Principle of Ethics Compliance based and values based code of ethics Professional obligation Role of regulatory authority Respect for Privacy Confidentiality Inform Consent and debriefing

1. PROFESSIONAL ETHICS &
SOCIAL RESPONSIBILITY
MODULE III
By Dr. Nancy Girdhar
Code of Ethics

2. Books and References
Text:
• John R Boatright, “Ethics and the Conduct of Business”, Pearson Education,
New Delhi, 2003
• Edmund G Seebauer and Robert L Barry, “Fundametals of Ethics for
Scientists and Engineers”, Oxford University Press, Oxford, 2001
References:
• Laura P. Hartman and Joe Desjardins, “Business Ethics: Decision Making for
Personal Integrity and Social Responsibility” Mc Graw Hill education, India Pvt.
Ltd. New Delhi 2013.
• A Global Standard for Professional Ethics: Cross-Border Business Concerns By
Allen, Catherine; Bunting, Robert Journal of Accountancy, Vol. 205, No. 5, May
2008

3. 3
CODE OF ETHICS

4. • Principle of Ethics
• Compliance based and values based code of ethics
• Professional obligation
• Role of regulatory authority
• Respect for Privacy
• Confidentiality
• Inform Consent and debriefing
Content

5. Principles of Ethics
Professional ethics examines the moral and ethical
issues that arise in a corporate environment.

6. • Truthfulness
• Confidentiality
• Autonomy
• Informed consent
• Beneficence
• No maleficence (Nonmaleficence)
• Justice
Principles of Ethics

7. Truthfulness
Truthfulness is about telling
the truth to someone who has
the right to know the truth.
The concept of truthfulness
urges the professional not to
lie.

8. If as a doctor if some patient have resulted as HIV positive
and he/she asks to know about the his/her result, you
should tell the truth the person the truth even though
this might be very upsetting to that person.
Truthfulness

9. Confidentiality
Confidentiality urges you to keep
a secret – by which we mean
knowledge or information that a
person has the right or obligation
to conceal.

10. • If the family of a person who has had an HIV test
demands that you give them the result, you must not tell
them. You must keep the result confidential unless your
client gives you permission to tell their family.
Confidentiality

11. Autonomy
The term refers to every
individual’s right of self-
determination, independence
and freedom to make their own
choices.

12. • If a doctor may feel that Michael’s parents should know
what has happened to their daughter, but you must
respect Michael’s right to maintain confidentiality about
her condition.
• However, there are conditions in which that personal
choice or autonomy may be restricted because of
concern for the wellbeing of the community. For
instance, if a communicable disease, such as
tuberculosis, is diagnosed, clients can be required to
take prescribed medication and may have to be isolated
to prevent the spread of the infectious agent to others.
Autonomy

13. Informed Consent
Informed consent means that
each person who has any sort
of procedure done to them in a
any context should give their
approval for that procedure to
be done to them.

14. It is the duty of the healthcare worker to tell the person
exactly what the procedure will involve as well as the
things that might happen if the procedure is not carried
out.
Informed Consent

15. The performance of medical or surgical procedures shall be
preceded by appropriate informed consent.
When obtaining informed consent, pertinent medical facts
and recommendations consistent with good medical
practice must be presented in understandable terms to the
patient or to the person responsible for the patient.
Such information should include alternative modes of
treatment, the objectives, risks, and possible complications
of such a treatment, and the consequences of no treatment.
The operating ophthalmologist must personally confirm
with the patient or patient surrogate their (his or her)
comprehension of this information.
Informed Consent

16. Debriefing is similar to informed consent. you should
reveal the research question and full design of the study.
For example, if participants are tested under only one
condition, then you should explain what happened in the
other conditions.
Debriefing is also a good time to provide additional
benefits to research participants by giving them relevant
practical information or referrals to other sources of
help. For example, in a study of attitudes toward
domestic abuse, you could provide pamphlets about
domestic abuse and referral information to the
university counseling center for those who might want it.
Debriefing

17. Beneficence
Beneficence is defined as
kindness and charity.
The term beneficence tells you
about ‘doing good’ for your
client.

