Since ancient times the Hippocratic Oath has been considered as the code of medical ethics. It could be argued that there is a need to adapt the healthcare system to the needs of patients, taking into account the principles of social responsibility. The basic idea of the new version of the Code of Medical Ethics is to ensure that the amount and quality of care do not depend solely on the solvency and social status of a patient. Apparently, the medical profession is closely related to conscience and ethics, and all patients should be treated equally, regardless of the size of their wallet. However, it is not as simple as it might seem.
I recall one experience that made me ponder over the notion of ethics within the realm of healthcare. The patient was rather rude and reluctant to stick to the prescribed medicine due to his religious beliefs. As the nurse, I was both consistent and friendly in communication with this patient. I did my best to remove patient’s emotional stress and explained him the need for successful treatment. I suppose I partly stuck to the principle of autonomy, which requires respect for each patient and his decisions. The principle of autonomy is connected with such ethical concepts of care as confidentiality, respect for religious, political or other beliefs of a patient, informed consent to medical intervention and joint planning as well as implementation of the plan of care. Interestingly, this patient raised a pressing issue of waiting lists together with inappropriate use of scarce resources.
The principle of justice and social responsibility is a particularly acute ethical issue that tends to arise in relation to the problem of resource allocation. What patient should be treated first? How to set the priority of obtaining organs for transplantation, expensive equipment and medicines? Given that the right to protection of health is considered as one of the fundamental rights of a person, for instance refusal to treat homeless people or prisoners infected with tuberculosis might be regarded as a form of discrimination. When it comes to the allocation of resources, there is no clear-cut answer to this question whether the moral obligation to ensure a minimum satisfactory level of health for all citizens or the right to health care is a privilege only for the wealthy members of society (Turoldo, 2009). There has been considerable debate about whether the state along with the government should address these problems, and whether medical workers have to stick to the moral principle of fairness.
Thus, the virtue ethical theory as well as the utilitarian ethical theory are worth identifying. The utilitarian theory embraces the principle of utility as the standard definition of the correct action. However, the application of this principle is divided into two groups, utilitarian action and utilitarian rule. Utilitarian action means that this principle should apply to individual actions in individual circumstances. However, utilitarian rule insists on the application of this principle in the testing rules that can be used to solve the issue of correctness of individual actions. According to utilitarian theory, an action is morally right if no other actions could be of great benefit (Rainbow, 2002). On the other hand, when making moral choices, it is necessary to take into account the effects that make this decision a right one. According to the virtue ethical theory, there are two moral principles, namely correctness and kindness. Compassion and kindness make nurses able to recognize the correctness of a decision and a degree of certainty. Ultimately, in any particular case, medical workers should rely not only on regulations, but also on the mind and the understanding of the situation.
References
Rainbow, C. (2002). Descriptions of ethical theories and principles. Retrieved from http://www.bio.davidson.edu/people/kabernd/indep/carainbow/theories.htm
Turoldo, F. (2009). Responsibility as an ethical framework for public health interventions. American Journal of Public Health, 99(7), 1197–1202.
