Podcast
Questions and Answers
What has contributed to the complicated physician-patient relationship?
What has contributed to the complicated physician-patient relationship?
What does the term 'Bioethics' refer to?
What does the term 'Bioethics' refer to?
What does the Declaration of Geneva emphasize?
What does the Declaration of Geneva emphasize?
Which year was the Declaration of Geneva adopted?
Which year was the Declaration of Geneva adopted?
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What is one role of a medical council?
What is one role of a medical council?
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Which of the following is NOT included in the principles of medical ethics?
Which of the following is NOT included in the principles of medical ethics?
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What is a primary focus of modern medical ethics?
What is a primary focus of modern medical ethics?
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Which body is responsible for enforcing medical ethics through disciplinary actions?
Which body is responsible for enforcing medical ethics through disciplinary actions?
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Under what circumstances can confidentiality be disclosed for the sake of the public?
Under what circumstances can confidentiality be disclosed for the sake of the public?
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What is a key ethical consideration when dealing with terminally ill patients refusing treatment?
What is a key ethical consideration when dealing with terminally ill patients refusing treatment?
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When is it acceptable for a physician to disclose a patient’s confidential information for their own protection?
When is it acceptable for a physician to disclose a patient’s confidential information for their own protection?
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What principle of medical ethics focuses on respecting a patient's individual choices?
What principle of medical ethics focuses on respecting a patient's individual choices?
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In cases of brain death, when is it generally considered appropriate to turn off life support?
In cases of brain death, when is it generally considered appropriate to turn off life support?
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Which of the following is NOT a reason for disclosing patient confidentiality?
Which of the following is NOT a reason for disclosing patient confidentiality?
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What is often a dilemma faced by physicians concerning patients in vegetative states?
What is often a dilemma faced by physicians concerning patients in vegetative states?
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What ethical question arises with the administration of pain medication to cancer patients?
What ethical question arises with the administration of pain medication to cancer patients?
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What does the principle of beneficence emphasize in medical ethics?
What does the principle of beneficence emphasize in medical ethics?
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Which principle of medical ethics focuses on the obligation to avoid causing harm?
Which principle of medical ethics focuses on the obligation to avoid causing harm?
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How can lack of medical competence lead to a violation of non-maleficence?
How can lack of medical competence lead to a violation of non-maleficence?
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What does the principle of justice in medical ethics address?
What does the principle of justice in medical ethics address?
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Respect for autonomy entails which of the following?
Respect for autonomy entails which of the following?
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Informed consent is mainly associated with which principle of medical ethics?
Informed consent is mainly associated with which principle of medical ethics?
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What is a primary reason unethical medical practices occur despite established codes and rules?
What is a primary reason unethical medical practices occur despite established codes and rules?
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Which statement accurately reflects the application of the four principles of medical ethics?
Which statement accurately reflects the application of the four principles of medical ethics?
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What is a crucial element of informed consent?
What is a crucial element of informed consent?
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Which of the following is NOT an element of informed consent?
Which of the following is NOT an element of informed consent?
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Informed consent is considered invalid if it is given under which of the following conditions?
Informed consent is considered invalid if it is given under which of the following conditions?
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Which type of consent involves an explicit agreement, either orally or in writing?
Which type of consent involves an explicit agreement, either orally or in writing?
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What is necessary to ensure regarding the information provided during the informed consent process?
What is necessary to ensure regarding the information provided during the informed consent process?
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Which of the following is true about confidentiality in medical ethics?
Which of the following is true about confidentiality in medical ethics?
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In which situation is implied consent commonly applicable?
In which situation is implied consent commonly applicable?
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Which of the following conditions might make consent legally invalid?
Which of the following conditions might make consent legally invalid?
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What is a significant ethical dilemma faced by the family physician when a patient reveals a serious health condition?
What is a significant ethical dilemma faced by the family physician when a patient reveals a serious health condition?
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Which of the following principles is essential when practicing medical ethics?
Which of the following principles is essential when practicing medical ethics?
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In the context of the patient's request to not disclose their hypertension (HTN) status, what should be the physician's primary concern?
In the context of the patient's request to not disclose their hypertension (HTN) status, what should be the physician's primary concern?
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What is one of the historical factors that has influenced the development of medical ethics?
What is one of the historical factors that has influenced the development of medical ethics?
