Pillars of Medical Ethics

Medical ethics are the moral principles that govern the practice of medicine. Medical ethics is based on a set of pillars, or core values that doctors and other medical professionals can refer to when in conflict about a decision. These four pillars are; Autonomy, Non-maleficence, Beneficence and Justice. Autonomy means the right of self-government; it is about the patient being able to act and make decisions based on their personal values. Non-maleficence means not doing harm and is based on the idea of inflicting the least harm possible in order to reach the best outcome. Beneficence is the state of doing good, and means that all medical practitioners should promote the course of action they believe is in the best interests of the patient. Justice in medical ethics means acting in accordance with the law and being fair and balanced.

There are some common medical ethics topics that are discussed when talking about the pillars of medical ethics. Firstly, a very popular topic is about euthanasia, and there are arguments for and against this, using the four pillars. When using the pillar ‘Justice’ we can discuss the legality of it. In the UK all forms of euthanasia are against the law, however in other countries such as Switzerland both assisted suicide and passive euthanasia are legal. When discussing the pillars ‘Autonomy’ and ‘Non-maleficence’ we can argue about the patient being allowed their right to make their own decisions and exercise their right to end their suffering. However, in the Hippocratic oath it states that the doctors should not harm, and death is harming a patient.

Another common topic is about deciding between two patients in need, for example; ‘You have one liver available for transplant but two patients with equal medical need, a young mother and a 40 year old ex-alcoholic’, or, ‘How do you determine who gets a research grant? A team of researchers looking for a cure for cancer or researchers looking for a cure for diabetes?’. These questions are slightly more difficult to answer as they ask for an argument about who deserves it more. There are ways of solving some of these debates using a quantitative measure of the burden of disease, called a DALY. DALY stands for disability-adjusted life years. A DALY score measures the medical effects of a disease and the years of life lost due to premature death. DALY scores are split into two parts: morbidity and mortality. Mortality is the standard life expectancy of a healthy individual minus the age of the individual when they die. Morbidity is measured in a slightly different way. The illness effect is given a severity rating ranging from zero, which means fully healthy, to one, which means very severe, and since effects can be short or long term, the length of illness is factored in. Both of the mortality and morbidity calculations are added together and a DALY score is produced.

Bibliography:

“Autonomy.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/autonomy. Accessed 17 Feb. 2021.

Nineham, Laura. “Medical Ethics: Justice – The Medic Portal”. The Medic Portal, 2021, https://www.themedicportal.com/application-guide/medical-school-interview/medical-ethics/justice/

“Ethics Questions Asked At Medical Interviews – Euthanasia”. Themsag, 2021, https://www.google.co.uk/amp/s/amp.themsag.com/blogs/medical-school-interviews/ethics-questions-asked-at-medical-interviews-euthanasia

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