Here we are dealing with two entities ethics and health. One is a tangible and obvious thing health, the other rather abstract, ethics. Whenever we talk of these two terms together What comes to our mind or rings in our ears? And why?
What comes to our mind is that personally every individual must ensure to take good care of his health without abusing it and ethically equally ensure health care of others or adopt ethical ways and means in dealing with health governance. Why? because we as a civilized society must take the responsibility of ensuring primarily a sound physical health care and equally the psychological well being of every individual in our surrounding.
Without getting into the quagmire of jargon studded specifics let us analyze what is ethics? And what is ethical behavior? And how does it play a part in health care industry with all the players involved in it starting from the patient to the paramedical force to doctors to insurance 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 to choose among the several available, obvious and probable and competing options
There are too many relative terminologies here that defy logical uniformity and universal applicability and hence it is very difficult to frame any type of policy or regulation which can answer all the above mentioned aspects namely what constitutes as right, wrong, moral , proper in all societies. However, the value and principles can be broadly based on following categories:- psychological, sociological, cultural, political, economic environmental, physical , technological, philosophical and scientific. But there must not be any unjustifiable presumption that principles and values are amenable to homogenization, there must not be the wrong approach of generalizing the particular and particularizing the general, then we must also avoid using statistical data as a tool for vindicating certain principles or values.
The very values and principles can be categorized but cannot be homogenized because it varies from society to society, one place to another , one religious group to another and so on. So health care and administration issues, however well intended they may be, have to take into consideration the socio psycho cultural milieu where they are being addressed to. For example if you do not inform the kith and kin 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 sport in certain places.
So like morality, ethical values do differ from environment to environment, descent, common adaptation etc. So also even the genetic and biological make of the physic of individuals. Therefore ethics and health is rather environment specific issue. There have been several cases where different populations were immune to certain diseases because of their unique genetic make up whereas some others where more susceptible to certain disorders again because of their unique genetic make up. Just to site two examples some African tribes have been said to have certain genes which make them immune to blood cancer similarly there are certain ethnic group in India for whom certain anesthetic drugs when injected lead to their death.
However as mentioned earlier it is equally imperative that there exists some system or rule or law that is applicable and that can regulate and ensure that ethically proper health care is in place. It involves a collective 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 ethical health care basically and broadly they are for steps in Ethical Healthcare Decision Making.
They are :-Assessment, Plan, Evaluation and Implementation.
Assessment involves visioning, mentoring, monitoring, solution focused critical thinking, self awareness, system and practice review.
Plan involves facilitation, enabling health care teams’ research or development 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 in implementation and interdisciplinary sharing expertise.
The advantage of this classification is it minimizes the problems involved in making ethical choices between equally undesirable alternative courses of action, the consequent valid judgments about action and resource allocation based on the clarity of the steps involved. Process is also faster when we can choose the best actions to meet a desired goal from among the several mutually exclusive choices which are always popping up.
But all these must work on some basic premises like patient and his well being have an important value which must be respected and enhanced by all participants in health care decisions.
Thus ethical health is a very complex issue, it will be further complicated if we try to operate it based on any typical western homogenized universal applications. On the contrary it will be easily carried out if we adapt an environment specific approach and execute it.