Professionalism and Ethics Module: Portfolio Workbook

Professionalism and Ethics Module
Portfolio Workbook
Learning is Change in Behavior; Behavior is the

Reflection of Thought Process;
Thought Process Changes with Ones’ Exposure and
Experiences
Phase II, 4th Year MBBS

1439/40 H; 2018/19 G
Student Name: _____________________

University Number: __________________
3 Ethics Workbook & Study Guide
PORTFOLIO WORKBOOK Student’s Learning

Outcomes
Ethics & Professionalism  Describe the meaning of
What is Ethics? Professionalism and Ethics
 Explain the importance of
Ethics is the branch of philosophy that Professionalism & Ethics in
deals with morality. Ethics is concerned
healthcare profession
with distinguishing between good and evil
 Describe the fundamental
in the world, between right and wrong
human actions, and between virtuous and principles of medical ethics
non-virtuous characteristics of people.3  Describe the duties of
physicians towards
The rules or standards governing the patients, colleagues and
conduct of a person or the members of society
medical profession are called Medical
 Correlate duties of
Ethics, which is an essential part of
physicians with principles of
becoming a professionally competent
ethics
doctor.
What is Professionalism?
Professionalism is the basis of how a doctor works for the betterment of
his/her patients and improvement of the society. Due to this professionalism,
the doctor earns respect and trust in the society.
To be a professionally competent doctor, one has to practice effective use of
verbal & non-verbal communication, knowledge, technical skills, clinical
reasoning, emotions, values, and reflection in day-to-day work. 1
The competence or skill expected of a professional doctor includes 2:
 Character/ Integrity
 Attitude
 Excellence
 Competency
 Conduct
History of Medical Ethics

Ethical principles provide a generalized framework that can be applied to our
daily lives, including our profession. The specific ethical principles developed
to guide the professional behaviour are often called “Codes of Conduct”. These
codes help us in conducting our professional activities appropriately and guide
us in resolving ethical issues that occur in professional work.
Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Professional ethics and etiquettes are sourced from the glorious guidance of
Islam that urges the best of manners, good performance, and understanding
that Allah (SWT) observes all our deeds, as the messenger of Allah (PBUH)
said, “I was sent to complete the best of manners.” [Code of Ethics for
Healthcare Practitioners. The Saudi Commission for Health Specialties
(SCFHS), 2014]
The history of ethics in medical profession spans over the last 2500 years,
starting with the Greek and Roman period (the Hippocratic oath was published
in fifth century), moving on to medieval medicine (Ishaq Ibn Ali al-Ruhawi
wrote the Conduct of a Physician, the first book dedicated to medical ethics),
and embarking on to modern developments in Europe and America. Thomas
Percival, an English physician, coined the term of “medical ethics” in his book
in 1803. Based on Percival’s work, American Medical Association adopted its
first code of ethics in 1847. The need for revising the codes of ethics was felt
soon after the first draft of codes of medical ethics was written. This need was
mostly due to the scientific and technological advancements that generally
increased the risks for potentially harming the community, the patients and
the medical professionals. For example, the atrocities by medical researchers
during the 18th and 19th century lead to further revisions in ethical codes to
empower the vulnerable. The Nuremberg Code (1947) and the Declaration of
Helsinki (1964) are two well-known and well respected documents
contributing to medical ethics.
The modern codes of medical ethics are based on the common framework of
the "four principles" approach postulated by Tom Beauchamp and James
Childress in their textbook Principles of biomedical ethics, published in 1985.
The principles are expanded for the purpose of description in different codes
of medical ethics. Each principle focus on values that arise in interactions
between doctors and patients.6
Principles of Ethics
 Autonomy: People have the right to control what happens to their bodies.
This principle simply means that an informed, competent adult patient can
refuse or accept treatments, drugs, and surgeries according to their
wishes. The principle encompasses the concepts of consent,
confidentiality and privacy within its domain of respecting the choice of
the individual human being (Respect for human being).
 Beneficence: All doctors must strive to improve their patient’s health, to
do the maximum good for the patient in every situation. But what is good
for one patient may not be good for another, so each situation should be
considered individually. This principle gives the doctor the responsibility to
act as their patients’ advocate and do what is in their best interest.
 Non-maleficence: “First, do no harm” is the basis of medical ethics. In
every situation, doctors should avoid causing harm to their patients. This
harm can be physical, psychological or emotional in nature. Jeapordising

someone’s trust can be one way of harming them, thereby making truth-
telling a way of non-maleficence too.
 Justice: This principle demands that doctors should practice with fair-
dealing when caring for their patients, and protecting what they deserve.
Doctors should be able to justify their actions in every situation.
Duties of a Doctor
Stated in Chapter 2 of Code of Ethics of SCFHS, the relation between a
healthcare practitioner and his/her patient is based on mutual trust and
honesty between the two. It is the duty of the healthcare practitioner to
deliver comprehensive medical care to his/her patients according to their
medical needs with accuracy and proficiency in order to satisfy the patient’s
best interests while respecting the patient’s dignity, and considering the
patient’s rights. All of this should be within the ethical framework dictated by
the Islamic Sharia and professional duty, including the following:
A. It is the duty of a healthcare practitioner to treat his/her patient kindly

in all conditions
B. The healthcare practitioner should the patient’s interest and guard
his/her rights
C. The adult conscious patient’s permission (consent) should be sought
(whether the patient is male or female), or from his/her representative
in case the patient is not competent to deicide, before any medical or
surgical intervention
D. The healthcare practitioner should use his/her skills to reassure the
patient and alleviate his/her suffering, in accordance with the teaching
of the messenger of Allah (PBUH)
E. The knowledge of the health practitioner about the patient’s secrets
does not entitle him/her to disclose them or talking about them in a
way that would lead to their disclosure, except for exceptional
conditions
F. The patients should not be photographed in whole or in part of their
bodies except for a need or a necessity required for the purpose of their
care, or for the purposes of health (medical) education, or to undertake
health research
G. Deal appropriately with patient who refuses a medical procedure
H. The healthcare practitioner can - in a non-emergency situation, refrain
from treating a patient for personal or professional reasons that would
jeopardize the quality of care provided by the healthcare practitioner to
the patient, on condition that this [refrain] does not harm the patient’s
health, and that there is another practitioner who is capable of treating
the patient instead of him/her


Video Clip & Discussion

Wit
Vivian Bearing, professor of English poetry, is diagnosed with advanced stage
ovarian cancer. Her medical team includes the renowned Dr. Harvey Kelekian
and his fellow, Dr. Jason Posner, who happens to be an ex-student of hers.
She is being treated by an aggressive chemotherapeutic drug under clinical
trial. The scene that you are going to see shows the medical team’s
interaction with the patient.
While watching the short video clip, observe the following for
discussion:
Write down your points that you would use in discussion
What were the good and bad points noted in doctors’ interaction with
the patient?
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What was wrong with doctors’ interaction among the team-members?

