As more physicians join HMOs, accept capitation, and become owners of independent practice associations, each must address these issues independently. Ethical issues in medicine Ethics are the set of values, beliefs, and principles that guide our lives. Some of the concepts and behaviors we value in American society are autonomy of the individual, honesty, the sanctity of life, fairness, and keeping promises. These are not universal, however. Many people around the world do not value autonomy as we do, and in some cultures, doctors are not expected to tell the truth to their patients.
Ethical issues permeate medicine, starting with our duty to do no harm.
Beyond that are the issues of deciding what is best for patients' welfare, telling patients about our errors and those of other physicians, deciding whether assisting a suicide breaches the physician-patient bond, and the difficult responsibility of honoring the wishes of patients when they can no longer express them. The marketplace is forcing healthcare budgets into fairly narrow ranges, so MCOs must decide how to designate dollars for best effect. This allocation of resources by principle rather than at random is rationing in the good sense. Rationing simply means setting limits and is not in itself an ethical issue. Ethics become involved when value judgments are made in setting the limits.