The Core of the Hippocratic Tradition - Assignment Example

 The Core of the Hippocratic Tradition  The core of the Hippocratic tradition of professional medical ethics, which enjoyed a remarkable degree of continuity through the centuries, is the maxim of premium non nocere (first do not harm). On this basis, living organ donation, which requires healthy donors to be harmed by surgery, and the loss of an organ, seems morally contestable. Christian theology’s former strict ban on self-mutilation held similar principles. Ethical issues pose a problem or situation that requires a person or organization to choose between alternatives that must be evaluated as right (ethical) or wrong (unethical). A social, religious, or civil code of behaviour considered correct, especially that of a group, profession, or individual. Medically, particularly in issues in dropping patients from the transplant list, ethics espouses principles such as autonomy, beneficence, non-maleficence and justice. The paper focuses on organ transplant lists, how patients can qualify and be disqualified from this list, ethical principles in organ transplant, and how these principles can be used to criticize a patient dropping from the transplant list. Ethical Issues in Dropping Patients from Transplant List 1. Introduction Organ transplant list is a waiting list for patients waiting for organ transplantation surgery, to be performed on them. It is a computerized list that contains information about people waiting for an organ transplant operation. This information is mostly medical. In the list, there is no ranking order for patients deciding who will get the organ first. Also, a person’s position in the list will not change i.e. going up or down when another patient gets an organ. Different organ transplants have different factors to be considered to qualify to the waiting list. Wealth, citizenship, and social status have considerations in any of these transplants. Some of the factors considered include; geographical location, results of medical tests, clinical or medical status, time elapsed while waiting, and tissue marching results (Wilkinson & Leslie, 256). Several factors may be considered before dropping a patient from the transplant list. One of the factors is the psychological state of the patient. Patients waiting for an organ transplant go through sessions of psychological evaluations. If the patients fail to meet the required standards of psychological state, they can be withdrawn from the list. In most cases, it is mental retardation that will lead to a patient’s disqualification. The patient’s financial capability to pay for the organ transplant procedure is another factor to be considered (Wilkinson & Leslie, 156). Financial advisors and counsellors help to determine whether a patient is capable of handling the expenses of the organ transplant. They also determine if they can handle the many medical expenses arising from the medicines needed to ensure the body does not reject the organ. Addictive and harmful behaviour can also be a factor before the disqualification from an organ transplant. If the medical condition is caused by engaging in addictive and harmful activities, patients are required to quit these behaviours. If the patients fail to meet this requirement, they risk elimination from the waiting list. The ability of the patient to take care of themselves health wise is also put in great considerations when deciding qualifies for an organ transplant. Before an organ transplant procedure, patients get several instructions from their doctors. These instructions help maintain a good health state. If the patient fails to follow these instructions they risk being detached from the list, (Wilkinson & Leslie, 356). The world Health Organization (1991) intimates the ethical principles and theories that provide guidelines on which decisions should be made. Different points like a person’s duty to others and prediction of an outcome form the emphasis of the ethical theories. For an ethical theory to be applicable, it has to aim to a particular mutual goal. The general goal for ethical theories underlies in the ethical principles. These goals determine the accomplishment or failure of the theories. Ethical principles include beneficence, anatomy, justice and non-maleficence. These principles can be used to criticize the dropping of patients from the organ transplant list (Petechuck, 168). 1.1 Ethical Principles 1.1.1 Autonomy Autonomy is the main characteristic that distinguishes humans from animals. It is the ability of a person to reason out and make decisions about his actions by himself (Taskforce on Organ Transplantation, 1986). Therefore, the respect of autonomy means that people make the decisions that would affect their lives for themselves. In the medical world, the issue of respect of autonomy raises some question about who qualified for treatment as directed by this principle. Mostly, this is in the case of children and patient who are not in the right mental state. The issue on how old a child should become in order to be allowed to make his or her medical decisions is still debatable. Also, should patients who are not mentally stable be allowed to make their own medical and health decisions? (Petechuck, 168). According to this principle, patients should not be removed from the organ transplant list on the basis of; them not following the doctors instructions on how to live a healthy life, on their psychological state before the procedure except in the case of retards, on whether they will be able to cater for the medical expenses after the procedure and their involvement in addictive and harmful activities. In all these situations, it shows how an organ transplant patient is not given respect and freedom of making choices of how his is going to live his life. The system puts conditions that take away their freewill (Petechuck, 168). 1.1.2 Beneficence The term beneficence refers to the acts of mercy, charity and kindness. This principle guides people to do what is upright and veracious. It advocate for the acts of love, altruism, humanity and upholding the good on fellow humans (Robert, 174). This principle is a moral obligation for people to help others achieve their valued and legitimate goals by possibly preventing any harm that could affect them. Although it may be argued that the principle of beneficence is not an obligation of all the members of the society, this principle is an important obligation to people in role-assigned positions such as professionals. According to Land & Dossetor (1991: 56) in the case of organ transplant, doctors should be guided by the principle of beneficence. Doctors are required that to act in a manner that serves the betterment of the patient. Their professional ethics stipulates that they show mercy, compassion, kindness, care and charity to their patients. If a doctor drops a patient from the organ transfer list, he goes against his ethical requirements. Organs transfer patients suffer due to their organs failures. Removing them from the waiting implies condemning them to more suffering. 1.1.3 Non maleficence This has similarities to beneficence. However, in non-maleficence, all available choices will cause harm. This principle requires people to take choice that will cause the minimal harm to the least number of people. In the Hippocratic Oath, medical practitioners and physicians are obligated to do no harm to the patient because their primary role is to reduce their suffering but not to inflict more pain and suffering. Physicians should not act in malicious ways towards their patients or offer ineffective treatment since these actions may harm the patient (Robert, 154). In the case of organ transplant list, although the organs are limited the doctors should try their level best to be a fair to all patients. According to this principle, it is not in the best interest of all to drop some patients from the list. This includes cases where patients are dropped because they engage in harmful behaviour that aggravates their medical condition. 1.1.4 Justice This principle requires that, actions taken should be fair to the people affected. This means that people should be consistent while making decisions. In the context of medicine, justices does not mean providing equal number of organs equally to all locations, but it is equally giving organs to people who have equal needs for those organs. Doctors go against this principle when they remove patients from the list. Although these patients may have failed to meet the set conditions, their need for the transplant does not change (Robert, 203).                                                            Works Cited Petechuck, Peter, R., Organ Transplantation. California: Greenwood Publishing Group, Inc. 2008, Print. Robert, M., Veatche Organ Transplant Ethics. Washington DC: Georgetown University Press.2000, Print. Wilkinson, Judith, M. and Treas, Leslie, S., Fundamentals of Nursing: Thinking, Doing and Caring.  New York: Unknown PTHE Pub.2011, Print. Task Force on Organ Transplantation (1986) Organ transplantation. Issues and recommendations. U.S Department of Health and Human Services, Washington Land W, Dossetor JB, eds. (1991) Organ replacement therapy: ethics, justice and commerce. Springer, Berlin Heidelberg New York    World Health Organisation (1991) Guiding principles on human organ trans­plantation. Lancet 337:1470-1471   Read More