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The relationship between a physician and a patient is professional, personal and social. The doctor has to follow some policies stipulated by the institution where he is based or by the professional ethics code. (Alpers 1999) Some of the common accepted principals of health care are, the principal of respect for autonomy which states that a patient is allowed to make decisions without influence.
It is also called the principal of informed consent, the principal of nonmaleficence which states that one should not cause any harm to a patient, the principal of beneficence which requires that the physician be a help to the patient and always try to remove harm from that patient, and lastly the principal of justice which requires equal allocation of scarce resources on equal patients. (Principles of bioethics 2008)
On the other hand, the patient has some rights as an individual, right to information about his health; right to express his demands as regards the course of treatment-when to terminate treatment and also a right to confidentiality of personal health information (Shimizu 2009). There arises conflicts for example between when to disclose the information about a patient and when not to do it.To solve such conflicts, there should always be an agreement between the patient and the physician. (Edward 2003)
But here is a case where a patient’s health information is required by the law enforcement agencies. It may be that they want to determine whether the patient committed substance abuse, they may want to establish the HIV status of a rapist, law enforcement officers may want to know the health status of an inmate, or many other reasons appropriate to them. Shall the doctor give out the information to the police against the wishes of the patient?
Shall he refuse to disclose the information? What if it is to the interest of the society? The law gives advice on such issues. For example the federal law allows personal health information to be released to law enforcement agencies in some cases even without the consent of the patient. The French law states that the physician has the right to decide whether to disclose or not even when the patient has given him or her permission to do that. (Sabina 2003)
Before the information is released to law officers, the consent of the patient has to be sought. Suppose the patient refuses such a proceeding, the doctor is supposed to maintain the confidentiality of that patient. But the law is supreme and the person might be a threat to the security of the public. The question is should you respect your moral principals or should you respect the law. Since the two are contradicting, a balance has to be determined in tackling such a dilemma. (Sabina 2003)
There are what we call moral principals and moral actions. Things like not lying to a patient and saving the patients life all the time under whatever circumstances are moral principals. It is also a moral principal to respect the views and decision of a person. It will require one to weigh between the two issues which are conflicting. Experience is required in such cases, but what will the young doctor do? Whatever she feels is appropriate? The personal experience one has outside a profession will always influence and affect the moral experience in the profession. (Edward 2003)
Whatever the case, our personal issues should not make us compromise our moral integrity. After weighing all the contradicting issues and determining the course of action without influence from within or from without, we are saved from criticisms by either a third party or from our selves. For example, when a doctor decides to disclose the information to the law enforcement agencies, you live up with the blame that you did not observe the ethical principles, you even criticize yourself. This will only happen if you did not strike a good balance between the two issues. (Edward 2003)
But if you had balanced the issues of patients right to decision and the moral principal to protect life in case the patient wanted to or harmed other people, then you can always comfort your self that you really care, and that is why it took time, and it was hard to make that decision. Somebody once said “we give honor to life not by always preserving life at any cost but by the pains we take when we make decisions that have the opposite effect.”(Edward 2003)
Alders, A. Commentary: Respect for patients should dominate health care decisions. Western Journal of Medicine 170 (5), 291, 1999. Web.
Edward M. Hundert. A Model for Ethical Problem Solving in Medicine, With Practical Applications. 2003.
Principles of bioethics. The place of principles in bioethics. 2008. Web.
Sabina Michalowski. Medical confidentiality and crime. Pg 65-72. 2003. Web.
Shimizu Tetsuro.Ethical principles in palliative medicine. 2009. Web.