Ethics have always been an integral part of healthcare. Modern technological advances, however, have sometimes blurred the line between medical ethics and quality care.
These days, patients often feel like a commodity or customer instead of a “patient.” This further complicates modern medical ethics. Additionally, many medical situations have recently come under fire where ethics are concerned, including clinical trials and electronic health records.
But there is an upside. Thanks to recent advances in medical ethics, we’re likely to see an increase in social workers as part of the patient experience in both rural and urban settings. Also, taking a holistic approach to healthcare remains an important consideration in 2019 and beyond.
The Social Implications of Medical Ethics
Holistic treatment methods have entered the mainstream en masse in recent years, expanding the healthcare industry as a whole. Primary caregivers may work in tandem with social workers, nurses, and other professionals in order to treat their patients.
And, of course, ethical considerations often come into play in the realm of social work. According to professionals at Regis College, the “conflicting obligations” of social workers, such as patient confidentiality, can lead to challenging decisions.
Because of those potential conflicts, social workers must adhere to the code of ethics laid out by the National Association of Social Workers (NASW). The NASW ethics code is comprehensive, covering a variety of situations that a social worker might face.
The core principles of the NASW code of ethics include
- social justice,
- service, and
Further, the code encourages social workers to volunteer some of their time on a pro bono basis. They are also advised to ensure that patients are treated with dignity and respect.
STDs, STIs, and Medical Ethics
Treating patients with dignity should be a best practice for every healthcare provider. However, it’s imperative in the realm of sexually transmitted disease (STD) testing. By fostering open communication and employing professional conduct, healthcare providers can help eliminate the taboos associated with STD and sexually transmitted infection (STI) testing.
It’s recommended that patients get tested for STDs on a regular basis if they are sexually active, even if they have no visible symptoms. Healthcare providers should encourage this practice by helping their patients feel at ease and by answering questions honestly.
Getting STDs and/or STIs testing takes courage. Patients of all ages are more likely to get tested when they feel that their healthcare provider is discreet and trustworthy. No matter the reason for a patient’s visit, a healthcare provider should always inquire about the patient’s STD status and encourage testing as appropriate.
Patient Privacy and Electronic Health Records
Privacy issues don’t only crop up in matters related to STD and STI testing. Today, the majority of medical facilities are eschewing paper medical records in favor of digital data collection in electronic health records (EHRs). Many EHR systems store data in the cloud.
EHRs are supposed to improve treatment and cut costs. But more research is needed to verify the accuracy of these claims.
What we do know about EHRs is that large corporations are leading the way towards a complete digital takeover of medical records.
Related content: EHRs Can Advance Good Medicine If Doctors Are Aware of the Risks
Both Apple and Google already have a hand in the digital health record world. Apple’s iOS 11.3 includes a personal health record feature, and Google Cloud has partnered with several medical facilities to put patient data all in one place.
Ethical issues related to digitization of patient data
The digitization of patient data comes with ethical questions. Both patients and healthcare providers alike question the security of EHRs.
1996’s Health Insurance Portability and Accountability Act (HIPAA) included a provision ensuring the confidentiality and security of protected health information. However, HIPAA has not been updated for the modern era. Today, the security of EHRs is a job for healthcare facilities themselves.
Related Content: Evolution of the Hippocratic Oath and Medical Ethics
The Healthcare Industry’s Financial Incentives
Healthcare is big business in America. However, many healthcare providers believe that financial incentives are negatively impacting patient quality of care. Many believe that the very foundation of the medical industry is at risk due to the monetization of healthcare.
In the current medical landscape, the cost of treatment and/or medication is prohibitive for many.
According to the Centers for Medicare and Medicaid Services, in 2017, U.S. healthcare spending reached $3.5 trillion. That number translates to more than $10,000 per person. Myriad individuals find that their healthcare costs exceed their budget.
The cost of a cancer drug used to treat chronic myeloid leukemia is unattainably high for many patients according to a 2015 study. The authors of the study concluded that the high cost of life-saving drugs may even be immoral:
“Charging high prices for medicine needed to keep someone alive is profiteering. It is akin to jacking up the prices of essential goods after a natural disaster.”
Ethical Considerations in the Field of Nursing
The American Medical Association (AMA) introduced the inaugural Code of Medical Ethics in 1847. In it, the AMA laid out the following ethical principles, to be practiced by all healthcare professionals, from surgeons to nurses:
Patient autonomy is the idea that those seeking treatment can choose to accept or decline a healthcare professional’s recommendations. And today, considering the often prohibitive cost of care, patients may decline treatment more than any other time in history.
These facts mean that the idea of justice, or a patient’s right to an equal and/or fair distribution of resources, may no longer have a place in modern medicine. Thus, the role of nursing professionals is more complex than ever.
Good communication between nurses and patients is imperative so that healthcare providers can fully grasp a client’s situation. For example, if a patient refuses treatment, his or her nurse should work to understand the reasons behind the decision.
If the patient is concerned about the cost of treatment, a nurse or healthcare provider may be able to offer a solution that better fits into a patient’s budget. Conversely, if a patient is refusing treatment due to fear, a nurse can help ease their patient’s mind.
Related Article: The Ethical Strain on U.S. Medical Care
Today’s health care ethics challenges are myriad, from patient confidentiality to data and record privacy. Healthcare providers, including social workers and nurses, should familiarize themselves with modern medical ethics issues in order to ease patients’ anxiety.
The Code of Medical Ethics remains as relevant as ever, despite the digitization of healthcare records and the often-prohibitive cost of care.
Treating the whole patient today is a complex endeavor, and digital health records may help streamline the treatment process.
Healthcare professionals have a duty to give patients all relevant information regarding their treatment. They must also always “do no harm,” as the Code of Medical Ethics advocates.
Noah Yarnol Rue is a journalist and digital nomad. He is fascinated with global health and modern technology.
His love of writing and research began while attending college in the small Pacific Northwest town he called home. His writing is influenced by his journalistic integrity to share the truth and give the reader the information they crave to know.
Noah’s curiosity created his nomadic lifestyle. He is on the move across the U.S. meeting new people, learning about different cultures and current trends that influence people.
In his free time, Noah enjoys 1930s mystery novels, researching his next travel location and is a huge fan of the Olympics.
Thank you for sharing your tale. I’m very sorry for your loss and that you had to go through all of that during such a trying time. It’s a situation that often comes up in discussions in the medical community, and I hope that we can all do our part to get the word out there and ensure that fewer and fewer people have to fight for the basic decency and care they deserve (in any nation or hospital). Ignoring the living, breathing and as you said, valiant, person behind the charts and prognoses is one of the greatest failures of medical ethics as a numbers and technology-driven medical system emerges.
My husband recently passed in the hospital in ICU after a severe heart attack and 7 weeks of valiant effort on his part at recovery. I had to contact the ethics on numerous occasions for such things as neglecting to get informed consent to ignoring his requests for treatment that granted some dignity (such as putting in his dentures) to harassing him to choose to end his life rather than continue to pursue expensive treatment even though (or maybe because) we live in Canada.
The focus was on numbers and equipment not the patient behind the readouts. I would never have imagined that we would be so lost in the technology and it saddens me. The doctor of the week apologized but it was too little too late.
Thank you for raising these critical issues.
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