Modern medical ethics: Critical issue for the 21st century
“IF WE believe men have any personal rights at all as human beings, they have an absolute right to such a measure of good health as society, and society alone is able to give them” – Aristotle
Health systems as defined by World Health Organization (WHO) “all the activities whose primary purpose is to promote, restore or maintain health”. When we move into the 21st century, the promotion and protection of human rights is gaining greater momentum. The WHO constitution 1946 states “The enjoyment of the highest standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”
Patients, families and healthcare professionals occasionally face complicated decisions about medical treatments. These decisions may clash with a patient and/or family morals, religious beliefs or healthcare plan. In this risky situation medical ethics is not only considerate review of how to act in the best interest of patients and their family but also about making good choices based on beliefs and values regarding life, health, and suffering. In the past, only a few individual physicians devoted themselves to medical ethics. Beginning in the second half of twentieth century, the field undergoes explosive expansion and experts from numerous disciplines entered in medical ethics. The swift advances in medical diagnosis and treatment and the introduction of new technologies have created numerous new ethical problems, resulting in the maturation of medical ethics as a specialty in its own right.
Enormous development has been achieved in the medical field during the last few decades and more is projected in the following decades. Advances in diagnostic imaging and biological testing techniques as well as in medical forecasting based on genetic testing are ongoing. Advances in surgical and medical cures, organ and tissue transplantation, artificial organs, cloning, tissue culture techniques, molecular biology and information technology are reported almost daily.
“Modern Medical Ethics” is based on a concept derived from various disciplines, including the biomedical sciences, the behavioral sciences, philosophy, religion and law. Modern medical ethics is essentially a form of applied ethics, which seeks to clarify ethical questions that characterize the practice of medicine and to justify and weigh the various practical options and considerations. Thus medical ethics is the application of general ethical principles to ethical issues. The application of such an ethic is not specific to medicine but also relates to economy, law, journalism, and their like.
Medical ethics is now not only part of the curriculum in institutes of health professions in developed countries but also research institutes of medical ethics have been established at all levels. In developed nations the medical literature has proliferated, with numerous books and journals devoted entirely to the subject. In such countries common citizen is also vitally interested in this subject, and public lectures, newspaper articles, legal discussions and legislation on medical ethical issues are frequent. Within Canada, EU, United States, and somehow gulf countries, Modern Medical Ethics has emerged as a new professional. The individuals normally have specialized in one or more the fields of philosophy, ethics, law, religion and medicine, and serve as advisor in hospitals to physicians, patients and their families. They also effort to resolve difficult ethical questions posed to them by the medical team or by patients and their families.
Time has revolutionized the healthcare practice, and patients are more attentive of their healthcare rights. In Pakistan patients have now begun to question their physicians for their right to know their options, their planned treatment and possible obstacles. Because of the need in modern medicine to be knowledgeable in medical ethics and because medical students are exposed to medical ethical issues throughout their medical studies, it has become necessary to teach Modern Medical Ethics in colleges and universities of the health professions.
The Pakistan Medical and Dental Council (PMDC) curriculum noticeably advises the teaching of medical and healthcare ethics to medical students. However, like many other topics like management sciences, information and communication technology, health ethics is also not properly taught in most of the medical institutes of country. There is a need to develop an ethical culture in Pakistan and it is the best time that PMDC should make it obligatory for all medical institutes to include Modern Health Ethics in the syllabus. Similarly, medical universities and colleges across the country should take initiatives in training their graduates and postgraduates to prepare them for facing and managing modern ethical issues in clinical practice. The governments should also sensitize their own decision-making procedures in the light of ethics. Ethics, equity and respect for human rights must be incorporated in all aspect of health care.