Enhancing Patient Advocacy and Social Ethics

Abstract

Clinical bioethics has focused largely on individual clinical case dilemmas. Less attention has been given to the everyday ethics of being good healthcare practitioners, physicians, nurses, social workers, respiratory therapists, and physical therapists. Rapid scientific and technical advances push for public and professional ethical concerns focused on science and technology. Consequently, scientific protocols and technologies receive more attention in ethical discourse than everyday ethical comportment and relationships between patients and healthcare providers. Yet, technical and scientific aspects of practice would be ineffective without good patient-healthcare provider relationships. Many ethicists are calling for broader concerns to be addressed in professional ethics. Meeting patients and their families and recognizing their concerns about healthcare comprise the everyday ethical comportment of the practitioner. Patients and families, while encouraged to become empowered and take more responsibility for their health, are often vulnerable due to lack of knowledge of healthcare or due to crisis and reduced capacities. Therefore, patients rely on healthcare workers to have a fiduciary relationship with them. 1,2 That is, ethically and legally, healthcare workers are expected to act in the best interests of patients. This requires that commercial or research interests, or any other sources of conflict of interest, not triumph over a patient’s best interests. Being faithful to a patient’s best interests also requires advocacy for patients and their families in complex healthcare settings. Bioethics needs to focus on more than clinical case dilemmas and ethical issues at the individual level. Advocacy for good everyday ethical comportment, and social ethics and public pol