Medical ethicists are experts in three fields: law, ethics and medicine. Because of this, they can help both healthcare professionals and patients (together with their families) in complex healthcare situations. This dual support allows all parties to find agreement on the best course of action for optimal healthcare under complex circumstances. The successful intervention of a skilled medical ethicist can help prevent medical malpractice as well as unnecessary claims being made where no malpractice is evident.
When would a doctor call in a medical ethicist?
There may be several scenarios a medical professional may face where providing the best healthcare may conflict with a patient’s other rights. Here are two examples:
- A patient refuses a blood transfusion on religious grounds. While a healthcare professional may feel that a blood transfusion is the best possible life-saving action for a patient, the patient may refuse. They are allowed to do so as it is exercising their right to autonomy – in other words, to make informed decisions on how they wish to be treated medically – as well as their right to practice their religion.In this case, a medical ethicist could be brought in to guide the doctor on how best to communicate this within the bounds of the law, while balancing the patient’s various rights. This could mean the doctor provides counselling to the client, ensures that they have all the information, and then accepts the patient’s decision based on their informed consent.
- A child requires a blood transfusion but the guardian refuses to give consent due to religious reasons. In this case, the same set of rights may be in play as with the previous example, but an ethicist could help balance these with the child’s right to life. This would ensure that the doctor remains within the law while still performing their duty to provide the best possible care for the child.In South Africa, a child’s right to life supersedes their right to autonomy expressed through a guardian, so the doctor would be performing their duty by administering a blood transfusion in an emergency situation to save the child’s life, despite the guardian’s wishes. In this case, an ethicist could assist in obtaining an emergency court order in a matter of hours, which would allow the doctor to override autonomy and save their patient’s life.
Having a medical ethicist weigh in on the law and its ethical application in these more complex situations allows the healthcare practitioner to focus on their craft whilst remaining ethical and compliant at all times. This reduces instances of malpractice when healthcare scenarios enter murky areas, where the law, HPCSA guidelines, and ethics seem to conflict with one another. On the patient’s side, an ethicist is also able to support a patient to unpack whether or not malpractice is indeed present in these ethical grey zones, which can also limit unnecessary malpractice claims.
To learn more about the role a medical ethicist plays, listen to this interview with Revana Babulall.