Medical Ethics

The term medical ethics is used to describe a system of moral values and principles and their specific application in medicine. The word ethic, as defined in the Merriam-Webster dictionary, is the discipline that deals with what is good and bad, and with moral duty and obligation. A second meaning is "a set of moral principles." The word derives its meaning from the ancient Greek ethike and was first used in the 14th century.

Medical ethics set guidelines for proper behavior which support doctors and nurses and other medical professionals in their relations with patients. The codes guide professionals and help them act properly in a particular situation. They involve issues related to integrity and competency, trust and respect.

One of the principle tenets of medical ethics in the West is the Hippocratic Oath, thought to have been written around 500 B.C.E. This oath makes doctors swear that they will practice medicine in an ethical way, always with their patient's best interests as a guiding principle. Still used by practicing physicians in the 21st century, the Hippocratic Oath has been rewritten to comply with altering values.

A more recent guideline on medical ethics is The Declaration of Geneva, adopted by the World Medical Association (W.M.A.) in 1948 and amended in 1968 and 1983. This declaration was elaborated a year later and published as the International Code of Medical Ethics, to be observed by all countries in times of peace and war. It followed the outrageous experiments on human beings by German doctors with interned individuals during World War II.

The Declaration of Helsinki (1964) further clarified the moral principles for doctors, The Declaration of Tokyo (1975) stressed that doctors should not participate in inhuman treatment of patients, while The Declaration of Sydney (1968) focused on death-relates issues. The Declaration of Lisbon (1981), concerning the rights of patients, is another key update of the medical ethics codes.

Medical ethics contains four basic moral obligations: autonomy, or the right of patients to make their own decision and choose treatment. The second pillar in medical ethics is beneficence. It involves the doctors' duty to do their best in the patients' interest. Beneficence, however, is to a certain extent controversial as it concerns the issue of autonomy as well. For example, patients could choose treatment which is not the most appropriate, while doctors could insist that this treatment might endanger the patient's life.

The question about euthanasia, or the patient's desire to end their life in order to put an end to their suffering, is an example of this type of conflict.

Non-maleficence, which describes the doctors' duty to do no harm, is the third major principle in medical ethics. Some even assume that this is the most important duty with priority over beneficence. Non-maleficence sometimes contradicts with autonomy, when doctors and families believe that saying the truth to patients could affect their psychological condition.

There are other qualities related to the ethical practice in medicine as well. These are truthfulness, privacy and confidentiality, and fidelity. Truthfulness is crucial for patients. They expect from doctors to tell them their true diagnosis, rather than misleading them out of compassion or a desire to alleviate their suffering. At the same time, patients rely on doctors for their right to confidentiality.

Some of the main values in medical ethics have replaced others over time. For example, beneficence was once accepted as the overriding principle, while in the early 21st century, autonomy had become what matters the most.

Selected full-text books and articles on this topic

Practical Decision Making in Health Care Ethics: Cases and Concepts
Raymond J. Devettere.
Georgetown University Press, 2010 (3rd edition)
Ethics in Medicine
Milton D. Heifetz.
Prometheus Books, 1996
Methods in Medical Ethics
Jeremy Sugarman; Daniel P. Sulmasy.
Georgetown University Press, 2001
Ethics, Law, and Medical Practice
Kerry J. Breen; Vernon D. Plueckhahn; Stephen M. Cordner.
Allen & Unwin, 1997
Issues in Medical Research Ethics
Jürgen Boomgaarden; Pekka Louhiala; Urban Wiesing.
Berghahn Books, 2003
Clinical Ethics: An Invitation to Healing Professionals
William DePender; Wanda Ikeda-Chandlere.
Praeger, 1990
Ethical Foundations of Health Care: Responsibilities in Decision Making
Jane Singleton; Susan McLaren.
Mosby, 1995
Our Hands Are Tied: Legal Tensions and Medical Ethics
Marshall B. Kapp.
Auburn House, 1998
Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making
David J. Rothman.
Basic Books, 1991
From Clinic to Classroom: Medical Ethics and Moral Education
Howard B. Radest.
Praeger, 2000
Culture of Death: The Assault on Medical Ethics in America
Wesley J. Smith.
Encounter Books, 2000
Extending the Boundaries of Care: Medical Ethics and Caring Practices
Tamara Kohn; Rosemary McKechnie.
Berg, 1999
An Ethics Casebook for Hospitals: Practical Approaches to Everyday Cases
Mark G. Kuczewski; Rosa Lynn B. Pinkus.
Georgetown University Press, 1999
Health Care Ethics: A Catholic Theological Analysis
Benedict M. Ashley; Jean K. Deblois; Kevin D. O'Rourke.
Georgetown University Press, 2006 (5th edition)
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