Ethical and Moral Dilemmas in Today’s Medicine

Medicine asks us to act with high moral principles.

We have the great privilege of coming into our patients’ lives when they are at their most vulnerable, to hear their most intimate stories, to touch their bodies as no other might, to help them make difficult and life changing decisions and to stand beside them when sometimes the world as they know it is fragmenting.

To do this we agree to maintain high levels of professionalism, to adhere to our profession’s code of ethics and as best as possible, to attempt to alleviate our patients’ suffering in whatever form that suffering may present. That is the honour we are given as doctors.

In the most part our work is structured so that a scientific approach clearly guides us in diagnosis and management, however there are times when we face moral and ethical dilemmas where the solutions are not necessarily black and white but rather various shades of grey.

As elders in the profession, we ponder on some of these issues and know that these are problems we will be leaving the next less experienced generation to solve unless we start the hard conversations now.

Medical knowledge has expanded exponentially over recent years. There are a myriad of investigations and possible treatments available, many of which are very costly. This means that one of the most pressing decisions we have to make as a profession is how best the health dollar is spent. It may be considered that such issues are the domain of administrators and even insurance companies, but if our profession abdicates from the responsibility of making these decisions, Medicine will have even bigger problems than it already has.

Our profession needs to take a stand on issues such as assisted suicide and limiting futile treatment, and to clarify what a doctor’s role is in these areas. If we do not do this, it is possible that such decisions will be thrust upon us, made by those less equipped to do so.

Such complex decisions have profound effects on our patients’ lives, but also on our own lives, and need to be approached not only from the stand point of finances or even ethics, but with great compassion for all involved.

We would like to explore these ethical and moral dilemmas in today’s Medicine with the experience, love and compassion such issues deserve.

By Dr Jane Barker and Dr Anne Malatt – Photography by Alan Johnston

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