Medical malpractice is a huge problem for any healthcare system in the world. To fix it, specialists in healthcare ethics and management must understand the nature of the reason standing behind negligent actions. Another field of valuable knowledge is the scholarship of ethics and its implication in healthcare. This essay argues on the example of death-resulted medical case that deontological ethics and shared decision-making can highly mitigate the number of malpractice instances.
The Iturralde vs Hilo Medical Center case provides a vivid example of violating core medical ethics principles. In general, the medical staff did not ensure the minimum standards of healthcare. The well-known surgeons’ mantra “do not harm” was highly violated during treatment (Runciman et al., 2017). In the text of the case, Dr. Ricketson, who operated on Arthur Iturralde, decided not to wait for missing surgery materials (Iturralde v. Hilo med. ctr., n.d.). Instead, the surgery was conducted by doctor’s improvisation without the necessary tools for that, which led to the patient’s death. It is immoral and incorrect to make such a decision, so one needs to create the logical ethical guideline for such situations.
It seems that the deontological understanding of ethics may be the quite effective model of constraints for surgeons. Österberg (2019) characterizes deontology by the fact that “it considers morally relevant certain properties of action the relevance of which cannot be explained by reference to the value of the outcomes of actions” (pp. 40-41). Thus, Dr. Ricketson did not have moral permission to operate Iturralde before the delivery of necessary elements. Even if Dr. Ricketson had been sure that the outcome of immediate surgery would be better than of delayed, the moral theory would have restricted any actions of possible harm.
Modern healthcare is becoming a more patient-centered and evidence-based field. The reason is that modern research shows that the involvement of patients in decision-making is associated with better outcomes (Alden et al., 2013). The most suitable model for physician-patient decision-making is described by Alden et al. (2013). The main idea is a constant attention to the patient decision aids. Alden et al. (2013) argue that “[patient decision aid] helped patients choose the treatment most consistent with their own values” (p. 396). It can be explained by a more active participation of patients that will introduce more accountability and transparency in relations with physicians. Dr. Ricketson was not allowed to decide without the mutual physician-patient understanding. In reality, Iturralde’s opinion was not heard at all, which is highly unfair and immoral.
To avoid cases similar to Iturralde’s death, medical organisations should implement policies of shared decision-making and accountability. Physicians should always tell the truth about their actions to patients, creating the link of honest communication. This may be achieved by the free access of patients to all the documentation. Physicians need to complete some new educational courses to understand that evidence-based research shows significant increase of healthcare outcomes when physician-patient shared decision-making is implemented. As for ethical guidelines, doctors should act in accordance with deontological ethics, the principles of which they should also learn from internal courses. The deontological ethics and open access to all documents will ensure the accountability of physicians to the public. In the situation of uncertainty, patients will always have an opportunity to consult other specialists with the use of documents. It is especially effective in the online era of modern society.
To sum up, the death of Arthur Iturralde provides the ground for the discussion of possible reforms in healthcare. The possibility of malpractice may be reduced by the clearly defined ethical guidelines and policy implementations. The main conclusions of the essay are that the deontological approach to ethics and physicians’ open-minded attitude toward patients are crucial for the effective work of medical facilities. The future study may address the creation of practical steps that through federal mandates may reform the system.
References
Alden, D. L., Friend, J., & Chun, M. B. (2013). Shared decision making and patient decision aids: knowledge, attitudes, and practices among Hawai‘i physicians.Hawai’i Journal of Medicine & Public Health, 72(11), 396-400. Web.
Iturralde v. Hilo med. ctr. (n.d.). Casemine. Web.
Österberg, J. (2019). Deontological ethics: Exposition. In J. Österberg, E. Carson & R. Sliwinski (Eds.), Towards reunion in ethics (pp. 27-59). Springer.
Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: A guide to getting it right. CRC Press.