The term health care is broad enough to cover an impressive range of services and practices, found in hospitals as well as special care centers and nursing homes. At the same time, some basic principles of the health policy are preserved in any kind of medical practice, constituting the principles of doctoral ethics. The language of ethics is one of the most important in health practice, and it should be noted that the principles of bioethics are universally applicable in modern medicine. The bioethical basics imply the simultaneous fulfillment of four principles, which include autonomy, benefit, non-harm, and justice. Two of these principles, autonomy and justice, are considered particularly relevant for the current discussion.
The principle of autonomy underlies patient-centered care and means the primary postulate of the will of the patient in caring for their health, exceeding the will of the doctor to intervene. The patient, as assumed on the basis of this principle, is an independent subject capable of making informed decisions; thus, the patient’s decisions are unquestioning. To the greatest extent, this concept causes conflict in the context of euthanasia, since it conflicts with the condition of bringing benefit to the patient and not harm (Kaczor, 2020). The condition of benefit means that the doctor must do everything possible for the patient to experience relief and receive help. Non-maleficence means that it would be counter-ethical for a doctor to harm a patient, thus violating the key principles of his profession.
Finally, the principle of equity in health care implies the ideal notion that people are born equal in their ability to receive health care. This notion of justice seems worthy and even slightly utopian in that it refuses the criteria of sex, gender, race, age, religious preferences – any categorizations that may lead to discrimination. It is the principle of justice that deserves special attention as the one most important in healthcare along with the autonomy of the patient. Only ethical attitudes that correctly understand justice as the absence of privileges on one or another external or social basis are able to advance medicine as a humanistic apparatus (Ogbogu & Hardcastle, 2021). Medicine should be a means of helping everyone and cannot be selective. At the same time, it should not suppress the will of the patient, and doctors should never make final decisions for the patient. Human freedom and their fullness in rights and opportunities is expressed by the principles of autonomy and justice. They deserve attention as the most valuable and humanistically important principles in health practice.
The principle of fairness also implies an inclusive policy in clinical trials. Scientific experience can be considered biased and inferior if it does not include a certain ethnic-age diversity and minority groups. This allows scientists to compose more complete clinical pictures of the course of certain diseases or, conversely, therapeutic interventions. It is important to note that the principle of justice in medicine also applies to the distribution of finances. For example, if there is a shortage of resources in a particular polyclinic, it is with the help of this principle that it is possible to adequately distribute the amount of money and other auxiliary resources. This makes the principle of justice related to the concept of fairness, which allows us to speak about a certain interchangeability of these words in this context. One can understand to what extent the doctor’s decision is ethical by asking an additional question – how fair it is, to what extent it does not deprive people or areas that require investment. Thus, autonomy, the independent right of choice for the patient, and the desire for justice for the doctor, should create a healthy balance that constitutes the most favorable atmosphere for the provision of medical care.
References
Kaczor, C. (2020). Disputes in bioethics: Abortion, euthanasia, and other controversies. University of Notre Dame Press.
Ogbogu, U., & Hardcastle, L. (2021). Bioethics and practical justice in the post-COVID-19 era. Bioethics: Developing World, 21(1), 31-35.