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Some issues in the medical field such as relationship between patient and physician treatment of human and animal subjects in biomedical experimentation, allocation of scarce medical resources and many others require medical decisions. Some general philosophical principals are applied to these ethical issues. Ethicists have also made some basic frame works and procedures which help in making these decisions. (Ascension health. 2008)
A system known as principlism is one of these frameworks. It involves the consideration of four separate elements: respecting ones autonomy and their right to their own decisions and beliefs; the principal of beneficence, helping people as the primary goal; the principal of nonmaleficence, refraining from harming people; and justice, distributing benefits and burdens fairly. These are some of the theories used to solve some dilemmas in the medical world. We are going to consider these dilemmas and how we can resolve them using the ethical principals and theories and the sociological, economic, legal or political implication of the ethical principals in the process of resolution. (Ascension health. 2008)
One of the dilemmas is the mortality issue. In the past death meant the absence of a pulse or signs of breathing. When advances were made in life support technology, such as mechanical respirators and the heart-ling machine, these death signs became blurred and so there was developed another definition. “The end of all functions of the brain, even in a body sustained by artificial technology”. (Medical ethics 2008)
The question here is what will a doctor do in a case where a patient makes a directive early in advance that their life should not be supported by living machines? There also arises another issue here about euthanasia which is illegal. Disconnecting life support machines means allowing a person to die, or helping a patient achieve death. There arises a conflict between the legal implications of respecting the autonomy of the patient and the right to their own decision and beliefs. The ethical principals suggest respect of the autonomy and decisions of the patient, while the law may interpret this to be euthanasia. A decision has to be made. (Medical ethics 2008)
Another ethical issue concerns reproductive health. The development of birth control pills and legalization of abortion in the United States has raised ethical issues especially for people with religions that forbid these practices. Some countries like Canada have left abortion to be a decision between the physician and the patient. Controversy has developed in deciding when life starts, the rights of the fetus and pregnant woman and the role the state should play in reproductive decision. (Kellog Library 2003)
This controversy keeps abortion a political and ethical issue in this 21st century. There is a conflict brought about by the ethical principals we talked about earlier. The doctor is supposed to respect the autonomy and the decisions of the patient, at the same time he is supposed to apply the principal of beneficence, helping people as the primary goal, and also the principal of nonmaleficence, refraining from harming people. If the doctor refuses to do the abortion, he compromises the first and the second principal; if he does it he compromises the fourth one. Besides in a country where abortion is illegal he will be faced by the law. The society and the church are also watching, the whole issue is complicated but a decision has to be made. (Berwick D 1997)
Generally, these principals are based on moral laws. This means that they are not enough and alone they can not explain why a particular ethical issue is important. Moral judgments and laws should be used to define all important concepts and aspects of the directions we take. (A.E. Limenteni 1999)
Works cited
Key ethical principals.” Ascension health. (2008). Web.
A.E “Limenteni the role of ethical principals in health care and the implications for ethical codes” Journal of medical ethics 25(5): 394-399. ProQuest. (1999).
Berwick D, et al “An ethical code for every body in health care”. British medical 1997; 315; 1633-4 (1997).
Medical ethics. (2008). Web.
Kellog Library, Bioethics – Introduction and Definition. 2003. Web.
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