Whether your role is that of a doctor or a health care administrator, working in the field of health care is both highly rewarding and challenging. Many medical procedures and treatments have both merits and downsides, and patients have their own input and circumstances to consider. The four principles of health care ethics developed by Tom Beauchamp and James Childress in the 1985 ,Principles of Biomedical Ethics,provide medical practitioners with guidelines to make decisions when they inevitably face complicated situations involving patients. The four principles of health care ethics are autonomy, beneficence, non-maleficence, and justice.
The Four Principles of Health Care Ethics
The basic definitions of each of the four principles of health care ethics are commonly known and used often in the English language, but they take on special meaning when being utilized in a medical setting. All of these principles play a key role in ensuring optimal patient safety and care.
1. Autonomy: In medicine, autonomy refers to the right of the patient to retain control over his or her body. A health care professional can suggest or advise, but any actions that attempt to persuade or coerce the patient into making a choice are violations of this principle. In the end, the patient must be allowed to make his or her own decisions – whether or not the medical provider believes these choices are in that patient’s best interests – independently and according to his or her personal values and beliefs.
2. Beneficence: This principle states that health care providers must do all they can to benefit the patient in each situation. All procedures and treatments recommended must be with the intention to do the most good for the patient. To ensure beneficence, medical practitioners must develop and maintain a high level of skill and knowledge, make sure that they are trained in the most current and best medical practices, and must consider their patients’ individual circumstances; what is good for one patient will not necessary benefit another.
3. Non-Maleficence: Non-maleficence is probably the best known of the four principles. In short, it means, “to do no harm.” This principle is intended to be the end goal for all of a practitioner’s decisions, and means that medical providers must consider whether other people or society could be harmed by a decision made, even if it is made for the benefit of an individual patient.
4. Justice: The principle of justice states that there should be an element of fairness in all medical decisions: fairness in decisions that burden and benefit, as well as equal distribution of scarce resources and new treatments, and for medical practitioners to uphold applicable laws and legislation when making choices.
A Closer Look: Case Study
One hypothetical case study involves a patient who has an ovarian cyst that, left untreated, will result in kidney failure. An operation to remove the cyst is the best treatment, but the patient is frightened of needles and is against the surgery that would require a needle to give her anesthesia. The doctor must work with the patient to respect the fact that she dislikes needles and doesn’t want the operation (her autonomy), and needs to find a solution that would prevent her from going into kidney failure, which is in her best interest (beneficence). Although the surgery is the best choice, forcing the patient to accept the needle would be harmful to her (non-maleficence). Finally, the doctor needs to consider the impact that the patient’s choices might have on others if she starts to go into preventable kidney failure, she’ll need dialysis, which affects other people who need the same treatment (justice). So before making the final decision the doctor must consider all four principles of health care ethics, which will help the physician make the choice that will have the best possible benefits for both the patient and society.
The Role of a Health Care Administrator
Health care administrators plan, organize, and oversee the functions of the health care facilities at which they work, as well as the other members of the staff who work there, including doctors and nurses. Thus, they play a vital role in ensuring that patients are receiving high quality and ethical treatment.
While health care administrators are required to have a bachelor’s degree to enter the field, a graduate degree will help set candidates apart and further advance in their career. A Master’s in Health Administration increases the knowledge and skills of people who are already working in health care administration or who are interested in entering the field. Instructors from a variety of fields under the wide umbrella of health care contribute their knowledge on health care ethics to create a practice-based program that will meet the challenges of today’s medical system head on.
Although doctors and nurses directly oversee each patient’s health, health care administrators play an important role in facilitating decisions about patient care, particularly when the situation is one that might contain moral and ethical dilemmas, such as genetic testing prior to birth or end-of-life care. As science and technology further increase the abilities of doctors and advance the field of health care, the role of health care ethics will change and only continue to increase in importance. Thus, it is vital that health care administrators be properly trained to meet the current and future challenges of ethically helping patients receive the best care.