MEDICAL ETHICS

MECT 104
INTRODUCTION
Definition
• Is derived from the Greek “Ethos” = custom, character, practice
• Is the oldest scientific and philosophical discipline about moral problems
and deals with the art of living
• Is the study or analysis of principles to right and wrong conduct
• It’s all about morality for the standards that govern the conduct of a
person

- Ethics – discipline about moral or philosophy on moral

- Moral – system of norms or rules, written or not, about human behavior
 INTRODUCTION cont’d
• Medical Ethics is a curricula element that:

makes the clinical training to run integrated with basic disciplines to improve health
workers’ attitudes concerning patients

delivers a structure for coaching assimilated scientific medicine

improves learners for the clinical years

 Why Do we Need Medical Ethics ?
• Because:

• Health care decisions are based not only on Clinical and Technical grounds but also on
Ethical grounds
• Medical professionalism is defined as ‘a set of values, behaviors and relationships that
underpin the trust the public has in doctors, with doctors being committed to integrity,
compassion, altruism, continuous improvement, excellence and teamwork’ (RCPL)

• Need to recognize difficult situations and to deal with them in a rational and principled
manner
 Brief History of Ethics
 Foundations of medical ethics: Hippocratic Oath / Pledge

 Yet till date, the medical profession doesn’t have a universal basic curriculum on Ethics

1750’s translated oath: “I swear to fulfill to the best of my ability and judgment this covenant.
I’ll respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly
share such knowledge as is mine with those who are to follow”

I’ll respect the autonomy and dignity of my patient.

1948 Declaration of Geneva: “I’ll not permit consideration of age, disease or disability, creed,
ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing,
or any other factor to intervene between my duty and my patient”.
 Objectives in Ethics

a. to explain why all patients are deserving of respect and equal treatment

b. to identify the essential elements of informed consent

c. to explain how medical decisions should be made for patients who are incapable of making
their own decisions

d. to explain the justification for patient confidentiality and recognize legitimate exceptions to
confidentiality

e. to recognize the principal ethical issues that occur at the beginning and end of life

f. to summarize the arguments for and against the practice of euthanasia / assisted suicide and
the difference between these actions and palliative care or forgoing treatment
 Ethics vs Laws
1. Ethics are rules of conduct 1. Laws are rules developed by
governments in order to provide
2. Ethics comes from people’s
balance in society and protection to its
awareness of what is right and
citizens
wrong
2. Laws are enforced by governments to
3. Ethics are moral codes which every its people
person must conform to
3. Laws are codifications of ethics meant
4. Ethics does not carry any serious to regulate society
punishment to anyone who violates 4. The law will punish anyone who
it happens to violate it
5. Ethics comes from within a person’s 5. Laws are made with ethics as a
moral values guiding principle
 Ethics and Morality

 The terms Ethics and Morality are often used interchangeably

 they usually can mean the same thing, and in casual conversation there isn't a problem
with switching between one and the other

 However, there is a distinction between them in philosophy!

Comparison Chart
Ethics Moral
• The rules of conduct recognized in • Principles or habits with respect to right or
respect to a particular class of human wrong conduct
actions or a particular group, culture, etc. • It defines how things should work according
• It defines how thing are according to the to an individuals' ideals and principles
rules
 Comparison chart 2
Ethics Moral
Social system – External Individual – internal
Why we do it? Why we do it ?
Because society says it is the right thing Because we believe in something being
to do. right or wrong.
What if we don't do it?
What if we don't do it?
Doing something against one's morals and
We may face peer/societal disapproval, principles can have different effects on
or even be fired from our job. different people, they may feel
Acceptability uncomfortable, remorse, depressed etc.
Ethics are governed by professional and Acceptability
legal guidelines within a particular time Morality transcends cultural norms
and place
 Ethical Justifications
In ethics, the support or reasons ultimately come from moral values, principles and theories

• “I think we should do X because A and B are really important values”

• “Y wouldn’t be appropriate because it violates principles A and B”
• “X would be the right to do because of our obligation to do A”
• Jonathan Breslin, 2006.

• Example on human cloning:

1. “ it is wrong and should be absolutely prohibited, as this is playing God.” (Deontological)
2. “it can save many lives and should therefore be supported.”(Teleological)
 Socio Medical Situations
a. Reception / Communication
b. Medical examination
c. Wards
d. Theatres
e. Treatment options
f. Consent
g. Ventilatory support
h. Cost
i. Legal issues/courts
j. Research
k. Family planning
l. Abortion
m. Blood transfusion
n. Organ Donations & transplant
Socio Medical Situations
 Expectations on Completion of this Unit
The Medical Student should be able to:

• Demonstrate awareness of the main professional obligations of doctors

• Practice according to statutory requirements and codes of conduct for medical practice

• Critically analyze ethical issues commonly encountered in medical practice and formulate a
framework within which such issues could be resolved

• Demonstrate the ability to resolve ethical issues faced during common clinical scenarios

• Identify the ethical aspects involved in conducting research and apply ethical principles in conducting
research

• Demonstrate sensitivity to ethical issues and ethical behavior within and outside professional practice
 References
• Ray Noble. Introduction to Medical Ethics. DOI: 10.13140/RG.2.1.2581.5763

• Medical Ethics Manual. © 2005 by The World Medical Association, Inc

• WHO Module for Teaching Medical Ethics to Undergraduates. Regional Office of

South East Asia. 2009. SEA-HSD-321

• OMC Code of Medical Ethics. 2016

• R Gillon. (1994). Medical ethics: four principles plus attention to scope. BMJ
1994;309:184 (16 July)