medical ethics for doctors

8/11/2019 Medical Ethics for doctors

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Medical

EthicsIntroduction


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How are medical science andethics related?

What is medical science?

What is Ethics?


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Nowadays, conflicts of interestsbetween the government andmedical institutions, betweenmedical institutions and medicalpersonnel, between physicians andpatients are getting more and more

serious and complex.

Why Ethics Become Important?


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A new and more specific code ofethics must be developed to meetthe demands of social development

and medical service.

This new code integrates thetraditional medical ethics with

modern principles and values.


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Section 1: Morality, EthicsSection 2: Professional

ethics, medical ethics,

bioethics, clinical ethics

Section 3: The History of

Medical Ethics


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2.What is Ethics?

Ethicsare standards of conduct (orsocial norms) that prescribe behavior.

Ethics as a field of study is a

normative discipline whose maingoals are prescriptive and evaluativerather than descriptive andexplanatory. So Ethicists are

different from social scientists. Ethicists (or moral philosophers)

study standards of conduct.


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In thinking about standards of conduct, itwill be useful to distinguish betweenethics

and

morality

.

Morality consists of a societys mostgeneral standards. These standards applyto all people in society regardless of theirprofessional or institutional roles.

Moral standards include those rules thatmost people learn in childhood, e.g. dontlie, cheat, steal, harm other people, etc.

Many ethicists maintain that moral duties

and obligations override other ones: so,if I have a moral duty not to lie, then Ishould not lie even if my employmentrequires me to lie.


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3.Ethics and Morality

So that we can see, moral standardsdistinguish between right and wrong, goodand bad, virtue and vice, justice andinjustice.

Ethicsare not general standards ofconduct but the standards of a particularprofession, occupation, institution, orgroup within society. The word ethics,

when used in this way, usually serves as amodifier for another word, e.g. businessethics, medical ethics, sports ethics,military ethics, etc.

They are all professional ethics.


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4.to distinguish betweenEthics and Law

(1) some actions that are illegal may not beunethical. (kill)

(2) some actions that are unethical may not be

illegal. (secret) (3) laws can be unethical or immoral. (Nazis)

(4) we use different kinds of mechanisms toexpress, teach, inculcate, and enforce laws andethics.


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5.to distinguish betweenEthics and Policy

Political standards focus on the conduct ofgroups or social institutions, whereas ethical andmoral standards focus on the conduct ofindividuals.

Political standards take a macro-perspective onhuman affairs; ethical and moral standards adopta micro-perspective.

However, the distinction between ethics andpolitics is not absolute since many actions,

institutions, and situations can be evaluated froman ethical or political point of view.


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Section 2: Professional

ethics, medical ethics,

bioethics, clinical ethics


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1.Professional Ethics

Professional ethicsare standards ofconduct that apply to people who occupy aprofessional occupation or role.

A person who enters a profession acquires ethical

obligations because society trusts them toprovide valuable goods and services that cannotbe provided unless their conduct conforms tocertain standards.

Professionals who fail to live up to their ethicalobligations betray this trust.

Professional ethics studied by ethicists includemedical ethics.


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2.Medical ethics

The expressions professional ethicsand medical ethicswere coined byThomas Percival.

Medical ethicsis a special kind ofethics only as it relates to aparticular realm of facts and

concerns and not because itembodies or appeals to some specialmoral principles or methodology.


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It is applied ethics. It consists of thesame moral principles and rules thatwe would appeal to ,and argue for, in

ordinary circumstances.

It is just that in medical ethics thesefamiliar moral rules are being applied

to situations peculiar to the medicalworld.


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3.Bioethics

Bioethicscould be defined as thestudy of ethical issues and decision-making associated with the use ofliving organisms

Bioethics includes both medicalethics and environmental ethics.

Bioethics is learning how to balancedifferent benefits, risks and duties.


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4.Clinical ethics

Clinical ethicsis apractical discipline that

provides a structured approachfor identifying ,analyzing, andresolving ethical issues inclinical medicine.


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Clinical medical ethics is a practical and

applied discipline that aims to improvepatient care and patient outcomes byfocusing on reaching a right and gooddecision in individual cases.

It focuses on the doctor-patientrelationship and takes account of theethical and legal issues that patients,doctors, and hospitals must address toreach good decisions for individualpatients.


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Clinical ethics emphasizes that inpracticing good clinical medicine,physicians must combine scientific

and technical abilities with ethicalconcerns for the personal values ofthe patients who seek their help.


