MORALS

Now that you know what ethics are and you have read through some of the terminology, it is time to take a look at morals. Socrates said, "The unexamined custom or tradition is not worth living". So, how do we define moral behavior.

Morality comes from the Latin moralis, meaning customs or manners. Morality seems to point to the relationships between human beings. Morality deals with human conduct and human values. Morality deals with how humans treat other beings so as to promote mutual welfare, growth, creativity and meaning. It is also to strive for what is good over what is bad and what is right over what is wrong. Taken one step further, a moral system should contain certain guidelines that can be used to check for ethical correctness.

 

For our purposes, we will choose the following five values to review:

1. Value of Life

2. Principal of Goodness or Rightness

3. Principle of Justice or Fairness

4. Principle of Truth Telling ( Honesty)

5. Principle of Individual Freedom

 

The value of life guideline says, "Human beings should revere life and accept death". This means every life, not just the lives you choose to place value on.

 

The principle of goodness or rightness includes:

1. Beneficence - to promote goodness over badness and to do good

2. Nonmaleficence - to cause no harm and prevent harm

 

But, how do you define "goodness" or "badness", "right" or "wrong"?

For goodness, we could use the terms happiness, pleasure, harmony, life, freedom, honor, etc.

For badness, We could use the terms pain, lack of excellence, unhappiness, etc.

 

The principle of justice or fairness deals with the "fair" distribution of good and bad. Here are some questions you can ask yourself. How should this or how is this done in the medical profession? Who should be treated fairly? Should all patients be treated fairly? Does a "guilty" patient deserve different treatment? Can you be objective?

Now that you have asked yourself these questions, we will take a look at how this affects the medical profession. We will discuss several areas involved with this principle.

 

Triage

Have you ever heard the term triage?

Triage is the prioritization of patients for medical treatment. It is the prioritizing of sick or injured people for treatment according to the seriousness of their condition or injury. For example, when a patient enters the emergency room he or she is taken to triage where his/her medical situation will be evaluated. After he/she is evaluated, treatment can begin. Triage really comes into play when there is a major incident that has occurred. There has to be a way to decide which patients will be treated first and which ones will have to wait. If any of you have seen the movie Pearl Harbor, there is a great example of triage in that movie. When the bombs hit Pearl Harbor, there were too many victims to be seen and treated. Many healthcare workers were assessing patients and deciding what treatment they would receive. The patients were triaged in three ways:

1. Those who are likely to live

2. Those who are likely to die regardless of care

3. And those that immediate care might make a positive difference in the outcome

Those who were likely to die regardless of care were marked and left to die. The others were treated.

 

The Lottery System

For the lottery system, names are drawn to see who will receive treatment. For example, if 17 people need dialysis, but there are only slots for 10 people, how do you choose who will receive the dialysis. How do you choose between a housewife and mother, a lawyer, a doctor, an executive, a member of the clergy, a teacher or a laborer. All of these people are equally deserving of the treatment. So, their names are put in a drawing and the ten names that get pulled out are chosen to receive the dialysis treatment. This is considered the just and fair way to choose who will receive treatment because, with a drawing, they all have an equal chance of obtaining the good.

 

Save Doctors First

For saved doctors first, in an emergency situation, medical professionals who can be put back into service after receiving medical attention should have first priority. Then, patients who can, with some certainty, be saved should be next.

 

There's one other question I would like to ask you. Why is AIDS reported anonymously, but leprosy or hepatitis are reported with names? Can you answer this?

The reason AIDS is reported anonymously is because there is a stigma connected with AIDS. People must understand what it means to have HIV and AIDS. There are laws that protect those with AIDS because they could lose their jobs, societal status, friends and family if their condition is known. As healthcare professionals, we do not have the right to know if the patient has AIDS unless the patient decides to tell us. This is why you should use universal precautions on all patients.

 

The principle of truth telling is the basis of meaningful communication. Here are some questions you can ask yourself. What happens to relationship that does not embrace this principle? Is the relationship meaningful if it is surrounded by lies? Do you think it is ever okay to omit the truth?

Lying is an intentionally deceptive message in the form of a statement. Lying by omission, involves the not stating of certain information that is vital to a decision, relationship or other important human activity. It is appropriate for us to follow the old saying, "honesty is the best policy".

 

With the principle of individual freedom, you to choose how to be moral within the framework of the four other principles. It also says that everyone deserves freedom of choice--- including your patience.