The moral perspective: conflict between medicine and success

Healthcare practitioners must practice according to professional principles: all they do must be primarily driven in accordance with the health and best interests of their patients.

Personal ambitions of professional or financial gain must always be tempered by the need to have the best interests of the patient at heart.

In medicine, it is often the case that the relationship between doctor and patient is unequal: the patient does not necessarily have the technical understanding of his or her illness, let alone the necessary perspective from which to make a balanced decision concerning his or her care. This places the patient in a comparatively weak position, where their needs are often not able to be met without significant advice from their doctor.

Most patients believe what their doctor tells them, and they effectively delegate or entrust their care to their doctor. This places great responsibility on the person – the doctor – who has the power and, if ‘delegated’, the authority to make such decisions. Some doctors take advantage of this imbalanced relationship for personal (usually financial) or professional gain.

The majority of developed countries, therefore, have enacted legislation that is designed to protect patients, as the vulnerable party in the relationship. Practicing medicine and related healthcare occupations in an ethical manner is required by law, with laws in most countries setting minimum standards of conduct. While laws cannot account for every situation that every healthcare practitioner might encounter, they do require the professional to adopt and practice appropriate ethical approaches in all situations. They are required to maintain higher standards of behaviour and conduct than the general public.

It is not just clinical work that is governed by such ethical expectations, however, and all aspects of a professional’s life are expected to be guided by moral imperatives and a duty of accountability. This is why healthcare professionals are liable to be disciplined for any activity that might bring the profession – and, therefore, the relationship of trust between professional and patient – into disrepute.

In many other walks of life, the pursuit and acquisition of reward, affluence, entitlement and power, etc., define the extent of one’s success. For healthcare professionals, while these aims are not prohibited per se, they must be measured carefully against ethical expectations. And this may be an even harder measure for today’s intake of students, given the seemingly ever-increasing pressure on cost-of-living.
Any individual professional who neither understands nor accepts this ethical duty is at risk of violating the principle of honouring and protecting the patient and is in danger of compromising the health of their patients as well as risking their career.

For those willing to accept the ethical and moral responsibilities that are expected, medicine and allied professions can be extremely rewarding careers, bringing with them many professional and personal benefits.