For Love, Science or Vanity: Medical Ethics principles and why we keep them Holy By Ivainesu Mutasa

Through millennia of alterations to accommodate the evolution of the medical field, the ever-present principles of autonomy, beneficence, non-maleficence and justice have been fundamental for clinicians to uphold the underlying aim of practising medicine: to prevent, heal, and alleviate ailments with regard to human opinion, value, and circumstance.

 

Autonomy merits a prerequisite of respect between practitioner and patient. Thus, a patient's wishes concerning health should take precedence to ensure a non-heteronomous decision. If a patient is ill-informed, therefore falsifying their circumstance, the way they perceive themselves is as erroneous as the bias or preconception that propagated it. The Tuskegee Study of Untreated Syphilis capitalized on its 399 subjects' low educational and socioeconomic status by telling them they could cure their "bad blood" with ineffective vitamins, tonics and aspirins, all while observing their deterioration in the name of science. The façade of meagre financial incentives in, what to the subjects was medical treatment, effectively shackled them to the project, helping it to become the lengthiest study ever observed.

 

Physicians hold a fiduciary relationship with their patients. Patients should have the same level of trust in their doctor to further their welfare as they do in their doctor's expertise. The fulfilment of this obligation must include the intent that any resulting harm is reasonable and justifiable rather than sought after.

Beneficently treating patients validates trust, and when practitioners violate trust, they commit maleficence. Double-effect explains expected harm based on proportionality, such as giving pain relieving medication to a terminally ill patient that inadvertently shortens their lifespan. It assumes that the intention is not to hasten death but to relieve suffering and that the benefit of pain alleviation in a patient's final months outweighs the imperative to extend their lifespan.

 

Medical professionals cannot be apathetic on the subject of justice. A doctor may spend thirty minutes with a bereaved mother but only five with a lonely elderly woman. That incorporates that physician's acumen of justice as physicians delegate their resources to all patients to help as many as possible. The distinction between limited attention and refusal to assist separates personal righteousness from bigotry. In the early days of the HIV epidemic, some physicians refused to treat HIV-positive patients, claiming that the danger was unwarranted or because the doctor disagreed with the patient's lifestyle. While further research dispelled the former, the prevalence of practitioners withholding healthcare based on their convictions was an open secret.  It is dangerous to provide access to healthcare by using a patient's lifestyle to validate treatment because it is not a physician's position to be concerned with whether they agree with a patient's conduct; such a worldview can and has resulted in a discriminatory system.