What if a patient refuses treatment? What if a healthcare decision goes against a patient’s cultural beliefs? What if a member of the healthcare team makes a life-threatening mistake? Healthcare professionals face ethical dilemmas daily. With advances in medical technology and an increasingly diverse patient population, the industry’s need for clear ethical guidelines is more critical than ever.
Ethical issues in health care can be challenging. Healthcare providers prioritize patient well-being, which can sometimes mean respecting patients’ wishes they may disagree with. Healthcare professionals dedicated to upholding ethical decision-making to improve patient outcomes can consider an advanced degree to help guide their career journey.
What Is Ethics in Health Care?
Ethics in health care is what guides the work of professionals in the healthcare industry. These considerations are an essential component of providing health care, as they help ensure practitioners treat their patients with dignity and respect and that the decisions made by healthcare professionals are fair and just. Additionally, ethics helps to promote trust and confidence in the healthcare system, as it ensures that healthcare professionals act in their patient’s best interests.
Ethics have held an honored place in health care since a code of ethics was established in ancient Greece, known as the Hippocratic oath, to keep physicians accountable for taking care of their patients and bringing no harm to them.
The concept of a code of ethics that lays out guidelines for physicians’ professional conduct and their ethical obligations has remained relevant in the healthcare field ever since.
In fact, the rapid development of medical techniques, treatments, and knowledge following World War II culminated in the creation of several core ethical principles that are still used today in the medical field to guide ethical decision-making in patient care. The following are those core ethical principles, as well as examples of how they might guide people in resolving an ethical dilemma.
Beneficence
Beneficence refers to healthcare practitioners’ responsibility to act in their patient’s best interests. This principle entails improving the patient’s well-being and health, including giving treatments to relieve pain, avoid injury, and promote health. This idea is central to ethics in health care, and while making choices regarding patient care, healthcare practitioners must assess each course of action’s possible advantages and harms and recommend the actions they believe will best serve the patient.
The challenge with this notion is identifying what is beneficial to each patient. Before acting, healthcare practitioners should learn about and consider each patient’s individual goals, needs, and experiences. Knowing a patient’s background, religious beliefs, and life experiences might aid in determining what is best for them. Even small considerations can have big impacts on a patient’s comfort level and treatment success.
In many cases, beneficence is a frame of reference rather than a rule. For example, a healthcare worker may consider amputation in a case where a patient’s leg is severely injured and at risk of infection. However, given the lifelong complications that can result from amputation, providing alternative treatment options instead may be more beneficial to the patient, as a damaged leg and an infection are less detrimental than the loss of a limb.
Overall, beneficence ensures that in all possible treatment options, the healthcare provider will present the best possible course of action for the patient, taking into account their concerns and wishes.
Nonmaleficence
Nonmaleficence is the flip side of beneficence, as it dictates that healthcare practitioners should “do no harm,” meaning that they should not allow harm to a patient due to their own neglect. Healthcare workers should carefully consider all actions for how they will impact others, as their decisions may, intentionally or not, cause harm to patients or even other healthcare workers.
This principle establishes that it is up to each healthcare professional to be mindful of their actions’ consequences and to refrain from decisions that could harm others. For example, a physician might prescribe medication to a patient to help them with a particular health issue, but due to side effects stemming from the patient’s unrelated chronic condition, the physician’s decision to prescribe the medication unintentionally causes harm.
This principle should not be mistaken for avoiding any instances that cause pain. Patients may experience pain from life-saving surgeries or even from a simple injection, but these acts are often necessary to perform necessary medical tasks.
Nonmaleficence is a guiding principle, and actions can be taken if the likely good for the patient outweighs the pain or discomfort they may experience. This is why issues of ethics in health care can be complex and require administrative guidance.
Autonomy
In healthcare ethics, autonomy is a practice that acknowledges patients have the right to exercise control over what happens to them regarding treatment. Patient autonomy allows healthcare professionals to educate the patient but does not enable them to make decisions for the patient. Even when the professional believes a specific treatment is in the patient’s best interest, autonomy allows the patient to have the final say in the decision-making process.
Autonomy also requires informed consent, which involves communication between a patient and their healthcare provider that leads to an agreement or authorization for care, treatment, or services. It ensures that practitioners provide patients with information about their medical concerns and all possible testing and treatment alternatives. If the patient is soundly capable of making their own choices, medical treatment cannot begin until the patient provides informed permission.
In many cases, patients and professionals have different beliefs and experiences that may inform their feelings on the best treatment in a given scenario. For example, a medical professional may be able to restart someone’s heart in order to save their life, but respects the patient’s desire not to be resuscitated and refrains from taking action to do so. While these scenarios may seem to conflict with other edicts to always attempt to help patients, ultimately the patients’ wishes take priority.
Justice
Justice is a nuanced principle that means treating all patients fairly. The principle of justice does not necessarily mean equal care but rather equitable care. Healthcare equity means that patients should not be denied care, have restricted access to care, or be provided with lower-quality care based on their economic class, ethnicity, gender identity and expression, or any other characteristic. Justice can also be ascribed to sharing medical resources with a larger community that may not have access to those resources or helping other facilities if they become too full by accepting their patients.
