ethics in healthcare

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Table of Contents
TOC o “1-3” h z u Introduction PAGEREF _Toc506569010 h 2Ethics in medical practices PAGEREF _Toc506569013 h 2The theory of welfarism PAGEREF _Toc506569014 h 4Welfare economy and healthcare PAGEREF _Toc506569015 h 4The market mechanism moral perspective PAGEREF _Toc506569016 h 5Tenets of utilitarianism PAGEREF _Toc506569017 h 5Utility concept PAGEREF _Toc506569018 h 7Conclusion PAGEREF _Toc506569019 h 9Works Cited PAGEREF _Toc506569020 h 11

Ethics in Healthcare
Introduction
In healthcare, there are two moral dichotomies: deontology versus consequentialism, and individualism versus collectivism. Any time a physician is facing a dilemma in choosing between one or many, he or she must resort to the moral principle of promoting the good of the highest number or opt for the principle of maximizing utility. Utilitarianism is a creed that accepts as the basis of morals, in other words, the greatest happiness principle. The principle of utilitarianism holds that any act is correct in proportion as it tends to stimulate happiness as well as wrong as the actions have a tendency to yield the reverse of happiness. This implies that it embraces the four concepts in regards to health care that is maximization, consequentialism, welfare, and aggregation. This piece of writing analyses the ethical implication of applying the principle of utilitarian in healthcare decisions and at the same time illustrate how they relate to the welfarism concept (Mack 68).

Ethics in Medical Practices
Despite the fact that medicine is a cost-intensive science, it is also a limitless art concerning health economics. Today we are living in a swiftly changing world. This implies that every advancement in the medical field creates a new need that never existed. With technology, physicians have an infinite capacity to perfect their job execution. The implication is that physician can perform expensive interventions for their patient if only their patient need remains unfulfilled. A somewhat traditional physician’s stance is that every patient is an isolated universe. When a physician is in a situation demanding a competition for scarce resources, such a physician would plead the cause of the one patient by all means. In this case, the decision involves more than his patient’s interests. The result is embracing a commitment to public health amongst a myriad of other variables (Kukla 40). The involved physician, therefore, has to recognize that unrestrained advocacy of a single patient’s interest might auger well economists’ perception on what is the most advantageous policy for the public.
Characteristically, medical professionals deplore scarcities. A considerable number of the medical professionals are mostly unprepared for the principle of intransigence in regards to their duty for the patients (Moulton et al. 86). But, in case of a decision that involves several patients, availing more labor, medication or even expenses for just a single patient would imply less for the others. Through his competing loyalty, such a physician stumbles into a decision-making mode involving a choice between the many or the one patient. The underlying constraint is the commodity fitness. For instance, in cases that involve renal dialysis, the prioritization poses an ethical decision. If a patient gets treatment denial, he or she may succumb to death. The decision relating to public health is usually ambiguous and involves conflicting ethical principles. Some ideas such as human rights, efficiency, individual choices, and equality are commonly invoked. However, they do not get enough attention. The implication of this is that as the practice of medicine evolves, so should related medical ethics (Mazur et al. 100). In it, philosophy utilitarianism is the welfarist application of the principle of utilitarianism to health care. It requires a prior understanding of the theory of welfarist as explained by economists. Economics and ethics often overlap since they both deal with the correctness and wrongness of people’s behavior. Ethics deals with the wrongness and rightness of human actions and are rooted in human nature and reason.
The Theory of Welfarism
The theory is, at the very basic, built on four tenets namely consumer sovereignty, utility maximization, consequentialism as well as welfare. In regards to consumer sovereignty, the maxim is that a person is the best evaluator of his welfare. Utility maximization represents the behavioral proposition chosen rationally by an individual. However, it does not address the morals of choice. On the other hand, consequentialism holds that any choice or action should be judged exclusively with regards to its outcomes. Welfarism holds that the goodness of resource allocation is measured by the level of utility in a situation. Else, it is gauged on basic on welfare. All the four tenets dictate that a policy is evaluated independently in regards to the resultant use attained by individuals following their own assessment.
Welfare Economy and Healthcare
Welfare economy can be defined as the normative economic framework analysis (Culyer 40). Welfare economy studies the overall well-being and efficiency of a society founded on the alternative allocation of resources. In regards to healthcare, welfare economy attempts to address questions such as; through which ways can one know if the healthcare market is efficient? Does the free market favor healthcare? Is the general public getting what they demand? How can we know if people are paying more for their healthcare? In modern welfare, two elements occupy a central place. These are Pareto-optimality and perfect market role.
