What Principles, Values and Standards Medical Ethics Include - Research Paper Example

? Ethical Dilemma Ethical Dilemma Ethical dilemma is a complex situation that revolves around a mental conflict between moral imperatives in which obeying one would automatically result in transgressing another (Banyard, 2006). Basically, an ethical dilemma revolves around ethical matters especially in social settings. An ethical matter is an issue that governs the ethics and morals of our lives. It is an indispensible concept especially when it comes to making decisions that pertain to various situations that affect our life, hence very crucial. According to Harris (2001), health care ethics, or bioethics, is the most crucial ethics all over the world because it entails the lives of human beings. Medical ethic is a set of honourable principles, values and standards that give guidance to individuals in hours when choices or decisions have to be made about health care in medical facilities (Harris, 1985). It further incorporates the behaviour in line with the right ethics that govern a person’s behaviour particularly when it relates to the responsibility and individuals with a health care facility. Case Study However, these situations are not always present in the medical care facilities especially when there is a moral conflict that is related to a patient and the physician concerned. One particular case is a situation where two patients are in dire need of medication. Gene uses a low fat diet, exercises on a regular basis but has a strong hereditary heart disease. He suffers a heart attack at the age of 44. On the other hand, Fred eats fast food and never takes exercise. He suffers a heart attack at the age of 44 (Seedhouse, 1988). Unfortunately, the Intensive Care Unit has one empty bed. Is it morally right for Gene to have priority over Fred? Consequentialism as a moral theory denotes that normative properties work only on the basis of consequences. A situation that is useful at various levels, and assorted normative properties in relation to being right morally through actions are a situation that depends on the consequences of the act (Beauchamp and Childress, 2001). Hence, it is morally right for Gene to have priority over Fred because his heart attack is related to a hereditary heart disease. Due to this, his condition is at more risk in terms of losing his life as compared to Fred who has acquired the disease from the lifestyle of taking in more fats in the body and the lack of exercises – a situation that has led to accumulation of fats in the body leading to heart attack. In essence, the heart attack being experienced by Gene is irreversible as compared to Fred‘s, which can be gradually reversed in relation to dieting and healthy living. Moreover, in relation to utilitarianism, consequences sometimes overlook justice and rights. This is clearly demonstrated through the fact that doctors are not supposed to cut up the life of a patient at all cost especially through killing, but should let nature take its course (Fulford et al., 2002). Hence, the doctors who attend to the case of the two patients suffering from a heart attack, Gene and Fred, should understand that although Fred might have had more priority over Gene even in terms of material possession, justice may not privilege in this situation because Gene’s situation is complicated, and if left unattended he might succumb to the disease. In essence, classic utilitarianism is consequentiality because it denies that moral rightness depends directly on anything other than consequences (Chadwick and Levitt, 1998). On the other hand, autonomy is defined as the ability to be one’s own person where you are guided by desires, considerations, and characteristics that are not basically influenced by external factors. This irrefutable value can best be demonstrated by the doctor or other medical practitioners who are attending to the patients. They should be in a position to make decisions, which favour their patients in relation to their own will and their profession. Basically, they should be guided by their various considerations without being influenced by external factors. Nevertheless, paternalism may be used to handle this situation. Paternalism is the opposite of autonomy as it revolves around the lack of respect for autonomy. Most importantly, sometimes a doctor may be forced to hide the truth about the health situation of a patient so as not to inflict more pain on the patient or better still result in premature death (Beauchamp and Walters, 1999). The responsibility of the doctor is put to test as both patients, Gene and Fred, are suffering from a critical illness. Even though there is only one bed, it is the mandate of the doctor to ensure that he treats and offers help to the patients according to the professional codes and ethics of his work which dictates that he should save lives (Campbell et al., 2001). The patients, too, have the responsibility of looking after their health at all cost and ensuring that they follow the instruction that they receive from the doctors upon falling ill. In general, the health ethic and cultural pluralism should be practised at all cost to make certain that people have admittance to health facilities in an affordable manner. Additionally, the health facilities should be well equipped with the necessary equipment in order to handle patients in a professional manner (Chadwick and Levitt, 1998). The rational and social justice that is stipulated in the medical world dictates that most people who happen to take their loved ones to hospital want beneficial things done to them. To them, the cost of treatment becomes a lesser factor particularly when it is not being borne by them but through health insurance coverage. Dimond (2002) argues that rationing in the heath care resources have helped in defining the ethics of rationing, which states that physicians owe an absolute duty of fidelity to individual patients regardless of the cost. However, this objective is discontinued in case the resources are exhausted to the extent of depriving care to individual patients because the problem ends up being real as compared to the statistics being given. Nevertheless, according to the law, the actions of medical practitioners, especially physicians, can be considered to be ethical because a patient declining treatment could not be viewed as making an attempt to commit suicide. In essence, the action merely allows disease to follow its natural course. If it happens that the patient dies, it could be termed as a self-inflicted injury but merely not seen as a result of the underlying disease (Campbell et al., 2001). It is important to note that physicians should use advocacy to provide information to patients, advise them and finally allow them to make independent decisions that pertain to their disease (Coote, 1995). This situation is further followed by defending and abiding by the patient’s rights to make decisions. This is because nurses are medical practitioners who end up spending a lot of time with the patients. As a result, patients are more likely to develop a trusting relationship with the nurse – a situation that puts a nurse in a morally accountable position with the patients (Brazier, 2003). Moreover, the ethical importance