Infectious Disease and Medical Ethics
Medical ethics is a field of medicine related to treatment of infectious disease. It can be defined as a tactility of moral principles that have to be employed in practice of medicine. Medical ethics is applicable within a clinical set up as it involves several values and judgments that all medical practitioners must have in order to appropriately conduct themselves while on duty. The values include: autonomy of the patients, beneficence, non male-ficence, justice, dignity and honesty. These values do not necessarily provide a response to any specific situation but rather helps the practitioner to always have an in depth understanding of handling situations of conflict that may arise in the course of duty.
There several situations in which conflict may arise within a medical environment. In as much as the practitioner should be sensitive to the values of the patient, there can be a conflict between what the practitioner is suppose to do and what the patient wants. This therefore creates a dilemma or a huge crisis. Such an incident can occur when a patient refuses blood transfusion because of fears of contracting diseases such as HIV/AIDS.
Despite all these, the practitioners have to deal ethically with all the patients who seek treatment from them. The first way into being ethical in handling patients is through allowing the value of autonomy to take its course (Tauber, 2005). Here the practitioner has to understand that a patient can chose to accept or reject a treatment prescribed by the practitioner. However autonomy is a value that could cause a huge conflict especially in incidences where the patient’s life may be at serious risk and a specific form of treatment would be of help. The conflict can be even more serious when the patient totally refuses this mode of treatment. A good example is of a patient who refuses blood transfusion because of the risk of contracting HIV.
A second way of being ethical as medical practitioner is by acting in the best interest of a patient (Walter & Eran, 2003). This value is considered to be one of the most basic ethical values in the field of health care. Health care can be both long term and short term. The main idea behind this value is the fact that health care should do nothing but healing to the patient. This therefore means that some activities that are done by medical practitioners can be considered unethical. In as much as these activities are of the best interest of the patient, they do not bring healing to the body. They include euthanasia, contraception, and plastic surgery.
The third way is by embracing the philosophy of ‘first, do no harm’. This is related to the previous ethical value of having the best interest at heart (Beauchamp & Childress, 2001). It is the duty of the practitioner to be very much aware of the extent of harm that accompanies a particular treatment. The prescribed treatment should also have reduced harm to the patient. In as much as the interest at heart may be for the good of the patient, it is also nice to avoid any harm. A practitioner may prescribe a treatment that is good in nature but if employed to specific kind of patients the harm it does will be serious to them. Before employing any treatment to a patient, it is important to evaluate the extent of possible harm and see if it is at acceptable levels. Some treatments may be harmful but at the same time beneficial to the patient. Therefore it is also important that the practitioner weighs both the harm and the benefits before making any judgment or decision of a treatment.
There is however instances when conflict can arise while compelled to exercise this ethical practice. For instance, a case where lack of treatment is more harmful that employing a harmful treatment would mean that this ethical value fails to apply (Ross, Lackner, P, Gross, Wolfe, & HM, 2007). Then employing the harmful treatment would be a justifiable action in medicine. When it comes to law and medical mal practices, when a practitioner violates this ethical value then the y are liable to be charged in court.
Another way of being ethical while offering treatment of infectious diseases is by informed consent. This means having the patient is informed of what the treatment is all about. Explaining to them what the risks are and what the benefits are before coming to make a decision of the particular treatment. Failure to do this as a medical practitioner would lead to a patient making decisions without having to first consider his or her values and beliefs. The patient has to agree to a treatment before employing it to him or her. There are however cases where the patient can be incapacitated to make sound judgment. To take care of these situations, there are laws that give provision on what is supposed to be done. Therefore the practitioner can either consult with the patient’s next of kin or any other person appointed by the patient to make these decisions for them.
Confidentiality is also a very important thing that the medical practitioner should consider when offering treatment to infectious diseases. Patients value their secrets and when it comes to health related secrets it is the practitioner whom they entirely trust with the secrets. It is commonly known as patient-physician privilege where the patient has the privilege to trust the physician with information while the physician has the privilege to know all that the patient might want hidden (Tauber, 2005). The issue of confidentiality is so serious that not any one practitioner can be made to vow to reveal any discussion with the patients even in court. But however there are cases where this ethical value would seem unfair even in treatment of infectious diseases. Such cases are important for the physician to reveal because it not only serves the dignity of the patient but also the dignity of any person affected with revealing the information.
