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Ethics and Health

Here we are dealing with two entities ethics and health. One is atangible and obvious thing health, the other rather abstract, ethics.

Whenever we talk of these two terms together What comes to ourmind or rings in our ears? And why?

What comes to our mind is that personally every individual mustensure to take good care of his health without abusing it and ethicallyequally ensure health care of others or adopt ethical ways and meansin dealing with health governance. Why? because we as a civilizedsociety must take the responsibility of ensuring primarily a soundphysical health care and equally the psychological well being of everyindividual in our surrounding.

Without getting into the quagmire of jargon studded specifics let usanalyze what is ethics? And what is ethical behavior? And how does itplay a part in health care industry with all the players involved in itstarting from the patient to the paramedical force to doctors toinsurance agents etc .

What is ethics?

Ethics refers to values and principles that define behavior as right,wrong, moral and proper. Such values and principles provide a means

of evaluation and decision making based on those evaluation tochoose among the several available, obvious and probable andcompeting options

There are too many relative terminologies here that defy logicaluniformity and universal applicability and hence it is very difficult toframe any type of policy or regulation which can answer all the abovementioned aspects namely what constitutes as right, wrong, moral ,

proper in all societies. However, the value and principles can bebroadly based on following categories:- psychological, sociological,cultural, political, economic environmental, physical , technological,philosophical and scientific. But there must not be any unjustifiablepresumption that principles and values are amenable tohomogenization, there must not be the wrong approach ofgeneralizing the particular and particularizing the general, then we

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must also avoid using statistical data as a tool for vindicating certainprinciples or values.

The very values and principles can be categorized but cannot behomogenized because it varies from society to society, one place toanother , one religious group to another and so on. So health care andadministration issues, however well intended they may be, have totake into consideration the socio psycho cultural milieu where theyare being addressed to. For example if you do not inform the kith andkin about a health problem in India it is an offense whereas in USA

you do not have the right to inform without the consent of the patient.Abortion in certain places is a crime whereas it is almost a daily sportin certain places.

So like morality, ethical values do differ from environment toenvironment, descent, common adaptation etc. So also even thegenetic and biological make of the physic of individuals. Thereforeethics and health is rather environment specific issue. There have

been several cases where different populations were immune tocertain diseases because of their unique genetic make up whereassome others where more susceptible to certain disorders again

because of their unique genetic make up. Just to site two examplessome African tribes have been said to have certain genes which make

them immune to blood cancer similarly there are certain ethnic groupin India for whom certain anesthetic drugs when injected lead to theirdeath.

However as mentioned earlier it is equally imperative that there existssome system or rule or law that is applicable and that can regulateand ensure that ethically proper health care is in place. It involves acollective display of all those things that govern social behavior in

general like customs, traditions, ethics, law, religio morality etc

There are therefore various steps involved in implementing ethicalhealth care basically and broadly they are for steps in EthicalHealthcare Decision Making.

They are :-Assessment, Plan, Evaluation and Implementation.

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Assessment involves visioning, mentoring, monitoring, solutionfocused critical thinking, self awareness, system and practice review.

Plan involves facilitation, enabling health care teams research ordevelopment plan learning pathways.

Evaluation involves risk management, environment friendly practice,learning in and through practice, building block for practice.

Implementation involves communication, support of all involved inimplementation and interdisciplinary sharing expertise.

The advantage of this classification is it minimizes the problems

involved in making ethical choices between equally undesirablealternative courses of action, the consequent valid judgments aboutaction and resource allocation based on the clarity of the stepsinvolved. Process is also faster when we can choose the best actions tomeet a desired goal from among the several mutually exclusivechoices which are always popping up.

But all these must work on some basic premises like patient and hiswell being have an important value which must be respected andenhanced by all participants in health care decisions.

Thus ethical health is a very complex issue, it will be furthercomplicated if we try to operate it based on any typical westernhomogenized universal applications. On the contrary it will be easilycarried out if we adapt an environment specific approach and executeit