Health ethics

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Information about Health ethics
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Published on March 10, 2014

Author: abdifatahibrahim

Source: slideshare.net

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medical ethics

MEDICAL ETHICS Dr. Abdalnasir Moh. Almagzop MBBS / M.Sc (PH) / M.Sc (TROP. MED.) / MD (COMM. MED.)

• “And if anyone saved a life, it would be as if he saved the life of the whole people.” (Al Quran 5:32) • “No soul can die except by Allah's permission.” (Al Quran 3:185)

MEDICAL ETHICS • Medical ethics is primarily a field of applied ethics, the study of moral values and judgments as they apply to medicine. •‫آداب‬‫مهنة‬‫الطب‬‫هو‬‫في‬‫المقام‬‫األول‬‫مجال‬ ‫األخالقيات‬،‫التطبيقية‬‫ودراسة‬‫القيم‬‫األخالقية‬‫واألحكام‬ ‫التي‬‫تنطبق‬‫على‬‫الطب‬.

A NOBLE PROFESSION • Medical profession is the guardian of human life and is responsible for defending living beings from the miseries and death from disease. •‫مهنة‬‫الطب‬‫هو‬‫الوصي‬‫على‬‫حياة‬،‫اإلنسان‬‫وهي‬ ‫مسؤولة‬‫عن‬‫الدفاع‬‫عن‬‫حياة‬‫االنسان‬‫من‬‫مآسي‬ ‫المرض‬‫والموت‬.

•Medical ethics is a code of conduct of practicing doctors/ dental surgeons evolved over centuries nationally and internationally that is based on the most admirable human values and principles. •‫آداب‬‫مهنة‬‫الطب‬‫هي‬‫مدونة‬‫لقواعد‬ ‫السلوك‬‫في‬‫ممارسة‬‫األطباء‬/‫أطب‬‫اء‬ ‫األسنان‬‫تطورت‬‫على‬‫مدى‬‫قرون‬ ‫دوليا‬‫وعالميا‬‫والتي‬‫تقوم‬‫على‬‫ا‬‫لقيم‬ ‫اإلنسانية‬‫والمبادئ‬‫األكثر‬‫انتش‬‫ارا‬‫و‬ ‫اتفاقا‬‫عليها‬.

Greek healers in the 4th Century B.C., drafted the Hippocratic Oath and pledged to : “prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone”. ‫صاغ‬‫المعالج‬‫و‬‫ن‬‫اليوناني‬‫ون‬‫في‬‫القرن‬‫الراب‬‫ع‬ ‫قبل‬‫الميالد‬‫قسم‬‫أبقراط‬‫و‬‫الذي‬‫فيه‬‫المعالج‬‫ي‬‫تعهد‬ ‫ب‬...:”‫اصف‬‫ال‬‫نظم‬‫العالجية‬‫لصالح‬‫مرضاي‬ ‫وفقا‬‫لقدرتي‬‫وحكمي‬‫وأبدا‬‫ال‬‫ا‬‫ضر‬‫باي‬‫أحدا‬".

Muslim physicians: Ishaq bin Ali Rahawi (who wrote the Conduct of a Physician, the first book dedicated to medical ethics) Muhammad ibn Zakariya ar-Razi (known as Rhazes in the West)

Muslim physicians Ishaq bin Ali Rahawi: Who wrote the Adab al-Tabib (Conduct of a Physician), the first paper dedicated to medical ethics. He regarded physicians as "guardians of souls and bodies", and wrote twenty chapters on various topics related to medical ethics.

PRINCIPLES OF MEDICAL ETHICS ‫الطبية‬ ‫األخالق‬ ‫مبادئ‬

There are main four principles of Medical Ethics: 1. Patient Autonomy; 2. Beneficence; 3. Do No Harm (or Non-malificence); 4. Justice.

• In addition to the four ethical principles the following ethical principles have been included: Principles of confidentiality ‫مبادئ‬‫السرية‬ Protection of the vulnerable ‫الضعفاء‬ ‫حماية‬ Collegiality ‫الزمالة‬

1.Autonomy : ‫االستقاللية‬ •Respect the autonomy of the patient. •The patient has the right to refuse or choose their treatment.

2. Beneficence: ‫االحسان‬ •promoting what is best for the patient . •A practitioner should act in the best interest of the patient.

• Beneficence implies consideration of the patient's pain; their physical and mental suffering; the risk of disability and death; and their quality of life. At times, beneficence can imply not intervening, if the benefit of therapy would be minimal. •‫اإلحسان‬‫يعني‬‫النظر‬‫في‬‫آالم‬‫المريض؛‬‫المعاناة‬ ‫الجسدية‬‫والعقلية؛‬‫مخاطر‬‫العجز‬،‫والوفاة‬‫ونوعية‬ ‫حياتهم‬.‫في‬‫بعض‬،‫األحيان‬‫يمكن‬‫االحسان‬‫يعني‬‫عدم‬ ،‫التدخل‬‫إذا‬‫كانت‬‫الفائدة‬‫من‬‫العالج‬‫ضئيلة‬‫للغا‬‫ية‬.

