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Theories and Principles that Govern Ethical Decision Making in Medicine - Research Paper Example

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Theories and Principles that Govern Ethical Decision Making in Medicine
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Running Head: Theories and Principles that Govern Ethical Decision Making in Medicine Theories and Principles Governing Ethical Decision Making In Medicine
Abstract
This paper is written to present the underlying theoretical concepts and principles governing ethical decision making in the field of medicine. In addition, it aims to determine the ways in which conflicts of interest inherent in various financial and organizational arrangements for the practice of medicine can pose threats to the medical professionalism.
Introduction
The study of ethics has intrigued the faculties of scholars since early philosophers and ethicists during the times of Plato, Socrates, and Aristotle, to name a few. Johnson (1965) defined ethics as “the systematic inquiry into man’s moral behavior with the purpose of discovering the rules that ought to govern human action and the goods that are worth seeking in human life”. These ethical standards governing the existence of human life also encompass the realm of medical entities. This essay is written to present the underlying theoretical concepts and principles governing ethical decision making in the field of medicine. In addition, it aims to determine the ways in which conflicts of interest inherent in various financial and organizational arrangements for the practice of medicine can pose threats to the medical professionalism.
Theories and Principles
There are basically five underlying theoretical framework for ethical decision making in the medical profession, to wit: deontological theory (what one must do, based on duties and obligations), teleological theory (the purpose or consequences of the moral acts), consequentialist theory (the moral value of an act, rule or policy is to be found in its consequences, not in intentions or motives), virtue ethics (seen in the way we feel is the ‘right’ way to behave towards patients and to colleagues) and casuistry (or case based reasoning, does not focus on rules and theories but rather on practical decision-making in particular cases based on precedent). (Slowther, et.al. 2004)
Slowther, et.al. (2004) averred that “Beauchamp and Childress’ Four Principles approach is one of the most widely used frameworks and offers a broad consideration of medical ethics issues generally, not just for use in a clinical setting”. These principles are: “(1) respect for autonomy: respecting the decision-making capacities of autonomous persons; enabling individuals to make reasoned informed choices), (2) beneficence: balancing benefits of treatment against the risks and costs; the healthcare professional should act in a way that benefits the patient, (3) non maleficence: avoiding causing harm; the healthcare professional should not harm the patient. Most treatment involves some harm, even if minimal, but the harm should not be disproportionate to the benefits of the treatment. And (4) justice: respect for justice which takes the following forms: distribution of a fair share of benefits, legal justice - doing what the law says, rights based justice, which deals in the language, and perhaps the rhetoric, of claimed human rights, and hence goes beyond, though it includes, legal rights”. (Slowther, et.al. 2004)
Conflict of Interests
One source of conflict of interests lie in red tag cases: where patients confined in health institutions accrue bills which cannot be immediately settled. Due to long stay and numerous laboratory, diagnostic and therapeutic examinations, statements of account reach a staggering total which could not be immediately covered by the funds of the patient and her family. Once a patient has been classified as “red tag”, any procedure (therapeutic, diagnostic, laboratory, etc.) need to be immediately settled prior to the administration of the procedure, regardless of the necessity and the kind of the procedure to be undertaken. The rationale for this is to prevent further increases in the amount due to the hospital which might not be collected nor paid. This case poses threat to the medical profession since it inhibits the administration of the required medical attention and procedures due to the red tag policy. The above case is an ethical dilemma which falls under deontological ethics in terms of holding that at least some acts are morally obligatory regardless of their consequences for human welfare.
Other ways in which conflict of interests arise in the medical profession are: (1) when physicians accept gifts of any kind; (2) when physicians promote products or speak in behalf of a certain organization; and (3) when physicians have a financial interest on a certain product they are prescribing, using, or recommending (Lo & Field, 2009, p. 133).
Conclusion
Health care organizations have a great responsibility to ensure that patients receive the best possible treatment within their respective budgets or finances. Problems occur when one party fails to deliver what is expected by the other. Apart from financial problems brought about by hospital bills, patients and their families are faced with the burden of finding out possible outcomes from the delivery of health care. Another relevant ethical concerns faced by health organizations are medical errors. This is broad topic with legal implications. According to O’Rourke, “errors can be prevented by designing systems that make it hard for people to do the wrong thing and easy for people to do the right thing.” However, despite clearly stated policies and rules that ensure that management does the right things in compliance to ethical standards, inevitable events still occur which seem to contradict business ethics. In the end, by establishing a harmonious relationship and by ensuring that the health care organization has complied with the high standards of safety and efficient delivery of patient care, no ethical problem, business nor medical, could remain unresolved.
References
Johnson, O.A. (1965). Ethics: Selections from Classical and Contemporary Writers. Holt,
Rinehart and Winston, Inc. New York.
Lo, B. & Field, M. (2009). Conflict of Interest in Medical Research, Education and
Practice. Institute of Medicine, National Academy of Sciences.
O’Rourke, K. (2004). Medical Error: Some Ethical Concerns. Catholic Health
Association of the United States. Retrieved on June 21, 2009 from

Slowther, A., Johnston, C., Goodall, J., & Hope, T. (2004). A practical guide for clinical
ethics support. The Ethox Centre. Section C: Ethical Frameworks. Retrieved
August 27, 2009 from Read More
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