Medical ethics
Medical ethics is the discipline of evaluating the merits, risks, and social concerns of activities in the field of medicine.
Medical ethics shares many principles with other branches of healthcare ethics, such as nursing ethics.
Ethical thinkers have suggested many methods to help evaluate the ethics of a situation. These methods provide principles that doctors should consider while decision making.
Six of the principles commonly included are:
- Beneficence - a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)
- Non-maleficence - "first, do no harm" (primum non nocere).
- Autonomy - the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
- Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment.
- Dignity - the patient (and the person treating the patient) have the right to dignity.
- Truthfulness and honesty - the patient should not be lied to, and deserves to know the whole truth about their illness and treatment (though certain exceptions are made for the proper use of placebos).
Principles such as these do not give answers as to how to handle a particular situation, but guide doctors on what principles ought to apply to actual circumstances. The principles sometimes contradict each other leading to ethical dilemmas. For example, the principles of autonomy and beneficence clash when patients refuse life-saving blood transfusion.
To reconcile conflicting principles, Bernard Gert, a philosopher who specializes in medical ethics, propounds a theory that would require us to advocate our action publicly if we were to violate any basic moral principles (e.g., break a promise in order to save a life). Other philosophers, such as R. M. Hare, would require us to formulate a universal prescription in conformance with logic, such that all rational parties, including the patient (assuming he is rational), would subscribe to the same action in all circumstances that share the same essential properties.
In the United Kingdom, General Medical Council provides clear modern guidance in the form of its 'Good Medical Practice' statement.
Death and dying
- Euthanasia
- Final directives and ethics of resuscitation and the withdrawal of life support (See also Do Not Resuscitate and cardiopulmonary resuscitation)
- Use of human tissue in medicine, including blood transfusion and growth hormone treatment.
Reproductive medicine
Medical research
- Animal research
- Belmont Report
- CIOMS Guidelines
- Declaration of Geneva
- Declaration of Helsinki
- Declaration of Tokyo
- Human experimentation
- Nuremberg Code
- Patients' Bill of Rights
- Stem cell research
- Universal Declaration of Human Rights
- Willowbrook Study
Distribution and utilization of research and care
- Accessibility of health care
- Basis of priority for organ transplantation
- Institutionalization of care access through HMOs and medical insurance companies
Critiques of conventional medicine
- Committee for promoting responsible medicine
- Acceptability of toxicity in conventional medication (e.g. chemotherapy)
- Iatrogenic illness caused by medicine itself
- Institutional Damage caused by long term stay in hospitals, which is not an ideal substitute for family care and education.
- Invasiveness and inherent dangers of surgery
- Medical error
- Pervasiveness of medical advertising and material rewards for prescribing drugs which doctors are "bombarded" with - possibly placing emphasis on profits rather than patient wellbeing
Critiques of alternative medicine
- Issues of compatibility between varieties of alternative medicine and the scientific method
- Regulation of pre-scientific medicine
External links
- BMJJournals.com - 'JME Online: An international peer review journal for health professionals and researchers in medical ethics', Journal of Medical Ethics
- The HastingsCenter.org - 'The Hastings Center: Leading Bioethics into the Future'
- UChicago.edu - MacLean Center for Clinical Medical Ethics, University of Chicago Department of Medicine
- Washington.edu - 'Ethics in Medicine: Bioethics Topics', University of Washington School of Medicine
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