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How was the patient feeling when she was being examined?
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Facilitator’s Remarks/ Feedback:

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Medical Ethics - Islamic Student’s Learning

Perspective Outcomes
Muslims believe that God is the Creator of  Describe Islamic approach
life and life is a gift from Him. Muslims to healthcare delivery in
society
believe that all life is sacred and must be
 Explain the teachings of
protected (respect for human life). The
Quran on responsibilities of
respect for life in Islam is common for all
individual towards the sick
humans, irrespective of gender, age, race, and their care
color, faith, ethnic origin or financial status  Discuss the Islamic
(Justice). perspectives on issues
Islam extends the principles of providing related to transplantation
and euthanasia
care and help to the weak and diseased
(patients) under all conditions and
circumstances. Until the death has been declared, the patient is considered a
living person and has all the rights of a living person.5
According to the SCFHS’s code of ethics:

Islam has made the preservation and conservation of human life rank second
after preservation of religion. Thus, Islam has prohibited killing a human being
except for mandated legal retribution (Qasas), and has forbidden assault on
human beings. Allah SWT has said, “Because of that, We decreed upon the
children of Israel that whoever kills a soul unless for a soul or for corruption
done in the land - it is as if he had slain mankind entirely. And whoever saves
one - it is as if he had saved mankind entirely.” (Al-Ma’idah, 5:32)
The healthcare profession has become one of the noblest professions because
it is related to human soul, health and life preservation which is the most
precious thing. As a result, healthcare practitioners are entrusted with
patients’ secrets and most private matters.
Thus, a healthcare practitioner should strive to excel in his/her work and seek
perfection in performance while ensuring to adhere the noblest of manners
which Allah (SWT) has gifted to those who fulfil people’s needs, erase their
pains, and resolve their problems.
Of course, there are some characteristics which need to be emphasized in

order to achieve this level of nobleness in the medical and healthcare
profession, among which is practicing it with dedication and excellence, as
stated by prophet Mohammed (PBUH), “Verily, Allah loves that when anyone
of you does a job he should perfect it” [Reported by Abu Yalaa, Baihaqi, and
Tabarani; it is a good hadith. See the Series of Authentic Hadith (No. 1113)].
Consequently, all healthcare practitioners should consider the patient’s right
through their good behaviour and attitude.

Transplantation
Altruism has an important place in Islam. Similarly, saving a life is placed very
highly in the Quran. The Islamic Jurisprudence Assembly Council in Saudi
Arabia approved deceased and live donation in their landmark decision in
1988. Similar formal rulings are in place in Egypt, Iran, Malaysia, Pakistan,
and other countries.
The healthcare professionals involved in organ transplantation have duties

towards both donors and recipients. These duties include assuring:
 The rights of the donor (living or deceased)

 Implementation of proper counseling and informed voluntary consent
 Prevention of any possible coercion in the process
 Well-being of the recipient and donor
Euthanasia
“Euthanasia” or mercy killing is the act of ending the life of an individual
suffering from a terminal illness or an incurable condition. This can be through
lethal injection or the suspension of extraordinary medical treatment. The
term “physician assisted suicide” is used when a patient is knowingly
facilitated by a physician to commit suicide. The facilitation can be through
providing lethal medication or information regarding the use of medication for
the purpose of killing one-self.
In Islam, these acts are considered “killing a person”, that is a major sin and
strictly forbidden. Therefore, Muslims are against any form of euthanasia or
assisted suicide. They believe that all human life is sacred because it is given
by Allah, and that Allah chooses how long each person will live. Human beings
should not interfere in this.
Some of the medical professionals interpret euthanasia as the process for

ending life of terminally ill patients in a painless manner, thereby reducing
their misery. Many disagree with this interpretation. In majority of countries
euthanasia or assisted suicide is a punishable crime. However, in some
countries, or some parts of the countries, it is considered legal.
Further reading:
Al-Ghazal, Sharif Kaf. "Medical ethics in Islamic history at a glance." JISHIM3
(2004): 12-13.
http://faculty.ksu.edu.sa/nadalyousefi/Medical%20Ethics/medical%20ethics
%20in%20islamic%20history.pdf
Mustafa Y. Islam and the four principles of medical ethics. J Med Ethics
2014;40:479–483 http://jme.bmj.com/content/medethics/40/7/479.full.pdf
Williams, John R. "The Declaration of Helsinki and public health." Bulletin of
the World Health Organization 86.8 (2008): 650-652.
http://www.scielosp.org/pdf/bwho/v86n8/22.pdf

Reflection Exercise
From your past experience, write 5 good qualities that you saw in a
doctor that you visited?
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From your past experience of different professionals, what are the

behavioral traits that you would not want to see in a healthcare
provider (doctors, nurses, etc.)? (Write at least 3)
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A Muslim doctor has faith in God and destiny, and the conviction that
there is a cure for every disease. Our Prophet (SAWT), on the authority
of Yasir (RA), said: "For each disease there is a cure; and when the
fight (treatment) is given, the disease is cured by the Will of Allah"
[Ahmad and Muslim]

