LESSON 2.1
LESSON 2 READING
The concepts of ethics and morality have a large impact on health care in this country. Ethics and morality are separate concepts from the law. Society attempts to regulate morality through the law. There are, of course, certain acceptable absolutes that apply to ethics and the law. For instance, all ethical constructs tell us that murder is wrong regardless of the circumstance; however, the law allows for specific exceptions. Murder in the defense of self or others is permitted under modern law but not ethical or moral codes.
Health care and ethics, however, have fewer moral or legal absolutes. There are universal principles of ethics that apply to the healthcare industry. First, the principle of autonomy states that an individual has the right to make his or her own decisions regarding his or her personal health. This again intersects with the law in specific circumstances. For example, the ethical principle of autonomy does not apply if the patient is incapacitated or has subrogated that right to another individual through a healthcare proxy or other legal instrument.
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The third universal healthcare ethical principle is nonmaleficence, which dictates that healthcare providers are to avoid harming patients. The law supports this in most scenarios unless there is a conflict. The final universal ethical principle is justice. Justice in the ethical construct refers to the mandate that healthcare providers have an obligation to fairly distribute benefits and risk. A great example of this principle at work is the Affordable Care Act. This law requires that every adult have healthcare insurance. This requirement removes the previous system of health care for only the wealthy, employed, or extreme poor, and it redistributes healthcare access to everyone regardless of ability to pay for insurance, which some believe is a fairer system of health care across the country.
As we have read, religion has played an important role in the evolution of health care. The law is clear on many points regarding the obligations of healthcare providers and the religious preferences of patients. Recently however, there have been many instances of collision between health care and religion. For example, if a pharmacist has a religious objection to providing birth control to women, does he or she still have an obligation to provide it? Can he or she be legally required to do so? What about the rights of the patient? These are all potential ethical questions that affect health care and religion.
Since 1973, abortion in this country has been legal; however, for both sides of the debate, it is still far from settled (Pozgar, 2016). Legal and ethical arguments over women’s reproductive rights in this country still take place. There are groups that want to increase women’s access to abortion, and there are groups that want to restrict and eliminate that access. Various courts around the country have ruled in different ways regarding the abortion debate, leaving the nation with no clear guideline beyond its legality at a certain point.
Another controversial topic is wrongful birth. This might seem like an odd claim or even an insensitive charge to bring, but if you look at the typical facts of this kind of issue, you may feel differently. Imagine that a young couple is expecting its first child. When the couple meets with the doctor for a routine visit and discusses the health of the baby, the father is overheard talking to his wife and saying that he just wants a healthy baby no matter what. He goes on further to say that after the experience his mother had with her brother, a child with Down’s syndrome who became an adult with Down’s syndrome, he did not think he could ever deal with that kind of life. The doctor becomes concerned after hearing this conversation. The last tests of the baby revealed a genetic anomaly like Down’s syndrome. The doctor has very strictly held religious beliefs and decides not tell the couple for fear they may abort the baby because of the test results.
When the baby is born with Down’s syndrome, the parents are bewildered and confused. They ultimately decide to sue the doctor for wrongful birth. A wrongful birth claim is a very difficult claim to prove and to bring before a jury. The sad part is that the parents may appear to make an argument that they wish the child had never been born. This is usually an unsympathetic argument for a jury to hear. What the parents are actually doing, though, is bringing a claim that states that they had a right to know about the anomaly of their unborn child and that right was denied them. They may have prepared differently if they had known of the potential issues with the child. They may not have had the child at all. At the heart of this type of claim is the right to know, which can be a difficult thing to communicate to a jury. This is an unfortunate situation, but it is an example of a wrongful birth claim.
As we read in our textbook, many legal and ethical claims involve reproductive rights. For generations, there have been many examples of legal and ethical dilemmas centered on women’s reproductive,e rights. The law provides limited guidance, but it is slow to evolve compared to technology and society. Prior to the landmark case of Roe v Wade in 1973, abortions were illegal (Pozgar, 2016). That landmark decision, however gave women a legal right to choose to continue a pregnancy or to terminate it with an abortion. This ruling changed the U.S. healthcare system and women’s health care.
While currently legal, there are still many ethical and religious arguments against abortion. There are also many state-level legal restrictions because it is up to the individual states to regulate this activity to protect women’s health. States have implemented restrictions such as time limits within a pregnancy for an abortion, where a patient can have an abortion, and the types of medical facilities required to offer abortions to patients. With these restrictions also come many burdens for the providers and possible barriers for the patients. Providers who do not ethically agree with performing abortions may use the laws to deter women from seeking out the procedure.
For example, a doctor has ethical and religious objections to anyone performing an abortion. A new patient asks about the procedure because she is newly pregnant and does not wish to carry the baby to full term. The doctor is appalled by the patient’s request and provides false information and even tries to delay the patient until she is no longer able to legally have an abortion in her state. This results in the women giving birth to a baby that she is not capable of caring for.
In conclusion, these are just a couple of ethical scenarios that patients and providers can face. Patients look to providers for help and guidance with their health, but providers are not expected to put all their personal beliefs aside if it does not harm the patient. This, however, is a fine line to walk.