Role of eithics in hospital management


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Role of eithics in hospital management

  1. 1. ROLE OF EITHICS IN HOSPITAL MANAGEMENT Dr. Abdul.Ghafoor Shoro Executive Director College Of Family Medicine Pakistan
  2. 2. Medical Ethics Ethical Issues in Healthcare
  3. 3. WHAT IS MEDICAL ETHICS? • Medical ethics refers – chiefly to the rules of etiquette adopted by the medical profession to regulate professional conduct with each other, – but also towards their individual patients – and towards society, – and includes considerations of the motives behind that conduct.
  4. 4. Types of Ethics: Types of Ethics Medical Ethics: Clinical obligations fidelity first to patients’ interests telling the truth (cancer, errors).  Professional Ethics: Obligations of the profession self-regulation education of self and others. Bioethics: Guides for public policy gene technology, stem cell research health system reform
  5. 5. Interconnectedness of Rights, Trust, and Obligation Public Trust Patient Rights Health Care Worker Obligations 5
  6. 6. A new ethical code for health care in the 21st century? While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the Art, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.” (The Hippocratic Oath, 5th century B.C) Need for medical ethics In a world of health care economics, consumers, clients and service providers, health care has to be based on sound ethical principles that reflect the reality and needs of contemporary society
  7. 7. The philosophical underpinnings of medical ethics • ETHICAL THEORIES • DEONTOLOGY (Deon = duty) – Springs from moral obligations – Actions determined by rightness or wrongness ( virtue ethics) – The outcome of action is not important The philosophical underpinnings of medical
  8. 8. ETHICAL PRINCIPLES The Principles of medical ethics: Autonomy • Autonomy: Respect for an individual’s autonomy or ability to make decisions for him/herself – includes respect for their privacy and confidentiality – need to provide sufficient information for them to make informed choices – truth telling – protection of persons with diminished or impaired autonomy.
  9. 9. ETHICAL PRINCIPLES • Beneficence: This refers to the tradition of acting always in the patients’ best interest to maximise benefits and minimise harm. • Non-malfeasance: This principle ensures that treatment or research ought not to produce harm The Principles of medical ethics: Do good Do no harm – Negligence – Misconduct
  10. 10. ETHICAL PRINCIPLES • Justice: This refers to the need to treat all people equally and fairly • Society uses a variety of factors as a criteria for distributive justice, including the following: – – – – – – The Principles of medical ethics: Distributive justice to each person an equal share to each person according to need to each person according to effort to each person according to contribution to each person according to merit to each person according to free-market exchanges • We should strive to provide some decent minimum level of health care for all citizens, regardless of ability to pay
  11. 11. CONFLICTING PRINCIPLES? • Not hierarchical • Autonomy can conflict with beneficence • In India many people do not know how to deal with autonomy – Wishes of relatives also important • Autonomy/beneficence can conflict with justice • Need to balance beneficence with nonmalfeasance The Principles of medical ethics
  12. 12. THE RELATION BETWEEN LAW AND ETHICS • Ethical values have often been influenced by and influenced legal doctrine and legal principles are closely related to ethical principles. • Ethical obligations exceed legal duties • Law serves to demarcate the limits of individual autonomy in the interests of society. It also protects the rights of individuals
  13. 13. The Multi Layered Approach Patient Preferences Contextual features: legal, social, family, economic societal Medical Goals Quality of life issues Foundational Principles, Type of Ethical Problem
  14. 14. Lets also remember • Medicine is about : “Can we?” • Ethics is about: “Should we?” The ethicist as a hedge