Biomedical ethics revolve around the Hippocratic Oath that directs the medical practitioners to ensure that, in their undertaking, they do no harm to patients. In clinical practice, ethics concerns the limit of authority of the patient and physician, the extent of confidentiality between the patient and the physician, and the scope of acceptable medical interventions and treatments. My discussion focuses more on the basic principles to apply when making ethically sound medical decisions namely; respect for autonomy, justice, non-maleficence, and beneficence.
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Carter (2002) informs that the principle of beneficence requires the medical practitioners to act in the patients’ best interest. The medical practitioner’s main aim should be to prevent and remove harm and promote the well-being of the patient. The harm can be pain, disease, disability, or death (Carter, 2002). The well-being to promote should focus on the health and proper functioning of the individual.
The principal insists on the prevention of harm such as death and the promotion of life. However, the patient’s family members may insist on their loved one remaining alive even if it means support through artificial nutrition and hydration, but the health care provider thinks otherwise in the sense that continued life is the harm to prevent (Carter, 2002). The physician should act in the best interest of the patient and follow the Benedictines values that the patient should be left to die naturally.
The principle of non-maleficence states that medical practitioners should never involve in any activity that can cause harm to the patient (Carter, 2002). This principle puts emphasis on the comparison of risk and benefit of the physician’s intervention thus helping determine the patient’s best interest. For instance, in prescribing medication, practitioners must weigh the benefits and potential risks. The Benedictine values lay emphasis on treating patients with dignity and respect, meaning that physicians should only carry out a medical intervention that is beneficial to patients (Snyder, Gauthier & Tong, 2008).
The Trovan and ceftriaxone drug test Pfizer did in Kano state was to help in the treatment of meningitis, but instead resulted in the death of 11 children and 181 injuries. Therefore, Pfizer breached the principles of beneficence and non-maleficence.
According to Carter (2002), the principle of respect for autonomy states that medical practitioners respect the patients’ choice of accepting or refusing the medical interventions. The principle of respect for autonomy recommends self-determination by patients as concern for medical interventions. Nuremberg code requires the voluntary, informed consent of patients in any medical intervention (Snyder, Gauthier & Tong, 2008). It requires full disclosure of relevant and truthful information concerning the proposed treatment and available alternatives, coupled with the expected benefits, potential risks, and subsequent results of the proposed treatment (Snyder, Gauthier & Tong, 2008).
The determination of people who can make the decision is what matters. The test on the Nigerian children was without their parents’ consent, and that breached the principle of respect for autonomy. The Pfizer pharmaceutical did not comply with the Benedictine values of respect to fellow man by using the children on a clinical trial with drugs they did not know the subsequent results (Munson, 2009).
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The principle of justice recommends the treatment of everyone with respect and dignity (Carter, 2002). It entails respect for other people’s emotions, relationships, reasonable goals, bodily integrity, and privacy (Munson, 2009). This principle requires the respect of the social, cultural, and religious background of patients, surrogate decision-makers and their families (Munson, 2009). It advises physicians that when making medical decisions they should factor in the patient’s family and community background. The principle applies to patients who cannot make sound medical decisions (Snyder, Gauthier & Tong, 2008).
Pfizer pharmaceuticals breached this principle in that it performed a drug test on the Nigerian children without considering the family or the community members’ feelings. It was not justifiable to carry out a drug test on children without considering the long-term effect on their health. Pfizer breached Nuremberg code in the sense that the children could not make informed choices as minors; therefore, it was a requirement that Pfizer acquire “informed consent” from the children parents or guardians (Munson, 2009).
Carter, L. (2002). Office of Public Policy and Ethics. Australia: Institute for Molecular Bioscience, University of Queensland. Web.
Munson, R. (2009). Intervention and Reflection; Basic Issues in Medical Ethics. 8th edition. London: Oxford University Press.
Snyder, J., Gauthier, C. & Tong, R. (2008). Evidence-Based Medical Ethics: Cases for Practice-Based Learning. North Carolina: Humana press.