Bioethics in a Changing World
Bioethics is defined as the study of morality and ethics in biomedicine and addresses some issues related to the medical field and their potential impact on the community. Its practice dates back to the Greek Hippocratic Oath and has evolved based on development in new bioethical guidelines (Goldim, 2009). This practice utilizes various tools to define solutions to morality issues. Five major theories applied in bioethics include deontology, utilitarianism, justice theory, virtue ethics, and care ethics. The Deontology theory entails W.D. Ross and Immanuel Kant. According to Ross, actions are right because they fulfill duties. Kant supports this by saying that it is right to act consistently with reason and logic. In utilitarianism, actions are in consideration of the greatest happiness for the largest number of people. The justice theory stipulates that rights are morally justified while virtue ethics define the difference between being good and acting good. Care ethics, on the other hand, state that an individual is an interdependent social being that needs emotion and physical support. Additionally, four major principles are applied in bioethics: autonomy, justice, beneficence, and non-maleficence (Parks & Wike, 2010). Multiculturalism and Religion also find a place in the practice of bioethics. Autonomy implies independence while justice means that people should be treated fairly. Beneficence suggests doing good for patients and is the contrast to maleficence.
Medicine, nursing, and genetic counseling practices are governed by a code of ethics whose purpose is to set standards and define central values for professional practice. These ethical codes are written by members and change with time to reflect social changes. Bioethical responsibilities focus on three elements of a doctor-patient relationship. These include confidentiality, truth-telling and informed consent (Parks & Wike, 2010). Confidentiality is the practice of keeping intimate details in private while truth-telling infers to refrain from lying and withholding the truth. Acting in an informed consent allows the patient to make decisions about treatments by referring to the four conditions of competency, disclosure, understanding, and voluntariness.
The number of people without adequate access to healthcare is rapidly increasing, most of them being the uninsured population. The reason for this is because these people work part time and are ineligible for employment-based health insurance or their income is too high to receive Medicaid. In Canada, there is a universal health care system that ensures every citizen has the right to receive decent, basic health care that includes emergency care. However, some issues arise due to this, including disparities in health services in each province, decrease in previously insured services, and reduced payments to individual provinces. The USA has yet to pass such a universal health act, and the closest it has come it the Obama Affordable Health Care Act signed in 2010. In the US, undocumented workers and illegal immigrants can receive treatment through the ‘Emergency Medical Treatment and Active Labor Act signed in 1985’. This Act allows immigrants to pay sale taxes for purchases and pay into social security services and Medicare using their payroll. Arguments against this Act stipulate that illegal immigrants don’t pay taxes to support the Medicare funds and also, there are Americans that lack healthcare or can’t afford emergency care. The rise in medicine costs has discouraged the medication culture in society; this growth is attributed to pharmaceutical companies spending money on promoting and marketing drugs to doctors by sponsoring meetings and seminars. The increased cost has seen a need for research and development and public education using ads and internet marketing. However, the antagonists to this increase in costs of medication suggest that there is no need for consumer advertising and that the average citizen cannot evaluate medical conditions or know the needs for specific drugs (Parks & Wike, 2010).
The Case Study of Sam Levine
Sam Levine, who is 89 years old, is admitted to the hospital because he is suffering from bronchial pneumonia, advanced pulmonary edema, and urinary tract infection. Sam checks in and is presented with all the information about advance directives, and requests to be resuscitated with CPR should the heart stop beating. His wife supports this decision. To validate their consents, doctors present them with general information about the nature of the treatment and its efficacy. It is uncertain whether both of them know what they are getting into, but their physician, Dr. Arunadha Gupta decides to respect their decisions. After ten days in the hospital, Sam is recuperating poorly, and his vitals start to shut down. Dr. Gupta talks to Gladys about the possibilities of Sam going into a cardiac arrest, but she insists that they stick to the earlier decision. However, the Levine's daughters are skeptic of their father’s recovery and demand that their father be accorded a more humane treatment of choosing what would be best for him.
As a doctor, the best decision to make is to let the family sort out among themselves about the fate of their father. This decision is based on the effects caused by the death of a loved one. The person who is not directly involved or closely related to the family and Sam may not be able to feel the repercussions of his death in a similar effect to the immediate family. However, given the high possibility that Sam might not recover from the declining state of his vital organs, it would be best to advise the family to terminate his suffering. This is because the longer he stayed at the hospital, the higher his medical costs and consequently, negative effects on the family’s financials (Hendee, 2009). The meaning of life, cost, and recovery are bioethical issues related to this case, and it would be imperative for the doctor to keep them in mind while dealing with the patient and the family.
References
Goldim, J. R. (2009). Revisiting the beginning of bioethics: The contributions of Fritz Jahr (1927). Perspect Biol Med, Sum.
Hendee, W. R. (2000). Emerging Bioethical Issues in Health Care: The Challenge for Biomedical Engineering. Critical Reviews™ in Biomedical Engineering, 28(3-4), 499-504.
Holland, S. (2012). Arguing about bioethics. London: Routledge.
Parks, J., & Wike, V. (2010). Bioethics in a changing world. Upper Saddle River, N.J.: Prentice Hall.