The Market Mechanism Moral Perspective
The language of “value” and “freedom” is invoked by justification in advocating the market as an economic mechanism (Sen et al. 48). This implies that the market system is perceived as an arrangement through which the public is free to choose. Freedom here is perceived as the free will to act autonomously in making a choice on desired health services. In such a case, the achievement is the individual health state and the freedom that a person has come through having high income enough to afford specific health services above and over the “decent minimum” level of health care provided to such an individual via social security system. The theory of neoclassical welfare operates on two premises. First, it makes the assumption that each person knows what he or she wants and it is best that every person gets what they want. This implies that people obvious preferences are presumed to be knowable. The principle of Pareto optimality is the second premise. It holds that a community is better off if all individuals become better. The principle is seen as a good thing as it is non-controversial. However, it does not provide a full insight in regards to social choice (Bonvin 54). In matters relating to health policy, it may appear that industrialized countries believe in the principle of Pareto. In most cases, these nations allow their people to spend their own finances for additional health services beyond the government-sanctioned packages. However, the reality is society rarely tolerates big differences in access to healthcare.
Tenets of Utilitarianism
Other than welfarism, utilitarianism has two other concepts. As a theory of ethics, it gauges actions and their eventual consequences. Thus, it is consequentialist. According to consequentialism, the correct thing to do is maximize certain measures of collective or overall welfare. Consequentialism specifies a given structure for ethics. That is, morally correct acts are determined by a non-moral value that is produced by performance be it pleasure, health, knowledge or any other. The value is termed as non-moral since it is the general objective of human strife. Aggregation is the second concept that it embraced. Aggregation holds that the collective welfare is the sum total of individual welfare. For the purpose of this discussion, utilitarianism is a term that refers to the ethical theory that that uphold only one principle of ethics- “the principle of utility.” The principle of utility emphasizes that we must in all circumstance produce the utmost balance of value as compared to disvalue for all affected.
In regards to healthcare, the thinking of utilitarian stipulates that whenever a physician is presented with a choice between different yet equally efficacious approaches of treatment, the benefits of the patient must be maximized while minimizing risks and cost. Any other method that does not strive at maximizing the benefits would be regarded to be unethical. Conversely, theories concerning healthcare resource management in a manner that maximizes quality and quantity of public’s lives is referred to as neo-utilitarian. Because of such substitutes “pleasure and happiness” with “length and quality of life.” In other words, it may be termed as welfare maximization instead of happiness. All the same, the underlying principle is the same. In the event that available resources are insufficient to maximize the health of all the people, the rational and right course of action is to make the most of the health of the whole population. As far as utilitarianism is concerned, human action must be morally assessed in relation to their production. But controversial on the criteria to use and the values that could be produced in any particular instance? According to utilitarians, we must consider the production of what is intrinsically valuable compared to what is extrinsically valuable. The intrinsic value is what a thing has “in its own right” as we enjoy while passing the value for its own sake rather anything else life produces. Other than health, another example of intrinsic good may include consciousness, life, satisfaction, freedom, and peace amongst others. Intrinsic values are essential to a range of ethical judgments. According to consequentialism, whether an act is morally wrong or right has determined if the consequences of the action are intrinsically healthier compared to other actions performed if under similar situations.
Utility Concept
The rule and act of utilitarianism agree that the objective of molarity is to serve the common goal of the society by maximizing its utility. From the perspective of Act utilitarianism, a morally right action is the one that maximizes social utility in a given situation. On the other hand, Rule utilitarianism views morally right action in two steps (Bales 258). First, the moral right rule must be defined as an ethical rule whose acceptance will automatically maximize social utility in the same situation. The next step is to define morally right action as an action that complies with the moral rule. According to Act utilitarianism, a physician or a patient should act in a way that promises to contribute utmost happiness. That is, considering all the result of all possible actions and taking the best action. In regards to act utilitarianism, the moral of an individual action should be judged based on the overall consequences of the action. The only challenge of Act utilitarianism is the dilemma on what one should do now? On the other hand, rule utilitarianism is used to justify the actions and is in turn justified by utility principle.
Applying utilitarian approach in healthcare makes it necessary to analyze the situation. This enables health professionals to decide on the best overall consequences. In regards to health care, consequences of an action are the outcomes of care. Healthcare outcomes can be understood differently. First of all, there is a possibility that they can be equated to the state of health that is in line with individual needs. Secondly, they may be viewed in the light of maximum health benefits or gains. Lastly, the healthcare outcome may be understood as the degree to which the health gap is lessened. Of all the three, the common interpretation is the outcome of meeting the needs of an individual. The reason why this is the common interpretation is that the health professionals work with people and are often in the business of making these individuals better health wise.
