Medical Ethics is what every physician and healthcare worker should know. We need to understand Ethics and its application in various cultures, societies and its changes according to norms and values. Once society will be given health education regarding Medical Ethics many issues can be resolved in a decent manner. It ultimately gives a very positive impression of all the actions which a healthcare worker performs otherwise at times seems inappropriate by society. This is not for the sake of healthcare worker or for the patients it is primarily for the whole community. What are the rights of patient? role of ethical committee and parameters of a physician all need to be addressed properly.

1. Medical Ethics
By
Dr. Rizwan Saeed
(MBBS,MPH,DOMS,MBA)

6. Learning Objectives & Intended Outcomes

7. Learning Objectives
Good Concepts of Medical Ethics
Background Concepts and components
National recommended guidelines
Code of Medical Ethics
Components (essential)

8. Intended outcomes
To have good understanding of:
• Core concepts of medical ethics terminologies
• The International code of medical ethics
• Ethics and law

10. Background Concepts
&
Components

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

12. Attitude
Behaviour
Skill
Knowledge (cognition)

13. Attitude
A hypothetical
construct of like or
dislike (expression of
favor or disfavor)
toward a person,
place, thing, idea or
event .

14. Behaviour
behaviour is the
range of actions and
mannerisms made by
organisms, systems,
or artificial entities in
conjunction with
their environment

17. Medical ethics
• Medical ethics is a system of moral principles
that apply values and judgments to the
practice of medicine.
• As a scholarly discipline, medical ethics
encompasses its practical application in
clinical settings as well as work on its history,
philosophy, theology, and sociology.

18. Background
• Ethics in relation to the practice
of medicine had continuity from
the time of Hippocrates
460-377 BC 1970s  2013

19. Background
• the physician-patient relationship
• moral obligations of beneficence and non-maleficence.
• In the 1970s developments such as in vitro
fertilization (IVF) created concerns about the
adequacy of these long-established moral
obligations.

20. Background
• Helsinki Declaration (1964) on the protection
of human subjects had influence on the
establishment of ethics committees
worldwide
• shift toward focusing on the moral obligation
of respecting informed consent of research
subjects
• GMC Good medical practice (2013)

22. Medical ethics recommended guide lines
I. essential rules of international health
organizations
II. Medical-ethic guidelines regarding different
questions:
1. research examinations on men
2. Euthanasia
3. Transplantation
4. artificial insemination
5. sterilization, especially the operative sterilization of
mentally handicapped persons
6. medical-ethical committees.

24. Code of Medical Ethics
• The nine Principles of Medical Ethics
are the primary component of the
Code. They describe the core ethical
principles of the medical profession
• A single Principle should not be read in
isolation from others; the overall intent
of the nine Principles, read together,
guides physicians’ behavior.

25. Principles of medical ethics
I. A physician shall be dedicated to
providing competent medical care, with
compassion and respect for human
dignity and rights.
II. 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.

26. Principles of medical ethics
III. 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.
IV. 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.

27. Principles of medical ethics
V. 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.
VI. 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.

28. Principles of medical ethics
VII. A physician shall recognize a
responsibility to participate in
activities contributing to the
improvement of the community and
the betterment of public health.
VIII. A physician shall, while caring for a
patient, regard responsibility to the
patient as paramount.
IX. A physician shall support access to
medical care for all people.
• Adopted by the AMA's House of Delegates June 17, 2001.

29. Autonomy
• The patient has the right to refuse or choose
their treatment
• Autonomy can be defined as the ability of the
person to make his or her own decisions. This
faith in autonomy is the central premise of the
concept of informed consent and shared
decision making

30. Beneficence
A practitioner should act in the best interest of
the patient

31. Non-maleficence
"first, do no harm“
 Many consider that should be the main or
primary consideration Much harm has been done
to patients as a result, as in the saying, "The
treatment was a success, but the patient died."
 It is not only more important to do no harm than
to do good; it is also important to know how
likely it is that your treatment will harm a patient.

33. Justice
• concerns the distribution of scarce health
resources, and the decision of who gets what
treatment (fairness and equality).

34. Respect for persons
The patient (and the person treating the
patient) have the right to be treated with
dignity.

35. Truthfulness and honesty

36. Euthanasia
refers to the practice of intentionally ending a life in order to
relieve pain and suffering. mercy killing
The British House of Lords Select
Committee on Medical Ethics defines
euthanasia as "a deliberate intervention
undertaken with the express intention of
ending a life, to relieve intractable
suffering

37. Informed consent
a person must be fully informed about and
understand the potential benefits and risks of
their choice of treatment.

38. Confidentiality
• conversations between doctors and patients.
This concept is commonly known as patient-physician
privilege.

39. Ethics committees
• These bodies are composed primarily of
health care professionals, but may also
include philosophers, lay people, and clergy -
indeed, in many parts of the world their
presence is considered mandatory in order to
provide balance.

40. Referral
• doctors who receive income from referring
patients for medical tests have been shown to
refer more patients for medical tests

41. Truth-telling
Some cultures do not place
a great emphasis on
informing the patient of
the diagnosis, especially
when cancer is the
diagnosis

43. Ethics Over view

44. To distinguish between Ethics and Law
(1) some actions that are illegal may not be
unethical  (kill)
(2) some actions that are unethical may not be
illegal  (secret)
(3) laws can be unethical or immoral (Nazi’s)
 we use different kinds of mechanisms to
express, teach, inculcate, and enforce laws and
ethics.

45. SUGGESTED BOOKS:
BIOETHICS (F.M.KAMM) ; ABORTION (SUSAN A MARTINEL-FERNENEZ) ;
MEDICAL ETHICS BASIS (CAMBELL) ; MALPRACTICE (KAMM) ;
INFORMED CONCENT (DEBORAH BOWMAN, REHANA IQBAL)

49. QUIZ

50. 1. the patient has the right to refuse or choose
their treatment 
Autonomy
2. a practitioner should act in the best interest
of the patient
Beneficence
3. "first, do no harm” 
Non-maleficence
4. concerns the distribution of scarce health
resources, and the decision of who gets what
treatment (fairness and equality) 
Justice

51. Thank you

52. Reflection of understanding