Ethical and moral issues in healthcare

Ethical and moral issues in healthcare

Abstract

Healthcare is a business whose operation is done under various ethical and moral considerations. Ethics in healthcare can be described as a set of principles or values that should be used in making decisions and doing all operations within a hospital. Medical practitioners have their own ethical values that they should follow under guidance of their morality. A code of ethics is ensured or established to promote the moral behavior of all health practitioners. This paper looks at the end-of-life decisions in health care as a critical issue raising great reactions in the United States. This problem has been in existence since the beginning of advance technology in medicine. The issue comes about whenever considering the role of medicine in decision for end-of-life. While technology in medicine is meant to enhance the prolonging of life in a patient, some methods of treatment as well as moral practices of some medical practitioners make life of a patient more difficult after the provision of a medical procedure than it should have been. A patient may face severe side effects making the patient debilitated in a more serious way than he or she was before the treatment. Medical specialists may have little concern on the side effects in prescribing a certain procedure thereby leading to more problems than the problems facing the patient before the treatment was administered to him or her.

Introduction

It would too unethical for a medical practitioner to find a treatment procedure too complex to induce the termination of the patient’s life. Termination of a patient’s life is a common practice among some medical practitioners who end up claiming that that case was an assisted suicide incase everything about their unethical and immoral actions comes to disclosure. Doctors and other medical practitioners are encouraged to talk to their patients in too compromising situations and encourage them that they can still survive and get better with their current health conditions. It has been highly contended that treatments in medical practices should hardly be applied in situations whereby the results of the medication would result to decreased quality of life. The same issue concerning end-of-life decisions may involve some medical practitioners withholding treatments, which is a practice considered unethical and immoral in the field of medicine. Even in the case life threatening care for children, there are guidelines that ensure that health care professionals do not compromise their lives or health status through unethical and immoral practices (Solomon, Sellers, Heller, Dokken, Levetown, & Rushton, 2005). Ethical and moral practices apply to all patients irrespective of the distinctions by race, age, gender, or social classes.

Professional societies, courts, and various institutions of ethics have recommended on various principles that should be used by medical practitioners in the care of those children having life-threatening medical conditions. The United States is faced with a problem of medical practitioners working under guidance of the set principles. Some of them even go ahead with their unethical practices in withholding or withdrawing life support beside other unethical practices in American health care (Solomon, Sellers, Heller, Dokken, Levetown, & Rushton, 2005).

The case of life in health care is critical since the major reason why health care facilities and services are established is to prolong the life of every patient visiting the health facilities. This brings the aspect that all issues that regard decisions on the use of life in pediatric and neonatal cases should be taken with great care. It is generally agreed that support for life may be forgone given that the condition is too compromising to an extent that the cost of the treatment is not worth the benefits obtained from the administered medication (Solomon, Sellers, Heller, Dokken, Levetown, & Rushton, 2005). The case could apply when the treatment is predicted to cause many medical related problems that worsen the medical condition. In this case, the medical practitioners involved may fail to administer the procedure (Solomon, Sellers, Heller, Dokken, Levetown, & Rushton, 2005). The problem with some United States medical practitioners is that they may fail to consider the implications of a given medication given the prevailing health condition of a patient.

 Ethical Issues in Decision to Terminate a Patient’s Life

Decision to terminate the life of a patient may not be easy especially today when American medical practitioners who initially assistant in the suicidal decisions of patients are highly condemned. Various unethical practices are said to contribute to deaths of medical patients. A medical practitioner may withhold or withdraw a patient’s treatment due various reasons including personal motives such as selfishness and an aspect of immorality and less consideration of the code o ethics in medical field. Medical practitioners if derived by their own motives and less consideration of ethical decisions in withholding the medication of a patient may be said to have initiated unethical practices in health care. If a patient’s treatment procedure is withheld due to whichever reasons it could be, the life of the patient may be terminated due to such medical practice (American Medical Association, 1992).

The medical procedure in the US is usually expensive and it may require a patient to complete a certain part of the payments as the initial fee if the treatment has to be continued. This issue has been not only common to some American health care facilities but throughout the world. Withholding treatment due to medical complication could be in a situation whereby going on with the medication may lead to more complicated health conditions than the existed health condition of the patient. In most cases withholding the life, sustaining treatments are the most likely case of risking the death of a patient. This case could be termed as unethical but those medical treatments terminated given a situation whereby any continuity with the medication would contribute to advance medical conditions risking the life of the patient (Mayo DJ, 2002). In this case, this practice may not be considered as unethical but lack of medical code of ethics would come in a situation whereby the patient is not given adequate information concerning the decisions made to terminate the administration of treatment to a patient.

