Whether intentional or inadvertent, ethical rules are violated by physicians. As a healthcare ethics keynote speaker, healthcare ethics consultant and author, I have witnessed and spoken about numerous violations of trust. Often, the violations occur in clinical settings unbeknownst to the physicians, but whether known or unknown, they are abuses all the same. This is a pretty big deal because it can end up as a lawsuit – or much worse.
Which ethical rules do physicians most often violate?
As a medical ethics keynote speaker, medical ethics consultant and ethics book author, let me address some major violations that physicians – and those who operate (often without oversite) under their licensure commit:
- Patient justice. Patients have the right to be equally treated and without bias. While this seems fairly obvious, in practice it doesn’t always work that way. Whether the bias is one of race or religion or sexual orientation or combinations of factors, to fail to administer care on an equal basis is unethical.
- Refusal of treatment. The rules governing a refusal of treatment are quite specific and when violated, can be catastrophic.
- Patient sovereignty. All of us, physicians, nurses, medical receptionists or patients, are independent and sovereign. Ultimately, we can’t be coerced into a treatment if we are capable. Yet – it does happen, and whether we are talked into receiving an unapproved treatment, or (insurance) uncovered treatment or treated “just because,” patients have the rights over their bodies.
- Confidentiality. This, again, should be a given however, whether an egregious HIPAA violation, sharing a patient’s information with a pharma rep or having an unauthorized person (such as a relative!) in the treatment room or posting pictures on social media, confidentiality violations have led to numerous penalties.
- Provider-Patient agreements. Bottom line, is the physician and staff acting in the best interests of the patient? It is a fiduciary agreement, where there is a commitment to act in the most ethical manner is bound by legal and moral expectations.
- Informed consent. Does the patient fully understand the treatment? Has the patient consented to the treatment knowing all of the ramifications of that treatment? Again, this should be a given however, it has been shown in court numerous times to not be the case.
- Emergency care. The opposite argument for the above is the entire area of emergency care. The patient should expect that if they are incapacitated, the physician and/or staff will act in the patient’s best interests. Unfortunately, this has not always been the case.
- “At least do no harm.” Most properly, under proper patient treatment protocols malfeasance should not occur. Patients are entitled to be treated with dignity. Nevertheless, it does break down, particularly where there is a lack of oversite. As an example, numerous abuses have been recorded in nursing homes and tens of thousands of patients and former patients have died due opioid addictions.
The list of medical ethical issues I have presented above, by no means represent the entire range of violations that occur on virtually a daily basis. For example, the topic of “continuity of care” and respecting the sanctity of life could be easily added to the above.
Nevertheless, when I ask, “Which ethical rules do physicians most often violate?” no one in the area of providing healthcare can say with confidence that they have never violated any of these basic patient rights. It happens, we know it happens, but the issue is one of how can it be minimized?
The solution is ethical training with reinforcement of that training. As a medical ethics keynote speaker, medical ethics consultant and ethics book author, I can say with certainty that almost at this very minute a practice is in violation of the rules. If the violation is bad enough, it will result in legal or medical problems. At the end of the day, the choice is yours to make.
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