Abstract

Ethical issues spring up in every social profession. However, ethical dilemmas occurring in the medical profession are of greater concern as this profession is highly vulnerable and slight negligence can even cost a human life. Physicians have a moral and ethical responsibility to provide accurate diagnosis for their patients’ illnesses. Unfortunately, some physicians do not fulfill this obligation devotedly as personal gains are more important to them than the demands of the profession. Such individuals resort to different measures for the purpose of extorting more money out of their patients. In order to eliminate this practice from the face of our society, we need to educate every individual about their ethical responsibilities and ensure compliance to these responsibilities.

An Ethical Issue in the US Healthcare

Introduction

Managers and employees of every organization, be it government, private or non-profit, are subject to many ethical considerations. It is for this reason that every company charts its code of conduct, defining what behavior is acceptable in the company and what isn’t. Moreover, formal ethical training is also imparted from time to time to make the workforce aware of ethical issues and equip them with ways and procedures of managing them.

The American Medical Association promises to provide every citizen of the country with adequate health care.[1] This objective has been reinforced from time to time with new vigor as resolutions are passed in an attempt to address the current limitations of our hospitals and clinics.

True, many reforms have been introduced in the US healthcare over the times. People all over the US have considerable access to hospitals and other medical facilities. Patients are treated with care and dignity. Medication is readily available. People of all ages find the perfect health solutions as are suitable for them.

However, it would not be wrong to say that not all issues faced by the healthcare system have been addressed. People still express their concern for inadequate medical treatments. Others are dissatisfied with the ways in which patents are managed. Still others report of excessively over-priced medical facilities, and stay away from clinics for fear of losing all of their hard earned money.

As in other professions, ethical dilemmas are commonly faced by doctors and other medical staff. These ethical dilemmas spring due to loopholes that exist in the medical setup and carve difficult options for individuals who face them.

Purpose of the Essay

The purpose of this essay is to identify an ethical issue observed in the healthcare. This issue was reported by a colleague and is examined under the ethical principles that have been taught in our course. Furthermore, suggestions and recommendations are also included in this paper.

Jimmy & Dr. Bill

Jimmy had been suffering from severe fever for two days. He got an appointment with Dr. Bill over the telephone and went over to see him. His general physician was on vacation and this was the first time he was visiting Dr. Bill’s office.

During the examination, he reported his fever, weakness and lack of appetite to Dr. Bill. Dr. Bill made all the observations and told him that he was in a serious risk of suffering from typhoid. He said that he would need to take some tests and be admitted for at least two days. Jimmy asked the doctor’s assistant to give him an estimate for the two day’s stay along with all the tests that were to be conducted. He was surprised to hear the exorbitant amount they were charging him and decided to leave instantly.

On his way back, Jimmy called his general physician up and informed him everything. Dr. Andrew recommended another doctor to Jimmy and Jimmy went to see him the next day.

The new doctor checked Jimmy up and prescribed a few medicines, telling him there was nothing to worry about. Jimmy was surprised to hear this, and left the clinic feeling very relieved.

Two days after using the medicines, Jimmy perfectly recovered from his fever and realized how Dr. Bill had tried to take advantage of his sickness for the purpose of making more money.

Applying the Ethical Principles to the Issue

Ethics has been around ever since human life originated. Scholars and sages, over the times, have presented different ethical principles, all with the purpose of improving the standards of human life. Today a lot of research has been made into various ethical dilemmas. Based on this extensive research, core ethical principles are presented to us allowing us to take the right decision whenever we confront an ethical issue. Furthermore, organizations establish their code of conduct along with ethical training programs to instruct the employees about the ethical issues they will face and ways of dealing with them.

It is impossible to find a criterion for determining the validity of ethical judgments….because they have no objective validity….They are pure expressions of feeling and as such do not come under the category of truth and falsehood.(Ayer A. J. Language, Truth and Logic)

The intentions as well as the actions of Dr. Bill had been completely unethical. To start with, he had not been honest, and used deceptive measures to earn more from Jimmy. He took advantage of Jimmy’s sickness, using it to realize his false objectives. He was also not loyal with his profession as he was not providing the appropriate treatment to his patients.

Understanding the Ethical Issue (Deontology Theory)

 Physicians have an ethical obligation to provide their patients with the appropriate health care. They are required to diagnose patients accurately and counsel them the right treatment.

Unfortunately, medical profession is sought by most physicians as any other business profession wherein the primary objective is to maximize wealth. Where earning a living by rendering medical services isn’t unlawful, suggesting wrong treatments to make money certainly is.

