In my keynote talks on healthcare ethics, I point out that there are clearly core ethical principles. Nevertheless, as a healthcare ethics speaker, ethics consultant and author, the problem is that unethical people within healthcare disregard those principles. This post will try to answer the question of “Why.”
Four principles
There are four general principles that are considered core factors: autonomy, beneficence, non-maleficence and fairness. As a healthcare ethics speaker, I have seen many interpretations of the core principles of healthcare ethics however, generally speaking they break down as follows:
- Patients and their family members should have the power over their own body. The physician or provider can offer advice on treatment, but ultimately it is the patient’s decision.
- Treatment of any kind must do what is best for the patient based in the best interests of the patient.
- At least doing no intentional harm to the patient; the Hippocratic Oath.
- Fairness or justice is a balance between weighing the burdens of a treatment versus the benefits.
Obviously, I am grossly over-simplifying the issues. Within the field of medical and ethical healthcare issues there are entire libraries, specialties, medical departments, medical sub-specialties devoted to ethics.
On the other side of the equation are the law firms, law schools and mountains of litigation created from the interpretations of the four principles listed above. What should seem common sense and straightforward are usually anything but simple.
What are the core principles of healthcare ethics?
In fact, in my keynote speeches on healthcare ethics I often point out that knowing core principles as does the healthcare industry, from the respiratory therapist in the hospital to the head of research at a pharmaceutical conglomerate, is not the same thing as putting them into practice.
In fact, if I view the core principles, I can easily offer frauds and scandals around each one of the principles within the past few years alone.
The opioid crisis, nursing home abuses, price gouging, Medicaid fraud, fake vaccination cards, outrageous HIPAA violations, unlicensed practitioners in the OR, falsified provider resumes and on and on, are part and parcel of much larger issues than simply a failure to attend a medical ethics refresher.
It is time to get honest in all healthcare ethics discussions starting with the premise that the principles that apply to healthcare are somehow unique among all other fields. They aren’t. Poor choices leading to negative outcomes or consequences are hardly unique.
The healthcare “industry” is doing a terrible job of policing itself – and, it has not necessarily gotten better over time. During and after the pandemic this country experienced record amounts of fraud, prescription drug abuse and illegal distribution, over-billings and price gouging, elder and nursing care abuse and many other scandals.
The question as to “Why,” follows the same patterns of fraud as occurs in every other industry faced with fraud: an absence of strict oversite, a need for profits over people, and rationalizations from the sublime to the ridiculous.
Healthcare ethics in this ethics consultant’s view needs to be brought back from other-world egotism to real-world practicality.
The core principles of healthcare ethics are fine; the abuses have become catatrophic.
LEAVE YOUR COMMENTS!
