Medical Ethics for Challenging Times
[Finding Your Moorings in an Era of Dramatic Change]
By Render S. Davis
When I do good, I feel good; when I do bad, I feel bad. That’s my religion – Abraham Lincoln
There are few who would doubt that the practice of medicine today is dramatically changing. The standards that were predominant a generation ago appear to no longer drive the rapidly evolving relationship between physicians, patients, and health care organizations. Other entities, most notably payers and regulators, have interposed themselves into the relationship and the result is a rapidly evolving approach to health care.
Today, questions of cost, access, patient empowerment and quality drive a continuing and – at times – contentious debate.
Yet, the ethical principles of beneficence, respect for autonomy, and justice that served as a foundation for the healing professions since the age of Hippocrates, remain as important today as two millennia ago.
Ethical dilemmas arise, not from clear choices between good and evil, but when there are no clear choices between competing goods. Often these issues surface when ethical principles themselves are weighed in relationship to each other. When a physician’s obligation to treat conflicts with a patient’s right to self determination; or when an individual’s demand for autonomous choice offends our society’s sense of justice and fairness, are but a few examples of ethical principles in conflict.
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