3. Non-maleficence: ‫االيذاء‬ ‫عدم‬ •first, do no harm. •We have been given the gift of life, for goodness sakes, Protect it!!! Respect it!!!

4. Justice: ‫العدالة‬ •Resources are limited; you cannot cure everybody and so priorities must be set (hence the notion of triage). •‫عالج‬ ‫يمكنك‬ ‫ال‬ ،‫محدودة‬ ‫الموارد‬ ‫األولوي‬ ‫تحديد‬ ‫يجب‬ ‫ولذا‬ ‫الجميع‬‫ات‬ (‫الفرز‬ ‫فكرة‬ ‫هنا‬ ‫ومن‬).

Principles of confidentiality • Non-disclosure / disclosure of patients’ details and medical records. • To respect the privacy and preserve the dignity of each patient. •‫عدم‬‫الكشف‬/‫الكشف‬‫عن‬‫تفاصيل‬‫المريض‬ ‫والسجالت‬‫الصحية‬. •‫على‬ ‫والحفاظ‬ ‫الخصوصية‬ ‫احترام‬‫كرامة‬‫مريض‬ ‫كل‬.

Dignity: • The patient and the doctor have the right to dignity. •The spirit of humanity, respecting the worth of each person •Each person we encounter in our working day deserves our respect—patients, visitors, co-workers ‫والطبيب‬ ‫المريض‬ ‫من‬ ‫لكل‬ ‫حق‬ ‫الكرامة‬ ‫العمل‬ ‫اثناء‬ ‫نواجهه‬ ‫شخص‬ ‫كل‬ ‫احترامنا‬ ‫يستحق‬(‫زو‬ ، ‫مرضى‬‫ار‬ ‫العمل‬ ‫وزمالء‬) ‫واالحترام‬ ،‫اإلنسانية‬ ‫روح‬ ‫يستحق‬ ‫شخص‬ ‫كل‬

Confidentiality: •is commonly applied to conversations between doctors and patients. This concept is commonly known as patient- physician privilege. •‫تعني‬‫الحفاظ‬‫على‬‫سرية‬‫المريض‬‫من‬‫ج‬‫هة‬ ،‫الطبيب‬‫وهذه‬‫تسمى‬‫ميزة‬‫العالقة‬‫بين‬ ‫المريض‬‫والطبيب‬ •Legal protections prevent physicians from revealing their discussions with patients, even under oath in court. •‫الحماية‬‫القانونية‬‫تمنع‬‫األطباء‬‫من‬‫الك‬‫شف‬ ‫عن‬‫مناقشاتهم‬‫مع‬،‫المرضى‬‫حتى‬‫تحت‬ ‫القسم‬‫في‬‫المحكمة‬.

• Confidentiality forms a cornerstone of the doctor-patient relationship, but it is increasingly hard to maintain with the growth of electronic data. •‫ا‬‫لسرية‬‫تشكل‬‫حجر‬‫االساس‬‫في‬‫العالقة‬‫بين‬‫الطبيب‬،‫والمريض‬‫ولكن‬‫من‬‫الص‬‫عب‬ ‫ا‬‫لحفاظ‬‫على‬‫ذلك‬‫ل‬‫تزايد‬‫النمو‬‫في‬‫تناقل‬‫البيانات‬‫اإللكترونية‬. • In order to protect the trust between doctor and patient, the physician should not release personal medical information without the patient's consent. •‫من‬‫أجل‬‫حماية‬‫الثقة‬‫بين‬‫الطبيب‬‫والمريض‬‫ينبغي‬‫على‬‫الطبيب‬‫عدم‬‫التصري‬‫ح‬ ‫ب‬‫المعلومات‬‫الطبية‬‫الشخصية‬‫للمريض‬‫دون‬‫موافق‬‫تة‬‫المريض‬. • Like other ethical duties, however, confidentiality is not absolute. It can be necessary to override privacy in the interests of public health. However, this should always be done in a way that minimizes harm to the patient. •‫مثل‬‫الواجبات‬‫األخالقية‬،‫األخرى‬‫السرية‬‫ليست‬‫مطلقة‬.‫يمكن‬‫أن‬‫ي‬‫كون‬‫من‬‫ال‬‫ض‬‫رور‬‫ي‬ ‫تجاوز‬‫الخصوصية‬‫من‬‫اجل‬‫مصالح‬‫الصحة‬‫العامة‬،‫بشرط‬‫ان‬‫يتم‬‫ذلك‬‫بطريقة‬‫تقلل‬ ‫الضرر‬‫على‬‫المريض‬.

Discussion topic: A patient's relative gives you information on the patient but asks you not to reveal where the information came from. Do you have to keep this secret?

