Traditionally there are four basic principles of medical ethics:
- The right of the individual to self-determination.
- Informed consent is basic to health care.
- Do no harm. (Non-maleficence)
- Actions should not be the cause of harm.
- In practice, don't be hasty and do thorough evaluation.
- Do good. (Beneficence)
- Actions that promote the well-being of others.
- Needs of the patient come first.
- Justice and Respect for Human Rights
- Fair and equitable distribution of scarce resources
- Respect for the rights of each as a person.
Yes, a law can be unethical. Unethical does not mean illegal. We do not need to go to extremist countries to find laws that were unethical- at best- and inhumane at worst. Laws of segregation in the post-reconstruction South in the United States were not illegal. They were the law. But we know they were certainly unethical in spite of the ways they were justified. Eventually they were seen as "unconstitutional" which made them "illegal." But it took legal interpretations and arguments to get to that point.
I hope someone will take a hard ethical look at the proposed health care reform law in the Senate. Yes, there are conflicting needs and wants. There are questions, for example, about equitable distribution of resources.
- But will the new law cause harm?
- Will it be just and respectful of the life and dignity of individuals?
- Will it promote doing what supports the well being of others?
- Will it support the autonomy of all patients and their right to medical care?