Ethical Dilemmas: The Importance Of Medical Ethics In Healthcare

While I have participated in clinical rotations for only over a year, I have already encountered a variety of ethical dilemmas and situations. During my short tenure on the hospital wards, I have personally experienced the importance of medical ethics in the day-to-day professional practice and life of a physician. Determining what “the good” is in any situation is an integral function of interacting with life in general. In the field of medicine however this act plays a crucial role as the absolute issue of life and death imparts an even greater significance to the choices that a physician must make in the care of his or her patients. And these patients have inherent value systems that can differ drastically from the physician’s values and

An 85-year old gentleman had been diagnosed with laryngeal cancer a few years prior and had undergone resection as well as chemotherapy. He had returned to the hospital for a laryngoscopy for re-evaluation of his larynx. We quickly discovered two new lesions on his larynx that had developed since the most recent examination. The physician finished the procedure and began to orally dictate his report. In his assessment and plan, he stated that he would advise the patient on the next steps to take in terms of surgical procedures and treatments. The physician was clearly advocating for more treatment. However, the nursing staff that was in the OR was appalled that the doctor would even consider more treatment for this frail, elderly patient. When the physician had finished his report, one of the nurses told him quite bluntly that he was doing a disservice to the patient by attempting to continue treatment. The physician stated that he thought this was a still treatable cancer and that he was obligated to continue to care for the patient. The discussion ended very tensely as the nursing staff and physician departed their separate

A capable patient must be allowed to accept or refuse the treatments recommended by a physician. But to make this decision, the patient must be informed. In my scenario, it is of the utmost importance for the physician to evaluate the decision making capacity of the patient. If the physician deems the patient to be capable of making medical decisions, he must inform the patient of his options in terms of further aggressive treatment of his laryngeal cancer versus more conservative palliative care. The analogy I frequently use in this situation is that of “driving a bus”. The physician is simply the navigator, providing the many directions or options that the driver can choose to take. The driver of course is the patient who at the end of the day decides which direction to go. The physician above must then accept the treatment plan the patient chooses, even if it is not what the physician thinks is in the best interest of the patient 's