PRINCIPLES OF ETHICS IN MEDICINE ETHICS IN MEDICINE ETM: 400 GROUP 1 PRINCIPLES OF ETHICS IN MEDICINE (TRADITIONAL PILLARS OF MEDICINE)

INTRODUCTION Medical ethics is a system of moral principles that apply values and judgment to the practice of clinical medicine and in scientific research. Medical ethics allow for people, regardless of race, gender, or religion to be guaranteed quality and principled care. It is based on set of values that health care professionals can refer to in the case of any confusion or conflict. Due to the many variables that exist in the context of clinical cases as well as the fact in health care there are several ethical principles that seem to be applicable in many situations as we’ll see in this presentation. 

OBJECTIVES To understand the importance of ethics and professionalism in the practice of medicine To understand the four traditional principles of health care To understand the process of analyzing an ethical case To increase student knowledge and awareness regarding philosophy of morality and human rights  

DEFINITION OF TERMS Ethics: Moral principles that govern a person’s behavior or the conducting of an activity Principle: A fundamental truth or proposition that serves as the foundation for a system of belief or behavior. Standard: Refers to a level of quality or attainment. Morality: Refers to principles concerning the distinction between right and wrong or good and bad behavior.

ETHICS AND MEDICINE

MAIN DISCUSSION The four main traditional principles of health care are: Principle of respect for autonomy Principle of beneficence, Principle of non-maleficence and Principle of justice However there are many other principles guiding the health care professionals as we’ll see later in our discussion.

TRADITIONAL PILLARS OF HEALTH CARE

1. RESPECT OF AUTONOMY Autonomy refers to an individual freedom or one’s right to make decisions without being forced. The principle of respect for autonomy entails taking into account and giving consideration to the patient’s views on his/her treatment. This principle is the basis for the practice of informed consent in the physician/patient transaction regarding health care. Informed consent is analyzable in terms of autonomous choice by patients and subjects. The most common approach to the definition of informed consent has been to specify the elements of the concept which are: Competence Disclosure of information Understanding of information Voluntariness Authorization

PRINCIPLES OF ETHICS

2. PRINCIPLE OF BENEFICENCE The ordinary meaning of this principle is that health care providers have a duty to be of a benefit to the patient, as well as to take positive steps to prevent and to remove harm from the patient. These duties are viewed as rational and self-evident and are widely accepted as the proper goals of medicine. This principle is at the very heart of health care implying that a suffering supplicant (the patient) can enter into a relationship with one whom society has licensed as competent to provide medical care, trusting that the physician’s chief objective is to help

3. PRINCIPLE OF NON-MALEFICENCE The principle of non-maleficence requires us that we not intentionally create harm or injury to the patient, either through acts of commission or omission. This principle affirms the need for medical competence. It is clear that medical mistakes may occur, however, this principle articulates a fundamental commitment on the part of health care professionals to protect their patients from harm.

4. PRINCIPLE OF JUSTICE The fourth principle demands that you should try to be as fair as possible when offering treatments to patients and allocating scarce medical resources. You should be able to justify your actions in every situation. In fact, our society uses a variety of factors as criteria for distributing justice, including the following To each person an equal share To each person according to need To each person according to effort To each person according to contribution To each person according to merit To each person according to free market exchanges

PROFESSIONAL-PATIENT RELATIONSHIP The above explained principles are the main principles of medical ethics. However there are other principles which analyze various relationships between health care professionals and patients. These may be grounded to a single principle or several principles. Veracity This principle suggests that physicians should deal honestly with patients. It includes the obligation of telling the truth and not to lie or deceive patients. Privacy A person has privacy if others do not have or use access to him or her. This rule focus on the patient’s rightful control over access to himself or herself.

PROFESSIONAL-PATIENT RELATIONSHIP Confidentiality This principle suggests that a patient has a rightful control over access of information concerning him or her. Fidelity Fidelity refers to ‘faithfulness’ of a medical professional. In establishing a relationship with a patient, the physician makes an implicit or explicit promise to seek the patient’s welfare. A related promise is that the physician will not abandon the patient until the patient’s health is secured.

STEPS IN REACHING UNETHICAL DECISIONS Describe the case simply but with pertinent facts. Specify the ethical dilemma. Enumerate the alternatives available. List the key considerations (e.g. Autonomy, Beneficence) Propose a resolution. Review the choice critically. Do the right thing.

SUMMARY The principles of healthcare ethics complete the elements necessary for the reflective equilibrium. The primary principles of healthcare ethics are autonomy, beneficence, non-maleficence, and justice. Justice is by far the most complex principle, because it includes various conceptions of rights and there is greater dispute about what injustice is and how to achieve it. A person will have to use reason to pick among the principles, the theories, the common morality, and the considered judgment to apply them on the issue at hand.

CONCLUSIONS In this presentation we have moved beyond the obligations and rights created by the four basic moral principles and their derivative principles. The obligations, virtues, and ideals analyzed are basic and indispensable threads in the moral life, but the moral life is a still richer fabric with other threads in its weave.

RECOMMENDATIONS As discussed above, medical ethics are standards of morality of all health care professionals. These standards are guarded by principles which enables the physician to be fair and just but also to know the rights of the patients. All medical professionals ought to understand these principles since they apply values and judgment to the practice of clinical medicine. The understanding of these principles can be referred to by professionals in case of conflict and confusion.

REFERENCES Ruth Purtilo (2005) Ethical Dimensions in the Health Professions (4th Edition) Thomas A Mappes & David Degrazia (2001) Biomedical Ethics (5th Edition) Tom L.B & James F. C (1989) Principles of Biomedical Ethics (3rd Edition)