The life of a patient is also said to be at risk or may be terminated by euthanasia. Euthanasia is an ethical issue in the United States health care system in which case it involves the act of killing someone painlessly especially someone suffering from an incurable illness. Medical practitioners may practice this without the consent of the patient. Even in situations whereby the patient’s relatives provide their own views or decisions for the doctors to terminate the life of such patient it may be unethical to end the life of the patient without his final decision. The law also objects any decision by an individual to committee suicide. It would be even worse and assimilation of murder if a medical practitioner decides to terminate the life of a patient without his or her final decision. Euthanasia is medical practice that is unethical and patients hardly want the procedure applied on them. At the same time, the same case may be initiated through the provision of treatment in a palliative way. This kind of palliative treatment can be used to hasten a patient’s death. This case would as well be considered unethical if the patient is not involved in the decision making to terminate his or her life. In whichever condition the health of the patient might be, it would be unethical to decide on his or her death if other medical alternatives could b applied to lengthen or extend his or her life.

One of the greatest ethical issues in the health care system in the United States is the issue of assisted suicide of a patient in healthcare. This case is an ethical issue in the US medical care in which debates have existed concerning the decisions leading to medical practitioners giving in to assist patients in committing suicide. The introduction of new technologies that aid in the sustenance of patients’ lives are said to be used in place of initiating decisions to terminate the lives of patients with compromising health conditions (Department of Health; Information for a Healthy New York, 2011). It could turn out that a patient whose health condition indicate clear signs of death irrespective of whichever medical prescription may be administered may eventually turn out to be curable given the application of extra efforts in such kind of treatment. According to the Department of Health; Information for a Healthy New York (2011), the current debates on assisted suicide and on euthanasia is not considered alongside any argument on technology breakthrough. The department argued that these practices existed since a long time ago. While those supporting the practices argued that, the use pain relieving drugs such as morphine, barbiturates as well as other similar drugs assist patients from immense pain when being assisted to get out of their painful conditions through death, part of the debate postulates that assisted suicide should not be initiated. Suicide being hardly a new practice raise issues in its consideration as a breakthrough in medical advances. Initially, assisted suicide was considered ethical but a new course has arisen in the United States in which serious considerations are required as far as assisted suicide or direct killing of patients in hospitals and health care centers is concerned (Department of Health; Information for a Healthy New York, 2011).

This course of the debate has taken shape into considering direct killing of patients or taking part in assisted murder as unethical and immoral given that advancement in medical technologies have given chance for medical practitioners to take course in initiating medical practices that would lead to life sustaining rather than terminating the lives of patients. Life-sustaining treatments as well as other treatments that are aggressive in prolonging the lives of patients have made it easier for patients and medical practitioners to make informed choices about timing and the kind of death a patient would wish to go through. Advancements in medicine has also stimulated the public fear of losing control over patients’ dying processes in case of anthemia or assisted suicide (Department of Health; Information for a Healthy New York, 2011). Patients are provided with choice as part of ethical concern by the health departments through health policies especially about medical treatments in sustaining their lives. In some cases, the idea of life sustaining procedures is considered unethical and in many cases, the measures have been challenged by court cases (Department of Health; Information for a Healthy New York, 2011).

The Case of Acceptance

According to the American Medical Association Report (1992), euthanasia is a different case from assisted suicide. In this case, medical practitioners assist patients by administering a lethal agent to them. The patients usually wish to be assisted with their death and some medical practitioners find it easy to comply with the wish of these patients. Usually, patients in this case wish to dye rather than living with a health condition that is intolerable and untreatable. There has been a debate still, on this case as to whether medical practitioners should take charge in giving patients a hand in initiating an easy death with the use of their medical skills (Capron, 1986). This assisted death is found to raise many issues that differ from the public view through the point of view by the government to the medical professionals. In the United States, the public has been growing in support for euthanasia and its legalizations. This concern is viewed from an increased membership in organizations supporting both euthanasia and assisted suicide of patients especially in the 1980s (National Center for Health Statistics, 1990). In any case, euthanasia situation raise the concern on the medical practitioners’ roles in the treatment of those patients having intolerable health conditions without any dependency on treatments that call for life sustaining techniques.

On the case of assisted suicide as part of the end of death decision ethical issue facing the United Stated health sector, the case has greatly become a public center of focus. (American Medical Association Report, 1992). This was seen in the court case of Dr. Kevorkian, which provoked numerous and stron responses based on all faces of the issue. This doctor was involved in assisting the suicidal death of a patient using a suicidal machine. The suicide machine was invented by the physician with only one aim of assisting patients with their suicidal missions. This case was considered as one of the most unethical and irresponsible practices by medical practitioners in history of the Unted States especially considering the manner in which the assisted suicide was carried out. The problem today with such ethical issues in compromising or assisting a patient in his or her end-of-life decision has been growin with time. Many people in the US are accepting the cases of assisting in the termination of a patients life making the practice appear more ethical than being unthical.

