Immoral or Moral Ethics

        Richard Eastin

Bioethics

Professor Rakowsky

3-10-2016 

Immoral or moral ethics

        Body and soul cannot be separated for purposes of treatment, for they are one and indivisible. Sick minds must be healed as well as sick bodies.  (Jeff C. Miller) For one to learn the difference of immoral acts and moral acts; the individual must clearly define the parameters of the two words. Morals are the principles that we follow that help aid us in deciphering the difference between right and wrong. When someone is immoral, they make decisions that purposely violate a moral agreement. Immoral is sometimes confused with amoral, which describes someone who has no morals and doesn't know the difference between right or wrong. In my opinion withholding information, which may later hurt the patient or threaten their life is immoral.

        Alan Goldman in my opinion is a brilliant philosopher and his ideas of medical paternalism is vastly fascinating. Goldman states, “strong paternalism in medicine is unjustified. Patients have a right of self-determination, a right of freedom to make their own choices.” (pg.93) Decisions regarding their own futures should be left up to them because the individual is the  best judges of their own interests and because self-determination is valuable for its own sake regardless of its generally positive effects. Alan Goldman mentions, "the right to be told the truth about one's condition, and the right to accept or refuse or withdraw from treatment on the basis of adequate information regarding alternatives, risks and uncertainties." (pg.94-95) The faulty premise in the argument for medical paternalism, is that health and prolonged life can be assumed to be the top priorities for patients; thus, the physician can decide for the patient in accordance to their health and safety standards. In my opinion, very few people prioritize these values in this particular way.

        In relationship to Goldman and his ideas I believe the actions of Dr. Clark to not fully tell Jeff of the problems that could arise from this cancer is considerably immoral. In the case, Dr. Clark reviews the test results and determines that Jeff has a very small tumor  in his intestines. Dr. Clark states he has seen this tumor many times before; thus, it  is not immediately life-threatening. It can be removed with simple surgery. Furthermore, Dr. Clark knows there is a small chance (1/500) that individuals with a “Micro Dot” (even if removed) can develop serious cancer at a later date (6-8 months). I personally believe that by withholding this information from Jeff the doctor is not letting the individual have self-determination of their own life and the patient was not told the full truth. I understand why the doctor may have been reductant to tell Jeff the complete truth because of the anxiety, he would experience if he knew the risk involved. In addition, if the doctor was to disclose the correct information the patient may have ask for alternative treatments; consequently, that was not possible because the doctor decided to tell a white lie rather than disclose the risk factors of this micro dot cancer.

        This action by the doctor is considered immoral because it violates ethical standards that were put into effect. Virtue Ethics is an approach to ethics that emphasizes an individual's character as the key element of ethical thinking, rather than rules about the acts themselves (Deontology) or their consequences (consequentialism). (pg.42-43) I believe being dishonest to the patient about 1/500 chance that, he may develop a cancerous tumor in 6-8 months is moral wrong and defames a individuals autonomy. This is showing the negative character of Dr. Clark because he is not thinking ethically and rather than follow the rules of honesty and disclosing vital information to the patient he is making his own rules and is acting on it himself. Thus, the patient, Jeff, is the one that pays the prices with the consequences of the doctors choice to not divulge the information to Jeff, who is a knowledgeable and intelligent man. Ethically when you restrict an persons freedom of choice and decision making this action becomes irrefutably deceitful.  

        Furthermore, Howard Brody observes that the theory and the practice of informed consent are far apart and that accepted legal standards send physicians the wrong message about what they are supposed to do. Brody, “Thinks that a conversation standard of informed consent does send the right message but is probably legally unworkable.” (pg. 205) He proposes instead a "transparency standard," which says that "disclosure is adequate when the physician's basic thinking has been rendered transparent to the patient." (pg.208) In addition, a reasonably informed patient must consist of these two features; the physician must disclose the basis on which the planned treatment, or alternative treatments and the patient must be allowed to inquire information advisable by the disclosure of physician's reasoning. These questions must be answered to the patients satisfactions. I believe that according to the transparency standard, the physician failed to provide alternative treatment and failed to disclose the adequate information for the patient to comprehend; thus, the patient was unable to have reasonable informed consent.