Bioethics and Medical Ethics
Medical ethics is a form of applied ethics that is concerned with moral values and judgments as it applies to medicine.
Bioethics is a philosophical discipline encompassing social, legal, cultural, epidemiological, and ethical issues arising due to advance in healthcare and life science research.
Stories That Made History
"We need people who are committed to caring for people all the way through to their death as if they were family members, committed to relieving their suffering. Sometimes that requires helping people to die."
Timothy E. Quill, MD
“In quixotically trying to conquer death, doctors all too frequently do no good for their patients’ “ease”, but at the same time they do harm instead by prolonging and even magnifying patients’ dis-ease.”
― Jack Kevorkian,
The Blurred Lines of Ethics in Medicine and Science
The blurred image is difficult to look upon and it poses even greater difficulty when one attempts to focus. Equally difficult are the complex and painful choices doctors and families face in the area of medical ethics and bioethics. Turn right? Turn left? Move straight ahead with uncertainty? The playing field is never level; the boundaries are blurred lines, and no one ever has home court advantage.
At the crossroads of ethics, science and medicine lie the ruins of human life and the salvation of life through human sacrifice. How far should the arms of medicine and science reach in an effort to advance science and research and to save lives?
AMA CODE OF MEDICAL ETHICS
AMA PRINCIPLES OF MEDICAL ETHICS
The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. The following Principles adopted by the American Medical Association are not laws, but standards of conduct that define the essentials of honorable behavior for the physician.
Principles of medical ethics
- A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
- A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
- A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
- A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
- A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
- A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
- A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
- A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
- A physician shall support access to medical care for all people.
Medical Ethics and History
This short video featuring Dr. David Jones, a Bernard Ackman professor of the culture of medicine, provides a general overview of the history of ethics in this trailer for an academic course in medical ethics.
The Four Principles of Health Care Ethics
The four principles of health care ethics developed by Tom Beauchamp and James Childress in the 1985 Principles of Biomedical Ethics provide medical practitioners with guidelines to make decisions when they inevitably face complicated situations involving patients.
The basic definitions of each of the four principles of health care ethics are commonly known and used often in the English language, but they take on special meaning when being utilized in a medical setting. All of these principles play a key role in ensuring optimal patient safety and care.
1. Autonomy: In medicine, autonomy refers to the right of the patient to retain control over his or her body. A health care professional can suggest or advise, but any actions that attempt to persuade or coerce the patient into making a choice are violations of this principle. In the end, the patient must be allowed to make his or her own decisions – whether or not the medical provider believes these choices are in that patient’s best interests – independently and according to his or her personal values and beliefs.
2. Beneficence: This principle states that health care providers must do all they can to benefit the patient in each situation. All procedures and treatments recommended must be with the intention to do the most good for the patient. To ensure beneficence, medical practitioners must develop and maintain a high level of skill and knowledge, make sure that they are trained in the most current and best medical practices, and must consider their patients’ individual circumstances; what is good for one patient will not necessary benefit another.
3. Non-Maleficence: Non-maleficence is probably the best known of the four principles. In short, it means, “to do no harm.” This principle is intended to be the end goal for all of a practitioner’s decisions, and means that medical providers must consider whether other people or society could be harmed by a decision made, even if it is made for the benefit of an individual patient.
4. Justice: The principle of justice states that there should be an element of fairness in all medical decisions: fairness in decisions that burden and benefit, as well as equal distribution of scarce resources and new treatments, and for medical practitioners to uphold applicable laws and legislation when making choices.
- Informed consent to medical treatment is fundamental in both ethics and law.
- Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.
- Successful communication in the patient-physician relationship fosters trust and supports shared decision making
- .The process of informed consent occurs when communication between a patient and physician results in the patient’s authorization or agreement to undergo a specific medical intervention. In seeking a patient’s informed consent (or the consent of the patient’s surrogate if the patient lacks decision-making capacity or declines to participate in making decisions), physicians should:.
a. Assess the patient’s ability to understand relevant medical information and the implications of treatment alternatives and to make an independent, voluntary decision.
b. Present relevant information accurately and sensitively, in keeping with the patient’s preferences for receiving medical information.
c. Document the informed consent conversation and the patient’s (or surrogate’s) decision in the medical record in some manner. When the patient/surrogate has provided specific written consent, the consent form should be included in the record.