Medical Ethics: Not So Black and White
April 14, 2017
In the field of medicine, there are certain moral codes upheld called medical ethics. These include general values like respect for autonomy, beneficence, non-maleficence, justice, respect for persons, and truthfulness and honesty.
While these are helpful guidelines, physicians are often faced with situations that aren’t so ethically black and white, especially when certain values in medical ethics conflict. Here are three recent issues in the field of medicine to give you practice drawing your own conclusions:
Medical Ethics Scenario #1: Physicians googling patients
While patients are often encouraged to research their doctor, many don’t realize doctors often Google their patients. More often than not, physicians do this to get more information on a patient to better understand their background, discover neglected information, and ultimately provide better treatment.
Recent surveys say doctors are split down the middle on the morality of such behavior. While it supports certain medical ethics like beneficence and nonmaleficence, it seems to violate others like autonomy and truthfulness. Herein lies the crux of this internal conflict:
“Doctors are legally required under mandatory reporting laws to report information they have viewed relating to child abuse and neglect. But if they act on inaccurate information, that can harm the patient and others. If they don’t act on the information they find, they could be liable for not trying to protect the patient.”
Medical Ethics Scenario #2: Companies bribing doctors
Very few physicians are tempted by blatantly unethical behavior. Where the real danger lies is a far more subtle situation where right and wrong become a bit more fuzzy. Especially with the financial pressures on medical students, the temptation is even greater to seek opportunities to receive extra support and compensation. We can easily justify questionable behaviors in the name of savviness.
One physician learned this the hard way. When Michele Martinho finished medical school, she borrowed money from her parents to set up her own medical practice. She also accepted a considerable sum of money from a nearby laboratory in return for referring clients there for blood work, among other things. Though she didn’t realize the severity of it at the time, she is now a registered felon, facing up to five years in prison and a $250,000 fine.
To prevent this from happening to future students, she has reached out to over 350 medical schools: “If you hear this story, would you ever take a bribe for sending your lab work there? ‘No’ is the answer. But when it slowly infiltrates in such a way that you lose sight of whether it’s OK or not, that’s what we need to be better prepared for…we have not been prepared for the business of medicine. We were taught the medicine of medicine.”
Medical Ethics Scenario #3: Avoiding taboo topics
Doctors are encouraged to practice good bedside manners, but sometimes politeness comes at the expense of important health discussions. Obesity, for example, is an uncomfortable topic to bring up, because physicians fear making their patients feel insulted or judged. Yet, obesity is a very real concern and cause of many other health issues people face, so neglecting the topic does patients more of a disservice. In fact, in 2013, the American Medical Association officially deemed obesity a disease.
Plastic Surgeon Vik Reddy explains how he struggled with the idea of telling a female patient she was not a candidate for breast cancer surgery because of her weight. In fact, in 2013, the American Medical Association officially deemed obesity a disease. However, he understood that being fully honest was ultimately treating the patient better than presenting a half-truth.
Dr. Reddy points out, “If physicians are going to be able to truly prevent and manage obesity, we are going to have to learn to get out of our comfort zones and have honest conversations with our patients. Patients, however, will also have to understand that a discussion about their weight can no longer be considered a taboo subject.”
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