of advocacy as pertaining to accountability dictates that the natural role of performing tasks for patients, which the patient would have done for themselves were it not for the illness and affliction that they are going through, is a clear suggestion of advocacy on the part of the nurse. A nurse who identifies a patient’s right to a particular course of treatment is morally obliged to try and ensure that the patient gets the treatment, hence a patient’s advocate. The Ethical Dilemma The ethical dilemma in the case study is that both patients are suffering from the same critical illness that is a heart attack. However, Gene’s condition is hereditary while Fred’s condition has been caused by an unhealthy lifestyle. It is crystal clear that both patients are in dire need of urgent medical attention. The presence of only one empty bed at this particular hospital is in itself another dilemma for the doctor, and more so the family members of both patients who have brought them for treatment. Reactions Unfortunately, there are various stakeholders in this ethical dilemma. First, the patient is in a risky position which is accompanied by pain. Hence, all he wants is urgent treatment so he can continue with his life comfortably, free of pain. In fact, he cares less about whether there is an empty bed or not, but is more concerned with the doctor relieving him of the pain and agony he is going through as of now. Second, the family members of Fred do not understand the reason as to why the patient cannot get accommodation in the Intensive Care Unit (Kuhse and Singer, 1999). According to them, this shows lack of commitment on the side of hospital, as well as lack of respect for human beings. The health facility to them should be able to serve each patient without fail. The doctors and practitioners in this hospital have an ethical dilemma on what to do with either of the patients because both have similar conditions (Kuhse and Singer, 1998) Ethically speaking, there is a conflict between the doctor and the patients because he is not in a position to handle both of them due to lack of facilities. This is further deteriorated by the fact that at the end of the day, the doctor will only give one patient priority over the other without the consent of family members from both sides. Needless to mention is that all the parties involved here agree to a point that only one patient will have the empty bed. Influences on Ethical Dilemma Various issues have influenced the ethical dilemma in various ways. These issues include: gender, ethnicity, sexuality religion and age. In essence, ethics have become vital in the all perspective especially in the public domain (Fulford et al., 2002). Ethics in relation to gender is exceptionally philosophical and culturally complex with regard to choices that are made by individuals (Gillon, 1992). Different corporate groups and institutions expect employees to follow particular professional codes and ethics as dictated by their code of ethics. Moreover, different ethnicities have different ways in which they carry out their social lives and, hence, are obliged to follow ethics that govern them (Gillon, 1994). From the cultural perspective, ethics is incorporated as a culturally competent practice. When professionals practise in a culturally competent way, they must follow some of the programs that are meant to serve people who come from different cultural backgrounds (Morgan and Lawton, 1996). In essence, each person must be in possession of core fundamental capacities, which entails warmth empathy and the act of being genuine. Cultural competence is achieved sense of compassion as well as paying attention to cultures that are dissimilar. This should be accompanied by behavioural skills and moral responsibility. Hence, ethics in a cultural setup is about having congruent behaviours and attitudes (Singer, 1993). Rationing in the health sector ensures that money for health matters has been set aside by individuals, insurers or the state. However, some of these health rationings do not act in good of the patients as they force them to visit specific doctors whom they have negotiated with as per the insurance company. The dilemma in the case study above can be resolved if only the insurance companies set up venues where patients are allowed to see more than one doctor under the insurance cover. That way, Fred would have had an opportunity to seek medical attention from another medical practitioner and have his health cover still active (Kuhse and Singer, 1999). Basically, on a primary level decisions should be made by patients because it entails their lives. The government should also come up with ways in which the health of the state is standardized especially for those patients who are suffering from critical illnesses. The Oregon Health Plan was adopted by the American government in 1990, in which the state attempted to come up with procedures to be covered by its Medicaid program through the development of a transparent process that prioritised the medical services through laws and regulations – a process that was made public. In its settings, the Plan wanted citizens to be in a position where they would have universal access to a basic level of care. Thus, a panel of experts was called in to draw a line between the covered and uncovered services. This kind of plan would not have been applicable to the case study as it would have brought biasness to the entire health issue. Nevertheless, there is a need to understand the health rationing so as to help in choosing the care they need (Gillon, 1994). Conclusion Ethical dilemma is a complex situation that revolves around a mental conflict between moral imperatives in which obeying one would automatically result in transgressing another. Basically, an ethical dilemma revolves around ethical matters especially in social settings. Health care ethics, or bioethics, are the most crucial ethics all over the world because they entail the lives of human beings. Medical ethics is a set of honourable principles, values and standards that give guidance to individuals in hours when choices or decisions have to be made about health care in medical facilities. Consequentialism as a moral theory denotes that normative properties work only on consequences. A situation that is used at various levels, and dissimilar normative properties in relation to moral rightness of acts, argue that moral righteousness of any action works in relation to its consequences. On the other hand, autonomy is defined as the ability to be one’s own person where you are guided by desires, considerations, and characteristics that are not basically influenced by external factors. Paternalism is the opposite of autonomy as it revolves around the lack of respect for autonomy. In general, health ethics and cultural pluralism should be practised at all cost to make certain that people have admittance to health facilities in an affordable manner. The rationing in heath care resources have helped in defining the ethics of rationing, which states that physicians owe an absolute duty of fidelity to individual patients regardless of the cost. References Banyard, P., 2006. Ethnical issues in psychology. New York: Routledge. Brazier, M., 2003. 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