Communication Ethics Student’s Learning

Communication skills are extremely Outcomes
important in medical practice. Doctors use  Recognise the importance
their communication skills for different of communication skills in
daily tasks in their profession, including patient-doctor relationship
taking accurate history, asking permission  Describe the expectations
of patients in doctor-patient
for a procedure or deciding on treatment
relationship
(informed consent), inform about serious
 Demonstrate good
diagnosis (breaking bad news), provide communication (verbal,
reassurance to anxious or frightened non-verbal and written)
patients (counselling). skills
Professionals who understand the
requirements of ethical, moral and social values tend to perform better in
such difficult situations when dealing with patients. Principles of medical ethics
also provide guiding strategies for resolving conflicts in healthcare delivery. In
these situations, communication skills of medical professional play as
important a role as the ability to ethically analyze the issues.
Communication skills, verbal, non-verbal and written, are not only important
for interacting with patients, but they are also required for interacting with
fellow professionals and documentations.
Different aspects of communication with patients and others will be discussed

later in the workbook. Here are some guidelines to be used for patient-
centered communication.
Physicians can show good communication skills by:
 Showing respect to patient by sitting down at same level during patient

encounters
 Developing an understanding of the patient as an individual, not as a
disease or a condition
 Showing empathy and respect while listening and talking
 Listening attentively and creating a professional relationship of care and
trust
 Eliciting patients’ concerns and calming their fears by providing
scientific information in understandable language
 Answering questions honestly but not harshly
 Informing and educating patients about treatment options and the
course of care
 Involving patients in decisions concerning their medical care
 Demonstrating sensitivity to patients’ cultural and ethnic diversity
Further reading:
The ethics of health communication. World Health Forum, 1994.
http://apps.who.int/iris/bitstream/10665/51651/1/WHF_1994_15(2)_p175-
177.pdf

Reflection Exercise
A 12-year-old thalassemia child, who is on regular blood transfusion since the
age of two years has developed severe iron overload due to non-compliance
with Injection Desferral. As a result, now he has dilated cardiomyopathy and
congestive heart failure. He was admitted three times to the hospital last year
to control heart failure. He has come today for follow up and dose adjustment
of oral Iron Chelator.
Read the conversation between doctor, patient (Abdullah) and his mother
below and reflect on the following questions:
‫ ي اترى حس ين أخب اره‬.‫ كيف حالك يأم حسين إن شاء هللا تكونوا بخير‬، ‫ السالم عليكم يا حسين‬: ‫الطبيب‬ •
‫إيه؟‬
! ‫ الولد حالته متأخرة و مو عارفين كل اللى بيجرالنا ده ليه‬،‫ وهللا مانا عارفة يادكتور‬: ‫األم‬ •
‫ أنا عرف يأم حسين إن السنة اللى مضت كانت صعبة عليكم لكن إحنا تكلمن ا في الموض وع ده‬:‫الطبيب‬ •
‫ أخ ر‬.‫قبل كده و عارفين إن الحديد الزيادة اللى فى جسم حسين هو الس بب فى مش اكل القلب اللى عن ده‬
‫ ي اترى إي ه األخب ار‬، ‫مرة حضرتم فى المتابعة حسين كان ما بيقدر يمشى من غرفته لغاي ة ب اب ال بيت‬
‫اليوم ياحسين؟‬
‫ لكن ما بقدر أطل ع الس لم‬. ‫ أنا بقدر أمشى من عند البيت لغاية بيت الجيران فى منتصف الشارع‬: ‫حسين‬ •
.‫والزم أستريح كذا مرة فى الطريق‬
‫ ي اترى‬،‫ أنا كنت قلقان علي ك الم رة اللى مض ت‬.‫ ده كالم طيب جدا وواضح إنك إتحسنت كثير‬: ‫الطبيب‬ •
.‫عامل إيه مع اقراص عالج زيادة الحديد بتاخده بإنتظام وال أله‬
What are the good points in the above conversation?

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What are the issues that need improvement in the above

conversation?
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Role-play Exercise (Communication ethics)

Case scenario Student’s Learning
The nurse at the vaccination clinic informs Outcomes
the doctor that one of their patients who  Demonstrate good
visited last week was given wrong communication skills
vaccination. Although it was not harmful  Recognise strengths and
for the child but he must get the correct weaknesses in a
one also. Therefore, the nurse has called communication skills
the parents of the child for another visit. scenario (verbal and non-
The parents are, as expected, not happy, verbal)
because of the wrong vaccination and for  Discuss the guidelines on
the fact that they have to come all the way patient-centered
back to the clinic. communication
Volunteers & Roles

Nurse: informs the doctor about the mistake and the appointment
of the parents
Doctor: responds to the nurse’s information and deals with the
parents of the child
Parents: not happy with the nurse and the doctor
Discussion guidelines
The observers and volunteers will discuss the performances after role-play:
 What did the performers feel while doing the role-play?
 What did the observers feel regarding verbal and non-verbal
communication between the characters?
 What was good in the communication between doctor, nurse and the
parents?
 What could be improved?
Feedback
Students will get time for Q&A and feedback to and from the facilitator
Reflect on what you feel after the role-play session

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Confidentiality Student’s Learning Outcomes

Patient confidentiality refers to the  Explain the importance of
ethical principle that personal and confidentiality in healthcare
medical information given to a doctor or and its importance in doctor-
any health care provider will not be patient relationship
disclosed to others unless the patient  Recognize the challenges in
has given permission. This concept, is keeping confidentiality
developed from the principles of  Discuss situations where
autonomy and respect for human being. confidentiality may be
It creates the trust in a doctor-patient breached (exceptions to
relationship and allows the patient to confidentiality)
freely provide all the information to
his/her doctor which may help in
diagnosis and treatment.
The information that a patient provides can be extremely personal or secret to
the patient. At times, the information may have social implications on
patient’s life and therefore, patient would not want to share that information
with anybody else.
It is of utmost importance that the medical team asks the patient about who
the patient would like to share the information with. This permission can also
be used in-case when the patient becomes unable to take decisions (e.g.
unconsciousness)
Breach of confidentiality is when the doctor or any other member of the
medical team shares their patient’s information (verbally or in writing) with
someone without permission from the patient.7
There are specified instances when a physician is allowed to breach
the patient’s confidentiality.

The knowledge of the health practitioner about the patient’s secrets does not entitle
him/her to disclose them or talking about them in a way that would lead to their
disclosure, except for the following exceptional conditions:
1. If the disclosure is to protect the patient’s contacts from being infected or
harmed, like contagious diseases, drug addiction, or severe psychological
illnesses. In this case, disclosure should be confined to those who may become
harmed.
2. If the disclosure is to achieve a dominant interest of the society or to ward off
any evil from it. In this case, the disclosure should be made only to the official
specialized authorities. Examples of this condition are the following:
a. Reporting death resulting from a criminal act, or to prevent a crime
from happening.
b. Reporting of communicable or infectious diseases.
c. If disclosure is requested by a judiciary authority.
d. To defend a charge against a healthcare practitioner alleged by the
patient or his/her family in relation to the practitioner’s competence or
how he/she practices his/her profession. Disclosure should be only
before the official authorities.

