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.

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, and truthfulness may not always be upheld regarding the use of placebos in some instances.

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

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

Ethics | Medical ethics

Medizinethik | אתיקה רפואית | Medische ethiek | Medical ethics | Lääketieteen etiikka