Conclusion

In any case of decion making on ending the life of a patient, it should involve significant consideration on the reasons behind the made decision. The decision should not come from the medial practitioners since he or she has no authority over a patient’s life. The decision to terminate life should be from the patient but the situation should b acknowledgeable by all involved medical professionals. If medical practitioners take charge of the decision to end-of-life as an ethical responsibility, the case could deteriorate their moral responsibility as viewed by the law and the public. A more compromising situation would be a case whereby medical practitioners are willing to collaborate with a patient or the patient’s relatives to agree on terminating the patient’s life for various reasons. Death should be understand as an irreversible cessation of all body functions and that no medical practice or effort can brings one’s life back (Porter, Johnson, & Warren, 2005).

Many devices and technologies for saving patients lives have developed including respirators and heart-lung machines, artificial hearts, as well as pacemakers but this development has never changed anything about the ethical behavior or the morality of medical practitioners. There is the need for medical practitioners to attempt all possible solutions to sustain a patient’s life by making the application of all these technologies where applicable rather than withholding the treatment for unreasonable cases. Medical practitioners are usually guided by a code of ethics without which they may fail to deliver their services effectively. All medical practitioners are usually expected to provide every patient with everything they require in medical treatment as long as they meet the basic requirements such as finances and the legal requirement over that specific medical procedure. As long as a patient has his or her body being potential to interact with other people and the environment as well as respond effectively to stimuli while at the same time responding to communication, the patient’s body is said to be potential for life (Porter, Johnson, & Warren, 2005).

Defining the death of a patient has been a tough debate even for those patients whose lives are supported or maintained through artificial means and technologies. While many doctors or medical practitioners may give in to the relatives decisions to terminate the life of a patient, it is required that other considerations are made to assess the life of the patient in question. The use of technologies like electroencephalograms, electrocardiograms, drug screening, blood test in the laboratory, as well as angiography can be used to establish a clear decision of ending the life of a patient. Some methods are used to determine the death of a patient since it would b unethical and unprofessional to define the death of a patient without full test for his or her death. A patient would b considered as dead when all brain activities cease to function. When there is no traceable brain activity within a period of about 48 hour or more, the patient can be declared as dead. This could be in the case of artificial support for life. The brain function could have stopped while all other critical systems of the body are in action as they are fully supported by artificial means (Balaban, 2000). The issue of cerebral death and its definition has set grounds for medical practitioners to terminate other forms of treatment in a patient whose definition of death is established from a stopped brain function. Once the brain stops to function, the patient can be defined as dead and therefore termination or withdrawal of any other treatment efforts is applied. This life sustaining methods could be applied instead of directly assisting patients with assisted suicide of directly killing the patients with incurable medical conditions. Such practice would be unkind and very unethical. Medical practitioners have a significant role to play in making their final decisions in end-of-life-decisions (Lang & Quill, 2004 ).

References

American Medical Association. (1992). CEJA Report B – A-91: Decisions Near the End of Life. New York: American Medical Association.

Balaban, R. (2000). A physician’s guide to talking about end-of-life care. J Gen Intern Med, Vol. 5: Is. 1 , 195-200.

Capron, A. M. (1986). Legal and ethical problems in decisions for death. Law, Med &Health Care, Vol. 14, Is. 1 , 141-144.

Department of Health; Information for a Healthy New York. (2011, April). Chapter 6 – Crafting Public Policy on Assisted Suicide and Euthanasia. Retrieved April 20, 2013, from health.ny.gov: HYPERLINK “http://www.health.ny.gov/regulations/task_force/reports_publications/when_death_is_so” http://www.health.ny.gov/regulations/task_force/reports_publications/when_death_is_sought/chap6.htm

Golden, M., & Zoanni, T. (2010). Killing us softly: the dangers of legalizing assisted suicide. Disability and Health Journal Vol. 3 , 16-30.

LANG, F., & QUILL, T. (2004 ). Making Decisions with Families at the End of Life. Am Fam Physician, Vol. 70, Is. , 719-723.

Mayo DJ, G. M. (2002). Vitalism revitalized…. Vulnerable populations, prejudice, and physician-assisted death. Hastings Cent Rep, Vol. 32 Is. 4 , 14–21.

National Center for Health Statistics. (1990). Vital Statistics of the US, 1987 Vol. II, mortality, part A. Washington:: Public Health Service.

Porter, T. B., Johnson, P. B., & Warren, N. A. (2005). Bioethical Issues Concerning Death: Death, Dying, and End-of-Life Rights. Critical Care Nursing Quarterly Vol. 28 Is. 1 , 85-92.

Solomon, M. Z., Sellers, D. E., Heller, K. S., Dokken, D. L., Levetown, M., & Rushton, C. .. (2005). New and Lingering Controversies in Pediatric End-of-Life Care. Pediatrics, Vol. 116, Is. 4 , 872 – 883.