Running head: ETHICAL CHALLENGES IN HEALTHCARE 1

Ethical Challenges in Healthcare

Name

Institution
 ETHICAL CHALLENGES IN HEALTHCARE 2

Abstract

Ethical issues in health care occur from time to time. Differences in moral principles cause

divergent opinions on certain issues that require moral reasoning such as assisted physician

death. Four of the main ethical issues in health care in the United States currently include end-of-

life issues, patient confidentiality, relationships, and informed consent. Ethical challenges in the

health care sector result in compromising the safety of the patient, infringing on patient

autonomy and disrespecting the boundaries between patients and physicians as well as nurses.

For this reason, the Four Principles framework is a practical approach that would assist in

resolving ethical problems. The framework emphasizes on the respect for autonomy, doing good,

doing no harm and providing health care impartially. The application of this framework focuses

on prioritizing public health benefits. The key aim in resolving ethical issues is to establish

which option yields maximum public health benefits then include other moral principles.
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Ethical Challenges in Healthcare

The process of providing health care in this century comes with confusion in laws, rules,

and ethical guidelines. Despite health care providers having the best intentions towards their

patients, ethical challenges arise occasionally. It is important to note that being legal and being

ethical are different things. It is possible for something to be legal yet unethical. Issues such as

end-of-life decisions, relationships, patient confidentiality, and informed consent are some of the

biggest ethical issues that health providers face currently. Ethical challenges raise concerns over

the safety of the patients and health care providers, patient autonomy and boundaries established

between the two groups and there is the need for a framework that focuses on care principles to

handle such issues.

Ethical issues in healthcare

Physician-assisted suicide is a controversial issue globally with some places allowing it

while others argue against it. In most cases, the patient expresses the wish to end life but the

family opposes the notion (UT Tyler Online, 2019). Some health care practitioners perceive this

to be a violation of the ‘do no harm’ principle in medicine. However, in recent years, many

doctors have broadened their definition of the principle. There is a strict prohibition against

sexual intercourse between doctors and their patients. Recently, the sex scandal of the Olympiad

physician, Larry Nassar, reemphasizes the ethical implication of such relationships (Teel, 2019).

Such relationships have dire consequences for health care providers and could lead to the loss of

medical licenses. Additionally, it is unwise for patient-doctor sexual relationships regardless of

consent.

Patient confidentiality ranks among the top ethical concerns in medicine today. In a world

where there is more available patient data, there is a concern over the lack of strict regulations on
 ETHICAL CHALLENGES IN HEALTHCARE 4

the sharing of such information (Alkabba, Hussein, Albar, Bahnassy & Qadi, 2012). In the

majority of cases, the health practitioner has the role of deciding what information to share about

the patient. This feels like a violation of the patient’s rights. Patient data security lacks the

scrutiny that other ethical issues receive.

Informed consent in medical procedures and experiments raises suspicion. Informed

consent requires patients to understand the procedures, risks, and benefits of a medical process

before agreeing to it (Escobedo, Guerrero, Lujan, Ramirez, & Serrano, 2007). However, in most

cases, the paperwork is too long or the time the patient has to review the information is not

enough to make an informed choice. Additionally, physicians tend to oversell the positive

expectations, forming a bias for the procedure. In the case of clinical trials, this is an ethical issue

because a physician may subject the patient to harm in the pursuit of scientific breakthroughs.

Consequences of ethical challenges in health care

The safety of the patient is the primary concern of the effects of ethical issues. In

medicine, the patient’s welfare always comes first. However, a patient may unknowingly give

consent to procedures that may harm them in some instances (Haddad and Geiger, 2019). For

example, in the case of experimental cancer treatments, it is possible for a patient to lack enough

information on the consent papers and agree to procedures that are previously untested thus

leading to unintended harm on the patient. Such instances could have a larger impact on the

study and prevent the provision of the procedure to other patients who would otherwise have

benefitted.

Some of the ethical issues infringe on patient autonomy. For example, a patient has the

right over what happens to their bodies and as such, health care practitioners and their family

should respect the patient’s wishes. However, in a case like assisted suicide, the fact that the
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physician and family members may reject a patient’s wish for euthanasia infringes on patient

autonomy. Some of the patients are in extreme pain and desire a better quality of life. In this

case, death could offer a better solution to living in such pain. Other cases may include cases of

abortion where a woman’s autonomy may be demeaned by laws prohibiting the act.