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The content of clinical ethics

includes specific issues such as truth-telling,

informed consent, end of life care,

palliative care, allocation of clinicalresources, and the ethics of medicalresearch.

the study of the doctor-patientrelationship, including such issues ashonesty, competence, integrity, andrespect for persons.


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Section 3: The History ofMedical Ethics


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A brief history of medical

ethics in ChinaThe value system of medical ethics in China

has a long tradition that can be traced back to

ancient times.

As in ancient Greek medicine, the

professional values of ancient Chinese medicine

arose with the development of medicalprofessionalism itself. In ancient China,

profession meant ones duties.


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Zhou Dynasty (from 1065-771 B.C.E.)

an independent medical profession and medical

system took shape , built around four aspects: dietetic,

internal, surgery, and veterinary.

Spring and Autumn Period (770-476 B.C.E.) and the

Warring States (475-221 B.C.E.)

medicine began to divorce itself from witchcraft(magic) and became an experience-based knowledge and a

professional skill .


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In ancient China, folk physiciansdidnt have fixed clinics or hospitalsbut went from one place to another

practicing medicine freely.

They hadnt formal training andwerent licensed, but performed their

work by their own skills andconsciences.


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Ancient physicians paid greatattention to prognosis and

accumulated rich experience,codified in ancient medical bookssuch as the Canon of Medicine and

Classic on Medical Problems. By judging whether a patient was

curable or incurable, a physician

decided whether to accept the casefor treatment.


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the Han Dynasty (206 B.C.E.-220 C.E.)

Confucianismshaped the core values

of Chinese culture.medicine is a humane art

it emphasizes on caring about

patients and on physiciansself-cultivationin virtue.

Benevolence is the core of Confucianethics. In Confucianism benevolence

means, to love the people.


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The Confucian principle also calls for

respect for patients.The principle calls for universal

love,that is,

to treat every patient equally,regardless of social status, familybackground, appearances, age, etc.


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Whoever comes to seek curemust be treated like your ownrelatives regardless of their social

status, family economic conditions,appearances, ages, races, andmental abilities.

Simiao Sun


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For Confucians, morality is grounded inhuman nature, which is expressed byConfucius as renor humaneness,sometime simply as benevolence.

From this origin of morality, some more

concrete moral principles spurt out, suchas the principles of ren, yi, li andzhi, orprinciples of benevolence, of justice, ofpropriety , and of moral consciousness.

These are major guiding principles for ourcommon lives.


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Meanwhile, Western theories of

medical ethics and professionalstandards of medicine wereintroduced into China.


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never being selfish butalways ready to help

othershave become the

principal values of medicalethics.


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History of Medical Ethicsin the West


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1Ancient Egypt: Ancient

Egyptian Medicine

The people of Ancient Egypt made

several major medical discoveriesand began treating diseases in aphysical manner alongside olderspiritual cures.


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2Ancient Greek Medicine

Medical practice in Ancient Greece,like Egypt, was based largely uponreligious beliefs.

The works of Hippocrates and hisfollowers led to several scientificfacts being recorded for the first time

Hippocratestheory of the Four

Humours was, for a long time, thebasis upon which to develop medicalreasoning.


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Ancient Roman Medicine

Roman medicine was a mixture of newtheories and developments of Greekpractices. Medicine was improved through

the studies of Galen, through a desire tomaintain a fit and healthy army andthrough empirical observation.

Medicine in Ancient Rome also brought

about some great developments of PublicHealth facilities.


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Oriental and Islamic Medicine

The Islamic Authorities placed a lot ofvalue in medicine.

Baghdad had a hospital by AD 850

and doctors had to pass medicalexaminations by AD 931 in order topractice.

Hospitals were later developed throughout

the Islamic world, with the most famousbeing those in Damascus and Cairo.


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Rhazes said that it was vitally important toobserve patients and make notes of allminor details. He was the first man to

observe and record the differencesbetween smallpox and measles.

Avicenna wrote the Canon of medicine.This developed some of Galens ideas and

was used with aspiring doctors in bothArabia and later in the West.

Developments of Galen and Hippocrates

theories


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Medicine in Medieval andEarly Modern Europe

Medicine during the Medieval periodchanged in a number of ways, often

for the worse. Medieval Europe was a place that

placed less importance on the value

of Public Health facilities


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As the church taught that God sentillness, and that repenting wouldcure all evils, many people at the

time believed that pilgrimage wouldcure them. Other theories werebased upon astrology, the movementof the sun and stars.


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