Gurdeep Mannu writes on the philosophy of utilitarianism and how it can be applied to medical ethics. 

Osler famously describes medicine as an art, and we as medical students are future practitioners of this art. Science and art do not mix more so than in the ethics and morals by which we practice. It is essential for medical students worldwide to appreciate the moral implications of the medical decisions they make. This is despite the fact that philosophy and bioethics is a topic which is to a large part neglected in many undergraduate medical curriculums in spite of recent reforms. This article reviews the common philosophical theory of utilitarianism and examines this doctrine in the context of a medical dilemma.

This article first gives a brief account of the theory. It then discusses its various forms and respective strengths and weaknesses. These points will then be explored in the framework of a modern ethical dilemma in healthcare in order to ascertain whether utilitarianism in all its variations, is sufficient to explore all of the ethical dimensions of such a problem a student or doctor may face. (more…)

Ohad Oren, a 3rd year medical student at Bruce Rappaport Faculty of Medicine, in Haifa, Israel considers an ethical dilemma.

A profoundly disabled child whose annual growth rate is subnormal approaches your care. The parents ask you to test growth hormone function and to consider an active intervention to help their child attain a larger stature. How should you proceed? Increased growth will surely not benefit a severely brain impaired child, with no trace of body image whatsoever. A larger stature, moreover, will impose a higher burden on his caregivers, hampering their continuous care of their child.

This paradoxical scenario - whether to use medical treatments to increase the final stature of a developmentally-disabled child - is not uncommonly encountered in pediatric endocrine clinics. Rejecting the GH hormonal therapy may portray abandoning an effective medical therapy on the grounds of little or no benefit to the patient. But, is offering parents of severely disabled children proactive measures to attenuate growth an ethical thing to do? The Ashley X case, presented in this article, sparked an intensive public discussion concerning the ethical justification of irreversibly altering the body of a profoundly disabled and nonconsenting child. (more…)

The pharmaceutical industry and the medical profession are uneasy bedfellows as Tom Jaconelli discusses

It would be hard to imagine a functioning healthcare system without medicines.  Even outside the system many of us frequently take over-the-counter drugs for common ailments: in the USA 50 billion aspirin tablets are consumed each year. (1)  Also, it is difficult to think of any kind of human experience that doesn’t come with a health warning. (2) This medicalisation of society explains why pharmaceutical companies such as GlaxoSmithKline and AstraZeneca rank in the top 10 share prices in the UK economy.  However, the nature of pharmaceutical companies as profit-driven businesses in contrast to their role as health providers heralds a seemingly intrinsic problem: is their priority health or wealth? (more…)

Would you ever blow the whistle? Elizabeth Leyland explains more about this potentially career wrecking activity

From childish taunting in the playground to kiss-and-tell exposés, whistleblowing affects everybody at some stage of their lives. It raises awareness of ‘naughty’ behaviour, but is almost invariably damaging and very difficult to reverse. In healthcare there are particularly high stakes: lives, jobs and money are potentially at risk if inappropriate practice goes unchecked. If whistleblowing is used too freely the repercussions can be especially severe. I want to tune in to some of the difficulties associated with whistleblowing in a healthcare setting. With these in mind, I will consider the balance between moral responsibility and personal cost of ‘whistling while you work’.

(more…)