Medical Ethics

Dr. Raid Jastania

Right and Wrong

MoralityValues

Principles and ConceptsRight and Wrong

Ethics

Aim and Benefit of Ethics

Understand the Boundaries Be Good Enough

Example:

Evidence-Based MedicineGuidelines and

Recommendations

Standards of Practice

Be Good Enough

What is expected from me?What is appropriate to do?What is inappropriate to do?

Watch my Behavior!Why do I do what I do!Evaluate, Assess, Analyze….

How did we reach where we are?

• Belief• Values• Principles• Concepts

• Assumptions• Directions• Behavior• Pressure: cultural,

society, political, educational….

So What should We Do?

So What should We Do?

• Think, think, and think….!

• Watch our Behavior….!

• Evaluate, Assess….! Why do we do this!!

• Consider Right and Wrong concept….!

• Consider change and Improvement….!

• In short: “Be Good Enough”!

OK….., HOW?!

A Suggestion for a Start!

Medical Ethics

Medical Ethics

• Field of applied ethics, the study of moral, values and judgments as they apply to medicine.

Medical Ethics: History

• Ishaq Rahawi wrote (Conduct of Physician) the first book written in medical ethics

• Alrazi• Jewish thinkers: Thomas Aquinas….• 18th, 19th century: self-conscious discourse• Thomas Percival• 1847: The American Medical Association

adopted the first Code of Ethics.

Medical Ethics: History

• 20th century: Liberal Prostant, Joseph Fletcher..

• 1960, 1970: Liberal theory, Procedural justice.

• Bioethics

• Influence: Review Boards, Evaluate experiments, Ethics Committees….

Hippocratic Oath

Values in Medical Ethics• Autonomy: the patient has the right to refuse or

choose their treatment.• Beneficence: a practitioner should act in the best

interest of the patient.• Non-maleficence: First, Do no harm.• Justice: who gets what treatment (fairness and

equality).• Dignity: the patient has the right to dignity.• Truthfulness and honesty: eg. Informed consent.

Values in Medical Ethics

الحريةاألفضل عمل

الضرر منعالعدل

الكرامةالصدق

That’s Easy!

• Values give a useful framework for understanding conflicts.

• When values are in conflict, the result may be ethical dilemma.

Let’s Think

Autonomy vs Paternalism

Beneficence

Is treating always beneficial?

Autonomy vs Beneficence

Non-Maleficence

Do no harm.

Understand risk and benefits.

Double effect

Informed consent

Confidentiality

Can we break confidentiality?

Conflict of Interest

• Referring patients to tests and receiving benefits

• Drug companies

• Treating Family members

• Sexual relation with patients and relative of patients

The Take Home Message

Take Home Message

• Think, think, and think….!

• Watch our Behavior….!

• Evaluate, Assess….! Why do we do this!!

• Consider Right and Wrong concept….!

• Consider change and Improvement….!

• In short: “Be Good Enough”!