Ethics week 2: Brief Summary: History of ethics in healthcare

Ancient Greece and Rome:

Ethical concerns about medical practice can be traced back to ancient civilizations.

The Hippocratic Oath (ancient Greece and Rome)

attributed to Hippocrates around 400 BCE, is one of the earliest known documents outlining medical ethics, including principles of beneficence ("do good"), non-maleficence ("do no harm"),confidentiality and professionalism.

Medieval Period:

During the medieval period, ethical discussions in medicine were often influenced by religious and philosophical considerations

Medieval period: Christian and Islamic scholars

People like Thomas Aquinas and Avicenna, integrated moral philosophy with theological principles, emphasizing the sanctity of life and the moral duties of physicians

Medieval Hospitals:

The establishment of hospitals by

religious orders introduced new

ethical challenges, including

issues related to the care of the

poor, the terminally ill, and the

role of charity in healthcare

Renaissance

The Renaissance period saw a revival of interest in human anatomy and scientific inquiry, but ethical considerations were still rudimentary

Renaissance Continued:

The focus was primarily on

advancing knowledge rather

than addressing ethical

dilemmas.

Medical ethics manuals

began circulating, offering

professional codes of

conduct

19th Century:

The 19th century introduced significant medical advancements and ethical challenges

19th Century continued:

For example, the development of anesthesia and surgical techniques raised questions about consent and the rights of

patients.

Discussions about these issues were emerging but were not yet formalized as a distinct field.

Nuremberg Code (1947)

The atrocities of World War II, particularly the human experimentation conducted by the Nazis, led to the establishment of the Nuremberg Code.

This set of research ethics principles emphasized the necessity of informed consent and the importance of voluntary participation in medical research

Declaration of Helsinki (1964):

The World Medical Association introduced this declaration to provide ethical guidelines for medical research involving human subjects.

It expanded on the principles of the Nuremberg Code and continues to be influential in shaping research ethics

Tuskegee Syphilis Study (1932-1972):

The unethical study of untreated syphilis inAfrican American men, which lasted for decades, highlighted serious ethical breaches in research practices and contributed to the establishment of stricter ethical guidelines

Willowbrook Study (1956-1970):

This study on institutionalized children with hepatitis raised significant ethical concerns about consent and the treatment of vulnerable populations.

Belmont Report (1979):

Published by the National Commission for the Protection of Human Subjects ofBiomedical and BehavioralResearch in the U.S., theBelmont Report outlined key ethical principles for research ,including respect for persons ,beneficence, and justice. This report laid the groundwork for modern research ethics regulations

Rise of bioethics

as a field, addressing a variety of health care issues

Contemporary healthcare ethics: Four Principles Approach (Beauchamp & Childress, 1979):

Autonomy, beneficence, nonmaleficence, and justicebecame a standard framework for clinical ethics

Contemporary healthcare ethics: Global perspectives

Integration of non-Western traditions (e.g., Ubuntu ethics in Africa, Confucian bioethics in East Asia)

Contemporary healthcare ethics: Applied challenges

End-of-life care (euthanasia, palliative care).

Reproductive ethics (IVF, surrogacy, abortion).

Genetic engineering and stem cell research.

Equity and access to healthcare.

AI and digital medicine, raising new questions of

privacy, fairness, and responsibility

Future of Health Care Ethics

The future of ethics in healthcare is poised to

be influenced by rapid advancements in

technology, evolving societal values, and

ongoing global challenges.

Ethics

Ethics provides a language, some methods,

and tools for evaluating the components of

personal and societal, and group morality to

create a better path for yourself and others

Morality

A particular system of values and principles

of conduct, especially one held by a specified

person or society.

The extent to which an action is right or wrong.

Concerned with relationships between people

& how, ultimately, they can best live in peace

& harmony.

Goal is to protect the high quality of life for

an individual or the community as a whole

Values

Intrinsic things that a person holds dear, e.g. beauty, novelty, efficiency

Morals

Beliefs concerning what is wrong and right inhuman conduct

Moral duty

actions required if you are to play your part in preventing harm and building a society in which individuals can

thrive.

Moral character

Language used to describe traits, dispositions and attitudes needed to be able to trust each other and to provide for human flourishing in times of stress

Personal Morality

values, duties, actions, and character traits each person adopts as relevant for their life. It is "who you are" as a unique

moral being among others

Societal Morality

Large components of personal morality are drawn from amorality that is shared with others in society.

Group Morality

Most individuals join or is swept into one or more subgroups of society by virtue of being a member of a religious group, a work place culture, a club, a service organization, an ethnic cluster, or other deep affiliation

Code of Ethics

A resource that describes the details of a

professional group morality as it applies specifically to your chosen field

Ethics Committees -

Most institutions have ethics committees that include ethicists, other professionals and laypeople

Protections

Come in the form of: Case law, legislation, legally binding regulations

Case law (Constitutional Law)

as a result of court decisions from the lowest courts to the Supreme or High court of the land that set legal precedence for future similar situations

Legislation (statutory law or statutes)

passed through congress or parliament

Legally binding regulations (administrative law) promoted through a state's or national government's regulatory bodies such as the US Department of Health& Human Services

National or State laws are a big help because

They embody & codify moral values & types of duty that should govern individual & institutional conduct related to health professions

They provide legal interpretations of key professional issues. i.e. licensure requirements for professions

Licensing Laws

Written into licensing laws that govern professional practice are both responsibilities and protections/rights.

Designed to protect the public from incompetence

Protections for Ethical Decision-Making

codes of ethics (guide best practice)

Laws: Mandate moral behaviors

Interprofessional collaboration: invites broad perspective interpreting moral choices

Practice Standards

Standards of practice (standards of care) are guidelines used to determine what a professional should and should not do

Professional Standards

Highest level of quality of

care is utilized. A method to assure clients/patients are receiving the highest quality of care

Licensure

Grants formal permission from constituted authority to

practice in a particular profession

Power to grant a professional license is reserved for the

state