This I Believe
Cultural, Legal, and Ethical Issues in Health Care is an exciting class. At the beginning of the course we needed to answer questions about what we believe regarding different issues in health care. It will be interesting to see if my beliefs change as we search these issues more thoroughly.
Rights of patients and physicians
1. Patient autonomy, truth-telling, and confidentiality
I believe each patient has the right to hear the truth from their physicians and other medical staff about their condition. Patients need to be informed so they can make educated decisions about their own care. Also, I believe the medical team should explain all available treatment options, but shouldn’t try to influence the patient to choose one treatment over another. Each patient has the right to make their own decisions about their medical care based on their own values and beliefs.
Each patient also has the right to privacy. Physicians and other medical providers need to keep patient’s information confidential per current HIPPA laws. Each patient deserves to be treated with respect and to not have their information shared unless they have consented.
2. Medical research ethics and informed consent
I believe researchers shouldn’t collect data from a participant unless that participant has given their permission to be part of the study. Also, all pertinent information regarding the study should be given to the participant so they can make an informed decision before participating. If the participant is a minor then the guardian should be the one giving consent. I believe every patient has this right to protect their information and choose whether they want to be involved in research.
Controls
3. Genetic control
Genetically engineering or controlling genes is a newer issue. One of the biggest concerns that are raised is the idea of genetically engineering babies to parents’ ideal specifications. I believe that great care should be taken when considering controlling a gene. There is still so much we don’t know about gene expression and how “defects” in a gene may actually influence other factors in the body or even future generations. I worry that if we try to control genetics that we will do more harm than good. Who decides if a gene is “good” or “bad”? I believe we still have much to learn in genetics.
4. Reproductive control
There are many ethical issues that can arise when it comes to reproductive control. One of these issues is what to do with embryos that have been frozen at fertility clinics. There are very few laws on what to do with them, which leaves fertility centers to make their own policies. I believe we need to look at this issue more closely and I am currently undecided about what should be done.
I do believe that parents should have the first say on what happens. Problems still arise though because parents may divorce, lose touch with the clinic, or no longer be able to pay the costs of keeping the embryos frozen. Some argue that unused embryos should be used in stem cell research rather than simply discarded. I can see both sides of this issue. There is valuable research that needs stem cells, but there are concerns of the costs of using a human life to reach scientific advances.
Terminations
5. Abortion
I don’t feel abortion is a black and white issue. There are so many different scenarios that a woman may face when she becomes pregnant. I believe human life is precious and I wouldn’t want to have an abortion personally, but I don’t want there to be laws that would make abortions illegal. A woman may become pregnant due to incest or rape, and I don’t think that woman should be required to carry the baby. There is also the possibility that a women’s pregnancy could be fatal to her. To legally require a woman to carry the baby seems inhumane to me.
6. Treating or terminating impaired infants
When speaking about impaired infants I believe great caution should be followed. Impairment can mean so many different things to different people. Who measures the level of impairment and what infant is worthy of life? I don’t believe we should terminate the life of a child with Down syndrome or autism. I am less clear when it comes to a child who is in severe anguish and needs drastic medical care to stay alive and is receiving little relief. As a mother would I allow my child to pass out of this world, or would I fight for every possible medical treatment in the hopes that medical advances would someday provide better care and relief for my child? I don’t know what I would choose.
7. Euthanasia and physician-assisted suicide
Life is precious and important, but what happens when something goes wrong? I have mixed feelings on euthanasia and physician-assisted suicides. If I were personally stuck in a vegetative state, unable to every recover, I wouldn’t want life sustaining medical care to continue. I would want my body to be allowed to die by removing machines and other treatments. It is a good reminder for the need of living wills.
Physician assisted suicides are even more difficult. If a person doesn’t have a life threatening fatal disease I don’t feel physicians should be assisting their patients to die. I have great sympathy for those who are suffering, but I worry about ending a person’s life when things could improve for them.