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Which of the following best describes the concept of 'do no harm' in medical ethics?
Which of the following best describes the concept of 'do no harm' in medical ethics?
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What key aspect must a family physician consider when filling out a medical certificate for a patient with a serious condition?
What key aspect must a family physician consider when filling out a medical certificate for a patient with a serious condition?
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Which scenario directly involves a conflict between patient confidentiality and public health safety?
Which scenario directly involves a conflict between patient confidentiality and public health safety?
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What is primarily required for practicing ethics in daily family practice?
What is primarily required for practicing ethics in daily family practice?
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What is the primary ethical dilemma concerning patients with terminal conditions?
What is the primary ethical dilemma concerning patients with terminal conditions?
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Is organ donation permitted in medical ethics?
Is organ donation permitted in medical ethics?
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Is receiving animal-sourced organs for transplantation permitted?
Is receiving animal-sourced organs for transplantation permitted?
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What is the ethical position on fetal tissue transplants?
What is the ethical position on fetal tissue transplants?
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What is a common ethical consideration regarding abortion in cases of genetic diseases?
What is a common ethical consideration regarding abortion in cases of genetic diseases?
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What does the Golden Rule in medical ethics emphasize?
What does the Golden Rule in medical ethics emphasize?
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How should a doctor who opposes certain procedures uphold their values?
How should a doctor who opposes certain procedures uphold their values?
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In what way can medical ethics impact research and progress?
In what way can medical ethics impact research and progress?
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Study Notes
Ethics in Family Practice
- Presented by Dr. Mosleh A. Ismail, MD Family Medicine
- Focus on ethical dilemmas in family medicine practice
Patient's Problem
- Male patient (61 years old) known to the practice
- Periodic check-up; investigations requested
- FBS 200mg/dl, 2HPP 350 mg/dl
- Patient requested confidentiality of HCV status from spouse
- Wants treatment in secrecy
Ethical Dilemma
- Patient with HCV infection requests confidential treatment
- Physician faces a choice between patient confidentiality and preventing harm to spouse
- How to handle this conflict?
Ethical Dilemma (Driver)
- Male patient (61 years old) known to practice
- Periodic check-up (required for work renewal)
- Working as a driver
- Patient requests concealing hypertension to avoid renewal issues
- Physician's ethical behavior in this scenario?
Outline of Presentation
- Why Medical Ethics?
- Definition of Medical Ethics
- Principles of Medical Ethics
- Classification of medical ethics
- Who is involved with Medical Ethics?
- Practicing Ethics in daily family practice
Why Medical Ethics? (Evolution of ME)
- Medical ethics and codes are ancient
- Moral requirements are fundamental like laws of nature
- Traditional values (love, justice, honor, beneficence)
- Inherited through religion, philosophy and social workers
Why Medical Ethics? (Modern Era)
- 20th-century medical practice evolved more complex
- Legal issues arose, straining physician-patient relationship
- E.g., organ donation, euthanasia, illegal abortion, medical certificates
Why Medical Ethics? (Technological Advancements)
- Introduction of new technologies (like mechanical ventilation)
- Medical techniques (like organ transplantation, genetic engineering)
- Social concerns (like human experimentation or abuse of patient rights)
What do you mean by Ethics?
- Ethics is a discipline or process for examining and resolving moral issues.
- "Bio" means life
- "Ethics" means codes and principles for resolving right and wrong (morality)
- Ethics deals with guiding principles in conduct.
- Morality addresses societal conventions regarding right and wrong.
Who is Concerned with Medical Ethics?
- Medical syndicates/associations (licences, registers, removal of registration, and restoration services)
- Medical councils (disgraceful conducts, removal of names from register)
- Disciplinary committees (punishing misconduct)
Why Medical Ethics - Modern Ethics
- Dominated by the development of ethical theories and rules
- Declaration of Geneva (1948), Medical World Association Conferences (1949)
- Concept of four main principles developed in USA (1968)
Professional Conduct
- Declaration of Geneva (1948): Updated version of Hippocratic Oath
- Services to humanity/patients
- Respect patient secrets related to religion, nationality, politics, social standing considerations that interferes with patient's welfare.
- Respect human rights/laws.
