The ethics of medicine

Medicine is more than just seeing patients, diagnosing them and prescribing. The relationship that is formed between the physician and the patient is one that is based on trust, compassion, understanding, among other qualities.{{more}}

The medical profession has long subscribed to a body of ethical statements, developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self.

The medical profession is governed principally by four ethical principles. These principles are not laws, but standards of conduct that define the essentials of honourable behaviour for a physician. The four ethical principles are respect for autonomy, justice, beneficence and non-maleficence.

The principle of autonomy requires that the patient have autonomy of thought, intention, and action when making decisions regarding health care procedures. Therefore, the decision-making process must be free of coercion or coaxing. In order for a patient to make a fully informed decision, he/she must understand all risks and benefits of the procedure and the likelihood of success. Autonomy is basically self-governance. The patient has a right to be well informed in order for them to make a well-informed decision regarding his/her health.

The principle of beneficence requires that the procedure be provided with the intent of doing good for the patient involved. This principle demands that health care providers develop and maintain skills and knowledge, continually update training, consider individual circumstances of all patients, and strive for net benefit. Any procedure that the physician is doing for the patient must be done with the intention of benefiting the patient.

The principle of non-maleficence or “do no harm” requires that a procedure does not harm the patient involved or others in society. The Hippocratic oath speaks of this: ” With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage.”

In some cases, it is difficult for doctors to successfully apply the do no harm principle. The benefits and risks of procedures must be weighed and whatever procedure is done must have more benefits than harm to the patient.

Justice requires that procedures uphold the spirit of existing laws and are fair to all players involved. The health care provider must consider four main areas when evaluating justice: fair distribution of scarce resources, competing needs, rights and obligations, and potential conflicts with established legislation.

Ethical standards may promote the values of cooperation and collaborative work. Ethical standards in medical care promote other important moral and social values, such as social responsibility, human rights, patients’ welfare, compliance with the law, and patients’ safety. Adherence to ethical standards can significantly facilitate a pleasant environment for both patients and medical workers.

Dr Rosmond Adams is a medical doctor and a public health specialist.