Doctors have to contend with many ethical dilemmas

Posed photo of a medical practitioner.
Posed photo of a medical practitioner.PHOTO: ST FILE

Mr Ho Kwon Ping, in his speech at the graduation ceremony of Duke-NUS Medical School, chose to talk about ethical dilemmas faced by doctors (Paradoxes in medical technology, June 4).

Here are some other dilemmas to reflect on:

As our population ages, the pressure on doctors to keep sick people alive is ever increasing. Should they help people who want to end their lives and misery if stricken with a terminal disease? Parliament should consider whether a law is necessary to allow clinicians to help patients die in certain circumstances.

The ethical dilemma facing most doctors is whether, in very low-resource settings, the care of the individual overrides the equitable distribution of resources to society at large.

In economic terms, we might say that the person's care is not cost-effective because for the same amount invested in him, we could prevent more deaths for a greater number of patients.

An elderly driver has to go through periodic medical checks before his driving licence is renewed. Taking away the licence of a driver who has become demented or partially blind can stir up anger and depression. Most regard driving as a fundamental right, and without their licence, they are exposed to isolation and loneliness. But the doctor has a duty to advise his patient to stop driving.

Should doctors protect the public from colleagues who are impaired, addicted or downright incompetent? Some doctors who drink excessively suffer from memory loss.

In any case, the need to shield the public from harm outweighs the need to protect a doctor's reputation.

There are strong ethical arguments against doctors who date their patients. Having intimate relations with patients, even when consensual, can exploit the patient's vulnerability and compromise the doctor's ability to make objective judgments about the patient's care.

Like lawyers and priests, a doctor has an obligation to keep his patient's data and sickness confidential. If a person tells his general practitioner that he has been a victim of domestic abuse but refuses to tell the police, should the doctor do so?

Some rules and conventions may not be legal, but it behoves the doctor to have his patient's interest foremost in his mind.

Heng Cho Choon

A version of this article appeared in the print edition of The Straits Times on June 07, 2019, with the headline 'Doctors have to contend with many ethical dilemmas'. Print Edition | Subscribe