What is Health Ethics?
Health ethics looks at moral issues involved in our understanding of life. In health ethics we ask questions such as when does life begin, how should it continue, and when does it end. Often we think of health ethics and its relationship with healthcare, medicine and human values. Ethics is the attempt to:
- Think carefully and systematically about our options, then choose the best possible course of action.
- Consider everything that is at stake for everybody affected, not just the most obvious implications (and especially, not just our own interests).
- Balance different values and perspectives, as there is rarely a perfect answer.
- Focus on profoundly important matters, such as respect, fairness and compassion.
- Ask better questions than we've asked before about our options and values.
Almost every day health care practitioners, health care administrators, clinical ethics committee members, and patients and their families encounter issues which can have ethical decisions. For example, a recent news headline that touched most Albertans was the case of three month old Isaiah James May and the request to keep him on life support despite doctors' orders to the contrary. Other examples of areas where possible health ethics issues can be encountered are:
- Setting limits on treatments - when and in what circumstances is it suitable to withhold medical technology from patients?
- Who should decide which treatment a patient gets - doctors, insurance company, government regulators, patient, patient's family? What if the treatment is dangerous, extremely expensive, or usually doesn't work?
- Questions about withdrawal of life sustaining treatments - life‐sustaining therapy has been defined as encompassing all healthcare interventions that can increase the life span of patients. How are decisions made to withdraw these treatments?
- End of life decision making - when diagnosed with a serious life‐threatening illness, the decisions we make and what influences our decisions are not based solely on the medical facts, risks and benefits. The decisions are often based on the way we live our lives which is a reflection of who we are, our goals, values and beliefs.
- Informed consent - a process of communication between a patient and health care practitioner which results in the patient authorizing or not authorizing to undergo a specific medical intervention.
- Is it okay to conduct research on children who cannot consent to participate?
- How should laws and standards of health care handle controversial issues like abortion in a multicultural, multi-faith community where we just don't agree?
- Should we force people to stop smoking or wear seatbelts, or should people be free to injure themselves? Is it fair to make people who take avoidable risks pay more for health care?
Many times moral issues or ethical dilemmas involve a conflict between two or more desirable courses of action, and when faced with a situation, we find ourselves needing to choose between two or more alternatives. Coming to the best decisions at times can be very difficult and occur under duress. Health ethics provides tools for analysis and help us think about our options in the resolution of the dilemma.