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Wednesday, April 25, 2012

An introduction to clinical ethics

By Finley R. Newton

Clinical ethics, also known as medical ethics, is a group of moral values which applies to the practice of medicine. Not just applied to patients but other staff members, too, ethical values and judgements can be both practical and theoretical/philosophical. Helping to establish a good, ethical practice of medicine are moral values such as honesty, compassion, trust, commitment and respect.

Four main principles which are often expressed in health care books are to respect autonomy (the rights of self-determination), beneficence (the promotion of the well being of others), non-maleficence (to first do no harm) and fairness. However, whilst these principles in theory reflect what clinical ethics are about, some in the industry feel they do not quite reflect the reality of clinical settings.

Instead, health care book Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine has identified a slightly different set of four principles - medical indications, patient preferences, quality of life and contextual features - which is explained by: "Although the facts of each case differ, these four topics are always relevant."

Whether a medical professional chooses to use the first or second set of moral principles, or a different set of their own, the same ethical concerns and issues are dealt with by them on a day-to-day basis. Some classic examples of clinical ethics include euthanasia, confidentiality, informed consent, conflicts of interest, cultural concerns and communication. All require a medical professional to consider either of the sets of moral principles, and to answer them with the interest of the patient in mind.

As mentioned, clinical ethics is not just about the patients; it can also concern members of medical staff, too. One question clinical ethics may include is 'When should you report a colleague's error?' But whatever moral or ethical decisions have to be made in a clinical setting, they must be done within the social, economical, legal and administrative context in which the case occurs.

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