In Hippocrates’ Of the Epidemics, the ancient Greek physician says that healthcare providers should have two specific and special objectives in mind when tending to patients: “to do good or to do no harm.” The former is an obvious call to heal the sick, tend to those in pain, and, in general, improve the health of humanity as a whole. However, the latter is often left by the wayside. It’s an afterthought, a leftover item for a different conversation.
Yet, it shouldn’t be. Even in ancient times, physicians were aware of the importance of, “do no harm.” The higher ethical calling inherently present in healthcare professions isn’t difficult to draw attention to, either. There are many, many different reasons that a strict code of ethics should be impressed upon all healthcare systems, the world over — including the vast, intricate system currently present in the United States of America. Here are a few of the most important reasons that ethics should be front and center in the healthcare discussion in the U.S. at this time.
One of the most obvious causes of concern, ethically speaking, is the fact that healthcare in America is largely driven by money. While individual doctors and nurses may be genuinely concerned about the health of their patients, healthcare administrators typically have to put the bottom line first.
That doesn’t even have to be seen as a slight, either. It’s natural that a person tasked with overseeing an entire hospital or doctor’s office would prioritize keeping the money flowing in — and by extension, keeping the lights on and the services available.
The challenge has to do with finding a balance between the administrator’s fiscal responsibility and the ethics of their profession. This is precisely why greater structure and oversight from a government level could help to provide an ethical litmus test from which they could make their financial considerations.
For instance, while it’s important that a hospital is paid for its services, that doesn’t excuse the fact that U.S. citizens literally spend twice as much on healthcare as other high-income nations, all while suffering from healthcare concerns like some of the lowest life expectancy and high infant mortality rates. The cost does not accurately reflect the service and thus, should be addressed in order to bring a sense of integrity to the situation.
Another obvious area of the medical world that has always struggled with maintaining an ethical code is pharmaceuticals. Pharmaceutical companies ride the line between being part of the medical system and being an exterior force of business that impresses their corporate desires and opinions onto the medical world. This is, naturally, why said companies have long been an area of ethical concern.
Take, for example, Johnson & Johnson’s popular diabetes medication Invokana. While effective as a way to address type 2 diabetes, in the years following the drug’s release, the FDA posted warnings that the drug had dangerous unforeseen side effects, including Ketoacidosis, kidney damage, blood infections, UTIs, pancreatitis, cancer, and even lower limb amputations. The issue was significant enough that a federal court was set up specifically to deal with the hundreds and thousands of victims of the company’s unsafe drug.
While the Invokana case is serious, it’s just one of many different incidents over the years where drug companies managed to push a medication to the market that clearly wasn’t ready to be made available.
Part of the problem is that clinical trial regulations are extremely complicated and always changing. This easily enables a company that may want to hasten the production of a drug to work the system to their advantage since practically nobody is fully aware of what the regulations are at any one given moment. Once again, the ethical concerns of mixing business with health are left open to the abuse of anyone willing to compromise on their morals in order to make a buck. This leaves a glaring need for administrative oversight and regulations in order to enforce a moral code onto those providing the medications themselves.
Finally, we have the location factor. The specific location of a patient can have a significant impact on the quality of the healthcare that they’ll receive. Whether you’re talking about countries — France, for instance, has significantly better quality healthcare than the U.S. — or rural versus urban districts, geography makes a difference.
Fortunately, technology is helping to meet this need already. Things like telemedicine are providing superior services to those who cannot access it, like inhabitants of economically challenged rural areas or even those in prison. However, the concern of healthcare professionals pursuing more lucrative or otherwise beneficial opportunities that are geographically limited is one that continues to create significant ethical issues when it comes to providing equal healthcare for all who need it.
Finding an Ethical Solution
Unfortunately, as long as the healthcare situation is left independent and heavily influenced by the private sector, it is open to all sorts of ethical violations and loopholes. That is why greater oversight is required to provide a set of ethical standards over the industry as a whole.
In addition, recourse must be provided for those who have fallen victim to medical providers who have “done harm.” The federal court for Invokana victims is a good example of this. If you find that you’ve been negatively affected by a medical procedure or medication, you should always look to see if recourse is available.
In the meantime, it’s important to continue to spread awareness of the ethical struggle that is currently raging throughout the medical world. This has a twofold effect of empowering both patients and medical professionals to continue to individually wage the fight for a strong code of ethics throughout the American healthcare system.