Ethics

Corlia van VuurenJanuary 2011

Background

Two distinct areas of ethical conduct for health care professionals:

• Professional behaviour/professional conduct

• Research

Background (cont’d)

Reasons for the development of ethical rules/principles

• Inhumane research conducted, e.g.:

• World War II (Nuremberg code)

• Tuskegee study in syphilis

• Medical advancement

Ethical cornerstones

Ethical principles

Human rights

Medical

law

Ethical principles

• The right of patients to self-determination or to make their own informed choices, and to live their lives by their own beliefs, values and preferences.

Autonomy/ Respect others

Ethical principles(cont’d)

• Deals with actions that are in the best interest of the patients even when the interests of the patient conflict with the health care professionals’ own personal self-interest.

Beneficence/ Do good

Ethical principles(cont’d)

• Implies that health care professionals should not harm or act against the best interests of patients, even when the interests of the patients conflict with their own self-interest.

Non-maleficence/

Avoid harm to others

Ethical principles(cont’d)

• Health care professionals should treat all individuals and groups in an impartial, fair and just manner.Justice/ Be

fair

Ethical principles(cont’d)

• The quality or state of being of sound moral principle; uprightness, honesty, and sincerity.

Integrity

Ethical principles(cont’d)

• Freedom from deceit or falseness

• The quality of being authentic (genuine, real)Truthfulness

Ethical principles(cont’d)

• Sorrow for the sufferings or trouble of another or others, accompanied by an urge to help.

Compassion

Ethical principles(cont’d)

• Being tolerant, especially of views, beliefs, practices of others that differ from one's own

• Freedom from prejudice• The ability to endureTolerance

Ethical principles(cont’d)

• ?Philosophy vs Religion

Ethical cornerstones

Ethical principles

Human rights

Medical

law

Human rights

Human dignity

Patients’ rights charter

Patients’ responsibilities

Human rights (cont’d)

• What is human dignity?

• Useful or useless?Human dignity

Human rights (cont’d)

• Healthy and safe environment• Participation in decision-making• Access to health care• Knowledge of health

insurance/medical aid • Choice of health services• Treated by a named health care

professional

Patients’ rights charter

Human rights (cont’d)

• Informed consent• Refusal of treatment• A second opinion• Continuity of care• Complaints about health services• Confidentiality and privacy

Patients’ rights charter

(cont’d)

Human rights (cont’d)

• To take care of his or her own health

• To care for and protect the environment

• To respect the rights of other patients and health care providers

• To utilise the health care system properly and not to abuse it

Patients’ responsibilities

Human rights (cont’d)

• To know his or her local health services and what they offer

• To provide health care providers with relevant and accurate information for diagnostic, treatment, rehabilitation or counseling purposes.

Patients’ responsibilities

(cont’d)

Human rights (cont’d)

• To advise health care providers of his or her wishes with regard to his or her death.

• To comply with the prescribed treatment or rehabilitation procedures.

• To enquire about the related costs of treatment and/or rehabilitation and to arrange for payment.

Patients’ responsibilities

(cont’d)

Human rights (cont’d)

• To take care of the health records in his or her possession.

Patients’ responsibilities

(cont’d)

Ethical cornerstones

Ethical principles

Human rights

Medical

law

Medical law

Responsibilities of health care professionals

To patients

To other health care professionals

To themselves

To society

To the profession

To the environment

Human rights (cont’d)

• Act in the patients’ best interests when making referrals and providing/ arranging treatment.

• Treat patients referred to them in the same manner in which they would treat their own patients.

Health care professionals’

responsibilities to other health care

professionals

Human rights (cont’d)

• Maintain and improve the standard of their performance by keeping their professional knowledge and skills up to date throughout their working life.

• Acknowledge the limits of their professional knowledge and competence.

Health care professionals’

responsibilities to themselves

Human rights (cont’d)

• Keep accurate and up-to-date patient records.

• Refrain from engaging in activities that may affect their health and lead to impairment.

Health care professionals’

responsibilities to themselves

(cont’d)

Human rights (cont’d)

• Ensure that staff members employed by them are trained to respect patients’ rights; in particular the right to confidentiality.

Health care professionals’

responsibilities to themselves

(cont’d)

Conclusion

Did we act ethically??

Thank you

Questions