Med ethics by dr najeeb

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Med ethics by dr najeeb

  1. 1. DR: NAJEEB MEMON Asst: Professor COMMUNITY MEDICINE & P.H.S LUMHS, JAMSHORO Sind, PAKISTAN e mail mnajeeb80@gmail.com
  2. 2. also known as moral philosophy, branch of philosophy addresses questions about morality that is, concepts such as Good and evil, Right and wrong, Virtue and vice Justice & Crime. etc also known as moral philosophy, branch of philosophy addresses questions about morality that is, concepts such as:
  3. 3. Medical Ethics system of moral principles that apply values and judgments to the practice of medicine. Medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, & sociology.
  4. 4. OR The application of moral principles and analysis to medical situations
  5. 5. Medical Ethics (WHO) • Medical Ethics Ethics is the understanding of moral values. Medical ethics means the moral principles, which should guide the members of the medical profession in the course of their practice of medicine and in relationship with their patients and other members of the profession.1 Medical ethics is a code of conduct for the member of the medical profession in order to render the best possible service to the humanity and to maintain the honour and dignity of the profession. It is the code containing the main principles for the information & guidance of registered medical practitioners in course of their medical practice, which defines the duties of the doctors in general, their duties towards the sick & their duties towards one another. Central areas of health ethics : In the context of fairness and equity the physician should consider the economic situation of patient & family, choosing patients for treatment under resource constraints. WHO has given special emphasizes to work on some specific health issues like treating HIV/ AIDS patients, patients with mental illness, making end-of-life decision (Euthanasia), organ donation and transplantation and medical termination of pregnancy. Physicians of government and non-governmental organizations, lawmakers and member of the civil society should jointly come up with a policy to deal with these specific health issues mentioned by WHO.
  6. 6. “I solemnly pledge to: – dedicate my life to the service of humanity; – give due respect and gratitude to my teachers; – practise my profession with conscience and dignity; – make the health of my patient my first consideration; – respect the secrets which are confided in me; – uphold the honor and noble traditions of the medical profession; – SMC’S PHYSICIAN’S PLEDGE
  7. 7. –respect my colleagues as my professional brothers & sisters; – not allow the considerations of race, religion, nationality or social standing to intervene between my duty and my patient; – maintain due respect for human life; – use my medical knowledge in accordance with the laws of humanity; – comply with the provisions of the Ethical Code; – and constantly strive to add to my knowledge and skill; – I make these promises solemnly, freely and upon my honor.”
  8. 8. Hippocratic Oath “Do no harm” 460 --- 377 BC.  Ishaq bin Ali Rahawi 10th Century. ( Conduct of a Physician, the first book dedicated to medical ethics) Thomas Percival. “Code of medical ethics” 1803.  American Medical Association. Adopted its first “code of ethics” based on Percival work 1847. World Medical Association. Adopted “International Code of Medical Ethics” 1949. Adopted “Declaration of Helsinki”( research ethics) 1964. HISTORICAL BACKGROUND
  9. 9. Principles of medical ethics have evolved over centuries •Greek------4th centaury BC •Chinese code of conduct--dating from the 2nd century BC. • India----2000 years ago • Roman • Islamic code of medical ethics • Contemporary medical ethics & concept of legal practice Country wise [ regulating bodies PMDC,NHS, AMA] Who/Geneva WMA
  10. 10. The Principle of Autonomy The Principle of Beneficence The Principle of Non-Maleficence The Principle of Truth The Principle of Confidentiality(or Fidelity) The Principle of Social Responsibility and Justice http://mdmedicine.wordpress.com/2011/04/05/what-is-medical-ethics/ PRINCIPLES IN MEDICAL ETHICS
  11. 11. Patients must be able to trust doctors with their lives and wellbeing. To justify that trust, we as a profession have a duty to maintain a good standard of practice and care and to show respect for human life.
  12. 12. In particular as a doctor you must 1. Make the care of your patient your first concern.
  13. 13. 2 Treat every patient politely and considerately.
  14. 14. 3. Respect patients’ dignity and privacy.
  15. 15. 4. Listen to patients and respect their view.
  16. 16. 5. Give patients information in a way they can understand.
  17. 17. 6. Respect the rights of patients to be fully involved in decision about their care.
  18. 18. 7. Keep your professional knowledge and skills up to date.
  19. 19. 8. Recognize the limits of your professional competence.
  20. 20. 9. be honest and trustworthy
  21. 21. 10. Respect and protect confidential information.
  22. 22. 11.make sure that your personal beliefs do not prejudice your patients’ care.
  23. 23. 12. Act quickly to protect patients from risk if you have good reason to believe that you or a colleague may not be fit to practice.
  24. 24. 13. Avoid abusing your position as a doctor.
  25. 25. 14. Work with colleagues in the ways that best serve patients’ interests.
  26. 26. In all these matters: you must never discriminate unfairly against your patients or colleagues. And you must always be prepared to justify your actions to them .
  27. 27. Finally Always opt for the cheapest effective treatment
  28. 28. Always opt for the best treatment
  29. 29. Keep this confidence
  30. 30. What is my purpose? What is my priority?
  31. 31. Treat this patient rather than the patient
  32. 32. Respect patients wishes Maximize Autonomy Always strive to do the very best for one’s individual patient
  33. 33. Confidentiality
  34. 34. Confidentiality is at the centre of maintaining trust between patients and doctors
  35. 35. Principles of confidentiality
  36. 36. 1. Patients have a right to expect that you will not disclose any personal information which you learn during the course of your professional duties, unless they give permission
  37. 37. 2. When you are responsible for confidential information you must make sure that the information is effectively protected against improper disclosure when it is disposed of , stored, transmitted or received.
  38. 38. 3. When patients give consent to disclosure of information about them, you must make sure they understand what will be disclose, the reasons for disclosure and the likely consequences;
  39. 39. 4. You must make sure that patients are informed whenever information about them is likely to be disclosed to others involved in their health care , and that they have the opportunity to withhold permission,
  40. 40. 5. You must respect requests by patients that information should not be disclosed to third parties, save in exceptional circumstances
  41. 41. 6. If you disclose confidential information you should release only as much information as is necessary for the purpose
  42. 42. 7. You must make sure that health workers to whom you disclose information understand that it is given to them in confidence which they must respect.
  43. 43. 8. If you decide to disclose confidential information, you must be prepared to explain and justify your decision.
  44. 44. THANKYOU
  45. 45. How to Analyze an Ethics Case • What is being proposed? – What are the medical issues? – Risks, benefits, alternatives – Case and statutory law • Who are the stakeholders? • Patient, family, medical staff, hospital, state • Cultural and religious concerns • Are possible consultants to medical, legal, and ethical issues • When does this need to be done? – Emergency exceptions to informed consent • Why is an ethical dilemma being created? – Conflicts between decision makers, law and ethics • How can this be resolved? – Meeting(s), buying time, consultation(s)

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