Justice also applies to emergency situations. For instance, if a patient needed care for a relatively minor injury and arrived before another patient who needed intensive care, the latter patient should receive treatment first as they need it much faster. Healthcare workers must gauge the severity of patients’ conditions to determine the order in which each receives care. Patients should also be treated equally and not shown special treatment based on personal considerations or connections.
In emergency situations where supplies are limited, many healthcare facilities may need to choose which patients receive life-sustaining care. Unexpected events, such as the COVID-19 pandemic, often force healthcare workers to make these decisions. Moreover, when patients face severe injury, debate can arise among healthcare providers over how to deliver treatment equitably. Finding solutions to these dilemmas often falls to healthcare administrators, who must keep their decisions consistent with applicable ethics in health care.
Why Is Ethics Important in Healthcare Professions?
Because lives are at stake, the healthcare profession requires a strong ethical framework to guide decisions about patient care. Healthcare practitioners who are equipped to address ethical considerations can make compassionate, fair, and effective choices for their patient’s treatment.
Here are a few examples of why ethics is important in the healthcare profession, and how it can benefit both patients and practitioners.
Benefits for Patients
All of the ethical principles benefit patients by guaranteeing respect for their autonomy and equitable treatment, and that they will receive the best care available based on their beliefs and decisions. This has the effect of allowing the patient to trust their healthcare practitioner without reservation. Health care can be invasive, and without the promise of beneficence, many patients will delay seeking medical attention.
A 2021 study by NORC found that only 78 percent of participants trusted their primary care doctor, which may suggest that a significant portion of Americans might be unwilling to reveal important health information to their doctor or agree to lifesaving procedures or treatments. Maintaining a strong ethical framework for doctors to work within can increase patients’ willingness to trust them, and in doing so, can potentially save lives.
Benefits for Practitioners
The core ethical principles are designed to benefit patients, but that does not mean the guidelines do not benefit healthcare workers as well. Having an ethical framework to follow allows healthcare practitioners to talk candidly with patients and their families about end-of-life care or quickly inform their patients about their emergency care choices.
Here are a few ways practitioners can benefit from ethical guidelines:
- In situations where practitioners may run into ethical disagreements with patients, their families, their caregivers, or even other staff, practitioners can recommend a solution that places the patients’ care first.
- Having guidelines to support one’s decisions allows for one’s conscience to remain clear, as ethics will help dictate what the best decision should be for the ideal outcome.
- By having an ethical framework that encompasses an entire facility, healthcare workers can feel assured that their co-workers are operating with the same intent as they are. This allows for easier communication between co-workers, fewer misunderstandings, and a greater sense of mutual trust in each other’s decisions.
- Ethical guidelines help practitioners find the least obtrusive and most beneficial solution to a patient’s issue available, reducing the chance of risky or unnecessary procedures and treatments.
- The idea of nonmaleficence extends to patients and colleagues in the healthcare field. Healthcare personnel can feel their workplace is safe, and administrators can work to mitigate and alleviate stress as much as possible.
How Healthcare Administrators Uphold Ethics
A healthcare administrator maintains a facility’s regulatory compliance and upholds its ethics in health care. They also oversee the healthcare facility’s operation to varying degrees, depending on the facility’s size, so their scope can range from leading a specific department alongside other healthcare managers to running an entire facility independently. They perform most of their tasks behind the scenes, such as scheduling, managing finances, and processing insurance claims.
Healthcare administrators can directly impact lives by ensuring patients receive high-quality care and aligning their decision-making with all of the core ethical principles. While an individual healthcare practitioner may only visit a dozen patients daily, a healthcare administrator can help hundreds, if not thousands, of individuals through their leadership decisions and by upholding their facility’s ethical values and offering guidance that other staff members can follow.
These professionals also can benefit and improve the workplace for healthcare workers. Healthcare administrators are responsible for recruiting, training, and supervising a facility’s staff members, assigning them their schedules, and cultivating a positive culture. They have a leadership role that can reduce stress for their co-workers and maintain the ethical guidelines that allow their healthcare practitioners to be in the best environment to care for their patients.
Take the Lead with Ethics in Health Care
Adhering to ethics in health care supports improved patient outcomes, increased trust and confidence in the healthcare system, and better overall health and well-being for individuals and communities. These benefits are achievable when healthcare professionals have the knowledge, skills, and expertise to make ethical decisions in their daily work.
Those looking to take their careers in health care to the next stage and become leaders in the field should consider the benefits of pursuing Tulane University’s Online Master of Health Administration. Students can gain the education and training they need to make a positive impact through ethical leadership and develop the expertise to evolve their careers to the next level.
Graduates will be equipped to drive healthcare reform with a focus on equality and accessibility, enhance community health, and empower people to live better lives. Prepare to fight against disparities in health care and create impactful change in communities with an advanced health administration degree.
Recommended Readings
Data-Driven Decision-Making for Health Administrators
The Importance of Healthcare Leadership
Sources:
E7 Health, “DNR Orders Can Lead to Worse Care and Increase Death Rates”
Medical Principles and Practice, “Principles of Clinical Ethics and Their Application to Practice”
NORC, “Surveys of Trust in the U.S. Health Care System”
Rethinking Health Care Ethics, “The Rise of Bioethics: A Historical Overview”
Sermo, “Identifying and Navigating Ethical Issues in Healthcare”
StatPearls, “Nursing Ethical Considerations”
U.S. Bureau of Labor Statistics, Medical and Health Services Managers