1. ROLE OF EITHICS IN HOSPITAL
MANAGEMENT
Dr. Abdul.Ghafoor Shoro
Executive Director College Of Family
Medicine Pakistan

2. Medical Ethics
Ethical Issues in Healthcare

3. WHAT IS MEDICAL ETHICS?
• Medical ethics refers
– chiefly to the rules of etiquette adopted by
the medical profession to regulate
professional conduct with each other,
– but also towards their individual patients
– and towards society,
– and includes considerations of the motives
behind that conduct.

4. Types of Ethics:
Types of Ethics Medical Ethics:
Clinical obligations fidelity first to patients’
interests telling the truth (cancer, errors).
 Professional Ethics: Obligations of the
profession self-regulation education of self and
others.
Bioethics: Guides for public policy gene
technology, stem cell research health system
reform

5. Interconnectedness of Rights,
Trust, and Obligation
Public
Trust
Patient
Rights
Health Care
Worker
Obligations
5

6. A new ethical code for health care in the 21st
century?
While I continue to keep this Oath unviolated,
may it be granted to me to enjoy life and the
practice of the Art, respected by all men, in
all times. But should I trespass and violate
this Oath, may the reverse be my lot.”
(The Hippocratic Oath, 5th century B.C)
Need for
medical ethics
In a world of health care economics, consumers, clients and
service providers, health care has to be based on sound
ethical principles that reflect the reality and needs of
contemporary society

7. The philosophical underpinnings of
medical ethics
• ETHICAL THEORIES
• DEONTOLOGY (Deon = duty)
– Springs from moral obligations
– Actions determined by rightness or
wrongness ( virtue ethics)
– The outcome of action is not
important
The
philosophical
underpinnings
of medical

8. ETHICAL PRINCIPLES
The Principles of
medical ethics:
Autonomy
• Autonomy: Respect for an individual’s
autonomy or ability to make decisions for
him/herself
– includes respect for their privacy and
confidentiality
– need to provide sufficient information for
them to make informed choices
– truth telling
– protection of persons with diminished or
impaired autonomy.

9. ETHICAL PRINCIPLES
• Beneficence: This refers to the
tradition of acting always in the
patients’ best interest to maximise
benefits and minimise harm.
• Non-malfeasance:
This
principle
ensures that treatment or research
ought not to produce harm
The Principles of
medical ethics:
Do good
Do no harm
– Negligence
– Misconduct

10. ETHICAL PRINCIPLES
• Justice: This refers to the need to treat all
people equally and fairly
• Society uses a variety of factors as a criteria for
distributive justice, including the following:
–
–
–
–
–
–
The Principles of
medical ethics:
Distributive
justice
to each person an equal share
to each person according to need
to each person according to effort
to each person according to contribution
to each person according to merit
to each person according to free-market exchanges
• We should strive to provide some decent
minimum level of health care for all citizens,
regardless of ability to pay

11. CONFLICTING PRINCIPLES?
• Not hierarchical
• Autonomy can conflict with
beneficence
• In India many people do not know how
to deal with autonomy
– Wishes of relatives also important
• Autonomy/beneficence can conflict
with justice
• Need to balance beneficence with nonmalfeasance
The Principles of
medical ethics

12. THE RELATION BETWEEN LAW
AND ETHICS
• Ethical values have often been
influenced by and influenced legal
doctrine and legal principles are
closely related to ethical principles.
• Ethical obligations exceed legal
duties
• Law serves to demarcate the limits
of individual autonomy in the
interests of society. It also protects
the rights of individuals

13. The Multi Layered Approach
Patient Preferences
Contextual
features:
legal,
social,
family,
economic
societal
Medical Goals
Quality of life
issues
Foundational Principles, Type of Ethical Problem

14. Lets also remember
• Medicine is about : “Can we?”
• Ethics is about: “Should we?”
The ethicist as a
hedge