MBBS curriculum

1. OR

2. Medical Ethics
Dr Nikita Prabhakaran MBBS, MD
Senior Resident

3. Medical ethics
• Deals with the moral principles
• which should guide the members of medical profession
• In their dealings with each other, their patients and the State.

4. Medical etiquette
• Conventional laws of courtesy
• observed between the members of medical profession

5. MEDICAL JURISPRUDENCE
• Is the study of law in relation to medicine.
• It deals with the legal aspects of medicine
• such as legal rights, privileges,
and obligations of medical practitioner

8. DIFFERENT CODES OF ETHICS
• HIPPOCRATIC OATH -OLDEST ONE
• DECLARATION OF GENEVA –1948
• INTERNATIONAL CODE OF MEDICAL ETHICS-1949

9. • INDIAN MEDICAL DEGREES ACT -1919
• INDIAN MEDICAL COUNCIL ACT –1933, 1956
• MCI Amendment Act 2010
• NATIONAL MEDICAL COMMISSION ACT –2019

10. World
medical
association
National
medical
Council
State
Medical
council

12. INDIAN MEDICAL COUNCIL
•CONSTITUTION
1 member from each state (nominated by central Govt)
1 member from each university-medical faculty
1 member from each state
7 members from persons in any SMR
8 members nominated by central government
Among
themselves
Term of 5 years

13. FUNCTIONS OF INDIAN MEDICAL COUNCIL
1. Recognition of medical qualification
2. Supervision of undergraduate & postgraduate medical education
3. Recognition of foreign medical qualification

14. 4. Recognition of medical institutions
5. Warning notice
6. Appeal against disciplinary action

15. Warning notice
• IMC and SMC gives examples of offences which
constitutes serious professional misconduct
• but it stresses the fact that it is not a complete list.
• Each case has to be decided on its specific facts and merits

16. NATIONAL MEDICAL COMMISSION
• Passed in Lok Sabha in July 29, 2019
• NMC came into force from September 25, 2020
• Consists of 33 members
• A chairperson –a medical professional
• 10 ex officio members
• 22 part time members (law, research, public representatives)

17. National medical commission
• Chairman –Dr Suresh Chandra Sharma (former HOD, ENT, AIIMS) for 3 years
• Secretary –Dr Rakesh Kumar Vats (former secretory of board of governors of
IMC) for 3 years

18. • Registered medical practitioner may be known as
• ‘Graduate medical practitioner’

19. • Ensuring compliance by SMC with the regulations made under the bill
• Framing guidelines for determining the fee for up to 50% seats in
Private medical Colleges
Functions of NMC

20. Regulatory boards under NMC
• 4 autonomous boards
1. The Under Graduate Medical Education Board (UGMEB)
2. Post Graduate Medical Education Board (PGMEB)
3. The Medical Assessment and Rating Board (MARB) licensing new
institutions, maintenance of standards
4. The Ethics and Medical Registration Board misconduct

21. • Community Health Providers
• WHO standard Doctor : Population ratio = 1:1000
• India in Jan 2018 Doctor : Population ratio = 1: 1655
• This gap is to be filled by Community health providers who are licensed mid level medical
practitioners provided by NMC
• They prescribe specific medicines in Primary and Preventive health care
• Uniform NEET(National Eligibility cum Entrance Test)
• National Exit Test
• Common final year undergraduate exam for students graduating from medical institutions
• To obtain license for practice
• Serve as the basis for admission to postgraduate courses

22. State Medical Council
• Constituted by
• Medical teachers
• Registered medical practitioners
• State government nominees
Functions
Medical register
Disciplinary control

23. Judicial Proceedings in SMC
Conviction in court/
public complaint/
official complaint
Registrar President
Sub/
executive
committee
Doctor
summoned
Hearing and
enquiry
Disciplinary
committee
Vote and
judgment
Acquital
Warning
Temporary removal
Permanent erasure

24. PROFESSIONAL MISCONDUCT / INFAMOUS CONDUCT
Act of a medical man in the pursuit of his profession,
with regard to which it would be reasonably
regarded as Disgraceful or dishonourable
by his professional brethren of
Good repute & Competence.

25. 6 ‘A’s
• Abortion
• Addiction
• Adultery
• Advertising
• Association
• Conviction by court of law
• Refusing treatment on religious grounds
• Sex determination tests
• Dichotomy – splitting of fee
• Touting -selling
• Issuing false certificates
• Schedule H and L drugs
• Clinical trials without consent

26. PUNISHMENT
•Warning –minor offence
•Penal erasure

27. PENAL ERASURE / PROFESSIONAL DEATH SENTENCE
• Serious professional misconduct name is removed from the register temporarily/
permanently
• Permanent removal of name from the medical register PENAL ERASURE
• Death of practitioner
• Entries made in error
• Professional misconduct
• Not traceable in his address

28. RIGHTS & PRIVILEGES OF RMP
• Choose the patient
• Use title &description of qualification
• Appointment in public & local hospital
• Prescribe & dispense medicine

29. •Realize fee &expenses
•Issue medical certificates &ml reports
•Give evidence in a court of law
•Removal of organ for transplantation
•Perform MTP

30. Duties of medical practitioner
• 1.To uphold dignity of honour of profession
• 2.To exercise reasonable degree of skill and knowledge
• 3.With regard to attendance and examination
• 4.To furnish proper and suitable medicines

31. • 5.To give instructions
• 6.To control and warn
• 7.To third parties
• 8.Towards children and adults incapable of taking care of themselves

32. • 9.Inform patients of risks
• 10. With regards to poison
• 11.To notify certain diseases
• 12. With regards to operations
• 13. With regards to consultations
• 14. In connection with X-ray examination
• 15. Professional secrecy
• 16. Previleged communication

33. PROFESSIONAL SECRECY
• Doctor is obliged to keep as secrets all that he comes to know about
his patient during treatment
• Implied term of contract
• Disclosure without genuine reasons professional misconduct

34. PRIVILEGED COMMUNICATION
• Doctor can reveal certain information about a patient to protect the
interest of public or state.
• Better to get the consent of the patient

35. • 1.Veneral diseases spouse
• 2.Infectious diseases hostel
• 3.Notifiable diseases COVID 19
• 4. In patients interest
• 5. Suspected crime criminal case
• 6. Courts of Law offences
• 7. Insurance reports

36. Duties of a patient
• Furnish the doctor with complete past medical history, family
history of diseases and the facts and circumstances related to the
disease
• He should strictly adhere to the instructions of the doctor with
regard to diet, medicines, life style changes
• He should pay reasonable fee to the doctor

37. Privileges and Rights of patients
Choice
Access
Dignity
Privacy
Confidentiality
Information
Safety
Right to know
Right to refuse
Second opinion
Records
Continuity
Comfort
Complaint
Compensation

38. Lets add
smiles!!!!!!!!!!!!!!