Forms of professional relationship:

• 1. Between student and teacher. 2. Between doctors (including specialists) in the same discipline. 3. Between general practitioner (GP) and consultant. 4. Between two doctors in differing specialities. 5. Between the doctor and his doctor-patient.

Principles governing the relationship between doctors:

the International Code of Ethics (3) states the following:

يحب 1. هو كما زمالئه مع يتعامل أن الطبيب على يجب. زمالئه يعامله أن

.2. زمالئه عن المرضى اليبعد أن عليه يجب

Student and teacher:

أبقراط قسم عقائد إحدى على في يجب أنه قال

وبكل مايعرف كل طالبه بتعليم يقوم أن الطبيب. بالمكافأة تفكير وبال حرية

. يستحقه الذي واإلمتنان اإلحترام المعلم إعطاء يجب

The doctor- doctor relationship: professional criticism

Professional criticism

زميله خطأ في رأيه عن يعبر أن الطبيب على يجبفالهدف , بالزميل تضر ال وبطريقة سرية بمواجهة

. العداء إثارة وليس الخطأ تصحيح هو األخير في

يمكن وال خطير تصرف المريض أمام الطبيب نقد إن . يبرر أن

Professional criticism:

لغرض اليك يأتي الذي المريض مع التصرف يجبالى تحيله بأن معه زميلك بدأه عالج في رأيك معرفةتستغل أن لك يحل وال حالته تناقش إستشارية لجنةيؤدي ذلك فإن زميلك على أفضليتك إظهار في ذلك

. المهنة لمصداقية المريض فقدان الى

When your patient sees another doctor during an emergency, or because you are otherwise not available, do not criticise the other professional’s decisions. Be thankful to the doctor for having taken care of your case in your absence.

When you see negligence ?

المناسبة السلطة تبلغ أن المهني التزامك من إنه

أو مهامه تنفيذ في النقص عليه تالحظ زميل أي عن. السريرية قدرته

The Declaration of Geneva(World Medical Association, 1948 , 1968, 1983)

1 .I solemnly pledge to consecrate my life to the service

of humanity.

•. اإلنسانية للخدمة حياتي أكرس أن أتعهد

2 .I will give to my teachers the respect and gratitude

which is their due.

الذي • واإلمتنان اإلحترام أساتذتي أعطي سوف أنا يستحقونه.

3 .I will practice my profession with conscience and

dignity.

•. كرامة و ضمير بكل مهنتي أزاول سوف أنا

5 .I will respect the secrets which are confided in me ,

even after the patient has died.

إذا • حتى عهدتي في التي المريض أسرار أحترم سوف أناالمريض .توفى

6 .I will maintain by all means in my power, the honor

and the noble traditions of the medical profession.

والتقا • الشرف على قوتي معاني بكل أحافظ سوف أنا. الطبية للمهنة النبيلة ليد

7 .My colleagues will be my brothers•. إخوتي يكونوا سوف زمالئي

8. I will not permit considerations of religion, nationality, race, party politics, or social standing to intervene between my duty and my patient. 9. I will maintain the utmost respect for human life from its beginning even under threat and I will not use my medical knowledge contrary to the laws of humanity .

بدايتها • منذ اإلنسان لحياة األعلى اإلحترام على أحافظ سوف اناحتى

. اإلنسانية , قوانين ضد الطبية معرفتي أستخدم ولن التهديد تحت

10. I make these promises solemnly, freely, and upon my honour.

International Code of Medical Ethics(World Medical Association, 1949, 1968, 1983)

: General Duties of Physicians in

1.A physician shall always maintain the

highest standards of professional conduct.2.A physician shall not permit motives of

profit to influence the free and independent exercise of professional judgement on behalf of all patients.

بأن الربحية للجوانب اليسمح أن يجب الطبيب إن. الطبية المهنة شرف على تؤثر

, الرنة تسمع عندما اآلن موجود غير الطبيبوتشخيص والرقم إسمك أترك الموسيقية

مبدأي..

: General Duties of Physicians in

3. A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception.

المرضى مع بأمانة يتعامل أن الطبيب على يجبالناقصين األطباء أولئك لكشف ويجاهد والزمالء

واإلحتيال بالمكر يعرفون أو والسمعة الكفاءة .في

5.The following practices are deemed to be

unethical conduct:

a) Self advertising by physicians, unless

permitted by the laws of the country and the

Code of Ethics of the National Medical

Association.

b) Paying or receiving any fee or any other consideration solely to procure the referral of a patient or for prescribing or referring a patient to any source.

مقابل مكافأة أو أجر أى إستالم أو تقاضي. مصدر أي الى المريض تحويل

6. A physician shall respect the rights of patients,

of colleagues, and of other health professionals,

and shall safeguard patient confidences. والزمالء المرضى حقوق إحترام الطبيب على يجب

. به المرضى ثقة يصون وأن

7. A physician shall act only in the patient's interest

when providing medical care which might have

the effect of weakening the physical and medical

condition of the patient.

8. A physician shall use great caution in divulging discoveries or new techniques or treatment through non-professional channels.

الطبيب يأخذ على أسرار حذرأن إفشاء من هخالل من العالج أو الحديثة والتقنيات اإلكتشافات

. مهنية غير قنوات

9. A physician shall certify only that which he has personally verified.

به تحقق بما فقط الشهادة الطبيب على يجبشخصيا.

