Week 5: Confidentiality and Bioethical Issues (Nov 20 - Nov 27)
Welcome to Week 5!
This week, we discuss issues related to bioethics. Since the time of Hippocrates, “First Do No Harm” has been the medical mandate. It is the basic concept that drives all of the codes of ethics for the health professions. The concept is one of the first you learn in school. From this comes the duty to make ethical decisions “in the best interest of the patient.” While all medical professionals would agree that this is the goal, not all would agree on exactly what IS the best interest of the patient in a given situation.
Healthcare workers—and specifically physicians—work hard to save lives. Many times, death is seen as a medical failure. Health professionals go to great lengths to preserve life with the assumption that saving the life—at all costs—is in the best interest of all patients. In the past, if that left the patient paralyzed or in a vegetative coma, it was still success - they were alive. Today, this assumption is being reconsidered as patients themselves demand to decide for themselves what is in their own best interest.
Of particular interest is Oregon law which states, "an adult who is capable and has been determined by the attending doctor to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication for the purpose of ending his or her life in a humane and dignified manner." In short, the patient can decide when it is time to go, and request the necessary medication to bring about his or her own death. Oregon is the only state with such legislation in place, and the controversy surrounding this law is much what you would expect. This will be an interesting week in our course indeed!
Reading:
Chapter 10
Chapter 11
Discussions:
* Patient confidentiality (graded) * Unethical