All posts in Ethics

Responsibility Beyond Medicine

Excerpt from “The Hippocratic Oath” (modern version), cited from Wikipedia:

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I have the unique privilege to work in a specialty of medicine that deals with some of the most intimate personal and health issues that exist. On a daily basis I counsel women regarding libido, sexually transmitted infections, partner violence, desires for pregnancy and desires to not be pregnant to give a few examples. In a few minutes’ time I must gain the trust of a total stranger in order to provide them with optimal health care as a regular part of my job; add to this the challenge of addressing these sensitive issues and reward when able to make a difference in someone’s life and you can see why I love my profession.

Interlaced with these sensitive matters are some of the most controversial and charged political topics that have come to be major foci of lawmakers across the country. Women’s reproductive organs have once again ├é┬ábecome one of the hottest commodities over which to gain political control. Over 250 bills are being pushed through legislature right now that are anti-choice, anti-women, and anti-physician and it seems that most citizens are blissfully unaware.

I do not pretend to understand why there is such force behind trying to control women’s reproductive organs and, in turn, their bodies and their lives but I have sworn to advocate for them. Physicians take an oath to do what’s right, to care for their patients and advocate for them when they are unable to do so for themselves. This also includes taking political action whenever possible as becoming politically involved is the epitome of advocating for the basic human rights of the general public.

Physicians owe it to their patients, especially OB/Gyn’s where women’s health is concerned, to make their voices heard in politics. It is a crucial part of the responsibility we embrace as healthcare providers and patient advocates. We must not stand aside and watch in silence as human rights are compromised.

Patients, Doctors, Legislators- Green Journal

Ethics vs. Morals

According to the Oxford American Dictionary of Current English:

Ethics: n. pl. 1 the science of morals in human conduct 2a moral principles b a set of these (medical ethics)

Moral(s): n. 1a a moral lesson of a fable, story, event, etc. b a moral maxim or principle. 2 (in pl.) moral behavior.
Moral: adj. 1a concerned with goodness or badness of human character or behavior, or with the distinction between right and wrong. b concerned with accepted rules and standards of human behavior. 2a conforming to accepted standards of general conduct. b capable of moral action. 3 (of rights or duties, etc.) founded on moral law. 4a concerned with morals or ethics (moral philosophy). b (of a literary work, etc.) dealing with moral conduct. 5 concerned with or leading to a psychological effect associated with confidence in a right action (moral support; moral victory).

Physicians are held to the highest standards when it comes to morals, morality and ethics, and why shouldn’t they be? After all, people’s lives are often in their hands. However, when is it acceptable for a physician to act in accordance to their own morals, disregarding those of the patient or society? Answer: never. Nowhere in the aforementioned definitions does it say “of a personal nature” or “according to a personal views or standards.” Instead, words like “accepted standards of general conduct” and “accepted rules and standards of human behavior” are used.

If it is legal and deemed ethical by society and the experts in the medical field, no physician has the right to impose personal morals on the care of their patients. It is frightening how often this is an issue: end-of-life care, early pregnancy counseling, and birth control are just a few examples of areas where a physicians’ personal morals and belief systems can interfere with their counseling and treatment of a patient. A 2007 survey of physicians published in the New England Journal of Medicine showed that up to 40 million Americans may be treated by a physician who does not believe him/herself obligated to provide full counseling of all treatment options if they are not in line with his/her personal morals.* In other words: if you are unwed and desire birth control but your doctor does not believe in premarital sex, you may endure some slut-shaming instead of contraception counseling.

My morals and personal beliefs do not belong in my clinic, operating room, or hospital and certainly not in my patient’s chart amongst documentation of how I have counseled her on her options — ALL of her options, as long as they are legal and medically sound.

Be sure to ask your doctor the tough questions to ensure unbiased counseling of all medical treatment options.

Additional reading from the New England Journal of Medicine