Medical Ethics Prof. Jasim - PowerPoint Presentation

Slide1

Medical Ethics

Prof.

Jasim

N. Al-

Asadi

2018-2019

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Ethics and Morality

What are they?

The terms

ethics

and

morality

are often used interchangeably - indeed, they usually can mean the same thing, and in casual conversation there

is no

problem with switching between one and the other.

However, there is a distinction between them in philosophy!

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Ethics and Morality

Etymology

Morality and ethics have the same roots,

mores

which means

manner and customs

from the Latin and

etos

which means

custom and habits

from the Greek.

Robert

Louden

, Morality and Moral Theory

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Ethics and Morality

What are they?

Strictly speaking,

morality

is used to refer to what we would call

moral conduct

while

ethics

is used to refer to the

formal study

of moral conduct.

Ethics

is also often called

moral philosophy.

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Ethics and Morality

Morality:

first-order set of beliefs and practices about how to live a good life.

Ethics:

a second-order, conscious reflection on the adequacy of our moral beliefs.

MORALITY - PRAXIS

ETHICS - THEORY

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Normative S

ystems

Games

Law

Religion

Morality

Habits

Slide7

7

SOCIETAL NORMATIVE SYSTEMS

LAW

ETHICS

MORAL

Societal normative systems

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What is meant by Ethics?

Ethics refers to standards of behavior that tell us how human beings ought to act in many situations in which they find themselves as friends, parents, children, citizens, business people, teachers, professionals, and so on.

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What is Ethics?

Ethics

are standards of conduct (or social norms) that prescribe behavior.

Ethics as a field of study is a normative discipline whose main goals are prescriptive and evaluative rather than descriptive and explanatory. So Ethicists are different from social scientists.

Ethicists (or moral philosophers) study standards of conduct.

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Ethics and Morality

So that we can see, moral standards distinguish between right and wrong, good and bad, virtue and vice, justice and injustice.

Ethics

are not general standards of conduct but the standards of a particular profession, occupation, institution, or group within society. The word

“

ethics

”

, when used in this way, usually serves as a modifier for another word, e.g. business ethics, medical ethics, sports ethics, military ethics, etc.

They are all professional ethics.

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Medical ethics

A system of moral principals that apply values and judgments to the practice of medicine

Help the doctor to decide what is morally right

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Medical Ethics

Historically, medical ethics may be traced to guidelines on the duty of physicians such as the Hippocratic oath

A

physician must recognize responsibility to

patients first

and foremost, as well as

to society

, to

other health professionals

, and to

self

. These are not laws, but standards of conduct which define the essentials of honorable behavior for the physician

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Why it is necessary in medicine?

Doctors are dealing with lives of patients

They have the power to cure as well as the power to kill

Ensure highest care to community

Prevent doctors abusing trust and power

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Four basic Principles of Medical Ethics

Respect for Autonomy

(respect the patients ability to take decisions on behalf of themselves)

Beneficence

: do good

Non

maleficence

: do no harm

Justice

: treat equitably and distribute benefits fairly

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Justice

PHYSICIAN

Beneficence

Do no

harm

(Non-

maleficence

)

Autonomy

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Autonomy

The

p

atient has freedom of thought, intention and action when making decisions regarding health care procedures

For a patient to make a fully informed decision, she/he must understand all risks and benefits of the procedure and the likelihood of success.

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Always respect the autonomy of the patient - then the particular patient is free to

choose.

Such respect is not simply a matter of attitude, but a way of acting so as to recognize and even promote the autonomous actions of the patient.

The autonomous person may freely choose loyalties or systems of religious belief that may adversely affect

him.

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The patient must be informed clearly the consequences of his action that may affect him adversely.

Desiring to "benefit" the patient, the physician may strongly want to intervene believing it to be a clear "medical benefit." The physician has a duty to respect the autonomous choice of the patient, as well as a duty to avoid harm and to provide a medical benefit.

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But the physician should give greater priority to the respect for patient autonomy than to the other duties.

However, at times this can be difficult because it can conflict with the paternalistic attitude of many health care professionals.

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In the case of a child, the principle of avoiding the harm of death, and the principle of providing a medical benefit that can restore the child to health and life, would be given priority over the autonomy of the child's parents as surrogate decision makers.

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Beneficence

The practitioner should act in “the best interest” of the patient - the procedure be provided with the intent of doing good to the patient

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This needs health care provider to:

- develop and maintain skills and knowledge by continually updating training

- consider individual circumstances of all patients

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Non-maleficence

“Above all, do no harm,“ – Make sure that the procedure does not harm the patient or others in society

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When interventions undertaken by physicians create a positive outcome while also potentially doing harm it is known as the "double effect."

e.g., the use of morphine in the dying patient eases pain and suffering while hastening the death through suppression of the respiratory center.

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Physicians are obligated not to prescribe medications they know to be harmful.

Some interpret this value to exclude the practice of euthanasia

Violation of non-

maleficence

is the subject of medical malpractice litigation

Medical malpractice is “An act or omission by a health care provider that deviates from accepted standards of practice in the medical community which causes injury to the patient”.

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Justice

The distribution of scarce health resources, and the decision of who gets what treatment “fairness and equality”

The burdens and benefits of new or experimental treatments must be distributed equally among all groups in society

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The four main areas that Health Care

P

rovider must consider when evaluating justice

1. Fair distribution of scarce resources

2. Competing needs

3. Rights and obligations

4. Potential conflicts with established legislations

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New concepts

Bioethics

Deals with typically controversial ethical issues emerging from new situations arising due to advances in medicine.

It could be defined as the study of ethical issues and decision-making associated with the use of living organisms.

Bioethics includes both medical ethics and environmental ethics. Bioethics is learning how to balance different benefits, risks and duties.

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Clinical ethics

It is a practical discipline that provides a structured approach for identifying ,analyzing, and resolving ethical issues in clinical medicine.

Clinical medical ethics is a practical and applied discipline that aims to improve patient care and patient outcomes by focusing on reaching a right and good decision in individual cases.

It focuses on the doctor-patient relationship and takes account of the ethical and legal issues that patients, doctors, and hospitals must address to reach good decisions for individual patients.

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Clinical ethics emphasizes that in practicing good clinical medicine, physicians must combine scientific and technical abilities with ethical concerns for the personal values of the patients who seek their help.

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The content of clinical ethics includes

specific issues such as truth-telling, informed consent, end of life care, palliative care, allocation of clinical resources, and the ethics of medical research.

the study of the doctor-patient relationship, including such issues as honesty, competence, integrity, and respect for persons.