Medical ethics

Medical ethics is a system of moral

principles that apply values and judgments

to the practice of medicine

• Ethics does NOT decide what is morally right or wrong; rather it considers how we should act best in the light of our duties and obligations as moral agents

• Ethics deals with the choices we make and our actions in relation to those choices.

• It deals with choices made by both clinicians and patients.

• Medical ethics also deals with the choices made by society.

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”.

Human Rights American declaration of

independence• “All human beings are

born FREE and EQUAL in dignity and rights.’’

so. “All humans should be treated equally” “All humans should be treated fairly” “All humans should be given an equal consideration of their interests”

principles of Medical Ethics1.Respect for autonomy

2.Beneficence3.Non-maleficence4.Justice5.Confidentiality6.veracity

Autonomy –

The patient has the right to refuse or choose their treatment.

Autonomy –

The patient has the right to refuse or choose their treatment.

Beneficence –

A practitioner should act in the best interest of the patient.

Beneficence –

A practitioner should act in the best interest of the patient.

We have been given the gift of life, for goodness sakes. Protect it!!! Respect it!!!

Non-maleficence –

"first, do no harm"

Justice –the decision of who gets what treatment (fairness and equality).

Justice –the decision of who gets what treatment (fairness and equality).

is commonly applied to conversations between doctors and patients. This concept is commonly known as patient-physician privilege.Legal protections prevent physicians from revealing their discussions with patients, even under oath in court.

is commonly applied to conversations between doctors and patients. This concept is commonly known as patient-physician privilege.Legal protections prevent physicians from revealing their discussions with patients, even under oath in court.

Dignity – The patient (and the person treating the patient) have the right to dignity.

Dignity – The patient (and the person treating the patient) have the right to dignity.

The spirit of humanity, respecting the worth of each person

Veracity

The principle of veracity refers to telling the truth.Medical personnel hold a position of trust in the community and their veracity promotes accountability and overall professionalism.

Other values which are sometimes discussed include:

Respect for persons

Truthfulness and honesty informed consent

What is “Consent?”• Defined as permission,

approval, or assent

What is “INFORMED Consent?”

• Consent given by the patient based on knowledge of the procedure to be performed, including its risks and benefits, as well as alternatives to the proposed treatment.

relationshipsDoctor–patient relationship

Most universities teach students from the beginning, even before they set foot in hospitals, to maintain a professional rapport with patients, uphold patients’ dignity, and respect their privacy.

Fundamental Elements of the Patient-Physician Relationship(1) The patient has the right to receive information (2) The patient has the right to make decisions (3) The patient has the right respect, dignity, responsiveness.

(4) The patient has the right to confidentiality.

(5) The patient has the right to continuity of health care.

(6) The patient has a basic right to have available adequate health care

When a Doctor May Dismiss a Patient

•Patient non-compliance •Patient's failure to keep appointments. •A patient's rude or obnoxious behavior.•Non-payment of bills •A relatively new reason for dismissal seems to be based on the type of insurance a patient has.

The pateint also have the right to refuse the doctor if the doctor treated the pateint unethically and also can report the physician

THE PHYSICIAN-PHYSICIAN RELATIONSHIP

1. Physicians have a responsibility to maintain moral integrity, intellectual honesty, and clinical competence.

2. Physicians, as stewards of medical knowledge, have an obligation to educate and share information with colleagues, including physicians-in-training.

THE RELATIONSHIP OF THE PHYSICIAN TO SYSTEMS OF CARE

1. The physician's duty of patient should not be altered by the system of health care delivery in which the physician practices.

2. Physicians should resolve conflicts of interest in a fashion that gives primacy to the patient’s interests

3. Physicians should provide knowledgeable input into organizational decisions on the allocation of medical resources and the process of health care delivery.

THE RELATIONSHIP OF THE PHYSICIAN TO SOCIETY1. Physicians have a responsibility

to serve the health care needs of all members of society.

2. Physicians have an ethical obligation to participate in the formation of health care policy.

3. Physicians have an ethical obligation to preserve and protect the trust bestowed on them by society.

GETTING PAIDDealing With Patients Who Don’t Pay

The way your office staff handles payment problems with patients reflects on your entire practice, and the outcome can have a significant effect on your staff’s satisfaction and your bottom line. Here are a few tips for helping your staff manage difficult situations.

When patients don’t want to make their co-pays

(“My insurance company pays you. Why do I have to pay too?”)

for example, that the insurance company allows $42 for the service (despite the fact that your full fee is $50) and pays you $32 because the patient’s health insurance contract says he owes a $10 co-pay at each visit.

When patients say they can’t pay

You and your staff have probably heard these excuses a million times: “I don’t have my checkbook [or cash or a credit card]” or “I lost my checkbook.”

Another good idea is to make sure your practice accepts credit cards.

When patients want two visits for the price of one

When patients get angry

When patients get angry•Train your staff to listen first.Once the patient has calmed down, your staff member should assure the patient. •Make sure your staff follows up with the patient.•Encourage your staff to not take the patient’s anger personally.