Medical Ethics

What is medical ethics?

Medical ethics is a system of moral principles that apply values to the practice of clinical medicine and in scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice.

Respect for autonomy

Health professionals should enquire about their patient’s wishes to receive information and to make decisions. It must never be assumed that because a patient is part of a particular culture or community, they affirm that community’s values and beliefs. Respect for autonomy is not a mere ideal in healthcare – it is a professional obligation.

Non-maleficence

The principle of non-maleficence obligates us to abstain from causing harm to others. The principle of no-nmaleficence supports several moral rules, with examples here including:

Do not kill.

Do not cause pain or suffering.

Do not incapacitate.

Do not deprive others of the goods of life.

Beneficence

From an ethical viewpoint, morality requires that we not only treat patients autonomously and refrain from harming them, but that we also contribute to their welfare. These beneficial actions fall under the heading ‘beneficence’. The principles of beneficence potentially require more than those of non-maleficence, because doctors must take positive steps to help people and not merely refrain from harm. Patient welfare embodies medicine’s goal, justification and rationale – examples here include public health, preventative medicine and biomedical research.

Justice

No single moral principle is capable of addressing all problems of justice and no single theory of justice or system of distributing healthcare is sufficient for constructive reflection on health policy. Countries that lack a comprehensive and coherent healthcare system typically have larger numbers of unprotected citizens and therefore need to improve both utility (efficiency) and justice (fairness and equality). This is further complicated by the fact that the construction of a unified theory of justice that captures our diverse conceptions and use of principles of justice in biomedical ethics remains controversial and hard to pin down.

 

World Medical Association INTERNATIONAL CODE OF MEDICAL ETHICS
Adopted by the 3rd General Assembly of the World Medical Association, London, England, October 1949
and amended by the 22nd World Medical Assembly, Sydney, Australia, August 1968
and the 35th World Medical Assembly, Venice, Italy, October 1983
and the 57th WMA General Assembly, Pilanesberg, South Africa, October 2006

DUTIES OF PHYSICIANS IN GENERAL

A PHYSICIAN SHALL respect a competent patient’s right to accept or refuse treatment.
A PHYSICIAN SHALL not allow his/her judgment to be influenced by personal profit or unfair discrimination.
A PHYSICIAN SHALL be dedicated to providing competent medical service in full professional and moral independence, with compassion and respect for human dignity.
A PHYSICIAN SHALL deal honestly with patients and colleagues, and report to the appropriate authorities those physicians who practice unethically or incompetently or who engage in fraud or deception.
A PHYSICIAN SHALL not receive any financial benefits or other incentives solely for referring patients or prescribing specific products.
A PHYSICIAN SHALL respect the rights and preferences of patients, colleagues, and other health professionals.
A PHYSICIAN SHALL recognize his/her important role in educating the public but should use due caution in divulging discoveries or new techniques or treatment through non-professional channels.
A PHYSICIAN SHALL certify only that which he/she has personally verified.
A PHYSICIAN SHALL strive to use health care resources in the best way to benefit patients and their community.
A PHYSICIAN SHALL seek appropriate care and attention if he/she suffers from mental or physical illness.
A PHYSICIAN SHALL respect the local and national codes of ethics.

 

DUTIES OF PHYSICIANS TO PATIENTS

A PHYSICIAN SHALL always bear in mind the obligation to respect human life.
A PHYSICIAN SHALL act in the patient’s best interest when providing medical care.
A PHYSICIAN SHALL owe his/her patients complete loyalty and all the scientific resources available to him/her. Whenever an examination or treatment is beyond the physician’s capacity, he/she should consult with or refer to another physician who has the necessary ability.
A PHYSICIAN SHALL respect a patient’s right to confidentiality. It is ethical to disclose confidential information when the patient consents to it or when there is a real and imminent threat of harm to the patient or to others and this threat can be only removed by a breach of confidentiality.
A PHYSICIAN SHALL give emergency care as a humanitarian duty unless he/she is assured that others are willing and able to give such care.
A PHYSICIAN SHALL in situations when he/she is acting for a third party, ensure that the patient has full knowledge of that situation.
A PHYSICIAN SHALL not enter into a sexual relationship with his/her current patient or into any other abusive or exploitative relationship.

 

DUTIES OF PHYSICIANS TO COLLEAGUES

A PHYSICIAN SHALL behave towards colleagues as he/she would have them behave towards him/her.
A PHYSICIAN SHALL NOT undermine the patient-physician relationship of colleagues in order to attract patients.
A PHYSICIAN SHALL when medically necessary, communicate with colleagues who are involved in the care of the same patient. This communication should respect patient confidentiality and be confined to necessary information.

 

American Medical Association Principles of Medical Ethics

Explore the standards of conduct that define the essentials of honourable behaviour for the physician.

Preamble

The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. The following Principles adopted by the American Medical Association are not laws, but standards of conduct that define the essentials of honourable behaviour for the physician.

Principles of Medical Ethics

  1. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
  2. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
  3. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
  4. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
  5. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
  6. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
  7. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
  8. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
  9. A physician shall support access to medical care for all people.

 

Medical Ethics 1 – Moral Theories

 

Medical Ethics 2 – The Four Principles

 

Medical Ethics 3 – Confidentiality & Privacy

 

Medical Ethics 4 – Doctor – Patient Relationship

 

Medical Ethics 5 – Consent