This document provides an overview of medical ethics. It begins with definitions of ethics and discusses the history of ethics including the Hippocratic Oath and Nuremberg Code. The principles of ethics such as beneficence, non-maleficence, respect for persons, and justice are explained. Dental ethics codes and guidelines for research ethics to protect human subjects are also reviewed. The conclusion emphasizes that ethics is important in healthcare and professionals must place patient interests above all else.

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CONTENTS
• Introduction
• Definition of ethics
• History of ethics
• Principles of ethics
• Dental ethics
• Research ethics
• Conclusion
• References

3. • “Ethics” is derived from the Greek word
‘ethos’ meaning custom or character.
• Ethics is the philosophy of human conduct, a
way of stating and evaluating principles by
which problems of behaviour can be solved.
• It is considered with ideals and values.
• It’s a branch of philosophy concerned with
the study of those concepts that are used to
evaluate human activities, in particular the
concepts of goodness and obligation.
INTRODUCTION
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4. DEFINITION OF ETHICS
Is defined as "the science of the
ideal human character and
behaviour in situations where
distinction must be made between
right and wrong, duty must be
followed, and good interpersonal
relations maintained".
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5. Ethics can be of two types:
Micro
Focus primarily on
individuals’ rights and
duties and do not see
individuals as part of a
wider social order.
Macro
Guide the conduct of
population-based research
and practice.
These are a set of principles designed to protect the human dignity, integrity,
self-determination, confidentiality, rights and health of populations and the
people comprising them. 5

6. Code of Dental Ethics
• A systematic body of rules is needed ‘‘in order that dignity and honor of the
dental profession may be upheld, extended standards and the advancement of
dental science promoted.’’
• The members of the Dental Association may understand the duties and
obligations clearly to the dental profession, to their patients and to the
community at large.
HISTORY OF ETHICS
“Hippocratic oath" - regarded as summing up of
standard professional ethics.
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7. The Indian Scenario
• Dentist Act was amended via
Section 17 A – empowering DCI
to prescribe standards of
professional conduct and
etiquette .
• The code of ethics was framed
by the Dental Council in 1975
and later notified by the
Government of India as Dentists
Regulations 1976.
• It is in force from August 1976.
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8. PRINCIPLES OF ETHICS
1.TO DO NO HARM
(NON-
MALEFICENCE)
2.TO DO GOOD
3. RESPECT FOR
PERSONS
4. JUSTICE
5.TRUTHFULNESS
6.
CONFIDENTIALITY
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9. To do no harm (Non-maleficence)
• It is the foundation of social morality
• The dentist has a duty to refrain from harming the patient
• Keeping knowledge and skills up to date
• Should inform the patient who may have been exposed to blood borne
pathogen or other infectious disease
• In cases, where pain cannot be avoided, can make attempts to minimize the
pain
• E.g. Iatrogenic disease, Use of unsterilized instruments, under filling or over
filling, carelessness in handling hard and soft tissues can harm the patients.
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10. To do good (Beneficence)
• Beneficence refers to the principle of promoting or doing good
• Should always thing about the welfare of the patient
• Put the patient`s best interests as priority
• There is an agreement between the doctor and the patient that some good
will result.
• Process of treating a patient what must be weighed are the consequences of
treatment versus no treatment.
• E.g.,Treating questionable dental caries
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11. Respect for persons
Autonomy
• It is the principle that dictates that health care professionals' respects
patients right to make decisions concerning the treatment plan.
• An autonomous person is the one capable of deliberation about personal
goals and acting under the direction of such deliberations.
• Dentists usually try to direct the patient towards a particular mode of
treatment by stressing only over the advantages rather than mentioning
disadvantages.
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12. Informed consent
• The term 'consent' is defined as "When two or more persons agree upon
the same thing in some sense they are said to consent“.
• It is the legal issue that protects every patient's right not to be touched or
in any way treated without the patient's authorization.
• Types of consent
• Implied consent
• Expressed consent
• Proxy consent
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13. • Implied consent:
• It is determined by the behaviour of the patient.
• The fact that a patient comes to a doctor for an ailment implies that he is
agreeable to medical examination in the general sense.
• Expressed consent
• Anything other than the implied consent is express consent. This may
be either oral or written.
• Express oral consent is obtained for relatively minor examinations or
therapeutic procedures, preferably in the presence of a disinterested
third party.
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14. • Proxy consent
• All the above types of consent can take the shape of Proxy Consent.
• If a person cannot give informed consent, it is desirable to obtain proxy
consent.
• Parent for child, close relative for mentally unsound /unconscious
patient, etc.
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15. Justice
• Justice is described as fairness or equal treatment , giving to each her or his
right or due.
• Its difficult to provide well distributed health care amongst people.
• Primary duty of a health professional is to provide service irrespective of
class, creed, etc.
• Justice demands that each person be treated equally
• The principle of justice is to protect the weak and to ensure equality in rights
and benefits, for both groups and individuals
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16. Truthfulness (Veracity)
• The patient – doctor relationship is based on trust.
• Lying shows disrespect to the patient and threatens relationship.
• Patient expect dentist to be truthful about the information given,
treatment rendered and the prognosis.
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17. Confidentiality
• Is a principle that can be traced to the Hippocratic Oath and exists today in
The InternationalCode of Medical Ethics.
• Every patient has the right to expect that all communications and records
pertaining to his/her care will be treated as confidential.
• Dental professional have a legal and ethical duty to keep patient information
confidential.
• It comprises preservation of all information concerning patient, his/her
disease and treatment.
• Confidential information should be kept in a secure place at all times to
prevent unauthorized and accidental disclosure. 17

