When you’re trying to always do the right thing, the definitive line between what is morally right or wrong gets blurred. Healthcare professionals must constantly evaluate if what they personally feel is the best course of action. And often times, there’s not a lot of time to contemplate their decisions.
In 2010, Medscape released a survey recovering the opinions of about 10,000 practicing professionals regarding the biggest ethical dilemmas facing physicians. Their results show that you’re not alone in the struggle revolving around the great moral debates in healthcare practice.
Biggest Ethical Dilemmas Faced by Physicians
Administering life-sustaining therapy even though you know efforts are futile.
For nearly 40 percent of doctors surveyed, providing therapies to dying patients to keep them alive a bit longer depends on the situation. Perhaps, for instance, if the terminal patient requests to see their loved one before they pass and the only way is to keep them alive at least until they can make it to see them. However, it can be a difficult decision. Keeping someone alive for their request, yet seeing them suffer is extremely difficult to consider. And in other cases, people are so afraid of death that they refuse to attend despite facing excruciating agony.
Hiding information about terminal-diagnoses in hopes of “bolstering their attitude and spirit.”
60 percent of physicians said they “tell it like it is” when it comes to revealing the nature of a terminal or pre-terminal illness. However, some others (about 15 percent) felt that softening it was a better approach so that at least the person could hold on to a shred of hope, even if there’s a slim chance of survival. Sometimes, in cases of children or the senile elderly, who may not fully understand, telling a family member as opposed to the patient themselves is a more effective way of handling it. Additionally, less than 2 percent of doctors said they actually don’t tell them how bad their condition is “unless they are going to die immediately.”
Covering up/not revealing a mistake that causes no harm to the patient.
60 percent of doctors said it is unacceptable to hide a mistake you made. On the other hand, 20 percent said it was okay to do so because the patient was not harmed as a result of it. Some believe that causing unneeded emotional distress on a patient when no implications came from it is foolish. Others, believe that a mistake should NEVER be withheld and it’s unethical to do so. Balancing the harm to the patient versus harm to a physician’s reputation is a hard juggling act.
Physician assisted suicide.
Should a healthcare professional knowingly help end a person’s life if they are doing it for the right reasons? Physicians are constantly torn by this issue; approximately 45 percent said they would, 40 percent said they wouldn’t and 13 percent said it depends on the situation. Some feel that it is murder, while others are sympathetic feeling that they’d “want the same thing” done for them.
Dropping insurers that don’t pay well.
Would you feel conflicted about dropping insurances that didn’t pay? A lot of doctors (57 percent) surveyed said that they would. It would mean eliminating some long-term patients that you’ve gotten to know for years, but bring in more money to the practice. Money over morals: fighting for the proper reimbursements is the main goal for some; while others take on a more altruistic approach to medicine. But…you can’t heal the world if you’re practice goes bankrupt.
Breaking patient confidentiality to potentially protect others.
If you know that a person’s condition is troubling, what do you do? About 53 percent of doctors said they would break the code of patient confidentiality if they felt that the patient was a danger to themselves or others. Others try to guide them in a better path before breaking their confidence or, they try to persuade them to ask for outside help themselves. Is it against ethics and HIPAA if you think you’re disclosing their information for a greater good?
Performing abortions (even against your own beliefs.)
Some physicians (about 34 percent) feel that it is a woman’s decision and that it should be their choice even if that is against the physician’s personal beliefs. However, the majority (53 percent) said they would refuse to do the procedure and ask the patient to see someone else. Some feel that they respect a woman’s choice, but respect their integrity more in order to refuse personally conducting the procedure.
Accepting gifts or perks from pharmaceutical companies.
Many physicians feel that accepting things from pharmaceutical companies is unethical because it may influence their medical judgement. Nearly 47 percent said that refusing these perks/gifts was the right thing to do. However, others feel that accepting these trinkets is okay because they all generally send the same stuff anyway and you can never have enough extra sticky-note pads and pens.