Navigating Ethical Issues in Health Care

Ethical issues in health care aren’t always so black and white. For instance, even if something is considered “unethical” or simply frowned upon, it could still permissible from a legal standpoint. Thus, it is up to each individual physician to draw the line for themselves. Here are three common ethical issues in health care today to help you prepare for similar situations:
 

With so many doctor rating websites out there, patients now have more control than ever over which physician they choose to see. However, what’s lesser known is that physicians have the ability to select the patients they want to treat as well—also known as cherry-picking and lemon-dropping—a highly controversial ethical issue in health care.
For example, some physicians may choose not to take a patient for selfish reasons—the patient is difficult or uses up too many resources. At times, physicians are also faced with the moral dilemma of having to provide care to undeserving patients—either those who deliberately went against a doctor’s instructions or someone who committed a violent act and is now in need of care. On the other hand, it is prudent for a physician to let go of a patient if they feel treating them would significantly take away from the other patients.
When there are no legal or institutional guidelines regarding a certain issue, physicians are encouraged to use their own judgment. As health care business consultant, Keith C. Borglum, states: “There is no one answer on how you should select patients. It has to do with your own ethical framework—what lets you sleep at night.”

In addition to ethical issues in health care regarding patients, many arise regarding fellow physicians. For example, if you see another doctor conducting themselves in a questionable manner, should your loyalty be to your colleague or to the patient? While upholding patient safety at all costs seems like the obvious answer, there are several personal and professional dynamics that could be jeopardized as a result. Thus, in many ethical issues in health care, knowing the right thing is not the struggle, but rather doing the right thing.
A Kenneth Goodman, PhD, director of the Institute for Bioethics and Health Policy at the University of Miami puts it, “Finding the right answer is easy; it’s the actual doing that is hard. If you are of the view that your primary loyalty is to the patient, then the idea that friendship or your own self-interest could be a factor in your decision is really hard to defend. It takes moral courage.”

In addition to our own moral convictions, physicians are also called work according to the ethics of their place of work and their patients. The very first hospitals stemmed from the Judeo-Christian traditions of caring for the sick. Thus, many medical institutions today are named after saints and may have various restrictions on which services and procedures they provide.
For example, a patient may end up wanting physician-assisted dying, but a certain hospital may not condone or offer than option. That’s why it is crucial that both phy  sicians and patients practice informed consent, being transparent from the beginning about limitations in care and pointing them to alternative options elsewhere.
In other words, don’t wait until an ethical issue arises to address it, but rather take preventative measures to ensure everyone is on the same page. This due diligence will enable you to make decisions congruent with your organization and your patient’s’ wishes, and make the ethical choices you have to make much easier rather than having to choose between the two.

Some ethical issues in health care are a bit less obvious but worthy of mention. Burnout, for example, affects not only physicians, but many others as well. As in any profession, there will be times we’re super passionate about our jobs and other times when it feels like such a chore just showing up. But far more is at stake in medicine than our personal satisfaction.
We have a responsibility, not only to ourselves, but to our patients, to be passionate and committed to our work. Anything less puts our patients’ safety in jeopardy. Does this mean you’re never allowed to have a bad day? Of course not. It simply means you must take responsibility for your mental, emotional, and physical health.
You must also do an honest assessment of your chosen specialty and overall career choices to ensure it’s something you’re skilled at, passionate about, and cut out for the lifestyle that comes with it. There are many different paths in medicine, and choosing the right one for you will help with any other decisions you have to face throughout your career.