The Health Corner Vol. 46 – Ethics

Today, we will discuss ethics as related to health care, and specifically how I see ethics as a healthcare practitioner.

Ethics are primarily defined as having to do with moral duty and obligation, or a set of moral principles and values to which an individual or a group adheres. With this in mind, I once asked an individual, who is quite a business man, “How do you arrive at a fair price?” And his answer was, “I look at what I think the target market can afford.” According to this answer, if he were the only person on earth that had a particular product that people needed, he would charge as high as he thought the consumer would be willing to pay. In other words, whatever value the consumer put on the product would be what he could get. Let’s say for instance somebody had a very rare disease and the businessman in question had a cure for that disease. Well, according to him, a fair price would be whatever value that person put on his life … a million dollars, two million dollars, etc.

I disagree with this thinking because when we talk about ethics, we’re talking about what is good and what is bad, what is moral and what might be immoral. And, therefore, I tend to look at the idea of exchange and fair exchange in this light. Whenever someone enters into an agreement with another person regarding the purchase of a product or a service, there is the whole idea of exchange. This means that one person receives a product or service and, in exchange for that service or product, the other individual receives a payment. A good exchange is one in which both parties benefit, and in which there is some equity. For instance, if I sold you a lollipop and charged you a thousand dollars for it, that would not be a fair exchange. But if I only charged you a dollar for it, that would be fair.

One of the reasons ethics is a concern to me is that, for years, I did not understand the whole idea of treatment using the chiropractic principal. I did not recognize the fact that, often times, optimum results cannot be obtained in one, two, or even three visits. Many factors must be considered such as the severity of the condition, the length of time the patient has been suffering, the actual health of the individual, the age of the individual, etc. All of these things come into play in determining the effectiveness and length of treatment, and therefore the expense incurred to the patient. And since the practice of chiropractic espouses restoring proper function to the body and not just on the alleviation of symptoms, it takes quite a different turn from the medical model. Using the medical model, if you have pain, the fastest and easiest way to alleviate that pain may be just to destroy the nerve that pain signal is travelling along.

What may not be considered in any real depth is that the results of this nerve destruction may cause further problems for the patient down the road. In other words, if one is just concerned with getting rid of the pain as quickly as possible and nothing else, the end is going to be achieved, but there will most likely be great consequences as a result of that choice. I think you will agree that it is far better to get to the cause of the problem instead.
Let me give an example. Let’s say that what is causing a patient pain is a pinched nerve somewhere in the spine. Now, correcting a pinched nerve may require several applications of manipulative treatment. It’s often not a simple thing to relieve this kind of pain, but takes time and dedication. Where ethics comes into the picture is in the area of “how much time and consequently money should it actually take in order to correct this problem?” Those that adhere only to the application of the chiropractic principal to the exclusion of all other modalities would say that if the problem isn’t getting corrected it is because the individual isn’t undergoing enough treatment. This is not always the case. If there is more going on than what appears to be just a pinched nerve, then other things will have to be considered in order to properly handle the case.

This is where I have wrestled with the idea of ethical rightness or wrongness over the years. And I find that I must strike a balance between the patient’s best interests health-wise and what is expedient for him financially. I am not on the take, but greatly desire to see my patients fully benefit from my care. So, though I take into consideration the financial status of the patient, in the end, I must recommend treatment based fore mostly on the patient’s health needs. Again, I am sure you will agree this is a balanced and fair approach to the issue.

The bottom line is that I am committed to giving the best possible care to my patients AND to being fair in what I require for remuneration for said care. I will not charge for my services based on what I can ‘get’, like our friend the businessman, but will only perform the necessary procedures at a fair and reasonable price. I consider it my duty as a respected healthcare practitioner to deal justly with my patients on every level.

I am thankful for the trust people in this community have put in me, and I hope to continue to earn and keep that trust for years to come.

Here’s to your good health.

Dr. Jon R. Link