This document discusses several key ethical issues in medicine: informed consent, confidentiality, decision-making capacity, euthanasia, and malpractice. It defines informed consent as agreement by the patient to undergo examination or treatment, which requires competency and being informed of benefits, risks, and alternatives. Confidentiality is the duty of doctors to respect patient privacy in treatment and after death, with some exceptions like abuse. Decision-making capacity refers to understanding one's illness and treatment options. Euthanasia is administering a lethal drug to a patient with full consent. Malpractice requires establishing through evidence that a physician wronged and harmed a patient.

1. EHICAL ISSUES
DR. QURRAT-UL-AIN FATIMA

2. LEARNING OBJECTIVES
At the end of this lecture you will be able to know
Ethical Issues
Informed Consent
Confidentiality
Decision making capacity
Euthanasia
Malpractice

3. INFORMED CONSENT
Consent is the agreement by the patient to undergo an
examination, procedure, or treatment. It can be given
orally, by signing a form or a written statement or simply
agreeing by a gesture.

4. EXAMPLE
• Offering to pull up the shirt for letting the doctor
examine the abdomen. It must always be obtained in
advance. In order for the consent to be valid,
the patient should be competent that is should have the
capacity to make a decision.

5. EXCEPTIONS TO THE RULE OF
INFORMED CONSENT ARE
PATIENTS
• Brought into emergency and accident departments
• Unconscious and alone
• Requiring life-saving measures.
• Children under 16 years of age (the parents have the
right
• To provide informed consent)
• With an impaired capacity to give consent.

6. QUESTIONS FOR INFORMED
CONSENT
• Use your B.R.A.I.N.S.
B Benefits - What are the benefits of this procedure?
What are we hoping to achieve?
R Risks - What are the risks or side effects? What other
interventions will go along with this?
A Alternatives - What are our other options?

7. QUESTIONS FOR INFORMED
CONSENT

8. CONFIDENTIALITY
It is the common law duty of a doctor to respect the
confidence that a patient has in him.

9. CONFIDENTIALITY
• This applies not only during the treatment but also after
it and even after the patient's death. This is a means of
expressing respect for the patient's right to
privacy and helps the patient speak freely to the doctor.

10. BREACHES OF CONFIDENTIALITY
• ·When a patient authorizes it in situations such as while seeking
medical fitness to gain employment or getting a medical report
prepared for a second opinion.
• When information is to be shared within the health care team
• When the disclosure is in the best interest of the patient. As in
the case of physical or sexual abuse. Where confidentiality would
mean a continuation of a perpetual hazards.

11. BREACHES OF CONFIDENTIALITY
• When the disclosure is in public interest and the doctor's
attempt at holding back information may harm
members of the society.
• In case of a legislative requirement. This refers to matters
of Laws on Public Health and control of diseases such as
cholera. small pox, plague or venereal diseases.

12. BREACHES OF CONFIDENTIALITY
• For research purposes and case reporting as
anonymous data, or if the identity of the patient may be
surmised from it after the patient's consent.

13. MEDICAL STUDENTS AND THE ISSUES OF CONSENT
AND CONFIDENTIALITY:
A medical student can only undertake a procedure after;
• An informed consent has been taken.
• The patient has been briefed about the training level & status of
the student.
• Adequate safeguard should always be put into place in all such
settings.
• The Dean / Principal of the Medical College in all such matters
must be kept informed.

14. DECISION-MAKING CAPACITY
• Capacity in health ethics refers to the ability of the
individual to understand the nature of their illness, the
treatment options and the consequences of the decision.

15. EUTHANASIA
• Euthanasia is when a physician administers a lethal drug
to a patient. with the patient's full consent and voluntary
cooperation.

16. MALPRACTICE
• In order to state that a health professional has indulged in
malpractice.it must be established through adequate and
sustainable evidence that the physician has wronged a patient
and/or harmed them. It must be shown.