Ethics forms the basis for healthcare delivery and provision which differ from one discipline to another. This paper focuses on issues which makes ethics formulation troublesome. Contemporary bioethics is based on four major principles; autonomy, justice no-maleficence, and beneficence. The current healthcare delivery relies majorly on autonomy as the most critical factor for ethics establishment.
A recent ethical issue in healthcare concerns the approach of circumstance in which weak individuals are involved such as the unborn and the aged. The society has the obligation of protecting such individuals from oppression through professional and organizational ethic. This paper focuses on the ethics involved in helpless unborn members of a society. Further steps should be taken to ensure that the goals of healthcare delivery and access should be secondary to the welfare of a helpless being involved.
All life challenges have answers, although all answers are not founded on ethical principles. Principles only, do not end in ethical choices, that is, decisions that are not based on principles are ethically irrelevant (Sheikh, 2007). Moral mistakes still persist in different aspects of healthcare. Thus, ethical norms have to be observed in healthcare systems, science and technology, biomedical research, and public health (Beauchamp, & Childress, 2001).
Several key ethical issues accompany healthcare delivery and provision. These issues include concerns for how resources are allocated; who decides who gets what; measurement of outcomes; definition of success; prioritization with regard for cost-effectiveness; population health-being; health inequality or precise methods of health delivery; and special preferences or a more objective perception of best interest (Southern Cross Bioethics Institute, 2008).
Basis for healthcare ethics
Developing ideal guiding standards of healthcare is a challenging task. There are several alternative perspectives. The standards of ‘principlism’ are common in the sense that healthcare delivery is based on four principles including justice, non- maleficence autonomy, and beneficence (Gert, 2004).
Modern worldly bioethics base on autonomy as the superseding value, although many other critics indicate the impracticality and risks in this approach. Specifically, the likely outcomes of the approach of autonomy are the tendency towards a market representation of healthcare structure, a condition that contradicts the conventional principles of medicine (Beauchamp, & Walters, 1999). Besides, it contradicts the facts of life for sufferers of chronic and disabling illnesses, or who are wholly reliant on others for their routine necessities.
Determining who gets what is the core concern for medical ethics. In circumstances of limited healthcare resources, allocation of resources will be based on need, or paying ability, or prospect for profitable productivity, or other certain criteria. The question of who determines patient’s treatment is also important, wherein whether or not the patient’s treatment be decided by the physician or the managers or other relevant persons (Grinnell, 2004, p. 1213).
Also, whether or not every person has the right of access to healthcare services poses a challenge for the policy makers (Hope, 2004). For instance; should criminals or heavy smokers have right to receive transplants even when they are scarce. Moreover, a question whether or not cosmetic surgery should be supported with public funds emerges.
Healthcare as a right for every person implicate that people have unlimited access to it, that healthcare ought to be funded through taxes. Another factor that establishment of healthcare ethics considers whether means-tested healthcare ought to or not be provided. A question of imposing health care insurance and at what define income level, on all healthcare consumers is as well challenging.
The aforementioned ethical questions vary amongst different countries and states in countries, and is a complex process altogether. Noteworthy, the supposition and values underpinning fiscal and management choices should be identified and analyzed.
In the past two decades, bioethics has been defined as the examination and a study of process in which clinical and scientific decisions impact on every individual’s wellbeing and upon different societies and environment.
Bioethics deals with issues concerned with essential human values, including the rights to life and health-being, and the appropriateness or otherwise of specific development in medicine, healthcare organizations, life technological innovations, the health practitioners and society’s accountability for the wellbeing of its members.
Bioethics concerns questions relating to the commencement and ending of human life, ranging from matters associated with in-vitro fertilisation and pregnancy termination to palliative care and euthanasia. Also, the impact of this concept extends to every aspect of human community ranging from the community nursing home to the big international forums on matters such as the Human Genome.
Moreover, bioethics serves as a branch of applied ethics and prerequisite the competence of various professionals such as social science, nursing, the life sciences, medicine, theology, philosophy and law.
Bioethics poses numerous challenging ethical questions for generally all forms of organizations such as families, hospitals, authorities and society. Bioethics is important because essential human values including human life, the integrity of the frail and the aged, unbiased healthcare, bodily integrity and the potential to take decisive actions are at stake. The subsequent paragraphs will focus on how ethics applies to abortion and cloning.