18. A nurse demonstrating this ethical principle is by holding
a dying patient's hand.
Beneficence in that Chinese medicine is considered “a
humane art, and a physician must be loving in order to
treat the sick and heal the injured”
Beneficence

19. Nonmaleficence
The term nonmaleficence tells
you about ‘do not harm’ for
your client either intentionally
or unintentionally.

20. • It states that a professional has a duty to do no
harm or allow harm to be caused to a client
through neglect.
• Not abandoning a client who is in need of your
services.
• Example: A medical practitioner has a duty to
do no harm or allow harm to be caused to a
patient through neglect.
Nonmaleficence

21. • Let’s look at a classic example:
A 52-year-old man collapses in the street complaining of
severe acute pain in his right abdomen. A surgeon
happens to be passing and examines the man, suspecting
that he is on the brink of rupturing his appendix. The
surgeon decides the best course of action is to remove the
appendix in that situation, using his trusty pen-knife.
Beneficence & Nonmaleficence
What you would have decided in that
situation?

22. • From a beneficence perspective, a successful removal of
the appendix in situ would certainly improve the
patient’s life.
• But from a non-maleficence perspective, let’s examine
the potential harms to the patient.
• First of all, the environment is unlikely to be sterile (as
is that pen-knife) and so the risk of infection is
extremely high.
Beneficence & Nonmaleficence

23. • Second, the surgeon has no other clinical staff available
or surgical equipment meaning that the chances of a
successful operation are already lower than in normal
circumstances.
• Third, assuming that the surgeon has performed an
appendectomy before, they have almost certainly never
done it at the roadside – and so their experience is
decontextualized and therefore not wholly appropriate.
• Fourth, unless there isn’t a hospital around for miles
this is an incredibly disproportionate intervention.
Beneficence & Nonmaleficence

24. Justice
Justice is a complex ethical
principle and it entails
fairness, equality and
impartiality; in other words, it
is the obligation to be fair to
all people.

25. • To be fair while making judgments without being partial
with either of the party (client) involved.
• Legal is applicable to all practices, languages, processes,
procedures, cultures, and other relative concepts in a
system of the law.
• Ethics is rooted in morals and the perception of the
rightness or wrongness of an act or conduct.
Legal Vs Ethical ?

26. Code of Ethics
• Compliance based
code of ethics
• Value based code
of ethics

27. Compliance based
Compliance-based
codes have an
emphasis on not
violating laws.

28. • A compliance-based code of ethics is developed to
ensure that the business and its employees comply
with all laws and regulations in an appropriate
manner.
• Three key elements include the prevention,
detection and punishment of non-compliant
behavior.
Compliance based

29. • For example:
• Jeremy's compliance-based code may prohibit his
employees from making material
misrepresentations of facts when acting within the
scope of their employment. Telephone sales are
monitored to ensure that the sales force complies
with the code and sales people are punished if they
fail to do so.
Compliance based

30. Value based

31. Value based
A value-based code
of ethics addresses
a company's core
value system.

32. • It may outline standards of responsible conduct as
they relate to the larger public good and the
environment.
• Value-based ethical codes may require a greater
degree of self-regulation than compliance-based
codes.
Value based

33. • Some codes of conduct contain language that
addresses both compliance and values.
• For example, a grocery store chain might create a code
of conduct that espouses the company's
commitment to health and safety regulations above
financial gain.
• That grocery chain might also include a statement
about refusing to contract with suppliers that feed
hormones to livestock or raise animals in
inhumane living conditions.
Compliance & Value Based

34. Professional Obligation
The definition of an
obligation is something
that someone is required
to do.

35. • A commitment to moral actions (primary
obligation to protect the safety of the human beings
and respect their rights),
Professional Obligation

36. An example of obligation is for a student to turn in
his homework on time every day. These are one’s
moral responsibility i.e., duty to act right and in
moral ways.
The obligations such as honesty, fairness, and
decency are incumbent on every one.
Professional Obligation

37. Role of Regulatory Authority
A regulatory body also called regulatory agency is a public
authority or a government agency which is accountable for
exercising autonomous authority over some area of human
activity in a regulatory or supervisory capacity.