Why Medical Ethics? (Professional Codes/Rules of Conduct)
- World medical association's international code of medical ethics (1949)
- Adherence to the declaration of Geneva
- Maintain high professional and clinical standards related to patient care and collegial relations
Why Medical Ethics (Unethical Practices Continue)?
- Insufficient or inadequate codes/rules that ignore important issues
- Gap between theoretical ethics and real-life dilemmas.
Why Medical Ethics (Filling the Gap)
- Idea of Four Principles to bridge the theoretical gap and resolve clinical dilemmas
- Developed since 1968 in the United States
Principles of Medical Ethics (1. Beneficence)
- Doing good
- Physician's duty is to promote health and cure the patient
- Preventing harm to the community (such as by research)
Principles of Medical Ethics (2. Non-Maleficence)
- Avoiding harm to patients
- Duty to avoid physical and emotional harm
- Negligence, lack of competence can invite harm (e.g., surgical errors, inappropriate medications.)
Principles of Medical Ethics - (3. Justice)
- Fair/equitable treatment and distribution of resources
Principles of Medical Ethics (4. Respect for Autonomy)
- Self-Rule, Individuals' rights to make decisions ("free will")
- Informed consent (patients must receive all relevant information before making decisions)
- Includes truth-telling, respect for confidentiality
Principles of Medical Ethics. Informed consent
- Patient agreement required before any investigation (or treatment)
Principles of Medical Ethics (Informed Consent - Elements)
- Description of patient's condition
- Description of proposed treatment(s)
- Possible benefits and risks of the treatment
- Alternative therapies
Principles of Medical Ethics (Forms of Consent)
- Implied consent (emergency situations)
- Express consent (oral or written)
Principles of Medical Ethics (Invalid/Illegal Consent)
- Invalid - unlawful/unnecessary operations, abortions, artificial insemination, fraud involving the consent, given by a minor, or insane patient.
Principles of Medical Ethics. Confidentiality
- Secrecy between doctor and patient
- All medical personnel must maintain confidentiality
- Publishing patient info in scientific publications must be carefully considered.
Principles of Medical Ethics—Disclosure of Confidentiality
- Patient's request to disclose
- Patient's safety (mental health issues, possible danger to self/others)
- Public safety issues (epidemics, crimes)
Principles of Medical Ethics—Disclosure of Confidentiality (Specific Cases)
- Cases involving malpractice allegations
- Testimony as an expert witness, legal cases
- Sharing with other doctors or consulting with colleagues
Ethical Dilemmas Challenging Family Physicians
- End-of-life issues (brain death, euthanasia)
- Organ transplantation
- Moral issues related to abortion, adoption, and bio-technical reproduction
- Genetic manipulation
- Prenatal screening, termination
- Child abuse, discipline
- Ethical issues related to HIV/AIDS patients
- Medical certificates
Ethical Dilemmas Challenging Family Physicians -Questions
- Cardiopulmonary resuscitation (CPR)
- Withdrawing life support for patients without cerebral function
- When patients reject treatment due to faith-based beliefs/will
- Definition of 'dead'(brain death vs. brain-stem death)
- Patient in vegetative states
- Cancer/pain management - Patient's requests and patients' rights
- Newborn/congenital anomalies and life-saving treatments.
- Organs for transplant/ethical concerns (animal sources)
- Donor consent for organ retrieval & fetal tissue transplants
- Ethical considerations contraception vs abortion
- Genetic diagnosis vs abortion decisions
- Ethical choices in cases of rape
- Is cloning permissible
- Refusing patient who request treatments contrary to one's own moral beliefs.
- Does medical ethics hinder medical research?
Golden Rule
- Preservation of life
- Maintaining intellect and integrity
- Protecting property
- Freedom of belief
- Judging actions by intent
- Preventing harm
- Avoiding jeopardizing oneself
- Empathy (e.g., 'love for another like you love for yourself.')
Conclusion
- Medical ethics is a process for resolving moral dilemmas
- Medical practices and issues are getting more complex
- Unethical medical practices may still occur despite rules and codes
- Family physicians need strong ethical standards for daily practices not just unusual circumstances
- Respecting human life and integrity is central to all major religions.
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Description
Explore the ethical dilemmas faced by family physicians when it comes to patient confidentiality and the potential harm to others. This quiz delves into scenarios involving patient requests for secrecy and the physician's responsibilities. Engage with real-life cases to test your understanding of medical ethics.
