As the sphere of healthcare is of the utmost social importance, different ethical dilemmas may originate in it. They should be adequately addressed in order to prevent potential problems and misunderstandings between different parties. Two ethical dilemmas in healthcare are the following: the first one relates to privacy issues, and the second one analyzes the ethical aspects of whistle-blowing.
Privacy issues may lead to ethical dilemmas in a number of ways. For example, practitioners may have to make a choice between confidentiality and saving more lives. In some emergency situations, they may not have the possibility to respect all privacy issues and help the maximum amount of people at the same time. However, sacrificing privacy issues does not seem ethically justified even in an emergency. Privacy is an essential aspect of any medical services. Thus, if they are sacrificed, the treatment per se cannot be considered as effective. This dilemma includes both utilitarian and deontological characteristics. Utilitarian aspects should allow the maximization of utility for the largest number of people. If privacy issues are respected, the interests of patients are taken into account, and their needs are satisfied in the best possible way. It increases social welfare and total utility. Deontological aspects refer to respect for basic individual rights. As each patient has a right to privacy in healthcare, this right should be respected, even if it does not lead to a higher social utility.
This dilemma may occur in some emergency cases when a practitioner faces the moral choice of either helping less people and ensuring their privacy or helping more people with violations of their right to privacy. The only correct decision is acting in accordance with all privacy issues as this option is under both utilitarian and deontological ethics. In order to address and prevent such issues from happening, effective rules are typically implemented. They adequately describe the behavior of practitioners in these situations and create the necessary conditions for optimal behavior. In particular, such aspects as time, medications, and monitoring are properly addressed. If a practitioner behaves unethically, it decreases utility for a large number of people. If a practitioner tries to help all patients but violates their privacy rights, in fact, he/she makes the situation worse than it was before as violating the rights of people, he/she decreases utility for all of them. The only positive aspect is that a doctor contributes to better health of a large number of people.
Whistle-blowing is another example of ethical dilemmas in healthcare. It refers to reporting on actual problems to the external authority. If the problems under consideration are crucial (they directly or indirectly influence the health of patients), they should be reported. Then, the existing situation will be verified, and corresponding measures will be introduced. From the utilitarian perspective, it will allow the maximization of utility and happiness for the largest possible number of patients. From the deontological perspective, it will ensure the basic right of people to adequate healthcare services.
The example of such a situation may be the following. A doctor is aware that the privacy rights of patients are systematically violated in his/her hospital. Therefore, he/she has a moral right to inform government organizations about an urgent need to verify the situation in his/her hospital. In order to resolve the issue, the majority of medical institutions provide deep control in relation to the realization of existing standards. Many hospitals adopt even higher standards than are required by government agencies. If a doctor in the above-mentioned example fails to inform external control organizations, he/she poses additional threats to patients. Thus, he/she decreases social utility.
It may be concluded that ethical analysis is highly relevant to such industry as healthcare where controversial issues often arise. The utilitarian and deontological approaches may provide a reliable foundation for resolving such dilemmas.
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