Here are 3 assignments on medical ethics for a clinical officer: 1. Roles of a clinical officer in ethics: - Uphold ethical standards of the profession like confidentiality, informed consent, etc. - Act as a role model for ethical behavior for other healthcare workers and students - Identify and address any unethical practices in the healthcare facility - Provide ethical counseling and advice to patients, families and colleagues on difficult medical cases - Participate in ethics committees and help resolve ethical dilemmas - Educate patients and communities on their ethical rights and responsibilities 2. Principles of ethics with examples: - Autonomy: Respecting patient's right to make their own healthcare decisions. - Benef

1. medical Ethics and
Professionalism
Mr. Kigozi Edward
BME,DCM

2. Course Description
This course will enable the trainee develop
in-depth knowledge regarding the ethical
code of conduct, knowledge of laws and
regulations related to nursing practice
Professionalism.
Aim:
The course aims to equip the trainees with
knowledge, skills and attitude in clinical
Ethics and Professionalism

3. Objectives
By the end of the lesson, the trainee should
be able to;
i. Analyze the concepts, and principles of
medical Ethics and Professionalism
ii.Discuss common ethical issues related to
the health professions

4. Definition of Terms
Ethics:
A specialized area of philosophy whose origins can
be traced to ancient Greece.
Ethics are general declarations of what is right or
wrong and of what aught to be.
They are usually presented as systems of value
behaviours and beliefs.
They serve the purpose of governing conduct to
ensure the protection of an individual’s rights.
Ethics: usually refers to the practices, beliefs, and
standards of behavior of a particular group such
as health professionals. It also refers to the
method of inquiry that assists people to
understood the morality of human behavior (study

5. Cont’d
• Medical Ethics, are general ethics
applied to the practice of all aspects of
medical care.

6. CONT….
• This is a code of conduct which is
accepted voluntarily within medical
profession.
• The members pledge themselves upon
their honors to keep and to be governed
by it in their medical practice.
• It dates back to the time of the father of
medicine, Hippocrates, physician bone in
460 B.C. He founded the famous
Hippocratic oath

7. • This oath was modified in into Geneva
Declaration after world war II by WMA in
1949, ammended in 1968 and 1983

8. DECLARATION ON GEVEVA
At the time of being admitted as a member
of the medical profession; I solemnly pledge
myself to consecrate my life to the service of
humanity;
I will give my teachers the respect and
gratitude which is their due;
I will practice my profession with conscience
and dignity.
The health of my patient will be my first
consideration;

9. CONT…..
• I will respect the secrets which are
confided in me, even after the patient has
died;

10. CONT…..
I will maintain by all means in my power and
the noble traditions of the medical
profession;
My colleagues will be my brothers;
I will not permit considerations of religion,
nationality, race, party politics or social
standing to intervene between my duty and
my patient.
I will maintain the utmost respect for human
life from the time of its beginning even under

11. CONT,…….
threat and I will not use my medical
knowledge contrary to the laws of humanity;
I make these promises solemnly, freely and
upon my honour.

12. CONT…
This is a code of conduct which is accepted
voluntarily within medical profession
Code of conduct/medical ethics for
clinicians has 5 categories
•Responsibility to the patient
•Responsibility to the society
•Responsibility to colleagues
•Responsibility to the laws and the
profession

13. RESPONSIBILITY TO THE PATIENT
• The right to quality services
• The right to autonomous choice
• The right to be informed
• The right to be informed
• The right to privacy
• The right to health education
• The right to observe absolute
confidentiality
• The right to receive emergency care.

14. RESPONSIBILITY TO THE SOCIETY
• A doctor shall ensure that no action on his
or her part, or within his or her sphere of
responsibility is detrimental to the interest,
health or safety of the public.
Example
Notification of an outbreak e.g Ebola,
covid 19,etc

15. RESPONSIBILITY TO THE COLLEAGUES
•Cooperate with professional colleagues
Shall behave towards his colleagues as
he would have them behave towards him.
•Shall not entice patients from his
colleagues
• Report colleagues’ unethical practices.

