What is Medical Ethics ?

A perspectives based approach readily accepts this. Approaches based on principles or persons are among the relevant perspectives from which ethical issues can be addressed.

These widely accepted values often conflict with each other. For example, when patients refuse a treatment that could help them, the physician faces a conflict between respecting patient autonomy and doing what's best for the patient.

In 1815, the Apothecaries Act was passed by the Parliament of the United Kingdom. It introduced compulsory apprenticeship and formal qualifications for the apothecaries of the day under the license of the Society of Apothecaries.

Closing off your practice to new patients is another example of an ethical dilemma. Physicians are fully justified in not accepting every patient who comes through the door. Accepting every patient may or may not be a good business decision.

They are not, however, the whole ethical story, or necessarily where to start from. A perspectives based approach begins by focusing attention not on the act or the agent, but the case. Not at this stage, however, even in medical ethics, the clinical case.

Since the 1970s, the growing influence of ethics in contemporary medicine can be seen in the increasing use of Institutional Review Boards to evaluate experiments on human subjects, the establishment of hospital ethics committees, the expansion of the role of clinician ethicists, and the integration of ethics into many medical school curricula

This was the beginning of regulation of the medical profession in the UK.

Turning now from theory to practice, I want to explore some implications of a hermeneutic approach to medical ethics, in relation first to everyday ethical issues and second to public controversies.

After working through this dilemma, you may still decide to close off your practice, but you will have thought the issue through. You will be aware that the people you are turning away still need a doctor, and some physicians might decide to find a way in which they can help such people without burning themselves out, such as volunteering in a free clinic occasionally.

In 1847, the American Medical Association adopted its first code of ethics, with this being based in large part upon Percival's work

The principle of autonomy views the rights of an individual to self-determination. This is rooted in society's respect for individuals' ability to make informed decisions about personal matters with freedom. Autonomy has become more important as social values have shifted to define medical quality in terms of outcomes that are important to the patient and their family rather than medical professionals.

In everyday medical practice, a great variety of ethical issues can arise—for example, regarding consent or confidentiality or truth telling or priorities.

Medical ethics differs from morality. Ethics is based on values and reasoning, and it uses persuasion to get its message across, whereas morality involves adhering to a specific belief system or code of conduct.

people are, for good or understandable reasons, too preoccupied with other things to notice, and perhaps do not do so until a moral molehill has grown into a legal mountain.

The definition of autonomy is the ability of an individual to make a rational, un-influenced decision. Therefore, it can be said that autonomy is a general indicator of a healthy mind and body. The progression of many terminal diseases are characterized by loss of autonomy, in various manners and extents.

Morality relies on an authority, such as the Bible, to justify its message. Morality does not just involve religion. It can be political or personal, such as having a fascist or communist point of view, grounded in faith or tradition rather than facts or arguments.

While the secularized field borrowed largely from Catholic medical ethics, in the 20th century a distinctively liberal Protestant approach was articulated by thinkers such as Joseph Fletcher.

Psychiatrists and clinical psychologists are often asked to evaluate a patient's capacity for making life-and-death decisions at the end of life. Persons with a psychiatric condition such as delirium or clinical depression may lack capacity to make end-of-life decisions

The first stage of the hermeneutic process then is to listen; and so is the second—to listen to the different “stories” told by the other people involved, about what has been seen as a problem.

In contrast, medical ethics has a flexible set of solutions. It is based on facts and logic, and not religious doctrine. You can still have political opinions and religious faith, but you will need to set them aside when forming and offering an ethical opinion to those who do not follow your personal morality.

In the 1960s and 1970s, building upon liberal theory and procedural justice, much of the discourse of medical ethics went through a dramatic shift and largely reconfigured itself into bioethics.

The term beneficence refers to actions that promote the well being of others. In the medical context, this means taking actions that serve the best interests of patients and their families. However, uncertainty surrounds the precise definition of which practices do in fact help patients.

The aim is not for an ethicist to listen to everyone and then supply them with an ethical verdict. For the process to be productive, those involved in the situation (doctors, nurses, patients, family) need to listen to one another, so that they can work out among themselves what is going on ethically and, if possible, reach some new and more productive shared understanding of the situation

Some people view medicine almost as the new religion. People often come to the doctor with the same hopes that they bring to a minister: "Save me, prepare me, redeem me." Of course, science cannot redeem anyone, but it does need to have a heart.

The concept of non-maleficence is embodied by the phrase, "first, do no harm," or the Latin, primum non nocere. Many consider that should be the main or primary consideration (hence primum): that it is more important not to harm your patient, than to do them good, which is part of the hippocratic oath that doctors take