The imbedded role of ethics in healthcare: a contribution from translational research

Abstract

Die praktyk van publieke en globale gesondheid bevestig dat etiek onlosmaaklik deel is van gesondheidsorg. Hoewel etiek deel is van die gesondheidsorgprofessie word waardes en vertroue uitgedaag deur die kwaliteit van die produk (diens en dienslewering), ongelykheid in die globale gesondheidsorgsisteem en snelgroeiende tegnologiese ontwikkelings in gesondheidsorg. Ten spyte van goeie sisteme en ondersteunende etiese kodes in die gesondheidsorgpraktyk bestaan daar verskeie etiese uitdagings in gesondheidsorg. Etiek se kan hier ? tweeledige rol speel: enersyds as ? onderbou vir gesondheidsorgsisteme en andersyds as ? aktiwiteit naas baie ander gesondheidsorgaktiweite. Die artikel bespreek hierdie rolle in aansluiting by die bestaande, maar beperkte fokus op die pasiënt in die gesondheidsorgsisteem. Die argument word gevoer dat aandag gegee moet word aan die etiese behoeftes van verskillende rolspelers in die lewering van gesondheidsorg. Die fokus van hierdie artikel is op die rol wat etiek kan speel in gesondheidsorg as ? sisteem en as ? diens. Vier ontwikkelings word geïdentifiseer om hierdie fokus te ondersteun. Hierdie ontwikkelings is die koste van gesondheidsorg, kulturele invloede op en die gereedheid om diens te lewer, die groeiende aantal geriatriese pasiënte en hulle gesondheidsorgbehoeftes asook etiese uitdagings soos ingeligte toestemming.

The practice of public and global health confirms that ethics is imbedded in healthcare. Although ethics may be regarded as inherent to the healthcare profession, values and trust are challenged because of the quality of product (service and delivery), inequality in the global healthcare system and rapid technological developments in healthcare. Regardless of good systems and supportive ethical codes in healthcare practices, there are nevertheless ethical challenges in healthcare. This situation necessitates an attempt to understand the dual role that ethics can play as foundation for healthcare systems based on the global accepted understanding of “do no harm” and as an activity alongside many other healthcare activities. This paper discusses these roles of healthcare ethics in addition to the existing, but limited, focus on the patient in the healthcare system. The argument is presented that attention should be given to the ethical needs of those people (in different roles) engaged in the delivery of healthcare. The focus of the paper is on the role that ethics can play in healthcare as a system and a service. Four developments are identified in support of this focus, namely the cost of healthcare; cultural influences on and preparedness for service; the increasing number of aged individuals and their healthcare needs; and ethical challenges such as informed consent. From these developments the central perspective of the paper is presented, namely that ethics should be part of any healthcare system and the promotion of the well-being of people in healthcare, rather than merely the health of the individual patient only. Glouberman and Mintzberg’s identification of four worlds (cure, care, control and community) is used as context for the argument. The research is based on a translational research methodology approach to provide best practice perspectives to the healthcare industry.