Bioethics: Clinical

Abstract

Health-care providers face many important and challenging ethical dilemmas in their work environments on a daily basis. As professionals, they are accountable for their decisions to patients and their families, professional bodies, employers, and colleagues. Consequently they must be able to justify their decisions or recommendations. Clinical ethics refers to decision-making and reflection about the best choice(s) to make in the delivery of health care. In attempting to resolve ethical dilemmas in clinical practice, the conflict between two or more equally important but competing values must be identified, and the ethical dilemma must be articulated. This is an important starting point. Gathering as much data as possible is the next critical activity. Seeking medical information about the patient’s condition, prognosis, and alternatives is important. In addition, relevant health law, patient and family preferences, value systems of health-care workers, and the sociopolitical context must be explored. Engaging in ethical analysis using theories and principles is important. Finally, a decision is reached in collaboration with the patient and/or family, and policy is developed to facilitate decision-making in the future. Following a systematic process of data collection, reflection, and deliberation is essential. If, after this process, a decision cannot be reached, consultation with a clinical ethics committee is often necessary.