throw light on the lack of understanding of medical ethics and how it should not be taken as a blanket code but needs to be interpreted case by case. There have been several cases of medical malfeasance that have been recorded over the past decade. In these cases, there have been a number of instances in which the intention of the doctor in carrying out an alternative procedure or administering a different drug was totally innocent. However, the procedure going awry might have resulted in negative side effects to the patient or even the patient dying (Limentani, 2012). Such mishaps, though accidental, should not always be construed as lack of understanding on the part of the doctor or his/her laxity in approach. Sweeping all such cases as acts of misdemeanour by the doctor would prevent doctors in going with their gut instinct choosing instead to be on the safe side. There are also instances where these principles of ethics enter a gray area and impact the delivery of healthcare. Euthanasia, or mercy killing, is a contested topic across the medical community with some advocating that use of this procedure is actually allowing the patient to die a dignified death (Moreland, 2000). However, this has been contested in many countries since it argues that doctors do not have the right to terminate a patient. Doctors advocating euthanasia argue that the infrastructure or life support that is being provided to a patient in a vegetative state could actually be put to better use on another patient who has more chances of increasing his quality of life. Healthcare should be in the eyes of the patient being equal to all. However, there are always certain sections of disadvantaged patients that seem to be low on the governments or hospitals radar. Autism in children and Alzheimer’s in older people are some examples where the debate still rages whether it would be better to employ a care organization which would look after the affairs of these people or go for in costly drug treatments (Limentani, 2012). This is because the nature of this disease is such that no one is exactly sure as to what extent the costly drug would help in treating the patient. Conclusion The principles of ethics act as guidelines for healthcare providers and facilitate care givers in taking decisions that would respect human dignity and also would be in line with the accepted norms of civilised human behaviour. However, these principles are not carved in stone and application of these principles would have to be debated depending on the merit of each case. The essay covers several challenges faced by the medical community in trying to seek a balance between the treatments provided to the patient, which might not always be in tune with the specified ethical guidelines. Bibliography Gabr, M., 2010. Healthcare ethics, equity and human dignity, [online], Available at [Accessed 30 November 2012] Limentani, A., 2012. The role of ethical principles in health care and the implications for ethical codes, Journal of Medical Ethics, pp. 394-398. Moreland, J.P, 2000. The euthanasia debate-understanding the issues, CRI, [online], Available at [Accessed 30 November 2012] Nelson, J., 2007. Ethical, legal and economic foundations of the educational process, [online], Available at: [Accessed 30 November 2012] Smith, R., Hiatt, H.,and Berwic, D., 1999. A shared statement of ethical principles for those who shape and give health care: a working draft from the Tavistock group, Effective Clinical Practice Volume 2, Number 3, pp. 141-144. Stewart, A., and Chisholm, D., 1998. Economics and ethics in mental health care: traditions and trade-offs, The Journal of Mental Health Policy and Economics, pp. 55-62. Suroor, H., 2012. Savita’s husband to approach European court of rights, The Hindu, 1st December, p. 22b. Read More