16. RESPONSIBILITY TO THE LAWS AND THE
PROFESSION
•Uphold law, honor, dignity and ethical
principles.
•Not engaging in activities which discredit
the profession.
•Must be registered to practice

17. RESPONSIBILITY TO
RESEARCH
• Not to participate in research that is
not conforming with nationally and
internationally accepted guidelines

18. Definition of Terms cont’d
Code of Ethics:
Is a written list of a profession’s values and
standards of conduct.
It is a framework for decision making by the
profession and should be oriented toward
the day-to-day decisions made by
members of the profession.

19. UNETHICAL CODE OF
CONDUCT
• Self advertising by doctors, unless
permitted by the laws of the country.
• Paying or receiving fee to procure referral
of patient or prescribing a product for
patients.
• Divulging discoveries of new techniques or
treatment through non-professional
channels.
• Not issue certificate to cases he has not
personally verified.

20. CONT…
• Drug addiction
• Divulging into sexual intercourse with
patients and patient’s attendant

21. CONT…
GAZETTED DISCIPLINARY MEASURES
1.Warning
2.Suspension from some activities
3.Interdiction
4.Retirement in public interest
5.Dismissal

22. Definition of Terms cont’d
Values:
Are ideals or concepts that give meaning to the
individual’s life.
Values are usually derived from societal norms,
religion and family orientation.
They serve as the framework for making decisions
and taking certain actions in everyday life.
They are usually not written down.
It is necessary to undertake a value clarification
process

23. Definition of Terms cont’d
Value Conflicts:
Can force an individual to select a higher
priority value over a lower one e.g. a HCP
who values both his/her career and his/her
family may be forced to decide between
going to work and staying at home with a
sick relative etc.

24. value clarification process
Requires that the Health Care Provider
(HCP):
•Identify,
•assess,
•evaluate
•Then determines a set of personal values
•Find out how the priority values are to be
ranked.

25. 25
Helping clients identifying their
values
• List alternatives
• Examine possible consequences of choices
• Choose freely
• Feel good about the choice
• Affirm the choice
• Act on the choice
• Act with a pattern
Remember: never impose your personal values
never offer an opinion

26. Definition of Terms cont’d
Morals:
The fundamental standards of right and wrong that
an individual learns and internalizes, usually in
the early stages of childhood development.
Moral behavior is usually in accordance with a
group’s beliefs, norms, customs or
traditions/culture.
• Morals: is similar to ethics and many people use
the two wards interchangeably (closely
associated with the concept of ethics)
• Derived from the Latin “mores”, means custom

27. 27
Comparison of morals and ethics
Morals
• Principles and rules of right
conduct
• Private, and personal
• Commitment to principles and
values is usually defended in
daily life
• Pertain to an individual‘s
character
Ethics
• Formal responding process used to
determine right conduct
• Professionally and publicly stated
• Inquiry or study of principles and
values
• Process of questioning, and perhaps
changing, one’s morals
• Speaks to relationships between
human beings

28. Definition of Terms cont’d
Rights
Something owed to an individual according
to just claims, legal guarantees or moral
and ethical principles.
Many times, individuals tend to claim things
as rights, when what they are claiming are
really privileges, concessions or freedoms.
In order to avoid confusion in claims, rights
are classified in the following three types:

29. i) Welfare rights (also called legal rights)
are based on a legal entitlement to some
good or benefit. Those rights are
guaranteed by law e.g. The Nurses Act,
Pharmacy Act etc.
A violation of such rights can be punished
under the legal systems e.g. all rightly
trained and certified HCPs have a right to
professional registration and practice,
regardless of race, sexual preferences or
religion.

30. ii) Ethical rights (also called moral rights)
are based on a moral or ethical principle.
Ethical rights do not usually need to
have the power of law in order to be
enforced.
However, popular acceptance of ethical
rights can give them the force of a legal
right.

31. iii) Optional rights: These are rights that are
based on a fundamental belief in the dignity
and freedom of human beings. Optional rights
give individuals freedom of choice and the
right to live their lives as they choose, but
within a given set of prescribed boundaries
e.g. people may wear whatever clothes they
choose, as long as they wear some type of
clothing and don’t walk naked. In the USA and
other democratic countries, people may
choose to live a gay/lesbian live, as long as
they are not forced into it or force others into it.

