Five Moral Dilemmas in Healthcare
- Organ Transplantation
- Physician-Assisted Suicide
- When Families Disagree With Patients
- Care of Terminally Ill Patients
- Research Ethics
Although modern medicine has made many significant advances that enable healthcare providers to save patients who might not have survived in the past, these advances have also brought with them many dilemmas in healthcare ethics that did not exist in the past. New medicines and technologies can help healthcare providers keep patients alive, but they are of little help in determining what it means to be alive or how to balance the goal of preservation of life with that of quality of life. Five of the major ethical issues now facing healthcare providers as a result of the advances in modern medicine are listed below.
1. Organ Transplantation
There are far more patients who could be helped by organ transplants than there are organs available. The first consideration is how one should determine who receives an organ when it becomes available for transplant. Ethicists must balance the patients with the greatest need, who might be the ones in worst health, against the patients most likely to gain the greatest number of years of productive life. Similarly, sourcing for organs for transplant can also raise questions such as whether organ donation should be the default unless a potential donor expressly indicates objections and whether prisoners on death row should be able to have the freedom to sell or donate organs.
2. Physician-Assisted Suicide
Many countries and states within the United States are grappling with developing guidelines for physician-assisted suicide. One of the earliest states to pass laws allowing people of sound mind with terminal illnesses suffering from intractable pain to end their own lives with the assistance of physicians was Oregon, which passed the Death with Dignity Act in 1997.
3. When Families Disagree With Patients
Often families disagree with patients concerning care choices. For example, a patient may have expressed a wish for no extraordinary measures to be taken to preserve life, but a family member desires everything possible to be done. In such cases, healthcare providers are placed in a difficult position of having to advocate for the patients and to interpret the patients’ desires but at the same time take into account that families may know the patient best.
4. Care of Terminally Ill Patients
One of the major ethical issues confronting healthcare providers is that of quality versus quantity of life. Some medications might offer a slight chance of prolonging a patient’s life with a substantial chance of reducing quality of life. Other drugs which can reduce suffering may also either be addictive or possibly reduce life expectancy.
5. Research Ethics
Experimental treatments may promise improvements in the treatment of many diseases. For such treatments, especially clinical trials, the safety and effectiveness are not completely understood. If results are promising, it would be unethical to refuse such treatments to patients, but without double-blind studies, it is impossible to evaluate treatments.
Ethical Challenges of Advanced Healthcare Technology
Advances in medicine in the past few decades have increased the complexity of healthcare ethics. Hospitals are increasingly likely to have ethics committees devoted to the issues arising from the availability of transplants to the question whether aggressive life-prolonging treatments are actually the best choices for all patients. As medical science continues to advance in areas such as stem-cell and gene therapy and cloning, ethical issues are likely to multiply rather than disappear.