In the United States and around the world, medical professionals face a host of issues that erode their moral compass. These issues range from financial barriers to accessing care to cultural attitudes toward disease and medicine. It’s time to address these barriers in order to provide healthcare that truly serves people.
Medical justice is the concept that health care must be distributed based on needs and not privilege. This principle is central to many clinical ethics theories, and it guides policy decisions regarding the allocation of scarce resources.
It is also the basis for a set of CA Medical Justice principles that support actions to prevent harm, help persons with disabilities, and rescue persons in danger. A physician’s moral obligation to act in accordance with the principles of beneficence and nonmaleficence is augmented by a duty to promote social justice and equal treatment of all.
The concept of medical justice is central to the work done by many interprofessional organizations, such as The Praxis Project and APEN. These organizations collaborate with the School of Law to train healthcare and legal professionals, as well as community members in the tools necessary to advance medical justice in their localities.
Medical Justice is a new and emerging field that requires the collaboration of multiple disciplines in order to address underlying factors that impact the health of communities and individuals. It aims to reduce the vulnerability of vulnerable populations to the threat of health care disparities. It includes strategies to educate communities about how health disparities arise and to build community capacity to confront health inequities. It is about ensuring that all people receive adequate and equitable health services, regardless of their race, gender, income, or educational level.
For physicians, the defining responsibility is to do good in the service of patients. This is a complex task and includes addressing all aspects of a patient’s health, from access to care to decision-making in the face of serious illness or injury. It is important to identify and resolve ethical conflicts that may arise in patient care.
Often, these conflicts revolve around the 4 main ethical principles: beneficence, nonmaleficence, autonomy, and justice. Autonomy is the root of many ethical concepts, such as informed consent, truth-telling, and confidentiality. It is important to recognize that resistance to the principle of patient autonomy and its derivatives such as informed consent or truth-telling in some cultures can be due to cultural values rather than lack of competence.
Another source of conflict can arise when a physician’s ethical obligations contradict with established legislation. For example, the principle of nonmaleficence supports action to remove a condition that would harm the patient or to protect her from self-harm, but this cannot be accomplished without first informing the patient. Thus, the physician must choose between the legal requirement to inform the patient and the moral obligation to not cause harm. These conflicts must be resolved by a combination of evaluating the situation, weighing the risks and benefits, and seeking input from colleagues.