18. ETHICAL RULES FORTHE DENTISTS(Prescribed by the DCI)
Duties of dentist toward the patients
• Every dentist should be courteous, sympathetic, friendly and helpful.
• He should observe punctuality in fulfilling his appointments.
• He should establish a well merited reputation for professional ability and
fidelity.
• The welfare of the patient should be conserved to the utmost of the
practitioner’s ability.
• No consideration of religion, nationality, race, part politics or social standing to
intervene between his duties and his patients.
• Information of a personal nature which may be learned from a patient should be
kept in the utmost confidence. 18
Dental ethics would mean moral duties and obligations of the dentist towards his
patients, professional colleagues and to the society.

19. Duties of dentists towards one another
• Cherish a proper pride in your colleagues
• Should not make derogating comments of the procedures or qualification
of colleagues.
• Honor mutual arrangements made regarding remuneration
• On no account do anything harmful to the interest of the members of
fraternity.
• Institute correct treatment to previous faulty treatment at once with the
least comment.
• Regard it as a pleasure and privilege to render gratuitous services to
another dentist, his immediate family members.
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20. Duties of dentist towards the Community
• To participate in community affairs
• Educate the public in promotion of health
• To be trustworthy and honest
• To follow community laws
• To use the social services provided
• To take a leadership role in community and
• Elevate the esteem of profession
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21. Unethical Practices
• Use of bogus diplomas.
• Direct or indirect advertising.
• Practicing by unregistered persons
employed by the dentists.
• Issuing any certificate which is untrue or misleading
• Non referral, in case treatment beyond the dentist skill.
• Performing unnecessary services for purpose of monetary gain.
• Allowing commissions
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22. Need for Research Ethics
‘‘ Many prominent researchers in 19th and 20th Centuries conducted experiments
on patients without their consent and with little concern for the patients well
being’’
Historical background
• In 1700, Edward Jenner conducted the
vaccination trials and tested small pox
vaccines on his own son and on
neighbourhood children.
• Claude Bernard in 1865, justified
experiments on condemned criminals in
Egypt.
Research Ethics
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23. NAZI MEDICAL EXPERIMENTS
Inhumane experiments on
Prisoners including children
during World War II and the
holocaust
• Testing with infectious diseases
• Bone, Muscle, and Nerve
Regeneration and Bone
Transplantation Experiments
• High altitude experiments
• Experimental Surgery
• Traumatic experimentation
• Sterilization Experiments
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24. THE NUREMBERGTRIALS
The doctors’ trial lasted for 140 days and of the 23 charged German Physicians,
16 of the doctors were found guilty and 7 were executed
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25. Ten Point of Nuremberg Code
1.Consent must be voluntary
2.Experiments should yield fruitful results for the good of the
society.
3.Design should be based on results of animal experiments
and knowledge of natural history of the disease.
4.Avoid all unnecessary physical and mental suffering and
injury.
5.No experiment should be conducted where there is prior
reason to believe that death or disabling injury will occur.
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26. 6.The degree of risk should not exceed humanitarian principles.
7.Proper protection to the experimental subjects.
8. The experiment should be conducted only by scientifically
qualified persons.
9. Human subjects during any time of study should be at liberty to
bring the experiment to an end.
10. Scientist in charge must terminate the experiment at any
stage, if continuation of the experiment is likely to result in injury,
disability or death to the experimental subject.
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27. Evolution ofVarious guidance documents to improve the practice of ethics in
Biomedical Research
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28. Indian Council of Medical Research introduced Ethical Guidelines for Research on
Human Participants
NATIONAL GUIDELINES
National Ethical Guidelines for Biomedical and
Health Research Involving Human
Participants; ICMR, 2017. Available from
https://ethics.ncdirindia.org/ICMR_Ethical_Gu
idelines.aspx
All institutions in the country which carry out
any form of biomedical research involving
human beings should follow these guidelines
in letter and spirit to protect safety and well
being of all individuals.
There are several other national guidelines
available
Genome Policy and Genetic Research [2000],
Indian GCP [2001], Amendment of Drugs and
Cosmetics Act [2002], Assisted Reproductive
Technology [2005], Stem Cell Research and
Bio-banking [2006]
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29. INSTITUTIONAL REVIEW BOARD (IRB)
• Administrative body established to protect the right and welfare of human
research subjects.
• Authority to approve, modify or disapprove all research activities that fall
within its jurisdiction.
IRB Mission :
The IRB is in charge of protecting the rights, safety and well-being of humans in
clinical trials by:
• Reviewing protocols and consent forms.
• Providing approvals
• Monitoring the progress of studies
• All studies must have IRB approved prior to initiation of the protocol.
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30. CONCLUSION
• Ethics forms an important dimension in healthcare
profession.
• It should be remembered that profession exists as long as
it enjoys the trust of the society, and this can be assured
by always placing the interest of the patient above one’s
own interest.
• Ethics is not a rule or cannot be forced on anyone; It has to
be self cultivated.
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31. REFERENCES
• Essentials of preventive and community dentistry - Soben
peter (fifth edition).
• Textbook of public health dentistry- SS.Hiremath (third
edition).
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