Discuss & Reflect

Discuss and answer the following questions
You are an intern in the hospital. An old friend calls you to ask about the
prognosis and treatment options of a patient in your hospital. He says to you:
“Can you please check the patients file and find out and let me know about
this patient’s condition and treatment plan? No one seems to tell the relatives
what is going on. They have asked me to find out exactly what is happening”.
You can easily access the files and all reports.
Can there be any ethical issues in your going through the patient’s file
and sharing the information with his relatives?
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What possible harm can you do to the patient by sharing his
information with your friend?
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What will you do in this situation? (Refer to SCFHS code of ethics)
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What are the possible situations when a patient’s confidentiality can
be breached by the doctor?
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Informed Consent Student’s Learning

Informed consent refers to the principle that Outcomes
every individual has a right to decide for him  Describe the principle and
or herself. The individual should receive the components of “informed
required information to take the decision. In consent”
medical practice, a person must give  Demonstrate the process of
permission before receiving any type of consent-taking in different
treatment or undergoing investigation situations
(interventional or non-interventional).  Recognize ethical issues
arising due to improper
For consent to be valid, the person giving consent taking
consent should have the capacity (emotional
and psychological stability) to take decision
The consent it must be:
 Voluntary (without any undue pressure)
 Informed (with knowledge and understanding of the condition, treatment
options and possible outcomes)
It is duty of the healthcare professional to ensure that a proper process of

acquiring informed consent has taken place before any intervention.
The SCFHS’s code of ethics (page 17) has elaborated the conditions that must
apply for a consent to be valid. It also addresses the process of consent in
different situations like emergency & life-threatening conditions, incompetent
or unconscious patients, children and women.
Guidelines for Helping Patients Reach Informed Consent

For acquiring a valid consent, the doctor needs to be sure that patient
understands his/her condition and different options for the procedure. Consent
can be taken by initiating a conversation, asking questions, and
communicating clearly in a way that is understandable for the patient.
Following are guidelines for taking an informed consent:8
• Consent process should take place in a relaxed undisturbed atmosphere
• Doctor should carefully describe the diagnosis and possible treatment
options in a way that the patient can understand and comprehend
• Avoid medical jargon when describing treatments
• Give patient time to think and ask questions
• Listen carefully to patient’s questions and statements
• Use written forms describing procedures and interventions
• Ask your patient to explain the situation to you in their own words
• Be aware of religious or cultural differences that may affect
understanding
• Request an interpreter, if necessary
• Document the conversation in the patient’s file/charts

Video Clip & Reflection Exercise

Sound of Silence
This is an educational video clip in which a couple comes to the clinic of a
famous surgeon with complaint of abdominal pain. The surgeon and his
assistants diagnose the patient and make plans for surgery. The consent for
surgery is taken by one of the assistant. She finds the process discomforting.
This movie brings out the issue of respecting the patient’s wishes and
empowering the patient even when the individual appears to be disinterested.
It also explores the issues of privacy and empathy in the interaction between
physicians and patients.
Discuss and reflect on the following questions after watching

the video clip:
What did the doctors do well in their interaction with the patient?
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What messages are conveyed by the consultant’s body language to

the assistants and the patient?
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What do you think about the way the consent was taken?
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What would you recommend to the doctors to improve their

interaction with the patient in this situation?
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Role-Play Exercise (Informed consent)

Case scenario
Student’s Learning
A 40 year old patient, diagnosed with Outcomes
gallstones, needs to undergo surgery for
 Appreciate the importance
removal of gallbladder. He has come to
of communication skills in
clinic with an attendant (son). The doctor
taking consent
is to take an informed consent.
 Demonstrate the process
Volunteers & Roles of informed consent
 Identify possible issues that
Patient: diagnosed with can arise in taking informed
gallstone disease, consent
scared of surgery  Discuss the guidelines
Doctor: taking informed taking informed consent
consent (according to
above guidelines)
Attendant: asking questions about the surgery and anesthesia
Discussion guidelines
The observers and volunteers will discuss the performances after role-play
and give at-least three positive points about the role-play and few areas
where the process could have been improved. Areas to observe may include
(are not limited to):
o Steps of the consent process
o Body language
o Voice and tone
o Overall attitude of doctor
 What did the performers feel while doing the role-play?
 What did the observers feel regarding communication between the
characters?
 What was good in the communication between doctor, patient and the
attendant?
 What could be improved?
Feedback
Students will get time for Q&A and feedback to and from the facilitator
Reflect on what you feel after the role-play session

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Breaking Bad News

Student’s Learning Outcomes
 Explain the importance of
learning the proper way for
breaking bad news in
healthcare delivery
 Demonstrate appropriate
Doctors often have to deal with situations where they are needed to inform
patients or their relatives regarding some bad news. For example, informing a
patient that he/she is suffering from a malignancy, telling the parents that
their child has Down syndrome, or informing the relatives that their patient
has expired. Bad news is defined as “any information that drastically and
negatively alters the patient's view of future”. Giving such information to
patients is often considered the most difficult part of a doctor’s profession.
At times, the doctors may have their own issues about breaking bad news.
They may find it an unpleasant task. They may not want to take hope away
from their patient. They may be fearful of the patient's or family's reaction to
the news, or they may be uncertain of how to deal with an intense emotional
response.
To minimize the mental trauma to patients and to enhance the acceptance in

a positive way, all efforts should be taken by the doctors to give the bad news
in a way that is ethically and morally acceptable.
Guidelines for breaking bad news

Here is a simple step-by-step guideline for breaking bad news, however,
every situation is different and may require different ways to deal with them:
1. Getting started
The physical setting needs to be private, with both physician and
patient comfortably seated. You should ask the patient who else should
be present, and let the patient decide. It is helpful to start with a
question like, "How are you feeling right now?" to indicate to the
patient that this conversation will be a two-way affair.
2. How much the patient already knows?
By asking a question such as, "What have you already been told about
your illness?" you can begin to understand what the patient has already
been told or how much the patient understood about what's been said
and the patient's emotional state.
3. How much the patient wants to know?
It is useful to ask patients what level of detail they want you to cover.
For instance, you can say, "Some patients want me to cover every
medical detail, but other patients want only the big picture--what would
you prefer now?" This establishes that there is no right answer, and
that different patients have different styles. Also this question
establishes that a patient may ask for something different during the
conversation.
4. Sharing the information.

