- 1. 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.
2. Principles governing the relationship between doctors: the International Code of Ethics (3)states the following: .1 .2 3. Student and teacher: 4. The doctor- doctorrelationship:professional criticism 5. Professional criticism 6. Professionalcriticism 7. When your patient sees another doctor duringan emergency, or because you are otherwisenot available, do not criticise the otherprofessionals decisions. Be thankful to thedoctor for having taken care of your case inyour absence. 8. When you see negligence ? 9. 10. The Declaration of Geneva(World Medical Association, 1948 11. 1. I solemnly pledge to consecrate my life to the service of humanity.2. I will give to my teachers the respect and gratitude which is their due.3. I will practice my profession with conscience anddignity. 12. 5. I will respect the secrets which are confided in me,even after the patient has died.6. I will maintain by all means in my power, the honor and the noble traditions of the medical profession.7. My colleagues will be my brothers 13. 8. I will not permit considerations of religion, nationality, race, party politics, or social standing to intervene between my duty and mypatient.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 . 10. I make these promises solemnly, freely, and upon my honour. 14. International Code of MedicalEthics(World Medical Association, 1949, 1968, 1983) 15. :General Duties of Physicians in 1.A physician shall always maintain thehighest standards of professional conduct. 2.A physician shall not permit motives ofprofit to influence the free and independent exercise of professional judgement onbehalf of all patients. 16. :General Duties of Physicians in 3. A physician shall deal honestly with patientsand colleagues, and strive to expose thosephysicians deficient in character or competence, or who engage in fraud or deception. 17. 5.The following practices are deemed to beunethical conduct: a) Self advertising by physicians, unless permitted by the laws of the country and the Code of Ethics of the National Medical Association. 18. b) Paying or receiving any fee or any other consideration solely to procure the referral of a patient or for prescribing orreferring a patient to any source. 19. 6. A physician shall respect the rights of patients,of colleagues, and of other health professionals,and shall safeguard patient confidences.7. A physician shall act only in the patients interest when providing medical care which might have the effect of weakening the physical and medical condition of the patient. 20. 8. A physician shall use great caution indivulging discoveries or new techniques ortreatment through non-professional channels.9. A physician shall certify only that which hehas personally verified. 21. Regulations in Time of Armed Conflict Medical ethics in time of armed conflict areidentical to medical ethics in time of peace .The primary task of the medical profession is topreserve health and save life. Hence it deemedunethical for physicians to: o Give advice or perform prophylactic, diagnostic, or therapeutic procedures that are not justifiable in the patients 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. 22. Rights of those in need of care A patient/prisoner has the right to refuse to eator to refuse treatments. The nurse may need toverify that the patient/prisoner understands theimplications of such action but she should notparticipate in the administration of food ormedications to such patients. 23. Rights and duties of nursesIt is a duty to have informed consent of patientsrelative to having research done on them andin receiving treatments such as bloodtransfusions, anesthesia, grafts, etc. Suchinformed consent is a patients right and mustbe ensured. 24. AMA Principles of Medical Ethics 2001 25. I. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights. 26. II. A physician shall uphold the standards ofprofessionalism, be honest in all professionalinteractions, and strive to report physiciansdeficient in character or competence, orengaging in fraud or deception, toappropriate entities. 27. 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. 28. IV. A physician shall respect the rights ofpatients, colleagues, and other healthprofessionals, and shall safeguard patientconfidences and privacy within theconstraints of the law.V.A physician shall continue to study, apply,and advance scientific knowledge,maintain a commitment to medicaleducation, 29. VI. A physician shall, in the provision of appropriatepatient care, except in emergencies, be free tochoose whom to serve, with whom to associate,and the environment in which to provide medicalcare.VII.A physician shall recognize a responsibility toparticipate in activities contributing to theimprovement of the community and thebetterment 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 carefor all people. 30. CODE OF MEDICAL ETHICSAND PROFESSIONALISM FORORTHOPAEDIC SURGEONSSurgeons American Academy ofOrthopaedic 31. I. The Physician-Patient RelationshipA. 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 rendercare only for those conditions that he or she iscompetent to treat. The orthopaedist shall not decline to accept patientssolely on the basis of race, color, gender, sexualorientation, religion, or national origin or on any basisthat would constitute illegal discrimination. 32. B. The orthopaedic surgeon may choose whom he or she will serve. An orthopaedic surgeon should renderservices to the best of his or her ability. Unless discharged by the patient, theorthopaedic surgeon may discontinueservice only after giving adequate notice tothe patient so that the patient can securealternative care. 33. 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. 34. 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 surgeons financial interest is not immediately obvious, the orthopaedic surgeon must disclose this interest to the patient. 35. C. It is unethical for an orthopaedicsurgeon to receive compensation of anykind from industry for using a particulardevice or medication. 36. VII. General Principles of Care A. An orthopaedic surgeon should practiceonly within the scope of his or herpersonal education, training, andexperience. B. The orthopaedic surgeon should notperform a surgical operation undercircumstances in which the responsibilityfor diagnosis or care of the patient isdelegated to another who is not qualifiedto undertake it. 37. Doctors, drugs and ethics 38. GIFTS The gift is only of nominal value. The gift is not in cash. The gift, even one of nominal value, is notconnected to any stipulation that the physicianprescribes a certain medication, uses certaininstruments or materials or refers patients to acertain facility. Gifts should be accepted only if decision-making is left manifestly unimpaired. 39. Support for travel to conferences organisedby professional societies should be restrictedto people making formal contributions. Entertainment expenses should not belavish. 40. Access of representatives to students andhealth services should be limited. Sources of commercial funding should notinfluence the scientific, educational or publicpolicy decisions of professional bodies,which should not associate themselvesdirectly or indirectly with promotion ofproducts of commercial sponsors. 41. In conference, The name of acommercial entity providing financialsupport is publicly disclosed in order toallow the medical community and thepublic to assess the information presentedin light of the source of funding. 42. A conference can be recognised for purposes ofcontinuing medical education/ continuingprofessional development (CME/CPD) only if itconforms 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.