Regulations in Time of Armed Conflict

Medical ethics in time of armed conflict are identical to medical ethics in time of peace .

The primary task of the medical profession is to preserve health and save life. Hence it deemed unethical for physicians to: o Give advice or perform prophylactic, diagnostic, or

therapeutic procedures that are not justifiable in the patient's interest.

o Weaken the physical or mental strength of a human being without therapeutic justification.

o Employ scientific knowledge to imperil health or destroy life.

Rights of those in need of care

A patient/prisoner has the right to refuse to eat or to refuse treatments. The nurse may need to verify that the patient/prisoner understands the implications of such action but she should not participate in the administration of food or medications to such patients.

Rights and duties of nurses

It is a duty to have informed consent of patients relative to having research done on them and in receiving treatments such as blood transfusions, anesthesia, grafts, etc. Such informed consent is a patient's right and must be ensured.

AMA Principles of Medical Ethics

2001

I. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.

في جهده يكرس أن الطبيب على يجبالشفقة , مع المتميزة الطبية العناية إعطاء

. اإلنسان حقوق و لكرامة واإلحترام

II. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.

مع بأمانة يتعامل أن الطبيب على يجبأولئك لكشف ويجاهد والزمالء المرضى

أو والسمعة الكفاءة في الناقصين األطباء. واإلحتيال بالمكر يعرفون

III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.

ومعرفة القانون إحترام الطبيب على يجب. المريض مصالح يفيد مما جديد ماهو كل

IV. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.

حقوق إحترام الطبيب على يجبثقة يصون وأن والزمالء المرضى

. به المرضى

V. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education,

باإلشراف ) األطباء يقوم عندماالصحي القطاع في العاملين علىأن من متأكدين يكونوا أن من البد

وأن متحققة المناسبة العنايةأسمائهم تستخدم بأن اليسمحوا

اإلحترام من نوعا تعطي بأنالعالجية (لوصفاتهم

VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.

VII. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.

VIII. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.

IX. A physician shall support access to medical care for all people.

CODE OF MEDICAL ETHICS AND PROFESSIONALISM FOR ORTHOPAEDIC SURGEONS Surgeons American Academy of Orthopaedic

I. The Physician-Patient Relationship A. Both the patient and the orthopaedic surgeon are

free to enter or discontinue the relationship within any existing constraints of a contract with a third party.

• An orthopaedic surgeon has an obligation to render care only for those conditions that he or she is competent to treat.

• The orthopaedist shall not decline to accept patients solely on the basis of race, color, gender, sexual orientation, religion, or national origin or on any basis that would constitute illegal discrimination.

B. The orthopaedic surgeon may choose whom he or she will serve. • An orthopaedic surgeon should render

services to the best of his or her ability. • Unless discharged by the patient, the

orthopaedic surgeon may discontinue service only after giving adequate notice to the patient so that the patient can secure alternative care.

C. When obtaining informed consent for treatment, the orthopaedic surgeon is obligated to present to the patient or to the person responsible for the patient, in understandable terms, pertinent medical facts and recommendations consistent with good medical practice. Such information should include alternative modes of treatment, the objectives, risk and possible complications of such treatment, and the complications and consequences of no treatment.

II. Conflicts of Interest :

a) When a conflict of interest arises, it must be resolved in the best interest of the patient , If the conflict of interest cannot be resolved, the orthopaedic surgeon should notify the patient of his or her intention to withdraw from the relationship.

b) If the orthopaedic surgeon has a financial or ownership interest in a durable medical goods provider, imaging center, surgery center or other health care facility where the orthopaedic surgeon's financial interest is not immediately obvious, the orthopaedic surgeon must disclose this interest to the patient.

C. It is unethical for an orthopaedic surgeon to receive compensation of any kind from industry for using a particular device or medication.

أي يتسلم أن العظام لجراح غيرأخالقي إنهإلستخدامه المصنع من المكافآت من نوع

األدوية أو األدوات من خاصا نوعا

VII. General Principles of Care

A. An orthopaedic surgeon should practice only within the scope of his or her personal education, training, and experience.

B. The orthopaedic surgeon should not perform a surgical operation under circumstances in which the responsibility for diagnosis or care of the patient is delegated to another who is not qualified to undertake it.

Doctors, drugs and ethics

GIFTS The gift is only of nominal value. The gift is not in cash. The gift, even one of nominal value, is not

connected to any stipulation that the physician prescribes a certain medication, uses certain instruments or materials or refers patients to a certain facility.

Gifts should be accepted only if decision-making is left manifestly unimpaired.

Support for travel to conferences organised by professional societies should be restricted to people making formal contributions.

Entertainment expenses should not be lavish.

Access of representatives to students and health services should be limited.

Sources of commercial funding should not influence the scientific, educational or public policy decisions of professional bodies, which should not associate themselves directly or indirectly with promotion of products of commercial sponsors.

In conference, The name of a commercial entity providing financial support is publicly disclosed in order to allow the medical community and the public to assess the information presented in light of the source of funding.

A conference can be recognised for purposes of continuing medical education/ continuing professional development (CME/CPD) only if it conforms to the following principles:

1.The commercial entities acting as

sponsors, such as pharmaceutical companies, have no influence on the content, presentation, choice of lecturers, or publication of results. 2. Funding for the conference is accepted only as a contribution to the general costs of the meeting.