Medical Ethics, Bioethics, Professionalism

1. MBBS, MPH, DPH, MCPS, MBA, DCPS-HPE, PGD-
Statistics, CCRP
matharm@yahoo.com

2. 3/20/2021 DR ATHAR KHAN LCMD 2
Surah Ar-Rum Ayat 15
‫رہے‬ ‫کرتے‬ ‫نیک‬ ‫عمل‬ ‫اور‬ ‫الئے‬ ‫ایمان‬ ‫لوگ‬ ‫جو‬ ‫تو‬
‫وہ‬
(
‫کے‬ ‫بہشت‬
)
﴿‫گے‬ ‫ہوں‬ ‫حال‬ ‫خوش‬ ‫میں‬ ‫باغ‬
۱۵
﴾

6. Sunnah means what
the Prophet
Muhammad said, did,
or conducted.
Islamic Law - The Shariah

10. The character of a person consists of all the
qualities they have that make them distinct
from other people. Conduct (person
behaves)
Customs: A traditional and widely accepted way of behaving or doing something that is
specific to a particular society, place, or time.
‫اخالقیات‬
Ethics

11. ‫اخالقیات‬
Ethics

12. ‫اخالق‬ ‫بہ‬
,
‫رکھنے‬ ‫سمجھ‬ ‫کی‬ ‫وبد‬ ‫نیک‬
‫واال‬
,
‫و‬ُ‫خ‬
,
‫عادت‬
,
‫اخالقی‬
,
‫شائستہ‬

14. The ethical dentist strives to do that which is
right and good.

16. ‫اختیاری‬ ‫خود‬ ‫حق‬
PATIENT AUTONOMY (“self-governance”)
The dentist has a duty to respect the patient’s rights
to self-determination and confidentiality.
‫رازداری‬
PATIENT INVOLVEMENT CONFIDENTIALITY OF PATIENT RECORDS

17. NONMALEFICENCE (“do no harm”). The dentist has
a duty to refrain from harming the patient.
Obligation of keeping
their knowledge and skill
current
Knowing one’s own limitations
and when to refer to other
professional
Supervise the patient care
provided by all auxiliary
personnel working under their
direction
Don’t use abusing controlled
substances, alcohol or other
chemical agents which
impair the ability to practice

18. NONMALEFICENCE (“do no harm”). The dentist has
a duty to refrain from harming the patient.
Immediately inform any patient who may have been exposed
to blood or other potentially infectious material in the dental
office
Dentists should avoid interpersonal relationships that could
impair their professional judgment or risk the possibility of
exploiting the confidence placed in them by a patient.

19. BENEFICENCE (“do good”). The dentist has a duty to
promote the patient’s welfare.
Dentist’s primary obligation is service to the patient and the
public-at-large.
COMMUNITY SERVICE During public health crises or
emergencies provide services to
public
A part of a professional
society and of observing
its rules of ethics

20. BENEFICENCE (“do good”). The dentist has a duty to
promote the patient’s welfare.
RESEARCH AND DEVELOPMENT
REPORTING ABUSE AND NEGLECT
Provide a workplace environment that supports respectful
and collaborative relationships for all those involved in oral
health care

21. JUSTICE (“fairness”). The dentist has a duty to treat
people fairly.
Dentists shall not refuse to accept patients into their practice
to patients because of the patient’s race,, color, gender,
national origin or disability.

22. VERACITY (“truthfulness”). The dentist has a duty to
communicate truthfully.
Dentists shall not represent the care being rendered to their
patients in a false or misleading manner.

23. Ethical Dilemma – competing obligations with two or
more options possible to resolve the situation.

24. Scenario 1: You’ve been running behind schedule all
day and have not had time to clean and sterilize
instruments from the morning patients. You’ve
discovered that there are no more sterile cord-packing
instruments, and your last patient of the day has waited
10 minutes past her appointment time for a crown prep
procedure. CHOICES: You can quickly process the
instruments you need and sterilize them in an
“immediate use” cycle in the autoclave, delaying the
procedure at least another 10 minutes, or you can
thoroughly wipe down the instruments with a one-minute
intermediate-level disinfectant and incorporate them in
your tray set-up.

25. Scenario 2: An 80-year-old, fully conscious, and
competent man with advanced incurable cancer needed
palliative chemotherapy. The family objected when the
doctor wanted to obtain informed consent from the
patient because that would involve disclosing the
diagnosis, which would make the patient very sad and
depressed. The family wanted to make the decision
without informing the patient. What should the doctor
do? Provide your moral reasoning.

26. Scenario 2: The doctor should respect the patient‟s
autonomy. He should first ask the patient whether he
personally wanted to receive information about his
condition in order to make decisions on his treatment, or
whether he would prefer that the information be
disclosed to his family, and the family authorized to
make decisions on his behalf. If he insists on making
decisions for himself, he must receive full disclosure and
exercise his autonomous right to informed consent. If he
chooses to leave everything to the family, the doctor can
deal with the family accordingly.

27. Scenario 3: A young neurosurgeon planned to operate
on a patient with lumbar spinal injury that had a 5 - 10%
chance of success. He felt uncertain about taking
informed consent. If he informed the patient that the
operation could go wrong and result in paraplegia, there
was a 90% chance the patient would refuse the
operation. If the operation was not carried out, there
was a 95% chance of further deterioration, leading to
paraplegia after a few months. What should the
neurosurgeon do? Provide your moral reasoning.

28. Scenario 3: The patient has a right to full disclosure
even if that will result in refusal of treatment. Fear of
refusal of necessary treatment is not a justification for
violating the patient‟s autonomy.

30. Dr Athar Khan
Liaquat College of Medicine & Dentistry
Karachi, Pakistan
matharm@yahoo.com
MBBS, MPH, DPH, MCPS, MBA, DCPS-HPE, PGD-Statistics,
CCRP
DR ATHAR KHAN LCMD
3/20/2021 30