The presence of ethical issues may affect patient-physician boundaries. Set guidelines of

conduct for both patients and health care providers allow both parties to act within a set of

boundaries that allow for a conducive environment for the doctors and nurses to help the patient

but work in a safe space. However, it is possible to harm both the patients and physicians. For

instance, in recent cases of the Ebola outbreak, the transmission of diseases versus the

requirement for physicians to provide health care to all presents an ethical issue where health

practitioners face the risk to harm themselves.

A framework for resolving ethical issues

In health care, there are many frameworks designed to address ethical issues. One

popular one comes from Beauchamp and Childress. The framework is advisable because it

contains four principles that align with moral norms (Teven & Gotlieb, 2018). The four

principals encompass the respect for autonomy, justice, the oath to do good and the ‘no harm’

principle. Respect for autonomy falls in line with the idea that morality involves respecting

another person’s moral principles (De Panfilis, Di Leo, Peruselli, Ghirotto & Tanzi, 2019).

Respect for autonomy argues that an individual is capable of making decisions regarding their

health and life and thus has the right to make such choices.

The second principle involves doing good. Health practitioners take an oath to do good.

Any decision regarding a patient should receive guidance from this principle. If this principle

were to be applied in all ethical dilemmas, it would be easy to resolve ethical problems and some
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issues would not exist. For example, in the case of non-consensual sexual intercourse between a

patient and a physician, the principal of doing good would prevent such situations from arising.

Nonmaleficence is the third governing principle in the Beauchamp and Childress

framework. This is the core of medicine practice. Physicians have the obligation to avoid doing

any harm regardless of the situation and the patient. For example, if a doctor is treating a rapist

or a murderer then despite personal feelings, they have the mandate to do everything in their

power to save the life of such a patient. This principle guides health care practitioners in making

informed and correct choices despite personal biases.

Justice demands that in the course of dispensing health care, the nurses and doctors

should adhere to impartiality. However, public health objectives surpass justice in case there is a

conflict of interest (Have, De Beaufort, Mackenbach, & Van der Heide, 2010). The other

principles culminate in public health goals. These first three principles which focus on

maximizing health benefits to all such that the benefits are more than the costs, override the

justice principle. For example, in the case of an unknown strain of disease, preventing mass

spread is more important than providing care to a few individuals.

Conclusion

Ethical issues occur from time to time in the health care sector but the core principles of

practicing medicine provide valuable solutions. The Four Principles framework adopted from

Beauchamp and Childress offers practical approaches to resolving such problems. Health

providers have the task of evaluating the situating and applying the moral principles to help

produce the best result. The key objective of health care is the welfare of patients as well as the

provision of a conducive environment for care providers to do work. In that regard, resolving

ethical issues is paramount in the sector.

References

Alkabba, A. F., Hussein, G. M., Albar, A. A., Bahnassy, A. A., & Qadi, M. (2012). The major

medical ethical challenges facing the public and healthcare providers in Saudi

Arabia. Journal of Family and Community Medicine, 19(1), 1.

De Panfilis, L., Di Leo, S., Peruselli, C., Ghirotto, L., & Tanzi, S. (2019). “I go into crisis

when…”: ethics of care and moral dilemmas in palliative care. BMC palliative

care, 18(1), 70.

Escobedo, C., Guerrero, J., Lujan, G., Ramirez, A., & Serrano, D. (2007). Ethical issues with

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Haddad, L. M., and R. A. Geiger. (2019). Nursing Ethical Considerations. Accessed 5 Nov

2019.

Have, M. T., De Beaufort, I. D., Mackenbach, J. P., & Van der Heide, A. (2010). An overview of

ethical frameworks in public health: can they be supportive in the evaluation of programs

to prevent overweight? BMC Public Health, 10(1). doi:10.1186/1471-2458-10-638

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A Big Topic Which Presents Even Bigger Challenges For Healthcare

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management-administration/five-top-challenges-affecting-healthcare-leaders-in-the-

future.html.

Teven, C. M., & Gottlieb, L. J. (2018). The four-quadrant approach to ethical issues in burn

care. AMA journal of ethics, 20(6), 595-601.

UT Tyler Online, (2019). Ethical Issues in Healthcare | UT Tyler Online. The University Of

Texas At Tyler, https://online.uttyler.edu/articles/ethical-issues-in-healthcare.aspx.

Health care magazine details

The online health care magazine that this paper would be published in is American Public

Health Press and this is the link for the author’s guidelines

https://ajph.aphapublications.org/authorinstructions