‘Ethics’ it is a Greek word, wherein ‘ethos’ means character, habits custom and ways of behavior. Or it is simply the moral philosophy.
Applied ethics is one of the approaches to ethics. Which means applying moral philosophy into various fields. Among them medical ethics is an important issue to deal with.
Brief history of medical ethics..
Western medical ethics may be traced to guidelines on the duty of physicians in antiquity, such as the Hippocratic Oath, and early Christian teachings. The first code of medical ethics, Formula Comitis Archiatrorum, was published in the 5th century. other medical ethical thinkers since then are (Muslim medicine) Ishaq ibn Ali al-Ruhawi, Muhammad ibn Zakariya ar-Razi (known as Rhazes in the West), Jewish thinkers such as Maimonides, Roman Catholic scholastic thinkers such as Thomas Aquinas, and the case-oriented analysis (casuistry) of Catholic moral theology. These intellectual traditions continue in Catholic, Islamic and Jewish medical ethics.
By the 18th and 19th centuries, medical ethics emerged as a more self-conscious discourse. In England, Thomas Percival, a physician and author, crafted the first modern code of medical ethics. He drew up a pamphlet with the code in 1794 and wrote an expanded version in 1803, in which he coined the expressions “medical ethics” and “medical jurisprudence”. In 1847, the American Medical Association adopted its first code of ethics, with this being based in large part upon Percival’s work. While the secularized field borrowed largely from Catholic medical ethics, in the 20th century a distinctively liberal Protestant approach was articulated by thinkers such as Joseph Fletcher.
Since the 1970s, the growing influence of ethics in contemporary medicine can be seen in the increasing use of Institutional Review Boards to evaluate experiments on human subjects, the establishment of hospital ethics committees, the expansion of the role of clinician ethicists, and the integration of ethics into many medical school curricula.
Values in medical ethics
A common framework used in the analysis of medical ethics is the “four principles” approach postulated by Tom Beauchamp and James Childress in their textbook Principles of biomedical ethics. It recognizes four basic moral principles, which are to be judged and weighed against each other, with attention given to the scope of their application. The four principles are
- Respect for autonomy – the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
- 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).
- Justice – concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).
Medical ethics usually combines with laws. (if an individual fails to perform his ethical duties or shows negligence, he is punishable under the court of law.)
Medical ethics doesn’t just apply to the medical practitioner involved but also to the party who is treated.
Medical ethics are given in the form of duties to the medical practitioner, some of these ethical duties are:
- To exercise a reasonable degree of skill and knowledge.
- Obligation to attend and examine a patient as long as it requires attention.
- To furnish proper and suitable medicines.
- To give proper instructions of the exact quantity and timing for taking the medicines.
- In case of infectious communicable diseases he must be warn the third parties who are in close association with the diseased.
- To take special precautions towards pediatric and geriatric age groups, incapable of taking care of themselves.
- To inform the risks of disease or medicines to the patients.
- To handle cases of poisons in immediate manner and assist to find the cause for such poisonous acts to the investigators.
- To notify certain diseases to public authority in order to prevent an epidemic or an endemic.
- To keep in breast with current standard practices and extreme precautions in case of operations.
- Under Geneva conventions – the sick wounded armed forces, shipwrecked persons, prisoners of wars or civilians of enemies treated without any distinction of sex, race, nationality etc.
- Confidentiality – to maintain professional secrecy. (exceptions in case of notifiable cases, medico legal cases where ample amount of information has to be provided to the authority)
- To furnish the medical practitioner with complete history of past illness and family history of diseased facts and circumstances of his illness.
- To strictly follow the instructions and directions regarding diet, medicine and mode of life.
- To pay a reasonable fee to the practitioner.
The importance of ethics in medical field.
ü To bring in good medical practitioners to the society to evaluate and treat diseases in a fast and a best manner.
ü To bring down the mortality of easily preventable and treatable disease.
ü For better understanding of the physical and mental sufferings of people so as to treat them in the earliest time with a good treatment possible.
ü To prescribe affordable treatment and medicines so that the poor are benefited, rather prescribing medicines and treatment of higher costs with ulterior motives.
ü To prevent misdiagnosis and add on suffering to the already suffering patients.
ü To have concern for one’s patient, and have a follow up.
ü To make the present practitioners an inspiration to the upcoming youth.
ü It is an important field as it has a direct impact to the society (e.g. it is an ethical duty and a responsibility to advice and counsel for sterilization procedure to a women mother of 3 kids. It not only controls fertility rate of the country, it protects mother’s health status, economic status and it indirectly prevents families to join below poverty. Hence it prevents malnourishment, better functioning of a family in socially, economically, educationally and spiritually to maintain a good health.)
ü To prevent specifically infant mortality rate (increase life expectancy at age 1) and be a cause for better HDI (human development index).
ü For better quality of living by elevating the levels of PQLI (physical quality of life index).
ü And so on for moving towards a better developed nation.
4th year MBBS
VIMS & RC