Ignorance Is Not Bliss In Ethical Decision-Making
Ethical virtues in medical professionals are an ever-increasing expectation of the public.
Medical school curricula now incorporates Medical Ethics training but many practicing physicians have had little formal education in these topics. Curricular emphasis on medical ethics may influence the development of a specialty discipline, but until adequate numbers of medical ethicists are accessible to the practicing physician, we must continue to assume responsibility for our own decisions.
"Ignorance is bliss" is never applicable to medical decision-making, and especially with respect to ethical issues. Individual physicians are held accountable for all their decisions, moral or otherwise. Fortunately, many decisions are simple, require minimal thought, and are made through education, imitation, repetition, regulation, or altruism.
On the other hand, there are decisions, especially those infrequently encountered, which cannot be met by simple or rote responses. Ethicists may educate us on doctrines and attempt to mediate decisions, but their highest role is to challenge us to examine our own ideas and motives. While they can offer assistance in decision-making and may even influence an outcome, decisions ultimately remain ours to make.
Should I accept pharmaceutical gifts? What do I do when a family demands medically futile treatment? Do I follow a patient's Advance Directives when the family disagrees? We have all found ourselves faced with questions like these.
The ACOFP Ethics Committee is offering this column to provide a forum for discussion of issues such as these.