(5) Privacy regarding source of payment and quality care without regard to
source to of payment (principle 3). Not all hospitals will include the right. Private
hospitals routinely request health insurance and other information before admitting a
patient unless it is an emergency. Courts are constantly confronted with cases in which
this right is violated. Those who cannot pay are refused care, and advised to go to a
state-subsidized hospital.
(6) The right to competent counseling on financial assistance (principle 20).
If a patient is in need of a liver transplant, he or she will ask the facility to make it known
that a donor and/or money is needed. The hospital will assist in this search.
1-9.
ETHICS IS NOT FLUFF; IT DEALS WITH REAL-LIFE ISSUES
We tend to assume that ethics is removed from the concerns of real life. (Most of
us don't study ethics formally in high school. And, we associate ethics with the
philosophy or religion department a university). To the uninitiated, ethics may seem
lofty and abstract. But if you take the time to explore it; you will discover that it is quite
practical in that it attempts to grapple with real (and difficult) issues of daily life. It is not
so much that ethics is abstract, it's that the questions ethics tries to answer are not so
easily resolved. Ethics forces us to bring to a conscious level our own underlying
assumptions about what is right and wrong, the ideal standards of behavior that we
normally take for granted.
1-10. ETHICS GRAPPLES WITH TOUGH QUESTIONS
a. Euthanasia. Consider the thorny question of euthanasia (mercy killing).
According to Lawrence K. Altman, M.D., "The public seems to be of two minds about
doctor-assisted suicide. People expect physicians to be healers, not takers of life, and
they applaud compassionate doctors who admit that they would help patients end their
suffering. While they have reservations about being treated by a pro-euthanasia doctor
they assume the right to die and expect physician's help in carrying out their wishes."46
(1) Patients are ambivalent. They seem to be saying: "Have the utmost
respect for life, but do otherwise when we tell you:" What about the law? Howard R.
Relin, Monroe County District Attorney investigating a doctor-assisted suicide case
says: "These are very difficult cases because the law is in conflict with people's
perception of their right to die.50 With the law and the patient's perception of his or her
rights in conflict, physicians conclude that public policy and medical practice are out of
step. University of Minnesota ethicist Arthur L. Kaplan states: "More than a dozen
doctors have confided in [me] about their role in responding to requests from conscious,
mentally clear patients to help them die. The doctors want the stories known to
stimulate more public discussion because they believe public policy and medical
practice are out of step."51
(2) Dr. Quill's story, below, shows why ethical issues do not have simple
black and white answers.
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