Ethical Dilemma, Essay Example

The role and place of professional ethics in medical careers can be exceedingly complex, bearing in mind that medical doctors always carry information that might be the final nail to a coffin, or a lifeline to a person’s life. When confronted with the need to offer distressing news to patients, doctors are in a dilemma on whether to deliver out rightly the monster news, or to tell the truth sparingly in the hope that a patient will be better off. A doctor that I work for has just diagnosed his friend with a rare, but treatable disease. If his friend takes proper care of himself and proper precautions, chance of survival is high. However, if he does not take care of himself, he may deteriorate overnight. Today, I am here to talk about the ethical dilemma that relates to the whether or not the doctor should tell his patient and friend the critical condition he is in and lessen hope, or consciously misinform him and hope to improve chances of survival by instilling hope. However, this is taking away the rights of the patient and altering the trust that this patient shares with his doctor and friend.

Introduction

Several factors influence a person’s capacity to tell the truth. Doctors at times need to conceal the truth because it has no effect in the health of a patient. However, there are many cases where telling the truth might be a matter of life and death. Conversely, there are instances where truths may have no impact on the health status of the patients. In other cases, doctors will refrain from telling the truth when they have a case of malpractice fearing that telling the patients some facts may lead to the suing of doctor. The situation is even more difficult when there is a personal relationship between the doctor and the patient just like this case. This is exceedingly common because many patients tend to have personal doctors while in other cases, they consistently visit a certain doctor, developing friendship with time.

Body

How truthful are doctors and other medical personnel? According to Alice Park, research has revealed that fifty-five percent of doctors have been more positive about the status of a patient than the patient was. This represents more than half of all the doctors. In another case, ten per cent of doctors have told patients something that was entirely untrue. This is an indication of how widespread practice of telling incorrect information is in the medical field. In order to understand the problem fully, we need to examine the underlying factors that contribute to this problem.

Doctors always face challenges that are different from other professions. They deal with human bodies, and room for errors are extremely slim. They also interact with patients. Therefore, they understand the pains and background problems that a person has endured. They constantly face the challenge of having to break some unpleasant or unwelcome news to their clients. On the other hand, the patients always look up to the doctors as their source hope and the determinant of a better life. Such matters complicate the careers of the medical personnel. When such moments come, the doctors are always in a dilemma on whether to say the truth, or to conceal some facts for the good of the patient.

When such moments come, some factors may determine the action that a doctor is like to take. First, the relationship between the patient and the doctor determines how willing a doctor will be to give distressing news. It may be easy to deliver such information to strangers or in indirect delivery of information inapplicable to a close person. The setting of delivering the information is also noteworthy because it takes a lot of counselling and explanations before the delivery of the terrible news. This means that if the doctor does not have enough time, he may opt not to disclose the information since the patient may not be fully prepared to receive news.

The extent of the distressing news is also a crucial determinant. In some cases, a doctor may discover that a patient needs to stop drinking in order to manage his body weight, but choose not to reveal this to a patient who may not be ready to stop drinking. However, when it comes to exceptionally serious cases, failure to give some information may lead to death of a patient. In such cases, the revelation of the news should be early enough despite the reception or reaction of the patient. All these factors show that there are different circumstances that the doctor chooses do conceal some information in the anticipation that it will help to better the condition of the patient.

There are other lesser cases where lying to a patient or concealing information perpetuates nefarious motives. This is especially in the case of malpractices. Occasionally, doctors realize having committed some mistakes while in the course of duty, which may eventually harm the patient. Research has shown that more than twenty per cent of all doctors have at one point refused to disclose a medical error to a patient, to avoid the suing by patients for malpractice. This extremely harmful practice is punishable by law.

Whilst looking at the factors that cause the doctors to conceal information from a patient, it is essential to look at the prospects of the patients while at the hospital. Many people have a lot of trust on the medical doctors because it develops with time. This is the reason people are consistent with their personal doctors, and do not want to go to another doctor other than that one. In addition, people usually have no background information on the state of their body. They believe that the doctor has the right information regarding their body. This implies that a patient expects that the doctor will be dead right, and will give true and precise information about the position of their health. The doctor ends up breaking a serious trust bestowed to him by the patients whenever a doctor does not live up to his word.

