Ethical dilemmas are an integral part of any profession. However, not all professions will pay special attention to ethical dilemmas in their fields. Despite this, medical practice is one of the few fields built with ethics in mind. This paper is, therefore, a short review of the contemporary ethical dilemmas in clinical practice.
Why is there a Struggle when Addressing End-of-life Issues?
Death is an essential part of life and the centerpiece for most religious beliefs. However, due to medical advancements, the norms of death, according to Karnik & Kanekar (2016), have changed. However, said advancements could only prolong life. For instance, under the Federal Patient Self-Determination Act (PSDA), patients have been granted the right to their end-of-life treatment (Karnik & Kanekar, 2016). This right, however, might conflict with the physician's duty to provide detailed information about the benefits, limitations, and side-effects of life-prolonging treatment. Therefore, while the physician's primary duty is to preserve life, it should not be justification to waste resources and creating more harm than good when administering the patient's preferred treatments. The physician is in a dilemma, follow the PSDA or waste scarce resources, including their time.
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Physician-Assisted Suicide and Allowing a Patient to Die
On the other hand, there have been serious contentions between physician-assisted suicide and allowing a patient to die. The differences, however, vary according to the country or jurisdiction. For instance, in the US, physician-assisted suicide is only applicable to strict eligibility conditions, such as having a terminal condition. According to Goligher (2017), allowing a patient to die is different in that the physician is not complicit in causing the patient's death. In other words, through commission or omission, the physician will let the patient die of natural causes (Friesen, 2020). Therefore, the difference between the two is in their definitions. The moral and ethical considerations are similar.
Patient's Right to Know and the Caregiver's Right to Privacy
The contention between these two opposing standards goes as follows. On the one hand, on the grounds of informed consent, patients have the right to know if their caregivers have HIV/AIDS. This is because informed consent is not only specific to treatments but also other health care dimensions that might expose them to unnecessary risks (Bickmore et al., 2018). On the other hand, caregivers are under no moral, legal, or ethical obligation to provide information that has no direct bearing on the physician's capacity to perform their duties (Le Roux-Kemp, 2013). Therefore, the same standards of informed consent specify what not to disclose. This is, therefore, the main contention.
Wrongful Birth, Life, and Conception
When parents are aware of a child's prenatal defects or abnormalities but still decide to give birth, this is wrongful birth. These defects and abnormalities can be discovered by prenatal caregivers using newer and different tests and technologies (Franti et al., 2017). Such information, however, is essential to provide the parents when making informed decisions on the possibility of terminating pregnancies. The ethical and moral controversy, therefore, wrongful life claims on behalf of the child are brought against the parents of other people claiming moral reprehensibility of the child's not-worth-living existence.
On the other hand, there are moral considerations when the parents take action against the physicians due to an unwanted burden that was avoidable. There are different moral considerations on both sides. For instance, is it right to burden the child unnecessarily? Is it right to take action against the physicians for unwanted burdens? Is it right for the physicians to advocate for or against terminating pregnancies based on defects and abnormalities? Answering any of these moral dilemmas is difficult as both sides have valid arguments.
Partial-Birth Abortions (PBA)
While PBA is the procedure that bridges the gap from abortion to infanticide where the doctor delivers a substantial portion of the child before killing them, proponents and opponents have different justifications. Proponents for the procedure, for instance, justify PBA as a life-saving measure when the mother is at a higher risk of infection and preterm birth, among others, due to a cervical dilation that spans 2-3 days (Boonstra, 2016). On the other hand, opponents of the procedure, among other reasons, cite the Supreme Court's ruling in Roe v. Wade, which has a provision that prohibited PBA (Linton & Quinlan, 2019). Ethical and moral considerations aside, it is clear that even with court rulings, the discussion is still alive.
Genetic Markers and Stem Cell Research
When it comes to stem cell research, the main controversy is if the human embryo is afforded their legal and moral rights. Since removing the blastocysts halts the development of the embryo, it is still undecided, morally, and legally, if it is questionable (Volarevic et al., 2018). Some believe that human life starts at birth, while others believe that it starts at conception, implying that the embryos have rights that protect them. On the other hand, the use of genetic markers has created the precedence for genetic testing of certain illnesses and predispositions.
While genetic markers could be a force for good, especially when testing and screening children and fetuses, there remains a discussion about its moral and ethical considerations. These considerations vary from those of wrongful birth, life, and conception (Franti et al., 2017) to eugenics ( González-Melado María & Di Pietro, 2012; Thomas & Rothman, 2016). What the controversies about genetic markers and stem cell research have in common is that they both are about the definition of human rights and life.
Conclusion
In summary, this paper has briefly discussed the different ethical and moral considerations different professionals in the medical industry navigate when performing their duties. This discussion, however, has been short and non-exhaustive.
References
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