An Ethical Analysis of Professional Codes in Health and Medical Care
Littleton, Vanessa, Meemon, Natthani, Breen, Gerald-Mark, Seblega, Binyam, Paek, Seung Chun, Loyal, Michael, Ellis, Nancy, Wan, Thomas T. H., Ethics & Medicine
The purpose of this analysis is to present a contextual discussion of the evolution of healthcare ethics utilizing relevant examples of historical and contemporary ethical issues in the healthcare system. We begin by providing a general overview of the conceptualization of the necessity for ethical considerations in healthcare services. We then examine the evolution of healthcare ethics - including leading philosophers and bioethicists - while offering a critical discussion of some of the most pressing ethical challenges faced by the health professions. Additionally, this analysis includes a timely discussion of the most influential ethical codes guiding the actions of various health professions, including the American Medical Association (AMA), American Society of Public Administrators (ASPA), World Medical Association (WMA), Health Informatics Professionals, and the Hippocratic Oath. In order to demonstrate the link between ethical theory and practice, an in-depth discussion of the values of healthcare professionals - coupled with a detailed ethical decision-making model for healthcare professions - is presented. This discussion and proposed model serve as a practical guide for ethical decision-making in the healthcare context. We conclude our analysis with a comprehensive summary of ethical findings presented throughout this paper, along with recommendations for future ethical considerations.
Since the 1940s, the intensity of ethical discussions has escalated to coincide with the rapid innovations in technology and medicine (Breen et al., 2008b), as well as the implications and consequences of public policy (Darr, 1993; Liebler & McConnell, 2008). Historical ethical discussions surrounding issues of abortion and euthanasia are now juxtaposed to new concerns such as those surrounding human cloning, stem cell research, provider selective participation in health plans, and quality of care for minorities. Technologies, such as in vitro fertilization, euthanasia, and more recently, human cloning and electronic medical records, have guided ethical discussions as society has sought to determine allowable ethical practices that positively advance the society. Similarly, medical advances in pharmaceutical sciences and alternative therapies have fueled comparable ethical discussions in particular relationships between providers and the pharmaceutical companies, representation of vulnerable groups in health services research, financial incentives, and the cost of healthcare to individuals and third-party payers. On the other front, public policy makers face a myriad of ethical consideration as they delve into discussions such as those related to cost, quality, and access. The most significant of these discussions centers on issues including: 1) whether the United States Constitution supports the assertion that healthcare is an individual right; 2) the persistent, inferior health statuses of racial and ethnic minorities; and 3) the safety and security of Protected Health Information (PHI).
While medicine and technology have enhanced the society's ability to sustain, improve, and manufacture life, public policy must work concurrently to ensure that ethical standards are not compromised, and that issues affecting social injustices are appropriately addressed. While implementing ethical decision-making models into various aspects of health, considerations should inherently and extrinsically include both individual and collective ethics and values. Individuals - as well as organizations - serve as moral agents, in that actions undertaken by either are not devoid of values. In carrying out their duties, healthcare providers and administrators must be guided by the founding principles of beneficence, non-malfeasance, respect for others, and justice (Darr, 1993), along with a comprehensive moral framework to guide their actions as they seek to appropriately prioritize the rights of their patients over external factors, and while ensuring the delivery of healthcare services to the public in a manner that is not only fair and ethical, but also just. …