Research has shown that many patients would rather get the bitter truth by a doctor, rather have the false information that will end up making their conditions worse. Doctors should know this critical bit of information since it would assist them to bring the distressing news easily with limited emotional attachment to the patient. By understanding that a patient wants to be hear the awful news irrespective of the magnitude of the problem, medical personnel will find it a bit easier to tell the truth. In the case of medical errors, research has shown that patients are less likely to initiate a legal proceeding against a medical practitioner if he willingly and voluntarily accepts responsibility for any errors.

Disseminating the unfortunate news is not an easy task even if the patient wants to hear them. A lot of counselling and debriefing may be required before this happens. Therefore, such provisions should always exist at all times. Doctors are busy people who may not have enough time to spend extended length of time with a client. On the other hand, even counselling is part of the treatment therapy that needs appropriate attention. The challenge faced here is trying to balance between the two antagonistic situations, so that everyone will emerge a winner. In order to achieve this, doctors training on how to counsel effectively before delivering the news is important so that it will consume the little time possible. It is worth noting that time constraints are the principal challenges that doctors face (Kerry, 2010).

In addition to the above, the use of other techniques available is a necessity in solving these problems. Medical assistants can assist the doctors when it comes to delivering the news. These can help in counselling the patients so that they are ready to receive the distressing news, saving the doctors the much-needed time. In the end, there is the realization of everyone’s needs whilst practicing all the required ethical standards.

From the case, it is evident that he best way for the medical doctor to do in this case, is to inform the friend about his rare condition. This will help to save the life of the friend, since he can institute the appropriate steps get the desired treatment. If the friend does not take precautions, death will result, and the doctor is to blame. What the doctor needs to understand is that there is no guilt in discovering the illness, and he should not take it personally that he is accountable for the poor health of the friend. What he can do is to find other medical personnel who can offer counselling to the friend, as well as delivering the news about the illness. Keeping quiet about the illness would be the worst possible mistake he would do to the friend, since he would result in killing his friend. The possibility that he will lose a friend is not even existent in this case because he will end up losing the friend more quickly through death.

If such situation is framed within Foucault’s ethical framework, a doctor as a moral agent is the ethical standard. The society in general and all the ideologies is the mode of subjection. The ideologies subject the doctor in a set of values that they follow in how he or she decides. The doctor is undergoes several self-forming activities within social institutions he or she takes or have taken part in during his lifetime. The doctor’s goal and fulfilment is something that he or she can determine, but this coincides with the idea of personal and professional development.

It is precisely for these reasons that a doctor encounters the ethical dilemma as described in the earlier sections. A doctor is a part of several modes of subjection. This means that there are sets of values the doctors have that may seem to contradict each other when the doctor faces such dilemmas. In other words, the telos from the doctor’s professional, public, and social life results to a feeling of uncertainty when the doctor encounters such ethical dilemma. As described above, his or her professional life involves a mode of subjection to certain dominant discourses that delineates the extent of truth the doctor has to say to a patient. The doctor’s social life also compels him or her to tell a patient, especially when the patient is a friend, the entire truth. This arises from emotional attachment to others. This also coincides with the doctor’s public life, which causes a struggle to choose which of the options available he will choose when encountering the dilemma. In other words, the doctor has to make herculean decision on how he or she will resist the dominating ideologies or discourse to assert his or herself as a moral agent. To surpass the ethical dilemma, the doctor has to weigh the consequences of the options he or she will make and choose what he or she thinks is the best solution.

References

Kerry, J. (2010). Good Medical Practice: Professionalism, Ethics and Law. Cambridge; Cambridge University Press

Park, A. (2012). White Coats, White Lies: How Honest Is Your Doctor? Time Healthland. Retrieved April 8, 2012, from http://healthland.time.com/2012/02/09/white-coats-white-lies-how-honest-is-your-doctor/