The imbedded role of ethics in healthcare: a contribution from translational research

Abstract

The practice of public and global health confirms that ethics is imbedded in healthcare. Although ethics may be regarded as inherent to the healthcare profession, values and trust are challenged because of the quality of product (service and delivery), inequality in the global healthcare system and rapid technological developments in healthcare. Regardless of good systems and supportive ethical codes in healthcare practices, there are nevertheless ethical challenges in healthcare. This situation necessitates an attempt to understand the dual role that ethics can play as foundation for healthcare systems based on the global accepted understanding of “do no harm” and as an activity alongside many other healthcare activities. This paper discusses these roles of healthcare ethics in addition to the existing, but limited, focus on the patient in the healthcare system. The argument is presented that attention should be given to the ethical needs of those people (in different roles) engaged in the delivery of healthcare. The focus of the paper is on the role that ethics can play in healthcare as a system and a service. Four developments are identified in support of this focus, namely the cost of healthcare; cultural influences on and preparedness for service; the increasing number of aged individuals and their healthcare needs; and ethical challenges such as informed consent. From these developments the central perspective of the paper is presented, namely that ethics should be part of any healthcare system and the promotion of the well-being of people in healthcare, rather than merely the health of the individual patient only. Glouberman and Mintzberg’s identification of four worlds (cure, care, control and community) is used as context for the argument. The research is based on a translational research methodology approach to provide best practice perspectives to the healthcare industry.