The "Give and Take" of Medical Morality

Doctors may face situations within the medical arena in which their conscience -- as a person and as a professional -- conflicts with patient autonomy and values. Consider the terminally ill patient who wishes to end all treatment interventions and elect to receive assisted suicide, and his physician who believes that aiding in death is a moral wrong.  This scenario creates a conflict of interests between physician and patient. Historically, a paternalistic model of physician-patient interaction has been employed to deal with dilemmas such as this, contributing to infringement of patient’s morals and rights and a lack of a comprehensive understanding of compassion and ethics on the part of the physician. This manifests as the physician’s inability to view the patient as an end in himself and to instead have a limited outlook of treatment. An increased emphasis on ethics training and implementation of the interpretive model of interaction within medical schools is necessary in order to retain the humanity and compassion of the medical profession. The interpretive model of doctor-patient interaction requires the physician to take the patient’s life narrative into consideration and aid the patient in making a well-informed medical decision that is in line with his or her personal morals. Implementing this revised model will protect the morals of both patient and physician, as it allows conscientious objection: a physician’s refusal of providing a certain treatment on the basis of personal morals that conflict with one or more of the values within medicine. However, these requests for conscientious objection will not always be honored by the hospital if there are serious infringements upon the rights of the patient, causing a give and take of morality. Consider the patient who is morally opposed to receiving blood transfusions but who requires one to ensure survival. The physician, who disagrees, must acknowledge the rationality of the patient and respect his wish to abstain. Ultimately, the physician experienced ‘give and take’ of morals, as he was required to sacrifice some of his morals for the good of the patient.It is necessary for physicians to be competent in the realm of ethics in order to effectively communicate with patients on a human level and provide treatment that is in line with many of the numerous conflicting tensions that physicians face.