Wait a second!
More handpicked essays just for you.
More handpicked essays just for you.
A medical ethics dilemma
A medical ethics dilemma
Economic disparities and access to healthcare
Don’t take our word for it - see why 10 million students trust us with their essay needs.
Recommended: A medical ethics dilemma
Ethical dilemma in healthcare comprises of a variety of medical decisions. Should one get an extensive surgery at the age of 95? Should we continue an 85-year-old patient on life support? These questions are extremely difficult to answer. “The ethical dilemma is how to balance the precepts of autonomy, beneficence, and distributive justice” (Teutsch & Rechel, 2012). Preference-based care and supply-based care, when used correctly, can help in such matters. Consequently, we have the debate of whether health care should be a right or a privilege. Reid mentions in his book, The Healing of America, that United Kingdom, Japan, France, Germany, Canada all have universal health care. He also adds that they have better health outcomes than the U.S. in addition to lower infant mortality rates (Reid, 2010, p. 31-34). The U.S.’s mindset views health care as a privilege. However, President Obama brought his liberal agenda to the table and proposed the Patient Protection and Affordable Care Act (PPACA) in 2010 (Teutsch & Rechel, 2012). It is projected that by the year 2019, the PPACA will transform healthcare as a right rather than a privilege (Teutsch & Rechel, 2012). Some U.S. The goals of ObamaCare are possible by reallocating funding and resources. There will be areas where compromises must be made. One such instance is the Medicare reform where hospitals will be receiving lower reimbursements from Medicare (Farley, 2014). Consequently, ethical issues arise with rationing of medical resources (Teutsch & Rechel, 2012). Reid (2010) discusses the rationing of healthcare in United Kingdom’s Beveridge model. In this model, rationing the medication, tests, and procedures in order to compensate for costs does budgeting. For this reason, people go without treatments and medications that the government would not cover. This brings up an ethical dilemma where an early implementation of measures must be taken to avoid a
Today, there are so many legal dilemmas dominating trial for the courts to make a sound legal decision on whose right in a complicated situation. Despite the outcome of the case, the disagreement usually has a profound effect on the healthcare organization, and the industry as a whole. Many cases are arguments centered around if the issue is a legal or moral principle. Regardless what the situation maybe, the final decision is left to the courts to differentiate between the legality issues at hand opposed to justifying a case based on moral rules. According to Pozgar (2012), an ethical dilemma arises in situations where a choice must be made between unpleasant alternative. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken (p. 367). In this paper, I will discuss cases that arose in the healthcare industry that have been tried and brought to justice by the United States court system.
Healthcare creates unique dilemmas that must consider the common good of every patient. Medical professionals, on a frequent basis, face situations that require complicated, and at times, difficult decision-making. The medical matters they decide on are often sensitive and critical in regards to patient needs and care. In the Case of Marguerite M and the Angiogram, the medical team in both cases were faced with the critical question of which patient gets the necessary medical care when resources are limited. In like manner, when one patient receives the appropriate care at the expense of another, medical professionals face the possibility of liability and litigation. These medical circumstances place a burden on the healthcare professionals to think and act in the best interest of the patient while still considering the ethical and legal issues they may confront as a result of their choices and actions. Medical ethics and law are always evolving as rapid advances in all areas of healthcare take place.
This ethical scenario presents an 86 year old female with numerous health issues and chronic illnesses. Mrs. Boswell’s advancing Alzheimer’s disease makes it extremely difficult to initiate dialysis, leading her physician to conclude a poor quality of life. The ethical dilemma portrayed in this case is between nonmaleficence and autonomy. Health care workers should focus on promoting the patient’s overall wellbeing and weigh the benefits and risks of the course of action, while also considering what the family declares they want done. Since the patient is deemed unable to make decisions, the goal is to collaborate with family, assess patient quality of life, address prognosis, and establish realistic care goals.
Principles of Biomedical Ethics, by Tom Beauchamp and James F. Childress, has for many critics in medical ethics exemplified the worse sins of "principlism." From its first edition, the authors have argued for the importance and usefulness of general principles for justifying ethical judgments about policies and cases in medical ethics. The organization of their book reflects this conviction, dividing discussion of particular ethical problems under the rubrics of the key ethical principles which the authors believe should govern our moral judgments: principles of autonomy, nonmaleficence, beneficence and justice.
According to editorial one, universal health care is a right that every American should be able to obtain. The author provides the scenario that insurance companies reject people with preexisting conditions and that people typically wait to receive health care until it's too much of a problem due to the extreme costs. Both of these scenarios are common among Americans so the author uses those situations to appeal to the readers' emotions. Editorial one also includes logical evidence that America could follow Canada's and Europe's universal health care systems because both of those nations are excelling in it.
One of the most controversial topics in the United States in recent years has been the route which should be undertaken in overhauling the healthcare system for the millions of Americans who are currently uninsured. It is important to note that the goal of the Affordable Care Act is to make healthcare affordable; it provides low-cost, government-subsidized insurance options through the State Health Insurance Marketplace (Amadeo 1). Our current president, Barack Obama, made it one of his goals to bring healthcare to all Americans through the Patient Protection and Affordable Care Act of 2010. This plan, which has been termed “Obamacare”, has come under scrutiny from many Americans, but has also received a large amount of support in turn for a variety of reasons. Some of these reasons include a decrease in insurance discrimination on the basis of health or gender and affordable healthcare coverage for the millions of uninsured. The opposition to this act has cited increased costs and debt accumulation, a reduction in employer healthcare coverage options, as well as a penalization of those already using private healthcare insurance.