Deontology holds that one’s acts are inherently good or bad. Dr. Bill’s act/intentions were inherently bad. He swayed from his ethical obligation to provide correct information to Jimmy and decided to take advantage of his sickness.

Immanuel Kant discusses several aspects of a morally correct act:[2]

1.      Act only according to that maxim by which you can also will that it would become a universal law.

2.      Act in such a way that you always treat humanity, whether in your own person or in the person of any other, never simply as a means, but always at the same time as an end.

3.      Act as though you were, through your maxims, a law-making member of a kingdom of ends.

The values that guided Dr. Bill into making this unethical decision formed the basis of his action. The consequences of this act may have been positive as far as Jimmy’s health is concerned. He’d have stayed in hospital care and received optimum treatment for which he would have been charged.

However, the act was inherently bad as the prime objective of carrying out this exercise was to earn money unrightfully, and to offer services when they were not required at all.

A study of prima facie duties presented by W.D. Ross (The Right and The Good) suggests the same:

1.      Duty of beneficence: A duty to help other people (increase pleasure, improve character)

2.      Duty of non-maleficence: A duty to avoid harming other people.

3.      Duty of justice: A duty to ensure people get what they deserve.

4.      Duty of self-improvement: A duty to improve ourselves.

5.      Duty of reparation: A duty to recompense someone if you have acted wrongly towards them.

6.      Duty of gratitude: A duty to benefit people who have benefited us.

7.      Duty of promise-keeping: A duty to act according to explicit and implicit promises, including the implicit promise to tell the truth.

Here, it is clearly manifested that individuals have to perform their duties righteously. Individuals from all walks of life have a responsibility to avoid harming other people. This includes harming others monetarily. They also have an obligation to discharge their duties justly. Dr. Bill and those of his like do not cater for these moral and ethical obligations and are concerned only with the end-objective of making more and more profit.

Options for Dealing with the Dilemma

Following options are available to deal with the dilemma:

1.      Exercise a formal ethical training program, making doctors and other medical staff aware of the ethical issues and ways of dealing with them.

2.      Instructing doctors that there is a very fine line between an unlawful act and an unethical act. However, both are wrong.

3.      Constant audits by medical committees to study the dealings of medical professionals.

4.      Publicizing doctors who conduct such acts.

5.      Having a medical committee exercise strict disciplinary action against all such individuals.

6.      Avoiding new doctors; if unavoidable, visiting those doctors whom our friends or family members are familiar with.

7.      Fixing basic medical charges at the same rate for all doctors.

8.      Consulting another doctor before deciding to go for a very expensive treatment.

Resolving the Dilemma

The patient, Jimmy, had been wise not to get himself instantly admitted. He thought his condition had not been so severe as to be recommended a two-day hospital stay. Besides, the charges of the treatment were quite unaffordable for him. Consulting his general physician over the telephone had been a good decision. The views of the other expert unfolded the entire plot and not only did Dr. Bill lose his patient (or customer as this is what Jimmy would have seemed to him), but also earned him bad repute. Word of mouth travels very fast and before they are aware of it, all such service providers end up losing more money than they make through these foul measures.

Conclusions & Recommendations

In a capitalist economy such as United States, every business and service is privately owned. Service providers are mostly involved in maximizing their wealth without adding much value to their work. Such individuals do not realize that this kind of business lasts a very short time. Those who indulge in such activities either end up behind the bars or bankrupt. On the contrary, organizations that focus on adding value and quality while keeping in mind the ethical and social considerations remain steadfast and prosperous. [3]

This important lesson needs to be taught from the elementary level down to our professional lives. It is one of the most fundamental principles of conducting any business or service.

Medical profession is a highly sensitized one where slight negligence can even cost a human life. As such, it is important to ensure that individuals are treated properly and given the right diagnosis and medication for their problems.

Some doctors have expressed that after treating a large number of patients, they no longer ‘feel’ the pain and suffering of the patients. Besides, they shift their focus to making a fortune out of their services and pay no heed to the suffering of their patients.

REFERENCES

Chadwick Ruth Professional Ethics

Brazier Margaret Medicine, Patients and the Law

Beauchamp, Tom L Philosophical Ethics: An Introduction to Moral Philosophy

Sulmasy DP. Physicians, cost control, and ethics.

Callahan D. What Kind of Life: The Limits of Medical Progress.

[1] Policy 140.975. 1993 Policy Compendium of the American Medical Association.
[2] Kant, Immanuel In The Metaphysical Elements of Ethics.
[3] Kotler, Philips Principles of Marketing