Ethical Issues in Health Care Reform

Ezekiel Emanuel has done considerably well in bringing out the issue of health care costs and the ethical consideration that go hand in hand with it. Ideally, by the fact that Emanuel an expert in healthcare debates, he has been able to able to identify the key issue that has been affecting the health care system of the United States. It is without doubts that the cost of health care in the United States has escalated in the past few decades. People have it rough in the bid to access health care. I agree with Emanuel that the most affected people with the high costs of health care are middle class and the people considered poor. As much as the cost of health care has been reported to be high, the United States government has tried the best to make sure that hospital and other healthcare facilities are offering quality services.

Contrary to the opinion of Emanuel, I believe that not all healthcare facilities within the United States need to be criticized because of poor and very inconsistent quality. Some hospital and healthcare professionals have acted professionals in providing patient care. Despite the challenges they encounter (in terms of finance) they go out their way in ensuring that patients receive the best health care there available.

Although the affordable care act since its inception has received quite a good share of praise as well as critics, it is right to say that it is the one that has laid the foundation for what Emanuel regards as ethics of healthcare.  Generally, the ACA was enacted to provide affordable health insurance and to make it available to more people. Since its inception it has created a state-run insurance exchange program from which patients who do not receive insurance covers from their employers they can research and apply for an insurance plan. It also provides consumers with subsidies aimed at lowering the cost of households in the United States. Secondly, ACA aims at expanding the Medicaid program to reach and cover adults with low income who were not covered by the Medicaid. Lastly, the goal of the law was to offer support to innovation in medical delivery methods which are responsible for lowering the cost of healthcare (Sommers et al., 2015).

In this sense, it is right to say that the ACA has revolutionized the health care systems in the United States. Hospitals, doctors, and pharmacists are working together in ways never experienced before. By recording all the patients’ medical records electronically instead of the paper way, service delivery in health care has seen a significant improvement. Due to the influence of ACA, health care providers are forming Accountable Care Organizations. These organizations coordinate patient care between doctors and specialist. Health status of the Americans has been on the rise since 2010. The insurance plan no longer excludes those with pre-existing health conditions. Annual and lifetime limits from previous plans are eliminated. The fascinating thing is that 60% of those who are eligible for ACA subsidies don’t even know it (Sommers et al., 2015).

For “Physician-Assisted Suicide Law”

There are a lot of debates on the issue of Physician-assisted suicide and Euthanasia where some people argue that in other cases one might procure an assisted suicide. By the fact that Samuel j. Aquila is an Archbishop it is expected of him to argue against physician-assisted suicide. The advocates of these points have often argued on the ethical consideration found in the situation that one is under so much pain and might need to secure assisted suicide. Although Aquila believes that no one has the right to take the life of a person despite the circumstances and some view physician-assisted suicide as a crime, I believe that the issue should be viewed in two dimensions.

First, in a situation where palliative care is affordable and available for the patient, there is no need for physician-assisted suicide. They understand the differences such as care and curative measures, as well as the effects of the two. There are several benefits to be derived out of palliative care. For the patient, this means relief from pain and the discomfort that is bound to follow due to the critical illness. However, such care is beneficial even for the family, as it provides a level of psychological support to everyone involved in this last stage of life of the patient. Typical palliative care involves stopping of curative options and only continuing those that can relieve various symptoms. Thus, proactive intervention in palliative care can allow for better life quality, good sleep, low pain, and less fatigue. This helps in the sense of well being for the patient. Thus, even with a lack of aggressive care, intervention can assist in enhancing the quality of life and also extend survival.

Second, if the patient is chronically ill and the pain is unbearable, there is no need for letting such a patient suffering from pain. Instead, their will should be granted and assist them with suicide. In as much as Aquila may call this unethical, I believe it is very ethical if certain guidelines are followed. These include veracity, justice, non-maleficence, beneficence, and autonomy. In the case of autonomy, a patient has the freedom to make informed decisions (Karnik & Kanekar, 2016). Medical practitioners are, thus, are expected to respect and honor the conclusion of the patient (Derse, 2016). Beneficence is also another principle that involves the duty of a person to do good (Koppel & Sullivan, 2012). It is mainly related to the nonmaleficence, which stands for the principle of not doing any harm. Not honoring the patients wish could cause more harm to the patient. There is also the principle of veracity, which refers to the duty of a professional to be truthful to their patients and ensure that they have sufficient information before they make their choices (Morton et al., 2017). Fidelity, on the other hand, is related to care virtue. It refers to the keeping of a commitment to a patient. Another ethical principle applies to the duty of any professional to act in a way that distributes both the risks and benefits equally. In this sense, it is right to say that administering a physician-assisted suicide is ethical as long as the above principles are followed.

Contra “Physician-Assisted Suicide Law”

It is true that certain states have legalized physician-assisted suicide. Being a complex issue, both arguments regarding physician-assisted suicide have strong points. Looking from the Mickey MacIntyre perspective, ending the lives of people with the terminal illness needs to be legalized. The main aim of assisted suicide is to end suffering to a patient. The proposal to legalize physician-assisted suicide is based on terminal illnesses. These are the ailments which make the patient lose hope for life. Some people go through severe pain and may wish to die instead of such suffering. Therefore, they should be allowed either to take their lives or be assisted in doing so. This will end their suffering and that of their relatives and friends. As such, saying that physicians should only be healers means that we do not have much concern for them. If healing is not possible and suffering is unbearable, then it is vital to shift the focus towards the patient’s wishes and help them end their suffering.

Another point is that the choice of when to die is a personal and a private decision. If one chooses to end their lives today, then a physician has no option other than to help them achieve their objective. With this, legalizing physician-assisted suicide will allow people to make such personal decision when their condition requires so. The fact that we have the right to choose all kinds of things in our lives means that we also have the right to decide when to die. This should be respected. Additionally, physician-assisted is economical. People may be spending large sums of money paying hospital bills and buying medication for patients whose death is imminent. With this, it is essential to take the best option that will reduce the wastage of resources. As a result, it is imperative to remember that healthcare involving individuals with a terminal illness is expensive. Therefore, assisted suicide will save money and it can be used in other things.

On the other hand, arguing based on Kelly Buckland perspective, I believe that legalizing physician-assisted suicide does not end suffering. It just passes it to others in a similar situation as they fear that they may be in line to have their lives seen as worthless. Legalizing physician-assisted suicide will increase pressure on people to kill themselves instead of fighting on. In addition to this, viewing suicide as a solution to some conditions undermines the willingness of healthcare professionals to do their job, show compassion, and address patients’ pain. It is essential to care for people for as long as they live and show that they have dignity and their lives matter.

Furthermore, encouraging physicians to carry out assisted suicide is against their code of conduct. It is understandable that when people go through severe pain and terminal illness, they may easily prefer to die. However, this should not be used as an excuse to promote voluntary euthanasia. Physician-assisted suicide is not compatible with their role as healers. Thus, it brings about severe ethical and societal risks. Therefore, if legalized, it may be extended to other vulnerable populations and increase the chances for passive. Therefore, many lives will be at risk as there may be no proof that the patient decided to die. Further, we do not want to be in a position to determine who lives and who dies.