Medical
Ethics
Momen Ashraf Samir
Ethic and Moral
• Ethics refers a set of moral principles, philosophy and applied to questions of correct behavior,
• The language of morality includes nouns like: "rights", "responsibilities" and "virtues" and
adjectives like: "good" and "bad", "right" and "wrong", "fair" and "unfair”.
Therefore, ethics is a matter of knowing, while morality is based on what to do.
Their close relationship consists of providing rational criteria for people to decide or behave in a
certain way.
What is medical
ethics?
Medical ethics is a system of principles,
beliefs and moral values that guide
us when making decisions about
medical care and practice, in
addition to scientific research.
Among the principles that govern
ethics in medicine we find those of
honesty, care, integrity,
nondiscrimination and
confidentiality. Thanks to medical
ethics, the patient is assured that
him personal information will be
private, or that him wishes for care
will be respected while he is
incapacitated.
These principles help us to make
difficult decisions in medical
practice when there is any
confusion of conflict. It is an
important part of medical
professionalism.
IMPORTANT: Violations of medical ethics
can threaten your job, your medical
license or even constitute a crime
The Basic Principles of Medical
Ethics
01 Autonomy 02 Beneficence
Non-
03 Maleficence 04 Justice
Autonom
y
The patient must have autonomy of
thought, intention, and action when
making decisions regarding health care
procedures. Therefore, the decision-
making process must be free of
coercion or coaxing. In order for a
patient make a decision must be fully
informed, she/he must understand all
risks and benefits of the procedure and
the likelihood of success.
In the case of children, the right of the
person who acts in their best interest
(the parent or guardian).
When is
autonomy
challenge?
Incompetence- Patient is legally deemed
unable to make rational decisions for
theselves. Often due to permanente
conditions such as dementia. Assigned a
surrogate by the court
Incapacity- Patient is clinically determined
to be unable to make a rational decisión for
themselves. May be due to transient
conditions such as lack of consciousness,
delirium, psychosis, etc. (*Should check for
durable power of attorney)
Threat to self or others-Usually in
psychiatric settings.
Beneficience
The actions of medical practice should seek the benefit of the patient
and society. Demands that health care providers develop and
maintain skills and knowledge, continually update training, consider
individual circumstances of all patients, and strive for net benefit.
The patient should not be coerced or
manipulated to make a decision
against their values, even though
objectively it may be the best decision
for their health.
In addition, the doctor must refrain
from administering the death penalty
or euthanasia
When patient autonomy is
compromised, beneficence must be
the guiding ethic.
Non-Maleficence
It is an inseparable pillar of ethics and is
closely related to beneficence.
It states that a physician has a duty not to
cause harm or allow harm to be caused to a
patient by negligence. Infertility specialists
operate under the assumption that they are
doing no harm or at least minimizing harm by
pursuing the greater good.
In some cases, it is difficult for clinicians to apply the do-harm principle successfully,
which is
why the following is involved:
• The principle of double effect- Unintended medical consequences are
aceptable if the intended consequences are legitimate and the harm is
proportionately smaller tan the Benefit, for example:
Removing an organ or limb that is causing disease
Justice
Requires fairness in the management of patients and distribution of resources especially in
the time of scarcity and when priority needs to be maintained such as during mass casualty
and pandemics. Individuals at all time should be treated fairly when they visit a health
facility. The distribution of health resources requires justice for it to be done fairly and
equitably. Justice is also necessary in respecting the rights of patients. In times of scarcity,
the ethical principle of justice is used to determine areas of priority in the distribution of
health resources.
When justice is a
challenge?
It may be tempting to provide more
luxurious care to high-ranking
individuals, for example a
governor or minister, due to
their position and power, but it
is part of medical ethics that
all patients are treated the
same. Therefore, a patient who
is an important person cannot
be treated differently from other
patients.
It must be taken into account that "medical ethics" may vary from one
country to another, for this reason, there are countries where they
have additional ethical principles. In addition, it could be different if it
is associated with a religious institution.
For this reason we
have two additional
Veracity (Truth telling)
A self-employed patient not only has the
right to know his diagnosis and prognosis,
but also has the option to waive this
disclosure. However, the doctor is obliged to
ask and know which of these 2 options the
patient prefers. All healthcare professionals,
including physicians, are expected to always
tell the truth to their patients, even if it turns
out to be bad news. That is why medical
ethics and bad news reporting are
incorporated into medical training.
In some cases this produces controversy because
cultures and religions prohibit telling the truth
when it is bad news and there is also a
contradiction between respect for the person as
an individual and the patient's right not to know
due to the autonomy of the patient.
The question of telling the truth has been debated
and has been a challenge in medical ethics
because there is no guideline on the limit of the
amount of information that must be provided to
the patient.
It is NEVER OK to lie to or deceive a
patient, for any reason!
Confidentiality
Doctors are obliged not to disclose discussions
and confidential information provided by the
patient to another part. The doctor requires the
patient's permission and consent before
disclosing such information to anyone else,
including other physicians and healthcare
professionals.
If the exchange of medical information for
patient care is necessary, approval must be
obtained first. The ethical principle of
confidentiality is related to other ethical
principles of autonomy and truthfulness.
In conclusion, the importance of
medical ethics lies in the need to
regulate medical acts in a world
in which scientific discoveries and
technological advances occur
rapidly, opening up new
possibilities for action.
Just because many things can be done does not
mean that all of them should be done.
Thank you
for your
attention !
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