When it comes to those with terminal illnesses I can understand why someone would want to end their life before they find themselves in great pain or needing large amounts of assistance. We already have hospice services though which allow all life sustaining drugs to be stopped and pain medications to be administered. I don’t know if it is necessary to take that final step of suicide.
Resources
8. Organ transplants and scarce medical resources
Organ scarcity is a big problem for patients who need a transplant to survive. I believe every life is important and that equal weight should be given to those needing an organ. The right to receive an organ shouldn’t be weighed based on someone’s wealth or status. I think the decision should fully depend on a person’s medical need and the compatibility of the organ donor to the recipient. A CEO is no more worthy than a man sitting in prison.
9. Distributing health care (How it should be allocated based on age/status/ability to pay)
I believe health care is a universal right and I would love to see a system put in place that allows all individuals to receive care regardless of their ability to pay. Being poor isn’t a crime or a moral wrong. Many have been born into circumstances, or have found themselves in a situation where they have lost their wealth. Age or someone’s status shouldn’t affect receiving health care either. We all have a right to receive care.
Challenges
10. Health care for women
I believe that women should have the same access to medical care as men. In the past women have been viewed as less competent or less important, but this isn’t the case. I also believe that women should be included in medical research. There have been times when women weren’t included in a study, and then blanket statements were given regarding what is the best medical care. We can’t make those conclusions unless women are included. Male and female bodies may respond differently to a treatment.
11. Health care for minorities
I believe all humans should have access to health care. Someone’s race should not exclude them from services. Also, when research is done it should include minorities because the findings of studies could be different, for example different drugs may be effective. The same informed consent should be required for minorities as it is required for anyone else. Everyone is important, has value, and should be taken care of.
12. Health care for and responsibilities of those with AIDS/HIV
People who are HIV positive or have aids have the right to treatment and access to health care. I also believe they have the right to the same confidentiality and privacy that any other patient would have. There has been so much fear surrounding the disease, especially in the past, which has caused many patients to be shunned or exposed. We need to treat others with respect regardless of their diagnosis.
Rights of patients and physicians
1. Patient autonomy, truth-telling, and confidentiality
I believe each patient has the right to hear the truth from their physicians and other medical staff about their condition. Patients need to be informed so they can make educated decisions about their own care. Also, I believe the medical team should explain all available treatment options, but shouldn’t try to influence the patient to choose one treatment over another. Each patient has the right to make their own decisions about their medical care based on their own values and beliefs.
Each patient also has the right to privacy. Physicians and other medical providers need to keep patient’s information confidential per current HIPPA laws. Each patient deserves to be treated with respect and to not have their information shared unless they have consented.
2. Medical research ethics and informed consent
I believe researchers shouldn’t collect data from a participant unless that participant has given their permission to be part of the study. Also, all pertinent information regarding the study should be given to the participant so they can make an informed decision before participating. If the participant is a minor then the guardian should be the one giving consent. I believe every patient has this right to protect their information and choose whether they want to be involved in research.
Controls
3. Genetic control
Genetically engineering or controlling genes is a newer issue. One of the biggest concerns that are raised is the idea of genetically engineering babies to parents’ ideal specifications. I believe that great care should be taken when considering controlling a gene. There is still so much we don’t know about gene expression and how “defects” in a gene may actually influence other factors in the body or even future generations. I worry that if we try to control genetics that we will do more harm than good. Who decides if a gene is “good” or “bad”? I believe we still have much to learn in genetics.
4. Reproductive control
There are many ethical issues that can arise when it comes to reproductive control. One of these issues is what to do with embryos that have been frozen at fertility clinics. There are very few laws on what to do with them, which leaves fertility centers to make their own policies. I believe we need to look at this issue more closely and I am currently undecided about what should be done.
