A Guide to Medical Ethics

Professions are assessed with the responsibilities and the standards of its practice. “Professional practice has a tradition that requires professionals to cultivate certain virtues” (Beauchamp, TomL;Childress, James F;, 2009, p. 34). Every profession such as teaching, doctoring, nursing has its’ own standards of the conduct and virtues. Moreover, “roles and practices in medicine and nursing reflect social expectations as well as standards and ideals internal to these professions”. The virtues related to those kinds of professions have risen along with the traditional healthcare relationship and the focal virtues that can be defined as trustworthiness, compassion, consciousness, integrity, discernment, truthfulness, respectfulness, benevolence, non malevolence, and faithfulness.

Every ethical system and professional ethical basis is centered to establish social welfare.Medical professionals are prominent because they spend their time, labor and knowledge to cure a patient from mental and physical illnesses. Medical profession can be defined as the practice of the diagnosis and treatments. Finally, it leads to cure the patient or prevent from illnesses.

Mainly, “in professional life, the traits that warrant encouragement and admiration often derive from role responsibilities” (Beauchamp, Tom L;Childress, James F;, 2009, p. 33). Thus, the doctor has the main responsibility about the patient from the very beginning of the diagnosis the illness of the patient. If the diagnosis goes wrong, then the illness would be turned into a severe one. However, only doctors cannot cure an illness. It is mentioned in eastern medicinal tradition that catuṣpādaya should evenly be there to cure an illness. Catuṣpādaya is defined as,

1. Doctor,

2. Medicine,

3. Attendant/ nurse

4. Patient.

That catuṣpādaya should do their duties and responsibilities in order to get rid of the disease. Without their maximum support it would be difficult for a patient to overcome, the illnesses because each one has different responsibilities to perform for the sake of get rid of an illness. Each one has to perform four duties. Although others give maximum to overcome the disease, it would be useless if one does not perform his duty well.

Hippocrates emphasized four actions that can be taken to cure any illness. They can be listed as following.

1. The doctor should listen to the patient.

2. The doctor should check the patient.

3. The doctor should explain the reason that has affected to cause the illness and the nature of the illness that could turn in the future.

4. The doctor should note down everything and give further treatments.

However, the performance of the doctors is more important according to the Susṛuta Saṃhitā. It has stated that a virtuous doctor is like a person who rides a boat. He is able to voyage to the opposite border of a river by using a boat without paddles. In the book called ‘Bhāva Prakāśa’, the scholar Bhāvamitra has stated that a doctor who does his duty to the best of his ability would gain dhana lāba, mitra lāba, damma lāba and yośo lāba.

The behavior of doctors and how it affects to the society studies under medical ethics because medical profession plays a key role in any given society. Thus, the life of a patient is based on the performances done by the doctors. Patients should be open to the doctors in order to get treatments. However, doctors have to keep them confidentially. If doctors do not keep privacy of the patients, then many issues can be occurred. Therefore, ethical agreement should be there within the context of medical profession. The views on the ethical requirements of Doctors that has been explained by Caraka, Sushrata, Vāgbhata and Bhāvamitra can be summarized as following.

I. Having a complete medical education

II. Having experiences that has taken by self-studies and by the teachers

III. Identify the illness and skillfully give treatments

IV. Maintain physical and mental cleanliness

V. Be a specialist/ having permission from the state

VI. Mindfulness

VII. Being an aristocratic

VIII. Having good medical equipments

IX. Should have to have active organs/ should have to have physical potential

X. Having principles

XI. Knowledge about the country

XII. Having enough time for treatments

XIII. Having good thoughts

XIV. Being an assistant to the patient

The scholar who is named as Caraka has stated that the doctors who do not consider justice, the one who does not know the ways to make medicines, who have misconceptions and the one who intentionally asks to come for treatments should be rejected, as they are not good physicians. According to him, the good physician is the one belong to the category of prānābhisara and he rejected to the physicians who are belong to the categories of Cadhmacara and siddha sādhita.

Hippocrates’ Oath

Medical profession is one of the major professions, which can affect to the lives of the human beings and its performances. Mainly, one cannot maintain personal limitations when taking treatments from the doctors. For that, medical profession has been a pressures occupation to the society. Therefore, the idea of making doctors to behave within a certain ethical framework is being discussed for centuries by the ancient philosophers. There occurs a question that can be discussed as how is ethics, medical practice and Hippocratic Oath connects. We are able to find many issues when we study these three. Hippocrates has introduced several ethical principles. However, with the time, physicians had to face difficulties when following the ethical principles in the Hippocratic Oath.

Hippocrates, who was an ancient Greek philosopher and a physician, has done a great contribution to establish an ethical conduct to the medical profession. Ancient Greece was full of myths and blind believes on illnesses. Hippocrates was able to identify that illnesses occur only because of unbalances of the human body. He studied different symptoms and discovered the interconnection between human being and the nature. He rejected the existed mythological believes by stating that there is no mysterious things behind the illnesses. These ideas have affected to emerge the western medicine. Therefore, he is considered as the father of the western medicine.