38. • Regulatory agency, independent governmental
body established by legislative act in order to set
standards in a specific field of activity, or
operations, in the private sector of the economy
and then to enforce those standards. Regulatory
agencies function outside direct executive
supervision.
Role of Regulatory Authority

39. • Privacy is concerned with the collection, storage, and
use of personal information. An important issue in
privacy analysis is whether the individual has
authorized particular uses of his or her personal
information
Privacy

40. Respecting privacy is a form of recognition of the attributes
that give humans their moral uniqueness such as:
Personal autonomy (the ability to make personal
decisions)
Individuality
Respect
Dignity and Worth as human beings
Importance of Privacy

41. Confidentiality

42.  Confidentiality is a fundamental principle of medical
ethics and is central to the trust between patients and
doctors.
 Patient information remains confidential even after
death.
 You should ensure as far as possible that the patient’s
privacy is maintained at all times and that accidental
disclosure of confidential information does not occur.
 You should ensure as far as possible that confidential
information in relation to patients is maintained
securely and in compliance with data protection
legislation.
Confidentiality

43. Confidentiality
• Most people consider health
information to be highly
personal and, therefore, need to
be confident that their privacy
will be protected whenever they
use a health service. Clear and
open communication between
the health service provider and
health consumer is integral to
good privacy.
Generally, if institution
/person ‘A’ holds information
about person ‘B’ then person
‘C’ cannot obtain that
information in the normal
course of events without the
consent of person ‘B’.

44. All identifiable patient information, whether written,
computerized, visual or audio recorded or simply held in the
memory of health professionals, is subject to the duty of
confidentiality. It covers:
Any clinical information about an individual’s diagnosis or
treatment
A picture, photograph, video, audiotape or other images of
the patient
Who the patient’s doctor is and what clinics patients
attend and when
Anything else that may be used to identify patients directly
or indirectly.
What information is Confidential?

45. Why respect Confidentiality?

46. Trust is an important aspect between patients and healthcare
professionals. Patients without fear of a breech of
confidentiality should be able to communicate symptoms that
often they may feel are embarrassing, stigmatizing, or indeed
trivial.
Without this trusting relationship patients may not divulge
information which may make treating them impossible.
Patients may not seek medical attention at all.
Confidentiality has important role in a professional patient
relationship establishing a sense of security, freedom of
action and self respect for patients.
Why respect Confidentiality?

47. Is the Duty of Confidentiality Absolute?

48.  In Ireland confidentiality or privacy is recognized by the
courts as a right, but not an absolute right.
 The belief that confidentiality is not absolute is also the
model which our two closest neighbors the U.S. and the
U.K. subscribe to.
 In France and Belgium confidentiality is considered as an
absolute requirement to protect the patient’s interests.
Case studies: Confidentiality

49. There are four circumstances where exceptions may be
justified in the absence of permission from the patient:
When ordered by a Judge in a Court of Law.
When necessary to protect the interests of the patient.
When necessary to protect the welfare of society.
When necessary to safeguard the welfare of another
individual or patient.
The Exceptions to Confidentiality

50. Case Study!
Scenario 1
A person recovering not want to
tell his family.

51. Think !
• Against all the odds, and despite being referred to a hospice,
Ian showed signs of recovering from bowel cancer. After
several months, the consultant decided that Ian was no longer
terminally ill, although she could not be certain that he would
not become ill again in the future.
• Accordingly, she felt he no longer required the extensive
support supplied by the hospice and discharged him.
• Ian was very upset by this, partly because he did not want to
loose his terminally ill status, which had generated him more
attention from his family that he had become accustomed to in
the past.
• The hospice staff were not unsympathetic. They had promised
that they would not abandon him and would care for him until
he died. The staff also widely believed that his family had
rather neglected him previously.

52. Think !
• Because they did not wish to let Ian down, he was given
radically reduced honorary status as an out-patient. For
instance he still attended social events and had his hair set by
the hair dresser who donated some of his spare time to the
hospice.
• It quickly became obvious that Ian’s family did not realize that
he was no longer thought to be terminally ill. The nurse
manager attempted to talk to Ian about this, but he was
politely and firmly told to mind her own business.’

53. THANK YOU!