A case where the patient has been infected with a sexual transmitted disease and wants to keep it secret from their sex partners, whether spouse or girlfriend/boyfriend, it is important that the doctor acts for the benefit of the partner and saves them from the risk of contracting the disease by informing them of what is happening. There are also other cases that are not related to infectious disease treatment where a physician may be unethical to exercise the ethical practice of confidentiality. These are cases where a law would require practitioners to report patients with gunshot wounds to assist the police in catching criminals or to assist in statistical data gathering purposes.
With infectious diseases, it is crucial for the practitioner to maintain communication with the patient. It may be due to lack of communication with the patient that there can be conflicts such as the ones discussed above in the paper. The doctor or the medical practitioner has to really know the position of the patient and also make the patient aware of the treatment he or she intends to employ on the patient. Communication should not only be aimed at the patient but also the physician should communicate with the patient family and relatives.
To avoid strong feelings and disagreements especially during the course of health care the practitioners have to maintain communication (Kelly, 1979). For example, in treatment of an HIV/AIDS patient the health care provider has to honest with the patient and at the same time they have to be positive while interacting to the patient and his or her family. Culture can be the impediment of this important aspect of medical ethics. For instance there are cultures where the practitioner is supposed to avoid revealing the diagnosis of a disease especially infectious disease that is stigmatized. It becomes hard for the physician to tell the patient, the truth about what is ailing them. But this in some culture is a not an issue because the physicians rely mainly on informed consent by asking their patients whether they really want to know their diagnosis. This is what is called truth telling in the field of medicine.
The issue of confidentiality can also be violated through the use online services. Physicians may reveal information that they are not required revealing through their blogs or in any other way online. Such a practice is considered unethical but however health facilities have put policies to scrutinize every activity of their stationed practitioners whether online or in any other form so as to ensure that such unethical practices do not happen.
Vendor relationship with particular doctors and medical practitioners is considered unethical (Ross, Lackner, P, Gross, Wolfe, & HM, 2007). A doctor may prescribe a medicine to a patient with an infectious disease because he or she has a direct gain from the manufacturing company of that particular drug. All drugs that enter into a health facility should have entered through unscrupulous means or through the back door. Drugs are very important in the field of medicine and prescribing a wrong drug just because there are some incentives and a gift that the vending company would provide later is wrong. Drugs are supposed to pass through test of quality before being shelved in any pharmacy or being used by any medical practitioner.
Lastly there can be a situation where treatment of a medical condition leads to futility. This means that whatever advancements a doctor does towards the patient with regard to treatment is not going to work or has very negligible probability of working. Such a case the doctor still has no authority to discontinue treatment but relies on the family members for any decision.
Infectious diseases require the medical practitioner constantly conduct themselves in ethical ways. Medical ethics does not provide the practitioner with solutions to problems they may encounter while working but rather provides an understanding of how to approach a situation of conflict. Infectious diseases as discussed are contagious and there are very many cases where there can be conflict between the practitioner and the patient.
Beauchamp, T. L., & Childress, J. F. (2001). Principles of Biomedical Ethics. New York:
Oxford University Press.
Kelly, D. (1979). The Emergence of Roman Catholic Medical Ethics in North America.
New York: The Edwin Mellen Press.
Ross, J., Lackner, J., P, L., Gross, C., Wolfe, S., & HM, K. (2007). Pharmaceutical
company payments to physicians: early experiences with disclosure laws in Vermont and Minnesota. JAMA , 297 (11): 1216–23.
Tauber, A. I. (2005). Patient Autonomy and the Ethics of Responsibility. Cambridge:
Walter, J., & Eran, P. K. (2003). The Story of Bioethics: From seminal works to
contemporary explorations. Goerge town: Georgetown University Press.