Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice.[1] Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal.[2]
It is important to note that these four values are not ranked in order of importance or relevance and that they all encompass values pertaining to medical ethics.[3] However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation.[4] Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.
The problem of fraud presents itself, before any discussion of morality and values. What if we are facing a totally corrupt system?
Richard Smith, until 2004 editor of the British Medical Journal, on July 5, 2021, wrote on the BMJ:
As he described in a webinar last week, Ian Roberts, professor of epidemiology at the London School of Hygiene & Tropical Medicine, began to have doubts about the honest reporting of trials after a colleague asked if he knew that his systematic review showing the mannitol halved death from head injury was based on trials that had never happened. He didn’t, but he set about investigating the trials and confirmed that they hadn’t ever happened. They all had a lead author who purported to come from an institution that didn’t exist and who killed himself a few years later. The trials were all published in prestigious neurosurgery journals and had multiple co-authors. None of the co-authors had contributed patients to the trials, and some didn’t know that they were co-authors until after the trials were published. When Roberts contacted one of the journals the editor responded that “I wouldn’t trust the data.” Why, Roberts wondered, did he publish the trial? None of the trials have been retracted.
There are different opinions among medical doctors, as there have always been. !70 years ago doctors had different opinions. The prevalent opinion turned out to be the wrong one. Same thing happened 100 years ago. 50 years ago the AMA refused to admit that cigarettes caused cancer, because contributions from the cigarette industry made that inconvenient.
It is happening again, and normal rationality allows us to determine which doctors are lying and which ones are not lying.
Medicine is rationally understandable. We cannot diagnose or prescribe, but we can discriminate between the reliability of diverse medical opinions, on the basis
Non-maleficence[edit]
The concept of non-maleficence is embodied by the phrase, "first, do no harm," or the Latin, primum non nocere. Many consider that should be the main or primary consideration (hence primum): that it is more important not to harm your patient, than to do them good, which is part of the Hippocratic oath that doctors take.[31]
Throughout history, medicine has often been in error.
This is partly because enthusiastic practitioners are prone to using treatments that they believe will do good, without first having evaluated them adequately to ensure they do no harm to the patient. Much harm has been done to patients as a result, as in the saying, "The treatment was a success, but the patient died." It is not only more important to do no harm than to do good; it is also important to know how likely it is that your treatment will harm a patient.
So a physician should go further than not prescribing medications they know to be harmful—he or she should not prescribe medications (or otherwise treat the patient) unless s/he knows that the treatment is unlikely to be harmful; or at the very least, that patient understands the risks and benefits, and that the likely benefits outweigh the likely risks.
Enthusiastic practitioners certainly were all the doctors that killed their patients--George Washington being one of the illustrious victims, who probably had pneumonia and was treated with bloodletting.
The president's doctors were doing nothing unusual--it's fortunate that they did not also give the President a purgative. Bloodletting and purgatives were the basic accepted treatments at the time, and there must have been peer pressure for doctors to act accordingly.
Nowadays, doctors are also facing financial pressures, to persuade them to use very expensive medications instead of cheap ones. Such a situation is evident when a useless and very expensive antiviral, remdesivir, is FDA-approved while very cheap, safe, and effective covid medications are forbidden and can lead to arrest and loss of medical license.
In practice, however, many treatments carry some risk of harm. In some circumstances, e.g. in desperate situations where the outcome without treatment will be grave, risky treatments that stand a high chance of harming the patient will be justified, as the risk of not treating is also very likely to do harm.
So the principle of non-maleficence is not absolute, and balances against the principle of beneficence (doing good), as the effects of the two principles together often give rise to a double effect (further described in next section). Even basic actions like taking a blood sample or an injection of a drug cause harm to the patient's body.
The desperateness of a situation can be created by reckless behaviour, such as using bloodletting and purgatives or refusing to cure the patient; the latter is the policy imposed by all health organisations allied to Big Pharma. The WHO is such a one, which has the led the world in opposing all cures that works and even all simple prophylactic steps in respiratory epidemic control, such as masking and vitamin D.
On the other hand, the WHO has distinguished itself for its work against ebola. Could the issue be that the corporations that control the economy do not want to lose the income from profitable respiratory illnesses?