Philosophy of Health Care Medical Ethics Essay

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Healthcare is one of the most important arenas for applied ethics and social justice. The concept of universal healthcare can be considered from a number of different ethical standpoints including consequential and deontological perspectives (Daniels 1). An ethical consequentialist approach could focus on the net gains to the society from offering universal healthcare coverage to all persons, or the net gains of improved overall quality of life in a more equitable society. Deontological ethics stress the importance of equal access as a fundamental human right.

Because the medical profession as a whole is comprised of individual doctors, each doctor or healthcare worker is required to perform pro bono service at some point during their career in order to promote the value of social justice in medicine. As Daniels points out, there is no way to ensure one hundred percent health equity, given that sociological factors impact health outcomes (1). A multi-tiered system is an effective interim solution, providing that all persons at least have access to preventative medicine (tests and screenings) as well as any necessary medical procedure. However, the current profit-driven system is unethical—both from a deontological and consequentialist point of view. The society benefits from having fewer people burden the system with preventative problems that could have been mitigated with affordable healthcare, and also benefits from promoting an ethic of social justice more generally.

Some of the arguments framed against universal healthcare assume that healthcare resources are limited, and presume that in such a situation, access should be market-driven and not rights-driven. Assuming that healthcare resources are finite and limited, macro-allocation serves effectively as a rationing of those resources (Scheunemann and White 1625). Resources tend to be allocated according to market forces, as when pharmaceutical companies invest in the research and development of products for which they can receive a ready return on investment, more so than they are driven by the desire to cure diseases. The present allocation of public health resources is complex and driven by politics and social norms; the United States has no single-payer system that allocates taxpayer funds to healthcare with the only exception being Medicare.

Like education, healthcare is a basic human right that promotes a high quality of life within the society. Therefore, healthcare should be something that is publically funded. Framing coverage as “mandatory” makes it seem coercive; in fact, coverage should be framed in a similar way as education, in which each person has equal access to the same basic coverage. Healthcare resources are also allocated on a micro-level, referring more to the procedural justice in healthcare. Distributive and procedural justice can coexist in an ethical model. There is no need to choose between the two. Patients have a right to procedural justice in their daily dealings with healthcare institutions and professions, but distributive justice principles ensure that no person can be denied an essential service.

The AMA might claim to oppose public healthcare out of fear that the state could interfere with case-by-case decisions, an unfounded fear given the success of socialized medicine programs in other countries. More likely, the members of the AMA know that doctors and especially insurers would theoretically profit less from socialized medicine. A socialized system would, however, not preclude doctors from earning additional money from customers willing to pay out of pocket for treatments or services that are not deemed “essential” through a single-payer system. Certainly doctors are violating the core ethical tenets of medicine when they oppose universal coverage based on spurious and selfish principles.

In fact, an abundance of financial and human resources can be liberated via a streamlined healthcare system that eliminates the bloat in the insurance and pharmaceutical industries. If these resources were freed, then the expensive procedures mentioned in the question would be made more affordable. Both the utilitarian and Kantian approaches show that equitable, needs-based rationing is good for the society as a whole. It is unethical categorically to withhold treatment from someone because it would entail allowing a person to suffer needlessly.

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Given the greatest number of people in society are of modest means, providing the utilitarian ideal of the greatest good for the greatest number of people means universal coverage and no denial even of expensive operations. Organs should be harvested by default. A person needs to opt out of organ donation, rather than opt in, to ensure a readily available supply of vital organs. There is no ethical reason why this should not be so; a person who feels strongly about not having their organs removed for whatever reason has the right to refuse. Thus, there is no infringement on autonomy, while the common good is also promoted.

Yes, it would be preferable to have universal access first but universal access might be a long way away. Besides, new drugs and treatments come on the market prior to universal access—without any ethical questions being raised about only the wealthy being able to afford them. Doctors do have an ethical obligation to promote health at the personal but also the public level, principles that are embedded in the Hippocratic Oath (Summers). They have every right to run a business and make profit too, but should also be obliged to provide a social service that includes lower-cost provisions of screenings and other public health needs. Doctors do spend an exorbitant amount of money on their education, and those costs will eventually be offset through the course of a career—even a career that includes some mandatory public service work. Yes, the cost of medical education can and should be subsidized, perhaps on a needs-based basis. Doctors are generally not motivated to enter medical school for financial reasons; otherwise they would simply become entrepreneurs. Eight years or more of training reveals on some level an interest in and affinity for medical practice.

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There are zero logical reasons to prevent access to family planning services including abortion. An abortion is not killing a human being, even this is the line of thinking most commonly used by the anti-abortion cohort (Patil, Dode & Ahirrao, 2014, p. 548). Therefore, there is no ethical problem with abortion whatsoever. In fact, there is an ethical problem with banning abortion because banning abortion forces a person to carry an unwanted child to term. “To compel women to bear unwanted children is a form of ethical despotism,” (Patil, Dode & Ahirrao, 2014, p. 548). From both deontological and utilitarian ethical perspective, disallowing abortion is an infringement on human rights.

The medical profession demonstrates a lot more respect for human life when empowering individuals to make these types of important choices for themselves. Abortion basically needs to be framed as a human right. No one has the right to force a person to have a child. Slippery slope arguments are inherently illogical, anyway. The medical profession suffers far more from not providing safe abortions than for allowing a shrill group of religiously minded individuals to dictate what other people can do. Legal abortion does not infringe on the rights of those who believe that abortion is unethical. On the other hand, illegal abortion does infringe on the rights of both the unborn and the living. The abortion issue illustrates some of the philosophical differences between positive and negative rights, too.

If a doctor does not wish to provide an abortion, that doctor has every right to defer to a colleague. Similarly, a pharmacist has the right to personally refuse access to birth control and morning after pills—but they pharmacy itself cannot have such a policy. In other words, institutions cannot pass anti-abortion policies but individual practitioners have every right to contentiously object. Mandatory training in abortion is a good idea, though, because a doctor’s views might change when faced with a life-threatening situation. For example, a doctor who contentiously objects might eventually be confronted with a situation in which the abortion saves the life….....

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