When it comes to choosing between prescribing addictive painkillers and prescribing a placebo for a patient exhibiting signs of addiction, the latter choice is definitely the most ethical choice to make. Whereas respecting the patient’s wishes are important, the choice made must be a moral one that results in the most good, in line with the principle of beneficence. Healthcare professionals usually face ethical dilemmas repeatedly during the course of their practice. In most cases ethical dilemmas usually come about due to situations that force an individual to choose between fulfilling their professional obligations and their moral obligations. Despite the existence of codes of conduct and guidelines on how to handle certain work situations, health practitioners also have the liberty in most cases to apply their own judgment when making decisions, more so on matters that require their discretion. In some cases, such as the ones cited by Fenton and Lomasky (586), as well as by Canter and Baum (2009), healthcare professionals may even withhold care or the provision of a service on account of their conscience. On this basis, prescribing a placebo for non-existent pain, to a patient who exhibits signs of addiction, is the best choice professionally and morally. As a healthcare professional, decisions normally hinge mainly on judgment and on policies regarding the given decision, more so decisions involving biomedical ethics and duty.
Fenton and Lomasky (583) highlight the cases of pharmacists citing their conscience as a reason for denying emergency contraceptives. The authors while arguing the fact that the pharmacists are justified in their decisions, point out that their being right is negated by the fact that they go against professional restrictions. Canter and Baum (2011) on the other hand, argue that the discretion of the pharmacist is just as important as the patient’s right to medication. This they point out, is on account of the fact that just like other members of the healthcare team, pharmacists are also qualified individuals capable of making sound judgments. As such, Canter and Baum (2011) propose a compromise that neither completely denies the pharmacist the right to decline filling out prescriptions on moral grounds, nor forces them to abandon individual morality. Personally, I do believe that policy must not be allowed to stifle an individual’s ability to make moral decisions, on the basis of their good judgment. Achieving quality ethical decisions must depend on a good balance between internal and external controls. External controls encompass rules, codes of conduct, policies and other regulations. Internal controls are especially of importance, as they are essentially the determinants of ethical behavior. Whereas rules may exist, they are very easily broken, especially when in ethical dilemmas in the absence of proper internal controls. Overall therefore, policies must exist so as to ensure that healthcare professionals do not abandon their duties, but the focus must be on recruiting and developing morally upright healthcare professionals capable of properly utilizing the discretion accorded to them. Healthcare professionals must be given the freedom to determine what is right or wrong for their patients, although the freedom to do so must be within a particular legal framework (Boshoff and van Zyl 286).
Opponents to such a position may argue that giving healthcare professionals the liberty to choose options simply on the basis of their morals and conscience would put patients in a precarious position. It is however not so, as medical professionals similar to other professions, if properly trained, should easily be able to make choices that are professional, moral and in the best interests of the patient in question. If anything, the training received, puts the professional in the best position to make a decision on a contentious issue. For instance, prescribing a placebo instead of what the patient requests, may actually be classified as negligence, but doing so may potentially save the life of the patient clearly addicted to OxyContin, making it ethically the correct choice.
Works Cited
Boshoff, E. and van Zyl, E.S. The Relationship Between Locus of Control and Ethical Behavior Among Employees in the Financial Sector. Koers Journal 76.2(2011):283-303.
Cantor, Julie and Baum, Ken. The Limits of Conscientious Objection – May Pharmacists Refuse to Fill Prescriptions for Emergency Contraception? The New England Journal of Medicine 351.19 (2008): 2008-2012
Fenton, Elizabeth and Lomasky, Loren. Dispensing with Liberty: Conscientious Refusal and the “Morning-After Pill”. Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 30.6 (2006): 579-592. Web
