Often, these standards are the subject of rigorous debate as religion or social agendas come to bear on the question of morality. This paper will examine some of the most recent professional literature in an effort to codify the existing standards, as well as reporting on the prevailing trends in regards to new technologies, the impact of culture, and the evolving morality surrounding life and the end of life care.
Healthcare is an extremely broad field comprised on numerous disciplines, and myriad roles for healthcare workers within each discipline. This paper will not address a specific discipline, but instead will examine healthcare ethics from a broad lens while focusing on the commonalities found throughout the different fields. Numerous professional organizations have their own codes of ethics and may have specific guidelines that deal with their clinical specialty. As an example, this may be seen in addiction services, mental health, or gender transformation. However, this paper will report with a broader brush and a major portion will be spent focusing on recent developments in ethics and the challenges that all healthcare workers face in the light of technology, changing demographics, and evolving social standards.
End of Life Care
One of the critical aspects of healthcare ethics is providing palliative care for the terminally ill, and the numerous issues facing end of life care. One of these important ethical issues is 'medical futility', and the application of medical treatment that has little hope of being beneficial. There can be significant disagreements among the patient, family, physician, and insurance providers that all have different treatment goals, as well as their own personal interpretation of medical futility (Bagheri 46). A hospital ethical review board, at the initiation of a physician or the patient, often mediates this dilemma. In a recent comprehensive study conducted at the Mayo Clinic, Rochester Minnesota, the most frequently cited reasons for an ethics review were "the permissibility of withholding and withdrawing life sustaining treatments, resuscitation issues, [and the] appropriateness of treatment (ie, futility vs. nonfutility" (Swetz et al. 690). However, this issue is steeped in controversy, and according to Bagheri, "Some argue that physicians should be given sole authority to make decisions to withhold or withdraw treatment" (47). Indeed, multiple studies have indicated that in the US, as well as in Europe, physicians unilaterally withhold treatment that they deem futile without consulting either the patient or their family (Bagheri 47). This approach demeans the patient's mental well-being and disregards the ethical component of autonomy. If a patient is mentally capable, they should be apprised of the lack of potential benefit (futility) of a treatment.
Eliminating the patient from being informed, or a part of the decision making process, is at best a questionable ethical practice. Still, "physicians cannot be forced (or even expected) to give 'futile' treatment to their patients" (Loewy 299). One question that should routinely be asked when making an ethical decision regarding futility is 'are there any better alternatives'. Professional medical organizations have