A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades. While sophisticated medical technology has allowed people to live longer, it has also caused protracted death, most often to the severe detriment of individuals and their families. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, believes too many Americans are “dying badly.” In discussing this issue, he stated, “Families cannot imagine there could be anything worse than their loved one dying, but in fact, there are things worse.” “It’s having someone you love…suffering, dying connected to machines” (CBS News, 2014). In the not distant past, the knowledge, skills, and technology were simply not available to cure, much less prolong the deaths of gravely ill people. In addition to the ethical and moral dilemmas this presents, the costs of intensive treatment often do not realize appreciable benefits. However, cost alone should not determine when care becomes “futile” as this veers medicine into an even more dangerous ethical quagmire. While preserving life with the best possible care is always good medicine, the suffering and protracted deaths caused from the continued use of futile measures benefits no one. For this reason, the determination of futility should be a joint decision between the physician, the patient, and his or her surrogate.
The facts bear out the conclusion that the way healthcare in this country is distributed is flawed. It causes us to lose money, productivity, and unjustly leaves too many people struggling for what Thomas Jefferson realized was fundamental. Among industrialized countries, America holds the unique position of not having any form of universal health care. This should lead Americans to ask why the health of its citizens is “less equal” than the health of a European.
The four major ethical principles in health care are: Autonomy – to honor the patient’s right to make their own decision (the opposite is paternalism - the health care provider knows best for the patient), Beneficence – to help the patient advance his/her own good, Nonmaleficence – to do no harm (many bioethical controversies involves this principle), and Justice – to be fair and treat like cases alike. All 4 principles are considered to be in effect at all times. In theory, each is of equal weight or importance. Ethical responsibilities in a given situation depend in part on the nature of the decision and in part on the roles everyone involved play.
America is known for democracy, freedom, and the American Dream. American citizens have the right to free speech, free press, the right to bear arms, and the right to religious freedom to name a few. The Declaration of Independence states that American citizens have the rights including “life, liberty, and the pursuit of happiness.” America promises equality and freedom and the protection of their rights as outlined in the Declaration of Independence and the Bill of Rights. But with all the rights and freedoms that American citizens enjoy, there is one particular area where the United States seems to be lacking. That area is health care. The United States is the only industrialized nation that doesn’t have some form of legal recognition of a right to health care (Yamin 1157). Health care reform in the United States has become a major controversy for politicians, health care professionals, businesses, and citizens. Those in opposition to reform claim that health care is not a human right, therefore the government should not be involved. Supporters of reform believe that health care is most definitely a human right and should be available to everyone in the United States instead of only those who can afford it, and that it is the government’s responsibility to uphold that right.
An important factor in debates over health care and treatment strategies is the issue of cost. It is tremendously expensive to provide the state-of-the-art care that the modern hospital offers. Concerns about where the money will come from to care for elderly citizens appear to be making the case for "mercy killing" even more compelling. Under financial pressure, hospitals are exercising their right to deny such expensive healthcare to the aged or seriously ill.
As a nurse in the medical field for the past ten years, I have learned the differences in my scope of practice in providing care and facility policies. An experience I encountered, was a patient requiring a procedure that I hadn’t been trained on. This situation left me to figure out what I was legally able to do, questioning if I should speak up, and examining if by doing this if it would directly affect my job or having any lasting repercussions.
In this diverse society we are confronted everyday with so many ethical choices in provision of healthcare for individuals. It becomes very difficult to find a guideline that would include a border perspective which might include individual’s beliefs and preference across the world. Due to these controversies, the four principles in biomedical ethic which includes autonomy, beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and acceptable. These principles are not only used to protect the rights of a patient but also the physician from being violated.
Steinbock, Bonnie, Alex J. London, and John D. Arras. "Rule-Utilitarianism versus Act-Utilitarianism." Ethical Issues in Modern Medicine. Contemporary Readings in Bioethics. 8th ed. New York: McGraw-Hill, 2013. 12. Print.
Resources have always been inadequate for food, economics and healthcare and all scarce resources are rationed in one way or another. Healthcare resources can be in the forms of medicine, machinery, expensive treatment and organ transplantation. For decades, allocation of healthcare resources in an equitable manner has always been the subject of debate, concern and analysis, yet the issue has persistently resisted resolution. Scarcity of resources for healthcare and issue of allocation is permanent and inescapable (Harris, “Deciding between Patients”). Scarcity can be defined in general, in emergency and in crises as well as shortage of certain kind of treatment, medicine or organs. As a result of scarcity of resources, and some people may be left untreated or die when certain patients are prioritized and intention of is that everyone will ultimately be treated (Harris, 2009: 335). Allocation of limited resources is an ethical issue since it is vital to address the question of justice and making fair decisions. Ethical judgments and concerns are part of daily choice in allocation of health resources and also to ensure these resources are allocated in a fair and just way. This paper will explore how QALYs, ageism and responsibility in particular influence the allocation of healthcare resources in general through the lens of justice, equity, social worth, fairness, and deservingness.