Moreover, Hippocrates was the first person who introduced a system of ethical values to medical professionals. Even in the present, the doctors have to swear under the oath, which was introduced by the Hippocrates. It has introduced by using witnesses from the Greek gods like Apollo. He has invented these ethical values in order to make medical profession a respectable occupation. They can be listed as following.

I. Look after the teacher who taught medicine as parents

II. Share money that earn from it with the teacher

III. Fulfill their needs in any given time

IV. Treat the children of the teacher as one’s own children and if they in need of learning medicine one should teach them without taking money

V. Teach everything that should be taught to one’s children, teacher’s children and other students/ give all knowledge without hiding

VI. Treat only for the healthiness of the patient

VII. Do not help patients to be die or for abortions

VIII. Treat for the healthiness of the patients regardless of their social status

IX. Withdraw from deceitful acts and do not encourage any married or unmarried man or a woman to sexual activities

X. Secure the confidentiality of the patient

The physicians should swear this oath before they get into the medical profession. However, some debatable things in the contemporary society are discussed under the Hippocratic Oath, but contradict with that because a number of physicians have claimed that Hippocratic Oath is not sufficient and it is inadequate to cope up with the changes that happen in the contemporary world. Nowadays, medical students learn medicine from the universities. There are no such things as going to the teacher’s house, help him do household activities instead of paying money, learn medicine, look after the teacher etc. Therefore, the some ethical statements of this Oath do not connect with the contemporary societies. Thus, there are violations of these ethical statements as there are many issues related to medical profession along with other occupations that are belong to the healthcare service. It is doubtful how practical these ethical statements are. There can be seen many situations that violates the medical ethical values. They can be discussed as following.

Moreover, there is a big voice raised from the society about abortion and euthanasia. As it has mentioned in the Hippocratic Oath, a physician should not kill anyone even though the person has requested to kill him. Euthanasia is the mostly discussed area in bio ethics. Earlier it was considered as the physician’s responsibility to eliminate the physical suffering of the patient. They express two different views on that. When it comes to euthanasia,“Throughout history it was sometimes approved and sometimes forbidden, approved because it was a way out for suffering, terminally ill persons, or for reasons of dignity, forbidden because it violated the rule against killing and letting God instead of the self be master of one’s life” (Thomas & Kushner, 1996, p. 207).

Euthanasia can be classified into two; voluntary and involuntary. Voluntary euthanasia is done with the parent’s consent. Non-voluntary euthanasia is done without the parent’s consent. It is considered as a murder and it is illegal in every country. Thus, abortion cannot be accepted according to the Hippocratic Oath. However, there are evidences that physicians do abortions for the sake of money. There are also physicians who do not violate these ethical principles.

Physicians tend to do private medical practices rather than doing their service in the government hospitals. They have given priority to earn money rather than giving their service to patients. But there are minorities of physicians who do not do private clinical practices. Thus, physicians do strikes by keeping patients as their victims. It is a violation of Hippocratic Oath as they only consider their wellbeing and economic growth.

Moreover, some physicians help businesses, which are profiteering from medicines. They ask patients to buy trade name of the tablets without giving its official name. To illustrate, some physicians recommend panadol tablet instead of paracetamol, which is less expensive than panadol. Professor Kolvin Gunaratne once stated that, physicians write trade names of the tablets just because for their benefit and for the benefit of the organizations that produce medical tablets.

Thus, many physicians do not pleasantly interact with patients and they do not ask the difficulties of the patient. One of the main issues in western medicine is it takes organs and illnesses separately and treats them separately. They do not consider human body as a whole. Therefore, the treatments can make the situation of the patient worse.

Furthermore, the latest updated ethical Oath is the enactment introduced in 2002. It can be stated as following.

I. Give priority to the healthiness of the patient

II. Respect the independence of the patient

III. Establish social equality in medical services

IV. being honest with the patients

V. Improve the professional efficiency

VI. Secure the confidentiality of the patient

VII. Do not take economical, sexual or other benefits from the patients

VIII. Improve the quality of the treatments

IX. Make the chance to get medicine

X. Distribute medical equipments in a fair way

XI. Update knowledge on the scientific knowledge

XII. Protect the trustworthiness (Weerawardhene, 2007, p. 107).

Physician has responsibilities and ethical background when dealing with patients. Therefore, the physician should not cross the limits. For that, above-mentioned ethical principles have introduced.

It is true that there is a connection in the combination of ethics, medical practice, and Hippocratic Oath. Hippocratic Oath has been played a significant role in the ancient times. However, with the technological development, the development and evolution of the society has affected to the modern health care service. In the contemporary society there can be violations of Hippocratic Oath and medical ethics. Therefore, Hippocratic Oath should have to have an updated version.

In the contemporary world, there are issues like abortion, euthanasia, etc, which have discussed in the contemporary world. Other issues have discussed in this assignment. In my point of view, it is necessary to have such ethical principles in order to decrease the issues that happen in the healthcare sector.

References 

Beauchamp, Tom L;Childress, James F;. (2009). Principles of Biomedical Ethics (6th Edition ed.). New

York: Oxford University Press.

Thomasma, D. C., & Kushner, T. (Eds.). (1996). Birth to Death. New York: Cambridge University Press.

Weerawardhene, S. (2007). Acharavidya Adyna Lipi. Author.