Decide on what information you are going to give before you sit down
with the patient, so that you have the relevant information at hand. You
should also prepare yourself for likely questions that patient may ask. If
patient asks something that you are not aware of, DO NOT GUESS or
make-up an answer. You can only give correct and true information.

There is no harm in saying “I don’t have this information now, but I will
find out and get back to you”, then make sure to get back with the
information.
Give the information in small chunks, and be sure to stop between each
chunk to ask the patient if he or she understands. Long lectures are
boring and confusing. Remember to translate medical terms into
understandable language and don't try to teach pathophysiology. Give
patient the time and opportunity to ask questions, or clarify what you
have said.
5. Responding to the patient's feelings
If you don't understand the patient's reaction, you will leave a lot of
unfinished business, and you will miss an opportunity to be a caring
physician. Learning to identify and acknowledge a patient's reaction is
something that definitely improves with experience, if you are
attentive.
6. Summarizing and Planning
Summarize your discussion at the end before documenting. Inform the
patient about what is the plan from now onwards. Outline a step-by-
step plan, explain it to the patient. Give the patient a phone number or
a way to contact the relevant healthcare person if something or concern
arises before the next planned meeting.
Guidelines on breaking bad news are also given in the SCFHS’s code of
ethics (page 19).
Point to Ponder
Even with all experience and planning, difficult situations can arise
while breaking bad news. One of the commonest is when the
patient starts crying!
In general, it is better simply to wait for the person to stop crying.

If it seems appropriate, you can acknowledge it but do not assume
you know the reason for the tears. Most patients are somewhat
embarrassed if they begin to cry and will not continue for long. It is
nice to offer tissues if they are readily available (something to plan
ahead); but try not to act as if tears are an emergency that must
be stopped, and don't run out of the room--you want to show that
you're willing to deal with anything that comes up.


The Doctor
“The Doctor” is a movie starring William Hurt (1991) in which he plays a
surgeon who is diagnosed with cancer of the larynx. His experience in the role
of an ordinary patient helps him in becoming a better surgeon (and a better
person). In the scene we are about to see, Dr. Jack McKee has a first
appointment with an ENT doctor who gives him his initial diagnosis. Please
watch for the ways in which Dr. Abbott, the ENT doctor, interacts with Jack
and shares with him his diagnosis.
Discuss and reflect on the following questions after watching

the video clip:
What does Dr. Abbott do well in her appointment with Jack?
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What messages are conveyed by Dr. Abbott’s body language?

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How do you think Jack feels during his appointment with Dr. Abbott?
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What would you recommend to Dr. Abbott to improve her

communication with Jack?
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Justice and Equity

The World Health Organization defines  Recognize that justice and
health as “A state of complete physical, equity are important ethical
mental and social well-being and not principle
merely the absence of disease or  Describe situations in
infirmity". The principles of justice and healthcare delivery where
equity in healthcare demand fairness rationing and prioritization
when offering treatments to patients, and cannot be avoided
allocating resources. Every action taken  Recognise the importance of
must be justifiable. fair allocation of health
resources
Justice and Equity addresses the
allocation of healthcare resources in
different social and geographical locations
for the health of population. It means not only insuring access to care for all,
but fighting for social, economic and environmental justice. 9
Justice, mercy, and people’s interests are among the basic principles
upon which the Islamic regulations, that rule all aspects of life, are
based. They have been characterized by the comprehensive nobility of
their aims…… The development of the regulations that regulate a
society’s different affairs is considered amongst the signs of societies’
development in our times
The healthcare practitioner should recognise his/her responsibility in

the empowerment of justice in the utilisation of healthcare resources.
Allocation of Scarce Health Resources
Every family, society and/or community spends some part of its financial
resources on healthcare. The decisions for appropriate use of these resources
need to be taken with justice and equity for all. This process is called resource
allocation for healthcare.
Resource allocation is a central part of the decision-making process in any

health care system. Resources are always finite. With technological
advancements and ever-increasing cost of patient management, there is an
ongoing debate for prioritizing allocation of healthcare resources. The ethical
issues involved are often conflicting and relate to issues of individual’s rights
and community benefits. Central feature of
resource allocation is based on decisions taken
on the outcomes of health care delivery, their
subsequent economic evaluation and audit of
results of clinical treatment. The up-to-date
knowledge and public involvement are seen as
integral parts of this process.10

Discuss and Reflect

Here is a case-scenarios for discussion and reflection. Consider the ethical
guidelines in relation to the case.
Case 1: A private hospital in Rabigh has acquired funds for upgrading their
intensive care unit (ICU) setup. The pediatric department wishes to use the
fund for purchasing an incubator for the neonatal ICU. This will help in
improving the survival of new-born children. The anesthesia department is
asking to purchase an adult ventilator for surgical ICU. This will help in saving
lives of critically ill patients. The funds can be used for any one of the two.
Task
 Identify the key elements that you may consider in deciding for the
equipment to purchase (justify each element by ethically relevant
factors such as need or likelihood of benefit)
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Self-Study Exercise
Look-up from the sources on internet and give short answers for the following
questions (Give references of the source of your information)
What is TRIAGE? In which situations is it applicable?

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What can be the ethical issues with application of TRIAGE?
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Suggested reading:
Ethics of Medical Triage. Available from: https://idiopathicmedicine.wordpress.
com/2010/08/15/the-ethics-of-medical-triage/

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Conflict of Interest Student’s Learning Outcomes

 Explain the meaning of
Physician’ primary purpose is to work for “conflict of interest” in
the betterment of their patient. A conflict of healthcare profession
interest arises when medical professionals  Recognise ethical issues
consider their personal interest or personal related to conflict of interest
in healthcare delivery
gain to be more important than their
 Discuss ways to prevent
professional responsibilities towards oneself from potential or
patients. actual conflict of interest
situations
This personal interest or gain can be of
direct or indirect financial profit,
professional benefit or scientific (research)
value. Although, these gains may be permissible secondary to providing
healthcare to patients; however, they should not become the primary focus of
a doctor’s efforts in treating patients. Even as secondary gains, the doctors
should be able to reveal them to their patients. 11
It is mandatory for doctors to avoid conflicts of interest and to always make

decisions based solely on the best interests of their patients. For a doctor to
unnecessarily keep the patient in hospital, prescribe a drug, or conduct
diagnostic tests for financial benefit is unethical.
Doctors are principally expected to be patients’ advocate. They must give

priority to their patients in any conflicting situation. This requires maintaining
professional and clinical independence from commercial interests and ensuring
that relationships with industry do not lead to any action that is not in the
best interests of their patients.
Healthcare providers should be careful in their conduct, as at times, even a

potential conflict of interest, where there is no apparent direct benefit but
possibility of indirect benefit to the doctor exists, may become unethical
behavior on evaluation.
The SCFHS’s code of ethics states that:

With the increase in the growth of the private sector in the provision of
health services, the general direction towards privatization and the
application of health insurance along with the spread of health
insurance companies; healthcare practitioners have become actively
tangled in the for-profit health sector. This could be followed by
commercial competition that could lead to attitudes that could breach
the ethics of the healthcare profession. Thus, attention should be paid
to the moral foundations that elevate the healthcare professions from
abuse, greed, avidity, extortion, or cheating in any way. The healthcare
practitioner should not consider earning money as a main goal, this
could lead to jeopardizing the noble aims of medicine.


