Ethics has always been a part of healthcare. Deciding who and how to treat is a question that many physicians and hospital groups have to deal with on a daily basis. If a person comes in with a debilitating illness but no money, do you treat them? If a dying child’s parents reject treatment on the basis of religion, do you follow their wishes? If an elderly person with a chronic illness wishes to peacefully end their life, do you facilitate it?
Navigating the tricky ground of healthcare ethics is not an easy feat, but it has to be done.
Here are four common ethical issues plaguing the industry today.
Cost versus care. Even with health insurance and the Affordable Care Act, costs for certain drugs and procedures remain out of reach for many patients. Faced with a patient who can’t pay the fees, physicians must make decisions about whether to provide treatment or let their patient suffer the consequences of foregoing care.
Efficiency. Hospitals are for-profit organizations. This sometimes means choosing the path that is most expedient, instead of the path that promises the greatest outcome for the patient.
Take for example peripheral artery disease (PAD), which affects about 1/3 of diabetics. Once it’s reached a severe stage many physicians will choose to amputate the limb, although salvaging it is possible with bypass surgery.
The problem? Saving the limb costs a lot, both in labor and post-surgical maintenance. As such, amputation continues to be the go-to response to advanced PAD, despite the fact that limb salvage leads to a significantly better quality of life for patients.
Confidentiality. Protecting personal information isn’t just the law; it’s a necessary function for providing patients with care they can trust. But as data sharing among healthcare institutions becomes more widespread and the ability of this information to cultivate real change becomes larger, the burden of protecting and honoring patients’ privacy increases.
The right to die. Some states have passed legislation allowing for assisted death for the chronically ill, and citizens in more and more states are requesting the same. The right to die—peacefully, safely, and on one’s own terms—is a right that many people want, but it’s not so easy to put into practice. Physicians must balance personal beliefs against the wishes of their patient and the laws of the state they practice in.
Trusting physicians, hospitals, and other providers means having faith in their ability to weigh ethical decisions against personal needs. As the industry evolves the ethical problems we face—and our response to them—will evolve too.