Ethical dilemmas
More and more teaching is being done in Medical School trying to help with some of the ethical dilemmas that face physicians every day. For years, we have focused on end of life scenarios, but there are many less dramatic choices that have to be made every day to survive in medicine. These issues are heightened because of more pressure coming from 3rd parties and government oversight.
Some of the more common ethical issues are as follows:
• Are you always obligated to honor a patient's advance directive?
• How aggressively should you treat an irreversibly comatose patient who doesn't have an advance directive?
• Should you write a prescription in a way that saves the patient money or write a prescription in a family members name to help the financial burden of the patient because of insurance reasons.
• Should you give little Johnny an excuse to keep him out of PE because of a parent request even though he is overweight and the kids pick on him?
• Are there times where you should withhold information from patients?
• Should you honor a family’s request not to inform a patient that he/she has a terminal illness?
• Should you inform a spouse who is your patient that their husband/wife has an STD?
• Is clinical decision-making compromised by gifts, trips, and other perks from pharmaceutical industry representatives?
• Is it ever ethical to write a bogus medical excuse for a patient who wants to collect disability payments, take time off from work, or get a refund from an airline?
• What do you do if you suspect that a colleague has a substance abuse problem or is clinically incompetent?
• What's your obligation to a patient when you make a medical error affecting that patient?
• Under what circumstances should you "fire" a patient?
• Should you exaggerate symptoms in order to keep a patient hospitalized longer because you believe or the family believes it is their best interest, even though you know the insurance would want them discharged?
• How do you deal with prescribing the morning after pill or referral for abortions?
• How do you deal with patient demands for tests that you know clinically are not warranted, such as MRI’s, CT scans, etc.?
• Do you give antibiotics for illnesses you are pretty confident are viral in nature?
All of these are issues that occur every day in primary care practices. Is there a right and wrong answer to each of these and, if so, who decides? But in the end, who will be faulted for the decision being made or the actions taken?
Practicing medicine in the 21st century is more than treating allergies or the common cold. There are numerous ethical and moral dilemmas that are decided every day.
Some of the more common ethical issues are as follows:
• Are you always obligated to honor a patient's advance directive?
• How aggressively should you treat an irreversibly comatose patient who doesn't have an advance directive?
• Should you write a prescription in a way that saves the patient money or write a prescription in a family members name to help the financial burden of the patient because of insurance reasons.
• Should you give little Johnny an excuse to keep him out of PE because of a parent request even though he is overweight and the kids pick on him?
• Are there times where you should withhold information from patients?
• Should you honor a family’s request not to inform a patient that he/she has a terminal illness?
• Should you inform a spouse who is your patient that their husband/wife has an STD?
• Is clinical decision-making compromised by gifts, trips, and other perks from pharmaceutical industry representatives?
• Is it ever ethical to write a bogus medical excuse for a patient who wants to collect disability payments, take time off from work, or get a refund from an airline?
• What do you do if you suspect that a colleague has a substance abuse problem or is clinically incompetent?
• What's your obligation to a patient when you make a medical error affecting that patient?
• Under what circumstances should you "fire" a patient?
• Should you exaggerate symptoms in order to keep a patient hospitalized longer because you believe or the family believes it is their best interest, even though you know the insurance would want them discharged?
• How do you deal with prescribing the morning after pill or referral for abortions?
• How do you deal with patient demands for tests that you know clinically are not warranted, such as MRI’s, CT scans, etc.?
• Do you give antibiotics for illnesses you are pretty confident are viral in nature?
All of these are issues that occur every day in primary care practices. Is there a right and wrong answer to each of these and, if so, who decides? But in the end, who will be faulted for the decision being made or the actions taken?
Practicing medicine in the 21st century is more than treating allergies or the common cold. There are numerous ethical and moral dilemmas that are decided every day.
posted by Anonymous at 6:05 AM
4 Comments:
I would think it would all come down to whether the person that is administering these services is honest or dishonest. It seems if some of the reasons listed were
provided a patient, the medical provider would be breaking the law, because they would be commiting fraud.
That has to be the best post we have had in months.
In Ireland, the pubs are nursing homes.
If you can tell your mother everything you have done today, you're probably behaving ethically.
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