Disclosure: •the doctor must disclose information that is materially relevant to the patient's understanding of his condition, his treatment options and likely outcomes. • This would include, for example, information on medical errors made in their care. • Errors do not necessarily constitute improper, negligent, or unethical behavior, but failure to disclose them may.

•‫يجب‬‫على‬‫الطبيب‬‫الكشف‬‫عن‬‫المعلومات‬‫للمريض‬ ‫لفهم‬‫حالته‬،‫الصحية‬‫وخيارات‬،‫العالج‬‫والنتائج‬ ‫المحتملة‬. •‫ويشمل‬،‫ذلك‬‫على‬‫سبيل‬،‫المثال‬‫معلومات‬‫عن‬‫األخ‬‫طاء‬ ‫الطبية‬‫المرتكبة‬‫اثناء‬‫تقديم‬‫الخدمة‬‫الطبية‬. •‫األخطاء‬‫الطبية‬‫ال‬‫تشكل‬‫بالضرورة‬‫سلوك‬‫غير‬ ،‫الئق‬،‫إهمال‬‫أو‬‫فعل‬‫غير‬،‫أخالقي‬‫بقدر‬‫ماهو‬‫عليه‬ ‫في‬‫عدم‬‫الكشف‬‫عنها‬.

Discussion topic: A teenage patient requests an abortion but asks you not to tell her parents. How do you balance protection of the patient's confidentiality against the rights of her parents?

Protection of the vulnerable ‫الضعفاء‬ ‫حماية‬ • Standing up for the rights of those who may be unable to speak or act for themselves. e.g.. Children, the frail elderly, and patients who are unable to make decisions for themselves. •‫الوقوف‬‫على‬‫حقوق‬‫أولئك‬‫الذين‬‫قد‬‫يكونون‬‫غير‬‫قادرين‬‫على‬‫الكالم‬ ‫أو‬‫العمل‬‫ألنفسهم‬.‫على‬‫سبيل‬‫المثال‬.‫األطفال‬‫والمسنين‬‫الضعف‬،‫اء‬ ‫والمرضى‬‫الذين‬‫ال‬‫يستطيعون‬‫اتخاذ‬‫قراراتهم‬‫بأنفسهم‬.

Collegiality ‫الزمالة‬: • Calls for support of colleagues and fellow practitioners and professionals. • Mutual respect & understanding for fellow optometrists, for other professionals and for their respective roles in the health care team.

•‫في‬ ‫الممارسين‬ ‫الزمالء‬ ‫من‬ ‫الدعم‬ ‫طلب‬ ‫يجب‬ ‫ذلك‬ ‫تطلب‬ ‫اذا‬ ‫الطبي‬ ‫لبحقل‬.. •‫للزمال‬ ‫والتفاهم‬ ‫المتبادل‬ ‫االحترام‬ ‫توفر‬ ‫يجب‬‫ء‬ ‫كل‬ ‫ودور‬ ‫المهنيين‬ ‫من‬ ‫غيرهم‬ ‫عن‬ ‫خبرة‬ ‫االكثر‬ ‫الصحية‬ ‫الرعاية‬ ‫فريق‬ ‫في‬ ‫منهما‬.

Doctor-Patient Relationship: All doctors know that it is unethical, at a minimum, to have a bad relationship with patients.

Truthfulness. ‫الثقة‬ Honesty. ‫والصدق‬ ‫الشرف‬ Informed consent. ‫والمعتم‬ ‫الرسمية‬ ‫الموافقة‬ ‫طلب‬‫دة‬ The Physician's moral integrity and virtuous character. ‫والشخصية‬ ‫األخالقية‬ ‫النزاهة‬ ‫للطبيب‬ ‫الفاضلة‬.

‫قال‬‫رسول‬‫هللا‬‫صلى‬‫هللا‬‫عليه‬‫وسلم‬:”‫ان‬‫أ‬‫زعمي‬ ‫بيت‬‫ب‬‫يف‬‫بض‬‫ر‬،‫نة‬‫جل‬‫ا‬‫ملن‬‫ترك‬‫اء‬‫ر‬‫امل‬‫ن‬‫ا‬‫و‬‫اكن‬‫حم‬،‫قا‬‫بيت‬‫ب‬‫و‬ ‫يف‬‫وسط‬،‫نة‬‫جل‬‫ا‬‫ملن‬‫ترك‬‫الكذب‬‫ن‬‫ا‬‫و‬‫اكن‬،‫مازحا‬‫ب‬‫و‬‫بيت‬ ‫يف‬‫عىل‬‫أ‬،‫نة‬‫جل‬‫ا‬‫ملن‬‫سن‬‫ح‬‫خلقه‬“. ‫رواه‬‫أبو‬‫داود‬‫والطبراني‬‫في‬‫معاجمه‬،‫وغيرهما‬‫وحسنه‬ ‫األلباني‬‫في‬‫صحيح‬‫سنن‬‫أبي‬‫داود‬.

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