Ethics and Abortion
The issue of abortion, the typical bioethics theme, poses in-depth private issues for many people. It is a polarizing and discordant matter that triggers controversies about politics, morals, religion, medicine, autonomy, and sexuality. The core issue is how the unborn children can be perceived, whereby the unborn child is initially termed an embryo and subsequently, fetus (Grinell, 2004).
The definition of their moral status describes their worth in life, and the general public responsibility towards them. In this regard, the issue of personhood emerges, as a theoretical and legal argument concerning the rights to accord them.
The question of everyone’s relationship to the unborn as a member of the human species is controversial. For instance, the question whether or not their lives should be safeguarded, or if their mothers are autonomous concerning choice of killing or protecting their unborn is debatable. The circumstances under which the killing of the unborn is permissible should be defined. In this regard the legal penalties associated with the practice of abortion on woman devoid of her approval, or to induce her to suffer a miscarriage arises.
Although the ethical perspective of abortion is related with its legal perspective, they are distinct. In this regard various questions arise. First, whether or not it is moral and it should be legal. Second, whether or not it should be abolished and should be accorded exceptions. Third, whether it should or not be funded by the public. Fourth, whether it should or not be restricted. Fifth, whether doctors and nurses should or not be granted the power to object based on their principles.
A weaker but significant argument on this issue focuses on the rationale behind a woman’s decision to undertake abortion. The question of whether or not the choice of abortion is free throughout, or women are subject to coercion in any manner is debatable (Cook & Dickens, 1994).
Also, whether or not it is liberal to undertake abortion because of despair arising from poverty, hostility, or lack of sustenance is arguable. In addition, the argument on what should or not be the community and policy reactions to women who are less confident of childbearing arise.
Ethics and cloning
Any debates about cloning must start with a cautious definition. Cloning can naturally occur at different levels including at the DNA level, cellular level, and organism level. Characteristically ethical concern is directed towards cloning in the context of genetic replication of an entire organism (Purtilo, 1999).
Although the cloning of non-mammals has been undertaken in research context for several years, the initial cloning of a mammal, a sheep called Dolly puzzled many in the scientific fraternity. This renaissance was rapidly followed by the cloning of other species and strong belief of the possibility of cloning human beings.
Subsequently, cloned human embryos have been developed although there are no reliable publications that any of these embryos have been implanted into a uterus of a woman and developed to a pregnancy. Cloning to birth is termed reproductive cloning, while the cloning of embryos in order to provide stem cells for prospective research or for therapeutic applications is termed therapeutic cloning.
The major ethical concern with therapeutic cloning arises from the moral status of the cloned embryo, which is developed purposely form destruction. The ethical issues for the reproductive cloning on the other hand, arises from concern include genetic degradation to the clone, health threats to the woman, very minimal success probability implying loss of large amount of fetuses and embryos, psychological adverse effects to the clone, intricate changed familial connection, and co-modification of human existence (Purtilo, 2009).
The responsibility of the healthcare practitioners concerns patient’s protection and fulfillment of legal requirements. It is important that patient’s welfare and human rights should be respected to ensure safe delivery of health care and preservation of life.
Beauchamp, T. L., & Walters, L. (1999).Contemporary Issues in Bioethics. 7th ed. Belmont, CA: Wadsworth Pub.
Beauchamp, T. L., & Childress, J. F. (2001). Principles of Biomedical Ethics. 5th ed. Oxford, New York: Oxford University Press.
Cook, R. J., & Dickens, B. M. (1994). Ethics, Justice and women’s health. Int J Gynaecol Obstet, 64, 81-5.
Gert, B. (2004).Common Morality: Deciding What to Do. New York, NY: Oxford University Press
Grinnell, F. (2004). Human embryo research, from moral uncertainity to death . Am J Bioethics, 4:1213.
Hope, T. (2004). Medical Ethics – a very short introduction. Oxford: Oxford University Press.
Purtilo, R. (1999). Ethical Dimensions in the Health Professions. 3rd ed. Philadelphia: WB Saunders.
Purtilo, R. (2009). The ethical life of rural health care professionals. One court street, Lebanon: Tristees of Dartmond college.
Sheikh, S. A. (2007). The Importance of ethics in health care system. JDUHS, 1(1), 46-48.
Southern Cross Bioethics Institute. (2008). Healthcare. Retrieved March 16, 2011, from http://www.bioethics.org.au/Resources/Resource%20Topics/Healthcare.html