Ethics of Medical Conflict

The alliance between the physician and the patient/family presents a source of significant healing power in the healthcare sector. Indeed, working together provides the chance to considerably increase the health status as well as the quality of life for the involved parties. In fact, the relationship between the parties is only beneficial when it involves specific and important obligations by both the physician and the patient/family. However, the relationship is not always smooth as evidenced by the number of conflicts between the parties. In fact, the issue is ranked as one of the biggest ethical challenges to the healthcare sector in the modern world. Normally, medical conflict between the physician and the patient/family emanates from disagreements in decisions concerning the treatment of the patient. Surprisingly, each of the parties believes that their decision is in the best interest of the patient therefore compounding the conflict further.

Medical disagreements between patients and doctors are better off avoided by both the physician and the patient for their complexity. Currently, the patient is allowed to make a treatment choice that is not in line with the physician’s recommendation even when the choice may result in the patient’s death. Conflicts in the health care sector present a very sensitive subject of ethics and morality. Besides patient and doctor conflicts, some scenarios may involve the disagreement between doctors and the patient’s families further compounding the situation. Although the issue of medical conflict rarely gets wide media coverage, it forms a major moral and ethical dilemma. Perhaps the reason for the low media coverage is the fact that most of these conflicts occur in private. In cases where children are involved as the patients, the conflicts happen between the healthcare providers and the parents. Normally, the families may want to prolong the life of their loved ones in decisions involving end of life scenarios (Cavalieri, 2011). In contrast, however, the doctors may feel that continued treatment in aggressive forms is a torture to the patients. In addition, disclosure of the issue by the doctors increases the anger in the families thus entrenching their position even further.

The lack of consensus between the parents and the health care team may lead to more suffering to the patients as the disagreements may go on for months. Moreover, the parents and other family members may feel judged and unsupported thus expanding the detrimental effects of the stalemate. While doctors are guided by professionalism in making their decisions regarding the choice of treatment for the patients, families are not. In fact, it is true that most family members are guided by a protective instinct, hope and a background of both religious and cultural beliefs (DesAutels et al, 1999). The disagreements between families and healthcare practitioners are not restricted to the incidence of children patients. Rather, they may occur in a wide range of contexts including surgery, family medicine and so on. Despite these revelations, medical conflict does not receive much attention thus raising concern on the commitment of the actors to bring it to light.

In solution of medical conflicts, it is important to realize that both parties are interested in advancing the best interest of the patients and their views should thus be considered equally. However, some studies have analyzed the general perception that parents are the most appropriate agents when making decisions about their children. While doctors agree and accept that the parents are best suited to advance the best interest of their children, they do not always agree with the choices made afterwards. In some cases, acting in accordance with the principle of valuing the opinion of parents may collide with the medical motive of reducing pointless suffering to the children (Goold et al, 2000). In such cases, the ethical dilemma involves a conflict between the autonomy of the parents in making decisions regarding their children and the principle of nonmaleficence which the doctors must respect. The best way to address these cases is to treat the scenarios individually and not generalizing the solution of such instances. In so doing, the doctors can assess the cases independently and therefore avoid any form of bias in solving the conflicts.

The law assumes that the parent has the direct authority of making treatment decisions for an incapacitated child. However, it outlines this authority to limit their scope to only decisions that are in the child’s best interests (Breslin et al, 2005). The solution of these disagreements depends on the specific cases and the expertise of the physician in explaining the benefit of the decisions to the parents. It should be remembered that just like the parent, the doctor also thinks that their choice of treatment decision is in the child’s best interest. The ethical dilemma is not unique and is often one of perception just like most issues in medical ethics. In cases of disagreements, the doctor must try and determine why there is a disagreement in the first place before making any attempts at solving the dilemmas. All along, the doctor must recognize that both the parent and they have the interest of the patient at heart and both decisions must be regarded with importance even when they appear insensible.

Normally, resolution of medical conflicts is often a matter of approach and the probability of achieving a positive solution depends on the approach adopted. The doctor must not only understand both the patients and the family but must have basic ethical principles in mind. In this respect, the physician must first assure the family that they are acting in the best interest of the patient (Field & Lo, 2009). Normally, most families assume that the physicians make decisions that favor the position of their hospitals and do not understand the patients or their family’s interest. Stressing the fact that the patient’s life means a lot to them is therefore important in resolution of such conflicts. The principle of beneficence comes in handy as it helps the physician to promote the welfare of others at all time. In addition, the ethical principle of nonmaleficence restricts the medical practitioners from causing any needless harm to others.

Besides practicing basic ethical concepts in the course of their work, the medical practitioners should acknowledge that decisions regarding patients may have lasting implications for the family (Field & Lo, 2009). This knowledge helps in assuring the patients that the physician is genuine and has the interest of the patient at heart. Although simple in theory, these steps are important in breaking down barriers between the two parties thus making the process of solving medical conflicts smooth and simple. In addition, the medical practitioner should state that their decisions are broader and objective in both professionalism and morality. Addressing of these points ensures the achievement of a collaborative approach between the parents and the medical practitioners.

 

References

Breslin, J. M., MacRae, S. K., Bell, J., & Singer, P. A. (2005). Top 10 health care ethics challenges facing the public: views of Toronto bioethicists. BMC medical ethics, 6(1), 1.

Cavalieri, T. A. (2011). Ethical issues at the end of life. The Journal of the American Osteopathic Association, 101(10), 616-624.

Goold, S. D., Williams, B., & Arnold, R. M. (2000). Conflicts regarding decisions to limit treatment: a differential diagnosis. Jama, 283(7), 909-914.

DesAutels, P., Battin, M. P., & May, L. (1999). Praying for a cure: When medical and religious practices conflict. Lanham, Md: Rowman & Littlefield.

Field, M. J., & Lo, B. (Eds.). (2009). Conflict of interest in medical research, education, and practice. National Academies Press.

 

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