Revelations from the Tuskegee syphilis experiment forced the medical community to enact policies to prevent such a tragedy from repeating itself. Consequently, the Belmont Principles and Declaration of Helsinki were created in order to establish a universal code of ethics for research involving human subjects. Both the Belmont Principle and Declaration of Helsinki emphasize that the well-being of research subjects triumphs over any research goals. Although these documents were created in order to simplify and unify medical ethics, their simplicity allowed for continued debate. In the editorial “The Ethics of Clinical Research in the Third World,” Marcia Angell argues that the current shift towards the privatization of clinical trials has diminished standards expressed by the Belmont Principles and the Declaration of Helsinki.
However, there exists a profession in which the ramification of these mistakes and imperfections can be most deadly. Medicine is one of the few highly regarded fields in which the professionals are able to dictate their own standards. The importance and magnitude of this liberty to self-govern can be a boon to those practicing within the ethical and moral confines, however, breaking the trust of self-governance as a profession not only puts the offender in peril but the integrity of the institution as well. Dishonesty as it relates to three aspects of medicine in particular will be discussed in this essay: Dishonesty as it relates to medical training, in particular, during medical school, Dishonesty as it relates to postgraduate medical work/career and lastly dishonesty as it relates to medical advancement, publications and data. Medical school is the defining moment for a young physician.
The GMC includes the importance of confidentiality in maintaining the trust that both patients and the public have for doctors. This is vital for public heath because a general mistrust for doctors can form a culture where individuals refrain from seeking medical advice. This could potentially increase the prevalence of disease and mortality rates. It is seen that various methodologies indirectly support the concept of confidentiality, implying that its ethical basis is principally inarguable. In the UK patient privacy is enforced by the law and the two aforementioned cases demonstrate the severe consequences that can ensue when health professionals breach confidentiality.
In this paper, I will explore the use of defensive medicine according to physician specialty and attempt to find their relationship to medical malpractice. Defining the term “defensive medicine” is crucial to the understanding of my project. In its most basic form, defensive medicine is “[the] practice of medicine centering, as its primary aim, around self-protection from liability in the event of a tragic outcome, rather than affording primacy to the patient's well-being…” (Hauser et al. 1991). Defensive medicine or defensive decision-making generally requires doctors to perform unnecessary tests and treatments for their patients.
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.
A practice commonly used in the medical field, “benevolent deception” is the act of physicians suppressing information about diagnoses in hopes of not causing patients emotional turmoil (Skloot 63). Benevolent deception is a contentious subject because when used, the bioethical principles of respect for autonomy and beneficence can conflict with each other. Respect for autonomy is when physicians acknowledge their patients’ abilities to make voluntary decisions on their own regarding their health care (McCormick 4). Meanwhile, beneficence is the duty of doctors to be of a benefit to patients, while also taking measures to prevent and remove harm from them (McCormick 5). When giving patients diagnoses, physicians need to follow these doctrines by creating a balance between telling the truth and providing hope, which is why some may mistakenly turn to benevolent deception as the answer.
The author explains how randomized clinical trials put physicians in ethically intolerable positions of choosing between the good of the patient and that of society. A kantian argument is formed when the author explains how the physician has the duty to tell the truth and not use the patient as a mere means to satisfy the needs of a majority. The well being of the patient is far more important than that of the society when it comes to treatment by personal physician, the Author suggests that there should be alternatives to randomized clinical trials to deal with observer bias and patient selection. The overall message of the article stresses the importance of a patient’s well being over the well being of a society because the physician has the duty to help the patient improve his/her health. Article two entitled “Clinical trials: are they ethical?” is written by Eugene Passamani discusses the importance of randomized clinical trials.
Privacy protections for medical records present a regulatory nightmare. Medical records are critical to quality care since they give a doctor a patient's history; they are key to preventing dangerous drug interactions, complications from allergies, and harmful drug side effects. Medical records also play a key role in medical and health system research. The information in a patient's medical records, however, can be used for much more insidious purposes; denial of medical care, denial of employment, character assassination, and extortion are all consequences of medical information falling into the wrong hands. The difficulty of balancing these needs has resulted in a thin patchwork of regulatory protection of medical information; as one commentator has noted, federal law protects video rental records more thoroughly and completely than medical records.
Medical and experiment research is important to the society and helped cures disease, cancer and other medical condition to human. But only if the experiments have to be ethical and the participant in the experiment should have the right to choose to continue in the experiment or research. In today medical world it would be very difficult for the science and the general community to accept any research or treatment similar to the Nazi physicians causes death to thousands of individual being test and subject to these research and development. The past of unethical research has created the framework of “Nuremberg Code” and “The declaration of Helsinki”, The Belmont Report to protect and avoided painful, death and unnecessary to human, animal. The research must be helpful and help to cure disease and must contribute a value to the peoples.
My stance is in support of the obligation to provide free care. Hospitals and providers must make extremely difficult decisions and evaluate patients on a case-by-case basis but when a circumstance is beyond the patient’s control and the treatment can dramatically improve a patient’s wellbeing, it is unethical to deny a patient free care (Welter, 2009). Theories of distributive justice, such as utilitarianism and egalitarianism, have emphasized the importance of applying decision-making principals uniformly and consistently (Welner,