Introduction
Emergencies, including natural disasters, present an ethical paradox for doctors who must do their best to save lives. Autonomy is one of the ethical principles that must be considered, allowing competent adult patients to make informed decisions on their medical care. Meanwhile, beneficence requires physicians to act in the best interest of their patients. Medical emergencies are often associated with scarce resources and may lead doctors to deviate from established ethical guidelines. This paper contends that physicians should adhere to the same ethical standards during major emergencies, guided by the moral principles of autonomy and beneficence.
Medical Ethical Dilemma Description
The emergence of natural pandemics, such as COVID-19, can be detrimental to the delivery of quality medical care (Haldane et al., 2021). In most cases, the doctors try to prioritize the patients in dire need of healthcare services. Moreover, the public health perspective is adopted to protect the interests of the affected community (Shammi et al., 2020). For instance, it would be significant to quarantine COVID-19 patients regardless of their desire to interact with their loved ones. Emergencies can pose significant threats to the provision of quality healthcare services, as doctors often face ethical dilemmas.
Application of Ethical Guidelines
Ethical guidelines play a crucial role when doctors face difficulties in making decisions during emergencies. For instance, the application of the principle of beneficence allows them to focus on saving the lives of their patients (Sawicki, 2022). Consequently, it is morally correct to prioritize critically ill patients over those with minor issues (Hsieh et al., 2023).
However, that does not mean that the ones with minor issues will not be attended to. Instead, the doctors adopt an approach that ensures the patients are treated and served based on the severity of their conditions. Therefore, ethical considerations make it easier for physicians to navigate difficult situations presented by emergencies.
Principles of Autonomy and Beneficence
The principles of autonomy and beneficence are crucial ethical guidelines in the medical profession. Although patients may at times be in vulnerable situations, it is their natural right to make informed decisions about their expected levels of medical care (Sarela, 2021). The principle of autonomy obliges doctors to respect patients’ decisions regarding the healthcare interventions they will or will not receive (Sellaiah et al., 2023). Beneficence is an ethical principle that requires healthcare professionals to always act in the interest of their patients. Beneficence and respect for autonomy are significant to doctors when faced with an ethical dilemma.
Different Ethical Guidelines Application
Although doctors have a set of ethical guidelines to follow when faced with dilemmas during emergencies, some of their decisions can be hurtful to patients. For example, in the aftermath of Hurricane Katrina, doctors and nurses had to make tough decisions that led to the death of some victims (Witter, 2022). Similarly, the problems associated with COVID-19 led to major rationing decisions in Italy (Cha, 2020).
The two scenarios presented the detriments associated with subjecting medical professionals to different ethical guidelines during emergencies. Although the measures taken were believed to be beneficial to the general public, the specific needs and rights of individual patients were infringed upon. Allowing doctors to operate under different ethical guidelines in the event of a major emergency can be risky to the principles of autonomy and beneficence.
Risks on Autonomy
Medical emergencies can compromise a patient’s autonomy, potentially giving doctors full control over their care. Patients in emergencies are often in distress and unconscious, and therefore cannot make informed decisions (Zanza et al., 2023). The healthcare givers and other stakeholders may have full control over what can or cannot be done to the patients. Failure to actively involve the patients in the decision-making process can encumber their response to the chosen medical intervention (Sellaiah et al., 2023). Similarly, doctors may decide to adopt an intervention such as euthanizing, which is harmful to patients, but to some extent beneficial in controlling the prevailing emergency.
Moreover, medical emergencies are often associated with restricted choices. For instance, the emergence of COVID-19 was countered with immediate interventions by governments and healthcare stakeholders. The urgency of the interventions made it difficult for victims to explore other alternative treatments available (Zanza et al., 2023). Instead, they were subjected to government regulations, including rationing of medical supplies and protective gear.
Restricted choices among patients risk their lives since they cannot access medical services that meet their unique needs (Sellaiah et al., 2023). Rationing medical equipment during medical emergencies harms patients, making the situation unacceptable. Deviation from the ethical principle of autonomy during medical emergencies causes harm to patients and consequent mistrust in the profession.
Risks on Beneficence
Patients are natural beings who deserve respect for their dignity, irrespective of the intervening situations. The ethical principle of beneficence requires physicians to act in a manner that is in the interest of their patients (Zanza et al., 2023). Emergencies can be risky to the application of the ethical principle. Resource scarcity during emergencies causes doctors to make the difficult decision of allocating them to victims, compromising their duty to treat patients with kindness and mercy (Haldane et al., 2021). While such action can be in the public interest, the lives of those whose access to the resources is limited are subject to death.
Medical emergencies such as COVID-19 are associated with an overwhelming patient load. In some areas, the number of doctors and nurses can be insufficient to meet the needs of the patients. During such situations, decisions are made based on limited time and resources while neglecting the patient’s right to life (Haldane et al., 2021).
Compromising the ethical principle of beneficence can lead to mistrust in the healthcare profession and high mortality rates. An increased number of deaths during emergencies can lead to emotional distress and other psychological disorders among caregivers and patients’ family members. Failure to provide quality healthcare, following the principle of beneficence, can also lead to unintended medical costs for the patients and their family members. Compromised beneficence is detrimental to patients and their family members.
The Solution to the Dilemma
Emergencies such as natural disasters are inevitable and must be approached in a manner that respects patients’ rights. Hurricane Katrina and COVID-19 are some natural disasters that presented ethical dilemmas to doctors. The approaches taken by the involved parties during the two disasters were detrimental to the moral principles of autonomy and beneficence.
The most significant solution to medical dilemmas during emergencies is strict adherence to ethical guidelines set by recognized institutions such as the World Health Organization (Nezhmetdinova et al., 2022). If a patient is in a condition that they cannot make any decision, the physicians should exhaust all the alternative means, including involving their family members. Meanwhile, when there are scarce resources, patients’ lives should be of priority when making any decision. Strict adherence to moral principles and ethical guidelines is beneficial to patients.
Conclusion
Natural disasters and other emergencies are associated with the issue of risk concerning autonomy and beneficence. Additionally, the situation can worsen patients’ health and financial conditions. Scarce resources, restricted choices, and overwhelming patient load can harm victims’ right to life and quality healthcare. While doctors and nurses may choose to protect the public from further damage from disasters, they should strictly adhere to ethical guidelines.
References
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