A Matter of Trust
This movie raises issues of physician-pharmaceutical interaction, and how it
can lead to potential conflicts of interest. It also explores the relationship of a
patient with a physician, therapeutic misconception, and the role of physician
as researcher.
After watching the video clip, answer the questions: (consider the PM&DC
ethical guidelines in relation to the questions)
What are the primary and secondary interests of the physician in this
video clip?
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What could have the physician do differently to avoid the conflict of

interest in this situation?
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Why was the patient upset in the last scene? What did he feel about
the physician’s research?
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Reflection Exercise
A doctor is invited to deliver a one hour talk in a conference organized by a
drug company at a resort in Dubai. The doctor is provided family air-tickets
along with two-day stay at the resort by the company.
Are there any ethical issues in this situation? What are they?
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What are the benefits to the drug company in providing this expensive
vocation to the doctor?
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What are the alternatives for the doctor?
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Role of Doctor in the Student’s Learning Outcomes

Community
 Describe different roles and
Doctors are considered elite of the responsibilities which doctors
society and community. They have should perform for uplifting
the physical and mental
knowledge and skills that can change health of community
(improve) lives of general population  Discuss the rights of
living in that community. Therefore, individuals in comparison
doctors working in the community with rights of community
 Recognize different ethical
are required to be, not only issues that may arise while
competent clinicians, but also good working in different
managers of healthcare delivery and communities
preventive programs, effective
administrators, competent trainers
and qualified researchers. They must not only work within the hospital
but also support the health personnel and primary healthcare workers
in improving the health of the community. These different roles of a
doctor working in the community requires a deep understanding of the
principles of ethics. While working with the people in the community,
doctors may come across different ethical issues related to health and
rights of individual patient’s verses wellbeing and rights of the
community as a whole. The concepts driven by the four basic principles
of ethics (autonomy, beneficence, non-maleficence and justice) may
seem to modify their meanings and application in the community and
public health domain. Similarly, at the times of natural disasters
(earthquake, floods) or man-made disasters (war, accidents) the values
and preferences for providing treatment may get modified due to large
number of casualties and limited resources of health care provision,
e.g. the concept of triage.
The community has positioned the healthcare practitioner in a special
social status that is not available to other members of the society.
Doctors should recognize that the community and environment are
important factors in the health of individuals by helping the community
to deal with the social and environmental
determinants of diseases.
Healthcare professionals should strive hard

through the use of his/her skills, knowledge and
expertise to improve the standards and quality of
health services available in the community,
whether in the work place or in general.

Reflection Exercise
This patient is
discharged from
hospital after
treatment of fracture
of both legs. He lives
on 5th floor, alone.
What are the issues/ problems shown in this picture scenario?

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What should have been the role of the doctor in this situation?
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End of Life Care Student’s Learning Outcomes

For any doctor, death of a patient is a  Explain what is meant by
crucial time in profession. Death is a DNR
reality and as doctors we must provide  Recognize the diversity of
care to our patients in life as well as opinion and laws in different
during the process of dying. parts of the world regarding
end of life care
As Muslim doctors, we have our faith to  Describe the local
look for guidance in end of life care. perspective on the issues
However, different cultures, societies and related to end of life care
countries have various opinions and laws
regarding patients’ end of life care. As
doctors, we may have to work in different
parts of the World or with people from multiple national, social or religious
backgrounds. It is our need to be aware of diverse viewpoints and have
comprehensive knowledge of legal and cultural norms to take decision on such
issues pertaining to end-of-life care.
Do Not Resuscitate (DNR) Code
A do not resuscitate order, or DNR, is a medical order written by a doctor. It
instructs health care providers not to do cardiopulmonary resuscitation (CPR)
if breathing stops or if the heart stops beating. The DNR order is decided
before an emergency situation arises. The decision is taken, in view of the
patient’s condition, after discussion with patient (if possible), next of kin
and/or the medical team looking after the patient.
If DNR is decided and written, rest of the treatment for disease and its effects
continue as prescribed.
Withholding or Withdrawing Treatment
Withholding and withdrawing artificial nutrition and hydration from terminally
ill patients can raise ethical issues. Artificial nutrition and hydration may be
futile and reduce quality of life. They can also harm the terminally ill patient
because of complications such as aspiration pneumonia, dyspnea, nausea,
diarrhea, and hypervolemia.
There is much variation over the decision for withholding or withdrawing
supportive treatment in different contexts.
Following is an abstract from the article by Alsolamy titled “Islamic views on
artificial nutrition and hydration in terminally ill patients” published in
Bioethics in 2012.15
From the perspective of Islam, rules governing the care of terminally ill
patients are derived from the principle that injury and harm should be
prevented or avoided. The hastening of death by the withdrawal of food
and drink is forbidden, but Islamic law permits the withdrawal of futile,
death-delaying treatment, including life support.
Nutritional support is considered basic care and not medical treatment,
and there is an obligation to provide nutrition and hydration for the dying
person unless it shortens life, causes more harm than benefit, or is
contrary to an advance directive that is consistent with Islamic law.