I do believe that parents should have the first say on what happens. Problems still arise though because parents may divorce, lose touch with the clinic, or no longer be able to pay the costs of keeping the embryos frozen. Some argue that unused embryos should be used in stem cell research rather than simply discarded. I can see both sides of this issue. There is valuable research that needs stem cells, but there are concerns of the costs of using a human life to reach scientific advances.
Terminations
5. Abortion
I don’t feel abortion is a black and white issue. There are so many different scenarios that a woman may face when she becomes pregnant. I believe human life is precious and I wouldn’t want to have an abortion personally, but I don’t want there to be laws that would make abortions illegal. A woman may become pregnant due to incest or rape, and I don’t think that woman should be required to carry the baby. There is also the possibility that a women’s pregnancy could be fatal to her. To legally require a woman to carry the baby seems inhumane to me.
6. Treating or terminating impaired infants
When speaking about impaired infants I believe great caution should be followed. Impairment can mean so many different things to different people. Who measures the level of impairment and what infant is worthy of life? I don’t believe we should terminate the life of a child with Down syndrome or autism. I am less clear when it comes to a child who is in severe anguish and needs drastic medical care to stay alive and is receiving little relief. As a mother would I allow my child to pass out of this world, or would I fight for every possible medical treatment in the hopes that medical advances would someday provide better care and relief for my child? I don’t know what I would choose.
7. Euthanasia and physician-assisted suicide
Life is precious and important, but what happens when something goes wrong? I have mixed feelings on euthanasia and physician-assisted suicides. If I were personally stuck in a vegetative state, unable to every recover, I wouldn’t want life sustaining medical care to continue. I would want my body to be allowed to die by removing machines and other treatments. It is a good reminder for the need of living wills.
Physician assisted suicides are even more difficult. If a person doesn’t have a life threatening fatal disease I don’t feel physicians should be assisting their patients to die. I have great sympathy for those who are suffering, but I worry about ending a person’s life when things could improve for them.
When it comes to those with terminal illnesses I can understand why someone would want to end their life before they find themselves in great pain or needing large amounts of assistance. We already have hospice services though which allow all life sustaining drugs to be stopped and pain medications to be administered. I don’t know if it is necessary to take that final step of suicide.
Resources
8. Organ transplants and scarce medical resources
Organ scarcity is a big problem for patients who need a transplant to survive. I believe every life is important and that equal weight should be given to those needing an organ. The right to receive an organ shouldn’t be weighed based on someone’s wealth or status. I think the decision should fully depend on a person’s medical need and the compatibility of the organ donor to the recipient. A CEO is no more worthy than a man sitting in prison.
9. Distributing health care (How it should be allocated based on age/status/ability to pay)
I believe health care is a universal right and I would love to see a system put in place that allows all individuals to receive care regardless of their ability to pay. Being poor isn’t a crime or a moral wrong. Many have been born into circumstances, or have found themselves in a situation where they have lost their wealth. Age or someone’s status shouldn’t affect receiving health care either. We all have a right to receive care.
Challenges
10. Health care for women
I believe that women should have the same access to medical care as men. In the past women have been viewed as less competent or less important, but this isn’t the case. I also believe that women should be included in medical research. There have been times when women weren’t included in a study, and then blanket statements were given regarding what is the best medical care. We can’t make those conclusions unless women are included. Male and female bodies may respond differently to a treatment.
11. Health care for minorities
I believe all humans should have access to health care. Someone’s race should not exclude them from services. Also, when research is done it should include minorities because the findings of studies could be different, for example different drugs may be effective. The same informed consent should be required for minorities as it is required for anyone else. Everyone is important, has value, and should be taken care of.
12. Health care for and responsibilities of those with AIDS/HIV
People who are HIV positive or have aids have the right to treatment and access to health care. I also believe they have the right to the same confidentiality and privacy that any other patient would have. There has been so much fear surrounding the disease, especially in the past, which has caused many patients to be shunned or exposed. We need to treat others with respect regardless of their diagnosis.