Mark E Borden MD | Defining Ethical Issues: Key Considerations

 

1. Contextual Factors: Ethical issues do not exist in isolation; they are shaped by the medical, social, and cultural context in which they arise. Dr. Mark E Borden MD emphasizes the need to consider the broader circumstances that influence the dilemma, including the patient’s medical condition, the available treatment options, and any cultural or religious factors that might affect decision-making. For example, a patient’s cultural beliefs about end-of-life care may impact their willingness to pursue certain treatments, adding a layer of complexity to the ethical issue.
2. Legal and Policy Considerations: Many ethical issues in healthcare are influenced by legal or institutional policies that govern patient rights, medical practices, and professional responsibilities. Dr. Borden highlights that defining an ethical issue often requires understanding how these external factors interact with the situation. For instance, a physician might face an ethical issue involving a patient’s right to refuse treatment, but legal frameworks surrounding informed consent and patient capacity may also play a role in determining how to proceed.
3. Moral Uncertainty: Dr. Borden explains that ethical issues often involve a degree of moral uncertainty, where the right course of action is not immediately clear. This uncertainty can arise from competing ethical principles or from the unpredictability of medical outcomes. Defining the ethical issue involves acknowledging this uncertainty and being open to different perspectives. For example, in cases of experimental treatments, there may be uncertainty about the potential benefits or risks, which complicates the ethical decision-making process.
4. Ethical Theories and Principles: When defining an ethical issue, Dr. Borden advises healthcare providers to refer to established ethical principles and theories as a framework for analysis. The four main principles of medical ethics—autonomy, beneficence, non-maleficence, and justice—can help in identifying which values are at play in a given situation. For example, if a physician is grappling with a decision about resource allocation during a public health crisis, the principle of justice, which emphasizes fairness, may be central to the ethical issue.