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Medical ethics case discussion
Medical ethics case discussion
Ethical dilemmas in medical field
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One notable example of a competing priority when the good of society is favored over the good of the individual is in the case of quarantines. In particular, the fear of an Ebola outbreak a few years ago led to some particularly public examples of individuals quarantined for reasons that they felt were not appropriate. A nurse who cared for Ebola patients in Africa, Kaci Hickox , was involuntarily quarantined upon her return back to the United States (Jobe, 2016). This quarantine was implemented despite CDC guidance that stated the quarantine was not necessary. It should be noted that politicians responsible for health related legislation may often have ulterior motives that may not abide by public or individual health ethics standards (Wynia, …show more content…
These tax-payer funds would likely be much better utilized providing more effective, low cost care to more individuals than high cost, low effective care to one individual. However, as the provider follows medical ethics and their obligation is to the patient, this occurs quite frequently in our current system. This can happen in the treatment of cancers with low success rates, or other expensive treatments involved in prolonging life for individuals with terminal illnesses. Ultimately, future restrictions in resources and funding may require more difficult decisions based on the good of the many over the good of the individual.
References
Bayer, R. (2007). The continuing tensions between individual rights and public health. Talking Point on public health versus civil liberties. EMBO Reports, 8(12), 1099–1103. http://doi.org/10.1038/sj.embor.7401134
Jobe, K. M. (2016). THE CONSTITUTIONALITY OF QUARANTINE AND ISOLATION ORDERS IN AN EBOLA EPIDEMIC AND BEYOND. Wake Forest Law Review, 51(1), 165-188.
Wynia, M. K. (2007). Ethics and Public Health Emergencies: Restrictions on Liberty. The American Journal of Bioethics, 7(2), 1-5.
There are many ethical paradigms through which humans find guidance and justification for their own actions. In the case of contractarianism, citizens of a state are entitled to human rights, considered to be unalienable, and legal rights, which are both protected by the state. As Spinello says, “The problem with most rights-based theories is that they do not provide adequate criteria for resolving practical disputes when rights are in conflict” (14). One case that supports Spinello is the case of Marlise Munoz, a brain-dead pregnant thirty-three year old, who was wrongly kept on life support for nearly two months at John Peter Smith Hospital in Fort Worth, Texas. Misinterpretation of the Texas Advance Directives Act by John Peter Smith Hospital led to the violation of the contractarian paradigm. Although the hospital was following the directive in order to maintain legal immunity for its hospital staff, the rights of the family were violated along with the medical fundamental principle to “first, do no harm.”
Over the years, medical researchers have violated parts of individual rights. However, the results from the famous study of Henrietta Lacks has provided for significant advancements in medical research. In hindsight, it makes sense to choose to save one hundred people while sacrificing only one individual in sake of the greater good. In the novel, Dawn by Octavia Butler, and an article written about Henrietta Lacks by Jessica L. Stump, correlations become evident between choosing the greater good over the individual. the choice to let an individual suffer somatically is acceptable when the sake of the greater good is in question.
Denise Dudzinski, PhD, MTS, Helene Starks, PhD, MPH, Nicole White, MD, MA (2009) ETHICS IN MEDICINE. Retrieved from: http://depts.washington.edu/bioethx/topics/pad.html
The patient should have confident and trust in their doctor, but the doctor must also recognize that the patient is entitled to have an attitude to illness and his preferred way of tackling this (Turner-Warwick, 1994). Buchanan infers that paternalism eliminates an individual’s power of making their own choices and thus pressed into making decisions. To achieve public health goals, greater considerations must be directed toward promoting a mutual understanding of a just society (Buchanan, 2008). So, if people are given the choice to make certain decision over another, then they are still granted freedom of choice. Buchanan identifies 3 arguments in justifying paternalistic actions: informed consent, weak paternalism, and utilitarianism. To support his argument of informed consent, Buchanan admits there is no significant ethical concern because an individual may reach out to the professional for help, but it is problematic when an intervention is targeting the entire population (Buchanan, 2008). This point of view from Buchanan is flawed and completely limits what public health is all about. The Institute of Medicine (IOM) defines public health as “what we, as a society, do collectively to assure the conditions for people to be healthy.” With its use of the phrase “we, as a society,” the IOM emphasizes cooperative and mutually shared obligation and it also reinforces the notion that collective
Providers must act in the best interest of the patient and their basic obligation is to do no harm and work for the public’s wellbeing. A physician shall always keep in mind the obligation of preserving human life. Providers must communicate full, accurate and unbiased information so patients can make informed decisions about their health care. As a result of their recommendations, providers are responsible for generating costs in health care but do not generate the need for those expenses. Every hospital has both an ethical as well as a legal responsibility to provide care, even if the care may be uncompensated.
Recently, there has been a large outbreak of the Ebola Hemorrhagic virus in West Africa, causing wide spread suffering and death in the region. In effect, many humanitarian missions have been deemed necessary to help countries treating patients suffering from the virus, as well as preventing the expansion of the epidemic. Unfortunately, some of the medical personnel who went on the humanitarian missions have returned to their own countries only to come down with the virus days later. As a result, some states in the U.S. implemented a mandatory 21 day quarantine for any person coming back from West Africa who treated a person infected with the Ebola virus. This quarantine was enforced on Kaci Hickox, a nurse, who was taken straight from the airport to a hospital and held for days after informing officials about her job abroad and having an elevated temperature after being questioned for several hours. The question in this case is it ethically right to make a mandatory quarantine for humanitarians. By applying both the Utilitarian and Deontological rational we can understand the perspective used to justify the quarantine or reject it.
Pillay, Navanethem. "Right to Health and the Universal Declaration of Human Rights."The Lancet 372.9655 (2008): 2005-6. ProQuest.Web. 30 Oct. 2013.
Gedge, E., & Waluchow, W. (2012). Readings in health care ethics (2nd ed.). Toronto, Ontario: Broadview Press.
Steinbock, Bonnie, Alex J. London, and John D. Arras. "’Rights- Based’ Approaches." Ethical Issues in Modern Medicine. Contemporary Readings in Bioethics. 8th ed. New York: McGraw-Hill, 2013. 23. Print.
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
Jecker, N. (1990). Integrating medical ethics with normative theory: Patient advocacy and social responsibility. 11(2), 125-139.
...ld they spend it on heroic medicine, which may aid in a lot of physical pain and suffering, with substantial compromised quality of life on the other end at the very best . The insurer should be 100% to poffer the patient as much of the savings as possible.
Webster, C. & French, J. (2002) The Cycle of Conflict. The History of Public Health and Health Movements London: Sage
The question of what is the government’s role in regulating healthy and unhealthy behavior is one that would probably spark a debate every time. Originally, the role was to assist in regulating and ensure those that were unable to afford or obtain healthcare insurance for various reasons would be eligible for medical care. However, now it seems that politicians are not really concerned about what’s best for the citizens but woul...
Medical ethics is focused on a single patient or family where public health ethics is focused on an entire population or group of people. Conflict may arise when the good of one patient does not meet the good of the entire population or the entire group that the one person belongs to. Public health emphasizes the greater good of larger numbers of people where medical ethics is focused on just one. The principle of justice plays an important role in both medical and public health ethics. Justice is the core of public health ethics and is associated with the equality of opportunity, equity of access, or equity in benefits (Williams & Torrens, 2008). Public health serves the entire population; thus it is focused on equity among various social