March 22, 2024

Monique Nguyen

10th Grade

Fountain Valley High School

Introduction

With the exponential growth in the healthcare industries, medical ethics is involved in even the most basic of operations. It is loosely defined as the moral obligations involved in a healthcare worker’s decisions to ensure a patient’s safety. As the concept has been developed, basic principles have been integrated as standards in procedures. This includes beneficence, autonomy, nonmaleficence, and justice. Beneficence is ensuring patient safety, autonomy is considering the patient’s will, nonmaleficence means doing no harm, and justice means providing fair treatment. 

History

The Hippocratic Oath is the well-known originator of the concept of medical ethics. Dating back to ancient Greece, the physician Hippocrates created the oath as a guide for students of medicine to pledge to ensure beneficial treatments to the best of their ability. In modern times, several versions or fragments of this oath are used in various parts of the world, including in medical graduation ceremonies and ethical standards developed by professionals and organizations. But medical ethics, or rather the lack of ethics, has persisted in multiple unfortunate situations. For example, from 2008 to 2014, a previously acclaimed thoracic surgeon Dr. Paolo Machhiarini was the culprit for seven deaths due to scientific misconduct. When conducting medical research, Macchiarini had disregarded his moral obligations with uninformed patient consent, forging medical records, research fraud, denying patients of other methods of treatment, and other ways of manipulation, abusing his capacity as a caretaker. Another instance is the human experiments conducted by the Nazis during World War II that were disguised as medical research. Prisoners were forced to undergo freezing experiments, drug testing, exposure to dangerous chemicals like mustard gas, and even sterilization by Nazi scientists. Considering the nonconsent, lack of research standards, and brutal environment, the Nuremberg Code was created later to ensure such exploitations were prohibited. 

Current Status

Even in modern times, decision-making has become increasingly challenging due to the complexity and variety of medical situations. Caretakers must consider both the patient’s opinions and their own judgment; however, with dubious situations of informed consent, surrogate decision-making, and physician-assisted suicide, finding a middle ground becomes exceptionally difficult. Especially in developing countries, ethical implications are a major concern with the lack of resources, funding, and infrastructure, which may compromise patient safety in the areas of medical research, physician malpractice, and complicated procedures. Not only in traditional procedures, medical ethics can be applied to common operations such as cosmetic surgery and organ transplants as well. For instance, to what extent does deceptive advertising have on the patient’s will to undergo a cosmetic surgical operation? What factors do healthcare workers use in selecting a patient for sought-after organ transplantations? The complicated factors that concern ethics in such procedures prompt a multitude of harrowing decisions for both the patient and the caretaker. Furthermore, there can be numerous influences and consequences affecting the physician as well. Mistakes such as WSPEs or wrong-site, wrong-procedure, and wrong-patient errors may cause significant pain, lead to mortality, as well as induce a large financial burden for the patient. Some patients have even filed lawsuits against their physicians for damages to their health. At the same time, physicians may have a financial or institutional motive, such as fulfilling surgical quotas, to perform unnecessary operations despite it not benefiting the patient’s well-being. A common example is the overuse of surgical hysterectomies. Almost 1 in 5 hysterectomies performed is not necessary, and almost 40% of the patients were not offered alternative options. 

Conclusion

As a result, this topic has prompted discussions and conferences worldwide, spurring the development of several international codes and standards that healthcare workers can adhere to. For example, the World Health Organization, a renowned organization under the United Nations, created the Surgical Safety Checklist and annually hosts the global conference World Patient Safety Day in order to further develop the concept of medical ethics into a global effort. With the evolving landscape in scientific advances, medical ethics has become a notably complex concept that healthcare workers are still trying to navigate.