Healthcare: Ethics, Fidelity and Justice

Common Ethical Considerations

• Loyalty reflects allegiance and support for others
• Fidelity represents faithfulness and adherence to promises
• Non-maleficence emphasizes avoiding harm to others
• Justice ensures fairness and equality in actions

Fidelity

• Principle: Healthcare providers must be faithful to their patients
• Provide services that are in the patient's best interest.
• Fidelity keeps the patients as a priority

Justice

• Treating people equitably and fairly regardless of who the recipient is.
• Principle requires all benefits and loads to be distributed equally
• Not all patients have an equal needs
• It is not always possible to provide the same level of care to all patients at all times

Prioritizing Surgical Procedures

• During a pandemic non-emergency surgeries should resume elective procedures to improve patient care
• During a pandemic emergency and cancer surgeries should focus on critical cases to save lives

Justice and Triage

• Triage is a system has to be established to provide care as fairly as possible by assignment of degrees of urgency.

Rapid Triage

• Priority 1 (Red): Immediate treatment is needed for life-threatening conditions.
• Priority 2 (Yellow): Urgent treatment is needed, with a delay of up to 1 hour.
• Priority 3 (Green): Treatment can be delayed for up to 3 hours.
• Priority 4 (Black): No care is needed, as the patient is deceased.

Additional Notes on Justice

• There is no justice in using a very expensive drug that has a limited benefit to treat a patient with a rare, non-life-threatening disease, or a disease that can be managed with simple preventive measures
• Use money to treat life-threatening and common diseases

Non-maleficence

• Prevention of harm and the removal of harmful conditions
• Overlaps with beneficence but it prevents harm
• Principle requires to not intentionally create harm or injury to the patient
• Refusal of a pharmacist to sell a medicine if the pharmacist thought it was being purchased for a wrong reason

Loyalty

• Keeping the patient coming to the pharmacy
• Most pharmacists focus on what products they have in their store instead of what they do in their store
• Implement an adherence program and investigate for pharmacy staff
• Know the market
• Do something different like multiple dose packaging or medication disposal programs