Medical Ethics or Bioethics is the application of ethical principles to healthcare
Dilemmas arise when these principles conflict.
A treatment is considered appropriate if the potential benefits outweigh the potential burdens or harm.
Life support (e.g. CPR, artificial feeding and ventilation) is appropriate if it provides an acceptable quality of life (as judged from the patient’s perspective).
Why Ethics Matters
Medical ethics is the foundation of medicine and applies every time you interact with a healthcare provider.
Our tests and treatments are merely tools. Ethics guides us in their appropriate use.
The Principles of Bioethics
- Nonmaleficence: The first rule of medicine: “Above all else, do no harm.”
- Beneficence:Do good. The primary goal of medicine is to help the individual patient.
- Autonomy:The right of the capable individual to direct his or her own healthcare. Informed consent is an essential aspect of autonomy.
- Justice:Be fair. Treat like cases alike.
- Confidentiality:Respecting personal information
When Confidentiality Can Be Breached
Duty to Protect: When you pose a serious threat to others
Duty to Report: unsafe drivers, child protection, certain sexually transmitted infections
Minors and others who rely on others to provide consent
What has access to your records?
- Your physician’s professional staff
- Other healthcare providers involved in your care (your hospital team, specialists to whom you are referred)
- 3rdparties (insurance companies, lawyers) with your written consent (or by court order)
Informed Consent requires:
- Sufficient information about the benefits, risks and alternatives of a test, procedure or drug before you can choose or refuse it.
- An individual capable of understanding the situation and the available options and able to make and communicate a decision.
With proactive reflection and discussion, future ethical dilemmas may be avoided.
- Anticipate the future when you may be incapable of medical decision-making and suffering from serious illness.
- Understand the benefits and burdens of CPR, artificial feeding and artificial ventilation.
- Consider what gives your life meaning and what constitutes a good quality of life.
- Communicate your values and your wishes while you can. Ensure your family knows what you would want.
An Advance Directive is a statement of what kind of medical care you would want in the event that you are unable to make your own decisions.
What procedures do you want?
What procedures do you refuse?
Under what conditions?
Who do you choose to make decisions for you?
e.g. You may not wish to have CPR (chest compressions, assisted breathing, a tube down your throat, electric paddles on the chest) if you had an irreversible, terminal condition with no hope for a return to an acceptable quality of life (by your standards).
You may not wish to be kept alive on machines if you were in a persistent coma with no hope of recovery.
For more information: google “My Voice”
Dr. Davidicus Wong is a physician in Vancouver, B.C., Canada. Please note that this article related to Western medical ethics. Healthcare providers in other countries may not follow the same principles or interpret them in the same way and laws regarding access to your medical records and who can make decisions on your behalf may vary in different countries and states.