Clinical ethics is a practical discipline that provides a structured approach to assist physicians in identifying, analyzing and resolving ethical issues in clinical medicine. Clinical ethics is both about the ethical features that are present in every clinical encounter and about the ethical problems that occasionally arise in those encounters. Clinical ethics relies upon the conviction that, even when perplexity is great and emotions run high, physicians and nurses, patients and families can work constructively to identify, analyze and resolve many of the ethical problems that arise in clinical medicine. University of Washington School of Medicine
Institutional Ethics provides a multidisciplinary forum for the analysis and discussion of ethical standards effecting patient care, professional education and community interests. Institute for Medical Humanities.
Provide an example of conflict between clinical ethics and institutional ethics.
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Healthcare Management: Conflict Between Clinical and Institutional Ethics
In clinical medicine, a variety of clinical cases are presented each day ranging from very simple cases to somewhat complex ones that involve overwhelming clinical dilemmas. Consequently, a field of clinical ethics was created to give the health personnel an idea of what can be done when certain dilemmas emerge. For the same reason, the field of institutional ethics was formed in order to create a balance between clinical practices and institutional principles. The following paper presents an example of an event whereby clinical and institutional ethics may conflict. It will then discuss the importance of the types of ethics and why they should be integrated to enhance the effectiveness of clinical medicine in improving patient outcomes.
Clinical ethics equip medical institutions, healthcare personnel, and professional medical staff with knowledge on how to resolve certain ethical issues in clinical medicine particularly the ones that involve critical decision-making (Boitte & Cobbaut, 2014). This critical approach involves the process of identifying the problem, analyzing it, and eventually deciding on the best way of resolving it. On the other hand, institutional ethics refer to the ethical and moral responsibilities of any an institution. Various departments such as institutional ethics committees are usually formed especially by healthcare facilities and professional societies and institutions to go over the decisions being made by various stakeholders and their ethical implications at the organizational level.
Conflict between Clinical and Institutional ethics
Clinical medicine is founded on the application of certain fundamental professional principles, and the main include beneficence, non-maleficence, autonomy, and justice (Agich, 2005). They lead to the drawing of the line between ordinary ethical issues and a conflict between clinical ethics and institutional ethics. For instance, there was a recent religious directive in Catholic hospitals that presented a conflict between institutional and clinical ethics. The Vatican’s office of the Doctrine of Faith declared that it was not acceptable to withhold hydration and food from terminally ill patients. This directive conflicted with clinical ethics that provide for the right of patients patient to mandate the withholding of food and hydration.
In this case, many questions were asked and issues raised regarding the Vatican’s statement on what is right or wrong. As such, a solution would be to move such a patient to another hospital that is not Catholic-sponsored in order to have his/her wishes granted. However, one may argue that such a decision would be tantamount to killing the patient. It is also unclear whether a patient should be allowed to make such a decision even when the medical personnel think they have a chance of making him/her get better. Such dilemmas continue to dominate the healthcare industry, whereby clinical and institutional ethics are in conflict regarding which patients’ requests should be granted and which ones should be downright ignored.
In conclusion, institutional and clinical ethics should be defined in such a way that there is synergy between as this will go a long way in reducing the possibility of a conflict between them. For instance, institutional ethics committees (IECs) were formed in the American health care system in order to resolve difficult and overwhelming clinical dilemmas in a bureaucratic and efficient way (Baron, Arnold & Fleetwood, 1989). Institutional ethics committees and ethics committees in general are a good way of dealing with all these conflicts as long as they are not driven by misguided goals.
Agich, G. J. (2005). What kind of doing is clinical ethics? Theoretical Medicine and Bioethics, 26(1), 7-24.
Boitte, P. & Cobbaut, J. P. (2014). Ethics as collective learning: Bioethics, clinical ethics and institutional ethics. Revista Romana de Bioetica, 12(2), 42-49.
Fleetwood, J. E., Arnold, R. M., & Baron, R. J. (1989). Giving answers or raising questions? The problematic role of institutional ethics committees. Journal of Medical Ethics, 15(3), 137-142.
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