The best way to do the right
Department: Diagnostic Medical Sonography
Biomedical Ethics , Professor: Gisela Llamas
Florida National University
Material & Methods (Click)
. Ethical dilemmas are all too common for case managers who must ask hard questions, juggle resources, and make decisions that impact patients and their family members. As a case manager you are in a dilemma as you try to balance the care needed by Leonard with the finances of the hospital.
Professional ethics are incumbent only on those individuals who occupy a professional role. Beyond that, each of us has a moral threshold, a bar below which we will not compromise. To compromise below your moral threshold is to compromise your personal integrity.
In 1947, following World War II, discussion of ethical standards turned from physician/patient concerns toward social issues. After awareness had grown of war atrocities such as the Nazi’s human experiments in the concentration camps and the Japanese experiments in China, news came of the Tuskegee controversy in the United States (in which medical research was done on black soldiers) and public outrage grew. Human rights cases were widely publicized, creating the need for stronger ethics standards.
Autonomy: In medicine, autonomy refers to the right of the patient to retain control over 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.
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.
Dr. Smith knows that Patient Jones has a disease for which there is no cure. Research shows that informing patients about their diagnosis of this disease causes psychological damage. Dr. Smith is considering keeping the diagnosis a secret from the patient to avoid causing psychological harm. Dr Smith thinks it doesn't matter, since there is no cure anyway.
• Consideration of the principles:
• Charity: Dr. Smith may believe that he is doing "right" by not informing the patient (of course, that is debatable).
• Non-Maleficence: Dr. Smith is trying to avoid the psychological damage that could follow.
• Autonomy: Dr. Smith is actually DENYING the autonomy of the patient, but does not allow him to access the power associated with knowledge of the diagnosis.
Justice: it could be argued that it is unfair to hide information from a customer.
Whether your role is that of a doctor or a health care administrator, working in the field of health care is both highly rewarding and challenging. Many medical procedures and treatments have both merits and downsides, and patients have their own input and circumstances to consider. 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 four principles of health care ethics are autonomy, beneficence, non-maleficence, and justice. Related Publications / Conferences/Article forthcoming/2014, ASBH – San Diego/2014, ICCEC – Paris/2009, J. Tuohey & J. Young, J. Hosp. Ethics (PDF)/2008, ICCEC – Rijeka