All hospitals are governed by the ethical decisions that are made by a body of individuals constituting the ethical committee, and it is these decisions that are taken into consideration whenever there is a conflict within the hospital. However, it is an unavoidable fact that very often, patients and their families ask this committee to either take action, or remain silent and inactive. One must remember the important fact that even the bets hospital in the world may not have all the resources available on demand at any given time, and this, more than anything lese, gives rise to conflict in a typical decision making process.
The ethics of the decision, the moral principles behind it, and the questions of who exactly would benefit from the decision; is it really essential to resuscitate a patient who is near death for example, and thereby spend precious resources on the patient who could never hope to have a life of quality anyway? (Hospital ethics board sharpen decision making 2005) In recent years, a typical hospital has become encumbered with making the ‘end of life’ ethical decision whenever needed.
In other words, the decision of whether to continue treatment for a loved one, or to withdraw it and therefore end his life peacefully is one that families, patients, and more importantly, medical personnel within a hospital are faced with. Medical personnel, especially, would be forced to keep in mind the ethical principles behind the medical profession when making this major decision, without giving way to conflict of any kind. In recent times, a program was organized jointly by the Division of the United States Studies and the Global Health Initiative so that discussions on the ethics behind the end of life decision could be discussed.
A conclusion was reached, that one must keep in mind who the decision maker is, how he had been appointed as the decision maker, and by whom, how to prevent the conflicts that may arise form his decision, and how to resolve them, should they arise. In most cases, the experts found that the patient, if he was mentally capable, could play the role of the decision maker, and in case he was mentally incapacitated, then he could appoint a surrogate decision maker in his place, an individual who is close to the patient, and who has absolutely no vested interest in any particular outcome of the decision being taken.
Raphael Cohen-Almagor, one of the participants in the program, stated that it was important that medical personnel recognize the fears of the patient and his family, and also that they undergo training in ethics before they complete their studies. This would help in convincing the patient or his family that the decision they were attempting to make was the right one, and on that would serve the patient well. (Reed, Acacia 2008) As mentioned earlier, a hospital would have to maintain a perfect balance between the resources that it has available, and the demand for the available resources.
A hospital would have to keep in mind, at all times, the fact that its decisions must be ethically appropriate, with no compromises. Maintaining an ethical framework upon which to base all major decisions would help, and one could consider these issues for the purpose: on what must the ethical standards be based, and, how must one apply these ethical standards that one makes? Experts state that there may be several kinds of ethical standards: a utilitarian approach, a rights approach, fairness and justice approach, the common good approach, and the virtue approach.
While the utilitarian approach emphasizes on the principle that come what may, an ethical decisions must prevail to bring in balance of good over harm, the rights approach considers the rights of the patient, based on basic human dignity, so that he may be able to choose freely and make his decision. The fairness approach considers Aristotle’s ideal that all human beings must be treated equally, and that they must be treated fairly based on accepted standards, while the common good approach states that since life in community is good, one’s actions must contribute towards the fact.
The virtue approach keeps in mind certain time tested dogmas that state that ethical actions must remain consistent with certain ideal virtues. (Velasquez, Manuel, Moberg, Dennis et al 1988) To conclude, it must be said that in the making of any decision, one may take any of the approaches detailed above to make what is known as an ‘ethical decision’, a decision that would help one to decide what is ethical, and what is not, even if it may be true that not everyone would agree with the principles upon which the decision is based.
All the facts involving the ethical decision must be considered, including the persons involved, their stakes in the decision, and so on. Nevertheless, if one keeps in mind the principle that no matter what the decision, it must be based on bringing the greatest balance of good over harm for the individual, then the decision would be an ethically and a morally right one.
References
Reed, Acacia (2008) Ethical decision making at the end of life United States Studies retrieved August 26, 2008 from http://www. wilsoncenter.org/index. cfm? topic_id=1427&fuseaction=topics. event_summary&event_id=303954 Manuel Velasquez, Dennis Moberg, Michael J. Meyer, Thomas Shanks, Margaret R. McLean, David DeCosse, Claire Andre, and Kirk O. Hanson (1988) Framework for ethical decision making Markkula Center for applied ethics. Retrieved on August 26, 2008 from http://www. scu. edu/ethics/practicing/decision/framework. html Hospital ethics board sharpen decision making (2005) Religion link Retrieved August 26, 2008 from http://www. religionlink. org/tip_050822. php