Medical Ethics Debate Guide

From PhiloWiki

Contents 1 Definitions 2 Code of Medical Ethics 3 Discussion questions 4 Case Study

Definitions

• Ethics: a conceptual tool to evaluate and guide moral decision making
• Medical Ethics: a discipline for considering the implications of medical technology and what ought to be done within that discipline
• Law: tells us directly how to behave under various specific circumstances and prescribes remedies or punishments to individuals who do not comply.
• Technology: the technical means people use to improve their surroundings and control our world by using knowledge, tools, and systems to make our lives better

Code of Medical Ethics

1. A physician shall be dedicated to providing competent medical care with compassion and respect for human life
2. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
3. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interest of the patient.
4. A physician shall respect the right of patients, colleagues, and other healthcare professionals and shall safeguard patient confidences and privacy with the constraints of the law.
5. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other healthcare professionals when indicated
6. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose who to serve, with who to associate, and the environment which to provide medical care.
7. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and in the betterment of public health.
8. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
9. A physician shall support access to medical care for all people.

Discussion questions

1. With all the technology available to keep life going indefinitely, it is hard to draw the line on how far we should go in certain situations. When do you think enough is enough? Who do you feel should determine when medical interventions should be ceased?
2. Regarding the debate over quality vs. quantity of life, use a chart and rank the key issues related to each by importance. Which of the two, quality or quantity, do you feel you would want for your loved one? This is not cut and dry here ...look at yourself and really think about what is truly important to YOU, not what is right in the eyes of others.
3. With rising health costs and avalible resources depleting, whom do you feel should be paying for these? Should medical decisions be based on ones ability to pay? Should the insured person be responsible for the uninsured person? What about illegal aliens?
4. What do you feel can be done to improve healthcare in the United States. Should we have a unitfied system of health care like Canada? Do you feel that the expectations that society has placed on healthcare are realistic?

Case Study

A man and his partner have been living together for about 10 years and have purchased a house together. Both partners have stated to the other their wishes for end of life care and have agreed to follow the other's wish. One member of this relationship has developed HIV and the other has diligently taken care of the sick partner. The sick partner's family has distanced themselves from this relationship and have had little or no contact with the sick partner for a number of years. The sick partner slips into a coma. The doctors believe he will not recover based on past medical information, the patient's advanced lung disease and his HIV status, but they could keep him alive on a ventilator indefinitely. The partner knows that the sick partner would not want that. The family is insisting all measures be taken to keep their son alive.

1. Who should be the primary decision maker here?
2. Given the families estrangement from their son, do you believe that they have the right to impose their wishes?
3. Should the sick partner's wishes be denied since he is unable to state them personally?
4. Based on the medical information, should the physicians be ethically bound to keep this person alive by extraordinary means?
5. If he is kept alive, should the parents be responsible to pay for and provide long-term care of their son or is it appropriate to impose these costs on society?
6. What would you want to have done if this was you?