Ethical issues in hospital medicine

The medical ethics of the new millennium will be fascinating and fast moving in our pluralistic Western society. This will be particularly true in ethics in the hospital setting and under hospitalist models. Ethical decisions are ubiquitous in medical practice, at the microlevel of the patient-physician relationship and at the macro-level of the allocation of resources and other ethical decisions. Hospitalists need to recognize that ethical issues are distinct from medical ones and need to utilize different techniques in their resolution. Ethics in the public sector, such as in hospitals and other health care organizations, cannot transcend politics completely, because the public sector is the political arena. For ethical guidelines to survive, however, they must be based not on political expediency but on sound ethical principles and reasoning. As the knowledge of medicine, technology, and science continues to grow, the challenges of regulation, policy, and ethical issues in the hospital setting and elsewhere in the health care system will occupy physicians for some time to come.