Business Ethics and Health Care

Clinical Health Care Ethics

These are issues that deal with the practice of clinical medicine that physicians and their patients encounter as they work together to diagnose and receive treatment, respectively, for the disease. For example, who has the right to keep or stop the lifesupporting devices? Does a badly wounded patient have the right to refuse medical care? Should euthanasia be considered legal? Who is eligible for an organ transplant, and how should the decision be made? Should the health care system encourage assisted reproduction or abortions?

Scientific Bioethics

This relates to the ethical questions associated with medical progress. For example, should humans be used as experimental research subjects? Should genetic and neuroscience research be allowed to progress? Are cloning and stem cell research ethical? Should the use of randomized trials—that is, studies in which the patient is randomly assigned to either the experimental or the control group—raise ethical problems?

Cultural Ethics

Does the fact that there are different cultural norms for ethical behavior imply that all ethical norms are relative to the cultures in which they are found and are valid only in that time and place? Does it assume that there are no universal ethical norms that transcend the borders of culture, tradition, and history? This happens more acutely when persons from one cultural tradition encounter the health care of another culture. For example, how do people of a particular country view the authority of physicians? How do people of specific religious denominations feel about abortion or about life support technology? Should a doctor inform a patient that he or she has cancer, even if it is inappropriate according to the patient's culture? How should a gynecologist from a Western country react to genital mutilations of young African patients, especially when their mothers vigorously defend the practice as holy and good for women?

Religious Freedom versus Patients' Rights

Health workers and patients have clashed when service providers have refused to give care that they feel violates their beliefs, resulting in an intense and complex debate over religious freedom versus patients' rights. On the one hand, those who believe in a “right of conscience” for health workers argue that there is nothing more dutiful and courageous than protecting individuals from being forced to violate their moral and religious values, while patient advocates and others point to a long tradition in medicine of having an ethical and professional responsibility of putting patients first.

Should an ambulance driver refuse to transport a patient for an abortion because of his or her beliefs? Should fertility specialists rebuff a gay woman seeking artificial insemination? Should a pharmacist turn away a rape victim seeking the morning-after pill?

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