The primary objective of any physician is to help the individual patient improve their health by addressing their specific needs (Kaplan 83). The effectiveness of the treatment is often measured by the impact of the treatment on an individual’s well-being. In regards to this fundamental task, nevertheless, there are other views in regard to medical practices that shift the focus of the outcome an individual patient to the patients’ population. Even then, the main objective is to meet the different needs a patient presents to the physician. At one moment, it is possible to accord individual lives less value as compared to statistical lives. By the use of Act utilitarianism, it is possible to evaluate benefits and risks that are an outcome, and the cost of providing, or not, treatment to a patient. In each case, the effort is on ensuring maximum utility or achievement of health benefit. It is obvious that this would lead to a state of inefficiency as a great deal of time would be spent on deciding if to attend to an individual patient. Usually, it is impossible to make this evaluation due to lack of information. Applying utilitarianism would mean using a huge amount of information as well as foreseeing all the possible consequences of each action. Both delayed and immediate, intended and unintended. Each health professional in such a case is supposed to be impossibly neutral between patient interest and his own, the patient’s friends and relatives as well as hospital management and anyone else involved in the care of the patient directly or indirectly. This implies that act utilitarianism makes every person a law unto herself or himself. Act utilitarianism assumes that the physician’s moral intuitions are infallible and that he or she has more theoretical and factual knowledge of a different sort as well as more prodigious capacity to evaluate the consequences as compared to anybody else.
On the other hand, rule utilitarianism does not expect acts evaluation and predictions. Instead, rule utilitarian recommends a physician follow familiar ethical rules. It values inbuilt habits that are against individual inducement of deeming own case as exceptional. In this way, it saves emotional energy and time that a physician may require agonizing each case. Adherence to ethical rules improves the ability of health professional in the prediction as well as in the coordination of a joint operation on a patient. Even though it is generally agreeable, sensible moral norms promote the interest of the society alongside individual interest. Utilitarians expand it further. Utilitarians have the perspective that the only rational basis for a physician to comply with the moral norms is the benefit it provides for them and the society. The assumption made is that in regards to ultimate analysis, health professional has only two basic concerns. The first one is their own well-being, and the other one is the well-being of their patient. The theory of utilitarianism is founded on the assumption that the interest of humans, despite their role in the society, is based on abstract values. Such values may include fairness, justice, and equality among others. The main focus of act utilitarianism is the social utility of the individual physician’s action while rule utility mainly focuses on the social utility of moral codes and rules (Williamson 180). Therefore, rule utilitarianism is the perspective that a morally right action complies with the optimum moral code. On the other hand, optimal moral code yields the highest social utility if it were to be followed.
Conclusion
In healthcare, there is involved a lot of considerate decisions resulting from well-researched factors. This, usually, is in a bid to enhance the operational ethics of a medical practitioner. In this swiftly changing world, physician and other healthcare professionals are facing numerous challenges in regards to an ethical dilemma. Conflict ever exist between physicians and the patient in matters regarding the best course of action. While health services, physicians, medical ethicist and researchers have advocated for rule utilitarianism that supports shared decision making. In the provision of healthcare services in the mainstream medical services, very few if any, the physician has successfully incorporated rule utilitarianism in their practice. The main thesis of welfarism and utilitarianism emphasize that ethics must ensure that lives go well. In his writing, John Mill defends welfarism with the help of a hedonist approach. He stresses that happiness is desirable to the end. Any other thing is desirable just as a means to the end. However, his argument is subject to critiques since there is more to welfarism other than ensuring life goes well. Welfarism can be viewed as a theory of monistic of the good. This because it asserts and promotes one kind of value.
According to monism, all things, irrespective of their variety and quantity, can be unified to one as represented by health or utility. The paper has outlined the main characteristics of utilitarian exploring them with regard to consequence they have in healthcare. The paper has also explored the following characteristics of utilitarianism welfarism, consequentialism, utility maximization as well as aggregation and consumer sovereignty. Further, the paper has also outlined the theoretical underpinning of the above characteristics while illustrating them in light of rightness and wrongness of decision making in matters regarding the health status of individual patients. The paper concludes with an outline of the utility concept and differentiating between act utilitarianism and rule utilitarianism and emphasizing the importance of adopting the rule utilitarianism in medical practices.
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