Reflection Exercise
Identify and discuss the issues that can be raised in the following
case scenarios. (Refer to SCFHS’s code of ethics, chapter 15)
Scenario 1: A 90-year-old COPD patient does not want to be ventilated if the

need arises. He suffers from yet another bout of pneumonia and the need for
ventilation arises. The doctors believe he could benefit from ventilation. His
wishes contrary to this are clearly documented and known. Family wants to do
everything including ventilating.
How should the doctor proceed with patient’s management? Discuss

the dilemma the doctor faces in this situation?
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Scenario 2: A 25-year-old with severe brain injury is ventilated. Prognosis was

always poor and he slips into deep coma and finally is declared brain dead.
Parents want to carry on with all treatment while physicians want to stop
ventilation and other supportive treatment.
What are the possible ethical issues in this case? What should the
doctor do?
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Medical Error Student’s Learning Outcomes

Medical errors are relatively common in  Differentiate between error
medical practice and may result in and medical negligence
serious morbidity and mortality of  Identify the importance of
reporting errors in medical
patients. A medical error is defined as an
practice
act of healthcare delivery that was
planned or performed to help, but brings
unintended harm (or potential harm) to the patient.
“Medical negligence” is a legal term, used in situations where a healthcare

provider fails to appropriately deliver the expected standard of care which
directly harms the patient.
Due to the nature of medical profession, errors can occur with anyone
involved in patient care. Reporting medical errors is based on the ethical
principles of non-maleficence and truth-telling. Patient care as the primary
interest of a medical professional also demands if an error is committed or
observed, efforts should be made to report, analyse and learn from it.
Understanding how medical errors can happen, and identifying and reporting
them is considered the best way to prevent them in future. It encourages
healthcare providers to learn and be extra careful in the professional work,
and brings about policy changes in the system that prevent such events.

Documentation of medical information and the certification of their
authenticity is one of the main tasks for a healthcare practitioner, and
he/she should pay close attention to such duties (of his/her profession)
for its significant importance. He/she should document each procedure
that he/she follows with the patient in accurate records, and strive to
be accurate when writing medical reports, in a way that achieves the
interest of the patient. Thus, he/she does should write what is the true
reality without exaggeration or underestimation and should not be
taken astray by the bonds of kinship, passion, fear or desire of benefit
to write a medical report that is untrue. He/she should use an honest
and trustful manner when issuing any certificate or document.

Discuss & Reflect

Read the case scenario, discuss among your groups and reflect on the
questions below:
Case scenario:
An athlete requires arthroscopy of his right knee under general anesthesia.
Just before finishing the procedure it is discovered that they were operating
on the wrong (left) knee. The surgeon then proceeds to do the arthroscopy of
the other (correct) knee. The surgeon explains to the patient after he wakes
up, that as he is an athlete he also looked inside the other knee to make sure
it was OK.
What are the ethical issues in this case?

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What could have the surgeon do differently after the surgery to avoid
ethical issues?
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If you were the surgeon’s assistant in this case, what would you have
done in this situation?
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Research Ethics Student’s Learning Outcomes

As medical professionals, one of our  Discuss the guiding principles
responsibilities is to conduct research to for ethical conduct of
research
improve the scientific knowledge.
 Recognize the presence of
Research is also important for codes for research ethics
professional growth and progress of  Demonstrate understanding
medical doctors. Medical research of ethical issues arising in
involving patients and other human research activities
subjects can raise complex ethical, legal
and social issues. While doing research,
medical professionals may get into situations where their obligations towards
research projects come into conflict with their responsibilities towards
patients.
Research ethics is the discipline that protects and ensures the benefits of
participants in the research process. There are three main objectives of
research ethics:
1. To protect human participants

2. To ensure that research is conducted in a way that serves interests of
individuals, groups and/or society as a whole
3. To examine specific research activities and projects for their ethical
soundness, looking at issues such as the risk management, protection
of confidentiality and the process of informed consent
The following principles guide the ethical conduct of research:
 Respect for persons/ autonomy: It is the duty of the researcher to

obtain informed consent from study participants, and ensure
confidentiality
 Beneficence: The research process must keep a favorable balance
between the potential benefits and harms that may come to the
participation
 Justice: The research should not exploit the vulnerable population and
the eligible candidates who may benefit from participation should not
be excluded without good cause
Researchers must ensure that the research that they are performing is
important enough to justify the risks of participation for their subjects. 16

Self-Study Exercise
Explore the terminologies through internet search and give short answers to
the questions:
1. Therapeutic Misconception
What do you understand by the terminology? _______________________
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2. Vulnerable population
Give example and briefly explain why they are called vulnerable?
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3. Ethics Review Committee
What is the role of this committee in research? _____________________
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4. International guidelines on research ethics
What are the benefits of having international guidelines? Give example of
one guideline. _______________________________________________
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Publication ethics
Scientific misconduct is the violation of  Describe Plagiarism and
the standard codes of ethical behavior in scientific misconduct
scientific research and scholarly  Discuss the authorship
activities. 17 criteria according to ICMJE
 Discuss issues in publication
Plagiarism is defined as using someone ethics
else’s ideas, thoughts or work without
giving due credit to that person. It can
also be defined as “theft of someone else’s ideas and concepts and pretending
that they are your own”.
Plagiarism can have very serious consequences for the authors including loss
of job, demotion, retraction of publication, loss of reputation and fine. The
journals can take actions against authors whose articles are plagiarized by
retracting the publication or may also blacklist the author for future works.
Plagiarism is a crime; it is unethical and unacceptable in any form.
There are different forms in which plagiarism can be done knowingly or

unknowingly. It is the authors’ responsibility to make sure that the research
or manuscript that they have prepared is not plagiarized. Not knowing about
plagiarism or its types/ forms does not stand as a justification for doing it.
It is requirement of all scientific journals that the authors certify that their
work is original and is not plagiarized in any form.
Some of the different types/ forms of plagiarism are:
 Copy-pasting from one or more sources

 Paraphrasing from other sources without due reference
 Publishing a figure or picture from some other source without consent
 Publishing your work in different places with or without changing the
title or language
Some types/ forms of scientific misconduct are:
 Making up data or modifying the data for changing the results

(fabrication)
 Manipulating research material, equipment or process (falsification)
 Omitting the publication of significant findings to safeguard the
interests of researcher or sponsor (suppression)