32. Definition of Terms cont’d
Laws:
Man-made rules of social conduct that protect
society and are based on concerns about
fairness and justice. Laws are enacted by an Act
of Parliament of any country.
The goals of laws are preserving the species and
promoting peaceful and productive interactions
between individuals or groups of individuals by
preventing the actions of one citizen from
infringing on the rights of another.
The two important aspects of laws are that;
• they are enforceable through some type of
police force, and
• they should be applied equally to all persons.

33. Definition of Terms cont’d
Ethical Dilemma/Challenge:
Is a situation that requires an individual to make a
choice between two equally unfavorable
alternatives. One’s obligations and another
person’s rights usually form the basis of the
dilemma/ challenge. By the very nature of the
ethical dilemma, there can be no simple correct
solution and whatever decision is made, often
must be defended by the decision maker,
against those who disagree with it.

34. Definition of Terms cont’d
Obligations:
Are demands made upon an individual, a
profession, a society or government to fulfill and
honor the rights of others.
Obligations are often divided into two categories:
i) Legal obligations – are those which have
become formal statements of law and are
enforceable under the law e.g. a HCP has a
legal obligation to provide safe and adequate
care for patients/clients under his/her care.

35. ii) Moral obligations – Are those based
on moral or ethical principles but are
not enforceable under the law e.g. in
most countries no legal obligation exist
for a HCP on a holiday/personal trip to
stop and help a road traffic accident
victim, but it is an ethical/moral
obligation to help such a victim.

36. Ethical obligations
• Respect of the code of ethics
• Respect for human rights
• Respect of persons
• Protection of privacy
• Integrity
• Access to health care services
• Respect of colleagues
• Safeguard patients confidences

37. Obligation to the sick
• Shall always bear in mind the obligation of
preserving life
• Shall owe his patients loyalty and all the
resources of his science. Whatever an
examination or treatment is beyond the
HCP’s capacity, should summon or refer to
another who has the necessary ability.
• Shall preserve absolute confidentiality on all
he/she knows about the patient even after the
patient has died.
• Shall give emergency care as a humanitarian
duty unless he/she is assured that others are
willing and able to give such care.

38. Obligations to colleagues
• Shall behave towards his/her colleagues
as he would have them behave towards
him
• Shall not entice patients from his/her
colleagues
• Shall observe the principles in the Geneva
declaration(oath)

39. Legal obligations
• Follow the code of health care ethics and
principle of medical ethics
• Observe the constitution of Uganda
• Follow the formal ways of delegation of care
for patients under your care after assessing
that the person being delegated is competent
enough
• HCP shall all the times comply with the
norms and standard, of professional conduct,
care and competence generally accepted by
the profession.

40. Obligations:
i. What are the ethical obligations of a
health care practitioner?
ii. What are Standards of professional
practice of a health care practitioner?
iii. What are the professional etiquette of a
health care practitioner?
iv. List the legal obligations of a health care
practitioner?
v. What are the General obligations of a
health care practitioner?

41. Standards of professional
practice
According to the international code of health
care ethics, a practioner shall,
i. Always maintain the highest standards of
professional conduct
ii. Not permit motives of profit to influence the
free and independent exercise of
professional judgment on behalf of patients
iii.In all types of nursing practice, be dedicated
to providing competent medical services in
full technical and moral independence, with
compassion and respect for human diginity.

42. Cont’d
• Deal honestly with patients and colleagues
and strive to expose those deficient in
character or competence, or who engage
in fraud or deception

43. CONT…
INTEGRITY
Is the practice of being honest and
showing a consistent and uncompromising
adherence to strong moral and ethical
principles and values
i.e. Integrity is regarded as being honesty
and truthfulness.

44. Question
• What is the Importance of observing ethics
in clinical practice

45. Importance of observing ethics in
medical practice
i. Nursing ethics is intended to protect and defend
the human dignity and rights of patients
ii. Guides medical practice
iii. Helps us to understand the patient’s behaviour
iv. There many in-coming medical/Nursing
challenges e.g legal suits/medical legal suits,
manipulation of science and genetics,
euthanasia, that nurses and other health care
providers need to address
v. Helps us to know how to conduct our selves
vi. Helps us to know how to handle student.
vii. Helps us to know how to make decisions in
ethical dilemma

46. Assignment
1. What are Roles of a clinical officer in
ethics
2. With clear and contemporary examples,
discuss the various principles of ethics.
3. Identify practices at your work places
which seem unethical.