Legal

Principle Medico-Legal Ethics in Medicine

In the last century, there have been several developments in medicine that have revolutionised the field of medical practice. This has made it possible to diagnose diseases faster and more accurately. However, as the new treatments and the field reforms, medical services experts face new legal and moral quandaries.

What do you mean by the term medico-legal?

The term medico-legal alludes to both medicine and law. It can mean the following things:

  • The study and application of medical and scientific methods as evidence in a legal case, e.g. paternity, cause of death, rape, etc. This is also referred to as legal medicine or medical jurisprudence.
  • Medical law : the part of law that governs legitimate medical practices.

The two need not be befuddled, although some legal cases can involve both. For instance, when a doctor is called upon as an expert witness in a malpractice case against another healthcare provider.

Principle Ethics in Medicine

In Principles of Biomedical Ethics, Tom L. Beauchamp and James F. Childress elaborate four principles that are primary for medical ethics:

1. Respect for autonomy

Personal autonomy is widely valued. Recognising its vulnerability in healthcare context has led to including respect for autonomy as a key concern in biomedical ethics.

This principle is brought up in conversations about confidentiality, fidelity, privacy, and telling the truth. Yet it is generally and strictly associated with the possibility that patients are to be permitted or enabled to make an autonomous, unbiased decision about the healthcare interventions they willingly take upon.

In spite of different patient safety guidelines and standards, less attention is paid to the ethical and legal aspects of this issue. The fundamental objective of patient safety in the health system can be studied under two aspects.

  • Functional: can be studied as the principal center which is its positive outcomes and advantages.
  • Moral: can be studied by considering the protection and promotion of humanity and human dignity.

Relational accounts encourage clinicians to consider patients’ autonomy in situations beyond decision-making. They prompt us to consider how illness and clinical practice can affect patients’ autonomy—positively or negatively—via their influence on autonomy capability and values and choices. The balance between allowing and enabling patients to decide (and, the balance between perceiving and supporting exercises of autonomy) actually needs careful consideration, but relational accounts should facilitate this.

2.Non-maleficence

All treatment involves some harm, even if minimal, but the harm should not be disproportionate to the benefits of treatment. The non-maleficence principle of medical ethics indicates that guaranteeing patients’ safety and forestalling any injury or harm to them is a significant priority for healthcare providers. Thus, it is the most emphasized component of the quality of healthcare services all around the world.

This idea reminds one that the primary concern when carrying out a task is to do no harm. Ideas of harm and benefit are shaped by setting. Thus cultural, economic, social, religious, political, and other factors tie into how non-maleficence and beneficence are utilized for moral independent decision making. In all cases, one must avoid activities that may be harmful (non-maleficence) and attempt to carry out the action that will benefit a host community (beneficence).

3.Beneficence

The principle of beneficence is the obligation of a physician to work for the benefit of the patient. It supports various moral duties to protect and defend the right of others, prevent harm, eliminate conditions that will cause harm, help persons with disabilities, and keep the patient out of danger. Thus, it refers to actions that promote the well-being of others.

The duty of professionals should be to benefit a party, and to take positive steps to prevent and remove harm from the party. This makes it vital to recognize two ideas under the general principle of beneficence:

  • Principle of positive beneficence: This principle requires providing benefits including preventing and removing harm from others (i.e. patients). It additionally incorporates the advancement of the welfare of others.
  • Principle of utility: This principle, in contrast to the first, requires balancing benefits and harms in moral life. This means that utility as a principle of beneficence mandates physicians and other health workers to painstakingly analyse, evaluate and promote those activities that carry more benefits to patients or the general public.

4.Justice

Justice is for the most part is interpreted as the fair, equitable, and appropriate treatment of people. Of the few categories of justice, the one that is generally suitable for clinical ethics is distributive justice. Distributive justice refers to the non-discriminatory, unbiased, and correct distribution of healthcare resources determined by justified norms that structure the terms of social cooperation.

When thinking about population level healthcare priority setting decisions, such as those made by the National Institute for Health and Care Excellence, good medical ethics expects considering three primary principles of health equity:

  • Cost-effectiveness (a part of beneficence)
  • Non-discrimination
  • Priority to the worse off concerning both, the current severity of illness and lifetime health.

Researchers as well as the autonomous bodies governing the medical law all around the world believe that these four principles represent a common morality and have given various arguments in support.

Some important legal terms for healthcare providers

Here’s an insight into a few important legally used terms that healthcare providers and administrators ought to know about:

  • Telehealth: The delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communication technologies.
  • Medical negligence: This is when a patient is injured as a result of negligent medical treatment. In such cases, patients can also seek compensation for this.
  • Proportionality principle: It demands that in weighing and balancing individual freedom against wider social goods, considerations should be made proportionately.
  • Health Maximization: A healthcare resource-usage philosophy, which gauges the economic value of different preventive measures and therapeutic interventions, inclining toward those that give the best efficacy. Under this methodology, the best therapy for the vast majority is liked.

References:

Author

Prachi Sinha

Dr. Prachi Sinha is an MBBS graduate from Smt. N.H.L Municipal Medical College, Ahmedabad. She makes her home currently in Ahmedabad with her family, a tiny undisciplined garden, and a growing number of incomplete baking projects. She has garnered much acclaim for her animal activism and adoption drives across Ahmedabad. When she is not working in the hospital, Prachi spends most of her time conducting online webinars for unprivileged women and watching her treasured Bollywood movies. An admitted food fanatic, she feeds her addiction to sushi by taking on her favorite sushi joints on Sunday afternoons.

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