It is crucial for health care givers to have a high level of ethical codes and principles. Different ethics can be used to improve the human health like the bioethics. The major ethical principles include; (Ascension Health, 2005) principle of beneficence, principle of common good, principle of distributive justice, principle of double effect, principles of formal and material cooperation, principle of human dignity, principle of informed consent, principles of integrity and totality, principle of proportionate and disproportionate means, principle of religious freedom, principle of respect for autonomy, principle of respect for persons, principle of stewardship, principle of subsidiary and principle of toleration. Ethical issues and dilemmas have occurred in accordance to these ethical principles since sometimes there is a conflict between these principles and the condition of a particular patient. Mostly, these ethical issues and dilemmas occur when dealing with the elderly, the critically ill, and infants who are not in a position to make their own decisions.
Ethical dilemmas can occur especially when following the ethical principle of respect for autonomy. This is where if the patient is in a position to make decision, they have the right to make decisions about what the want to be done about their health whether it is approved by the doctor, family or not. This puts the doctor, nurse or any other health care practitioner in a dilemma especially if the decision the patient is making can be of harm to the health of the patient. This ethical principle can be clearly followed if the health care practitioner explains vividly the medical condition and the risks which may be involved when a particular treatment is undertaken (Deshpande, 2009). For instance, an ethical dilemma may arise in the case where a cancer patient refuses to undergo chemotherapy and radiotherapy and opts for operation. The doctor is going to be in a dilemma because if the cancer cells have already spread, operation will not help. The decision of the patient may force the physician to do something which is not right. The dilemma also arises if the patient cannot make decision like for the elderly and infants who have to depend on other for decision making.
There is also another ethical dilemma which arises due to confidentiality since health care givers are supposed to maintain a high level of confidentiality. Confidentiality is important since it develops trust which is crucial in the healing process (Deshpande, 2009). Patients may have doubts if their information will remain private, they may fail to comply with treatments. Sometimes, it may be important to inform the family members or care givers about the patient especially when they are being discharged. Therefore the physician should seek the consent of the patient and explain the importance of passing the information to the caregivers. Sometimes the patient may refuse but the physician should adhere to this even if it is not good.
Sometimes there could be competing interests based on religion. There are some religious practices which are against some medical treatments (Ascension Health, 2005). The patient may refuse a particular procedure because it is against his/her religious beliefs (Buisman, 2010). In this condition, the physician is required to follow the principle of religious freedom and not force the patient towards what is against his/her religion. Under this circumstance, the physician should explain to the patient the importance of that procedure and the dangers which might arise if it is not carried out. Incase the patient is a minor, the guardians can be consulted (Ascension Health, 2005). In some conditions if the patient’s life is at stake and will lead to suffering to other people, this principle can be violated.
Conflict of interest can also occur if what the patient is deciding will bring harm to him/her or it is not what the physician prefers. In this condition, the physician should use the principle of respect for autonomy (Ascension Health, 2005). Conflict also occurs when the physician needs to pass some information to the patient’s caregivers but the patient is not willing. The physician should use the principle f confidentiality. Sometimes there could be competing interest especially where there is a group of patients (Ascension Health, 2005). In this condition the physician should use the principle of common good.
References
Ascension Health (2005). Key Ethical Principles. Retrieved on April 25, 2011, from http://www.ascensionhealth.org/ethics/public/key_principles/main.asp.
Buisman, A. (2010). Family Presence during CPR in the Emergency Department: A Nurse’s Reflection. Journal of Nursing.

Deshpande, S.P. (2009, Dec.). A Study of Ethical Decision Making by Physicians and Nurses in Hospitals. Journal of Business Ethics. (90)3, 387-397