Midterm reviewer: Is it proportionate to the scale of the medical

problem?
Ethics in Medicine
Is this option compatible with this patient’s
Medical ethics describes the moral principles by individual circumstances?
which a Doctor must conduct themselves. You
need to understand the concept of medical ethics Is this option and its outcomes in-line with the
when you’re applying for Medical School, but you patient’s expectations of treatment?
aren’t expected to be an expert.
You will notice that several considerations are
It’s worth being aware that medical ethics is a concerned with the patient’s expectations or
changing ideal. Something that might have been circumstances. This is also known as holistic or
considered ethical 30 years ago may not be today patient-centric care.
– and what we think is ethical right now may
change in the future. It is important to bear the patient’s expectations
in mind when ranking treatments because when
Why Is Medical Ethics Important? we refer to doing “good” we are not simply
referring to what is medically good for the patient,
Medical professionals frequently find themselves but also what is acceptable to the human being
facing moral questions and ethical dilemmas in we are treating.
their line of work. Medical ethics provide a
framework to help them make judgement calls
which are morally sound and right for the patient
in question. Why Is Beneficence Important?

It’s essential for aspiring Doctors to have a good Beneficence is important because it ensures that
moral compass and a solid grasp of medical ethics healthcare professionals consider individual
so they can consistently do what is best for their circumstances and remember that what is good
patients. for one patient may not necessarily be great for
another.
The four pillars of medical ethics are:
2. Non-maleficence is the sister to beneficence
1.Beneficence means that all medical and is often considered as an inseparable pillar of
practitioners have a moral duty to promote the ethics.
course of action that they believe is in the best
interests of the patient. Often, it’s simplified to Non-maleficence states that a medical practitioner
mean that practitioners must do good for their has a duty to do no harm or allow harm to be
patients – but thinking of it in such a simplistic caused to a patient through neglect. Any
way can be problematic. consideration of beneficence is likely, therefore,
to involve an examination of non-maleficence.
It’s better to think of beneficence as the process
of ranking the available options for the patient How Is Non-Maleficence Different to
from best to worst, taking into consideration the Beneficence?
following aspects:
Non-maleficence differs from beneficence in two
Will this option resolve this patient’s medical major ways.
problem?
First of all, it acts as a threshold for treatment. If a diagnosis and treatment – and not just deferring
treatment causes more harm than good, then it to their Doctor.
should not be considered. This is in contrast to
beneficence, where we consider all valid 4. Justice is one of the four pillars of ethics – but
treatment options and then rank them in order of what exactly does it mean?
preference.
What is Justice?
Second, we tend to use beneficence in response
Justice – in the context of medical ethics – is the
to a specific situation – such as determining the
principle that when weighing up if something is
best treatment for a patient. In contrast, non-
ethical or not, we have to think about whether it’s
maleficence is a constant in clinical practice. For
compatible with the law, the patient’s rights, and
example, if you see a patient collapse in a corridor
if it’s fair and balanced.
you have a duty to provide (or seek) medical
attention to prevent injury. It also means that we must ensure no one is
unfairly disadvantaged when it comes to access to
3. Autonomy is one of the four pillars of medical
healthcare.
ethics, so it’s essential that you understand it. This
guide outlines what patient autonomy is and why Medical Ethics Concept: Consequentialism
it’s important – and helps you understand how to
apply this to your Medical School interviews. Consequentialism is an ethical ideology that states
the morality of an action is dependent purely on
What Is Patient Autonomy? its consequences. A simpler way to phrase this
would be that the “ends justify the means”. If your
In Medicine, autonomy means that a patient has
action has an overall benefit, then it does not
the ultimate decision-making responsibility for
matter about the action itself.
their own treatment. A medical practitioner
cannot impose treatment on a patient. Example: Your patient has a terminal illness and is
not likely to survive the operation she is about to
The only exception is in cases where the patient is
undertake. Just as she is about to be
deemed unable to make autonomous decisions
anaesthetised, she asks you: “Doctor, will I be
(see Mental Capacity Act and Emergency
okay?” A consequentialist ideology supports that
Doctrine).
lying in this circumstance is acceptable, even
The principle that a patient has the right to choose though lying itself is not a moral action.
what happens to their body seems pretty
Medical Ethics Concept: Utilitarianism
straightforward – but it’s important to remember
that historically this has not always been the case! Utilitarianism says the best action is that one that
Even today, some patients defer all decision- brings about the best increase in utility (benefit).
making to the “wise Doctor” – even if they do not Utility is generally considered on a broad scale,
feel comfortable with their treatment plan. often taking into consideration wider society and
not just the patient in question. It’s a form of
Why Is Patient Autonomy Important?
consequentialism.
Autonomy is important because we need to make
Example: You have a sum of money to either fund
sure that the patient is actively involved in their
a very expensive treatment for one patient with a
rare disease or five patients with a very common
and easy-to-treat disease. Utilitarian ethics governmental measures. The right to practice law
dictates that treating the five patients is morally came to be limited to those who met prescribed
superior as a greater overall benefit is achieved. qualifications. Expulsion from practice and
criminal penalties were introduced for various
Medical Ethics Concept: Deontology types of misconduct.
Deontology is also known as “duty-based ethics”. These measures did more than correct abuses.
This ideology states that the correct course of They also gave recognition to the social
action is dependent on what your duties and importance of the functions performed by lawyers
obligations are. It means that the morality of an and identified those who were qualified to
action is based on whether you followed the rules, perform them. A consciousness developed within
rather than what the consequence of following the profession of the need for standards of
them was. conduct. This became the core of legal, or
professional, ethics.
This is in direct contrast with consequentialism.
Prior statutes, court rules, and other government
Example: If your terminally ill patient asks if they’ll
directives remained in force along with the
be ok after a surgery they’re unlikely to survive, a
profession’s self-imposed ethical standards.
deontological approach would suggest you don’t
Together with malpractice actions, they
lie to comfort them. That’s because according to
constituted the sum total of the restraints placed
this concept, lying isn’t morally acceptable
upon lawyers in regard to their professional
because it’s our obligation not to lie – no matter
conduct. This pattern has continued to the
the consequences.
present time.

In many countries professional associations of

Legal ethics, principles of conduct that members lawyers have sought to commit the principles of
of the legal profession are expected to observe in ethical conduct to written form, but a written
their practice. They are an outgrowth of the code is not essential. Ethical principles may exist
development of the legal profession itself. by common understanding as well as in the
literature and writings of the profession. A code,
Background however, makes ethically obligatory principles
readily available to the practitioner (and the
Practitioners of law emerged when legal systems
public) and thus helps to assure wider observance
became too complex for all those affected by
of them. When such a code does exist, it usually
them to fully understand and apply the law.
contains both statements of general ethical
Certain individuals with the required ability
principles and particular rules governing specific
mastered the law and offered their skills for hire.
problems of professional ethics. But no code can
No prescribed qualifications existed, and these
foresee every ethical problem that may arise in
specialists were not subject to legal controls. The
the practice of law. Hence, in many jurisdictions
incompetent, unscrupulous, and dishonest
codes are supplemented by opinions rendered
charged exorbitant fees, failed to perform as
and published by bar association committees.
promised, and engaged in delaying and
obstructive tactics in the tribunals before which Conflict of interest
they appeared. Action to prevent such abuses was
taken by legislation and by judicial and other
A lawyer is at times faced with the question of other. The same principles apply with respect to
whether to represent two or more clients whose interests of the attorney that may detract from
interests conflict. Quite aside from his ethical the full and faithful representation of his clients.
obligations, the legal systems of the world For example, he may not purchase property that
generally prohibit a lawyer from representing a he has been retained to acquire for his client, nor
client whose interests conflict with those of may he draw a will in which he is a beneficiary.
another, unless both consent.
These conflict-of-interest prohibitions are not
absolute. The client may consent to the
representation after full disclosure of the actual or
In legal systems the prohibition has three aspects. possible conflict. But even the client’s consent
may not suffice if public interest is deemed to be
1. the attorney is not permitted to represent
adversely affected.
two or more clients concurrently if, in
order to further the interests of one, he Confidential communications
must forgo advancing the conflicting
interests of another. In short, he cannot legal ethics generally forbid a lawyer to testify
be both for and against a client. about confidential communications between
2. he cannot subsequently accept himself and his client unless the client consents.
employment from another for the Provisions regarding confidentiality are also found
purpose of undoing what he had earlier in such diverse legal systems. In countries in which
been retained to accomplish. the attorney’s obligation to protect state interests
3. he may not accept subsequent is given relatively greater emphasis, there may be
employment from another if it involves a duty to disclose information when it is deemed
the use, the appearance of use, or the to be to the state’s advantage.
possible use of confidential information
received from his former client. Such What Is Privileged Communication?
actions are forbidden by law and by legal
Privileged communication is an interaction
ethics.
between two parties in which the law recognizes a
To illustrate, an attorney may not as a matter of private, protected relationship. Whatever is
course prepare an instrument for both buyer and communicated between the two parties must
seller in which their respective rights are defined. remain confidential, and the law cannot force
He may not prepare an instrument or negotiate a their disclosure.
settlement for a client and later accept
Even disclosure by one of the parties comes with
employment from another to defeat that
legal limitations. There are, however, exceptions
instrument or settlement. He ought not represent
that can invalidate a privileged communication
both a driver and his passenger in recovering
relationship. There are also various circumstances
damages from another party charged with
under which privileged communication can be
negligent driving in a collision, since the passenger
waived, either deliberately or unintentionally.
may have a claim against his own driver as well.
Commonly cited relationships where privileged
He may not represent two or more defendants in
communication exists are those between attorney
a criminal prosecution if their respective defenses
and client, doctor–or therapist–and patient, and
are inconsistent or, possibly, even when the case
priest and parishioner.
against one is stronger than the case against the
KEY TAKEAWAYS

Privileged communication protects the

confidentiality of interactions between two
parties, whom the law classifies as entitled to a
private, protected relationship.

Some relationships that provide the protection of

privileged communication include attorney-client,
doctor-patient, priest-parishioner, two spouses,
and (in some states) reporter-source.

If harm—or the threat of harm—to people is

involved, the privileged communication protection
disappears.

How Privileged Communication Works

In addition to attorney-client privilege and

conversations with medical professionals and
religious officials, privileged communications
include those between two spouses, accountant,
and client, and, in some states, reporters and their
sources.

In professional relationships, the right of

protection for the communication belongs to the
client, patient, or penitent. The recipient of the
information must keep the communication private
(unless the privilege is waived by the discloser of
the information). If the recipient of the
information fails to keep the information private,
in many instances they can lose their operating
license.

The key provisions of privilege between spouses

are that courts cannot force husbands or wives to
disclose the contents of confidential
communications made during marriage—nor can
either spouse be compelled to testify against the
other. These rights, which endure even after a
marriage is dissolved, are designed to protect the
honesty and confidentiality of marriage. However,
these protections do not prevent one or the other
spouse from testifying against the other in court
(should they choose to do so).