Authorship Criteria
There is always a debate on who can be the author. Junior researchers are
often obliged or under pressure to include names as authors of their senior
coulleages, helpers in the research, and/ or close friends in their manuscript.
International Committee of Medical Journals Editors (ICMJE) published

detailed guidelines on the criterias that must be met to be an author of a
publication. These guidelines are followed internationally.
As per ICMJE guidelines, the authorship should be based on the following

criteria:
1. Substantial contributions to conception and design, or acquisition of
data, or analysis and interpretation of data.
2. Drafting the article or revising it critically for important intellectual
content.
3. Final approval of the version to be published.
4. Agreement to be accountable for all aspects of the work in ensuring
that questions related to the accuracy or integrity of any part of the
work are appropriately investigated and resolved.
All those who meet the above four conditions are eligible to be included as
Authors in the manuscript.
The ICMJE18 further states that:
All persons designated as authors should qualify for authorship, and all
those who qualify should be listed. Acquisition of funding, collection of
data, or general supervision of the research group alone does not
constitute authorship.
Those who have contributed but do not meet all the criteria for authorship
should be listed in an acknowledgment section. Because acknowledgment
may imply endorsement, the corresponding author should obtain written
permission from all acknowledged individuals.
A conflict of interest exists when professional judgment concerning a

primary interest (such as patients' welfare or the validity of research) may
be influenced by a secondary interest (such as financial gain). Perceptions
of conflict of interest are as important as actual conflicts of interest. Public
trust in the scientific process and the credibility of published articles
depend in part on how transparently conflicts of interest are handled.
Authors should avoid entering in to agreements with study sponsors, that
interfere with authors’ access to the study’s data or that interfere with
their ability to analyse and interpret the data and to prepare and publish
manuscripts independently when and where they choose.


Publish or perish
This movie highlights several areas of scientific misconduct that can tempt
researchers, driven by increasing pressures to publish research work in order
to move up the academic ladder.
After watching the video clip; discuss in groups and answer the questions:
(consider the ICMJE guidelines in relation to the questions)
What are the ethical issues shown in this video clip? Identify at least
one related to each of the four main characters?
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What should be done by the sub-editor (fiancé) after the last scene?
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What do you understand by the term “whistle blowing” in this

situation?
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______________________________________________________________

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Reflection Exercise
Ali is writing an article on the research that he did with his two other friends
(co-researchers). Mamun comes to him and asks him to add his name in the
authors list. In return Mamun is ready to add Ali’s name in one of his articles
that is going for publication soon.
Can Ali add Mamun’s name in the authors list with or without asking
his two co-researchers? Why?
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______________________________________________________________
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______________________________________________________________
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Reflect on what possible ethical issues can arise in this situation?

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_______________________________________________________
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References
1. Epstein RM, Hundert EM. Defining and assessing professional
competence. JAMA. 2002;287(2):226–235
2. Article: Professionalism in new millennium. (http://www.afmc.ca/social-
professionalism-e.php)
3. The American Heritage® New Dictionary of Cultural Literacy, Third
Edition Copyright © 2005 by Houghton Mifflin Company. Published by
Houghton Mifflin Company. All rights reserved.)
4. Ahmed and Muslim. http://www.muslimdoctor.org/eng/post.php?id=50
5. Islamic Medical Ethics: The Islamic Medical Association of North
America
6. Principles of Ethics. http://www.dummies.com/how-to/content/basic-
principles-of-medical-ethics.html
7. http://www.surgeryencyclopedia.com/Pa-St/Patient-Confidentiality.
html#ixzz2kLQBK vk4
8. Consent. http://www.dummies.com/how-to/content/basic-principles-of-
medical-ethics.html
9. Justice and Equity.
http://www.amsa.org/AMSA/Homepage/About/Committees/
REACH/healthequity.aspx
10. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1376429/
11. Lemmens T, Singer PABioethics for clinicians: 17. Conflict of
interest in research, education and patient care. CMAJ. 1998 Oct
20;159(8):960-5.
12. http://www.uic.edu/depts/mcam/ethics/prenatal.htm
13. Genetic Counseling in the Muslim World: The Challenges, by Aida
Al Aqeel, Department of Pediatrics, Riyadh Armed Forces Hospital and
Department of Genetics, King Faisal Specialist Hospital and Research
Center, Riyadh, Saudi Arabia, published in the document of 2 nd Pan
Arab Human Genetics Conference.
14. Babgi A. Legal Issues in End-of-life Care: Perspectives from
Saudi Arabia and United States. American Journal of Hospice &
Palliative Medicine.Vol.26(2);April/May,2009
http://ajh.sagepub.com/content/26/2/119.long
15. http://www.ncbi.nlm.nih.gov/pubmed/22845721
16. C Weijer, B Dickens, and E M Meslin Bioethics for clinicians: 10.
Research ethics CMAJ 1997 April 15; 156(8): 1153–1157
17. http://explorable.com/scientific-misconduct
18. http://www.icmje.org/ethical_1author.html

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Professionalism and Ethics Module

Learning is Change in Behavior; Behavior is the

Phase II, 4th Year MBBS

Student Name: _____________________

PORTFOLIO WORKBOOK Student’s Learning

History of Medical Ethics

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

A. It is the duty of a healthcare practitioner to treat his/her patient kindly

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Video Clip & Discussion

Write down your points that you would use in discussion

What was wrong with doctors’ interaction among the team-members?

Facilitator’s Remarks/ Feedback:

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Medical Ethics - Islamic Student’s Learning

According to the SCFHS’s code of ethics:

Of course, there are some characteristics which need to be emphasized in

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

The healthcare professionals involved in organ transplantation have duties

 The rights of the donor (living or deceased)

Some of the medical professionals interpret euthanasia as the process for

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

From your past experience of different professionals, what are the

Facilitator’s Remarks/ Feedback:

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Communication Ethics Student’s Learning

Different aspects of communication with patients and others will be discussed

Physicians can show good communication skills by:

 Showing respect to patient by sitting down at same level during patient

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

What are the good points in the above conversation?

What are the issues that need improvement in the above

Facilitator’s Remarks/ Feedback:

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Role-play Exercise (Communication ethics)

Volunteers & Roles

Reflect on what you feel after the role-play session

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Confidentiality Student’s Learning Outcomes

According to the SCFHS’s code of ethics:

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Discuss & Reflect

Facilitator’s Remarks/ Feedback:

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Informed Consent Student’s Learning

It is duty of the healthcare professional to ensure that a proper process of

Guidelines for Helping Patients Reach Informed Consent

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Video Clip & Reflection Exercise

Discuss and reflect on the following questions after watching

What messages are conveyed by the consultant’s body language to

What would you recommend to the doctors to improve their

Facilitator’s Remarks/ Feedback:

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)

Role-Play Exercise (Informed consent)

Reflect on what you feel after the role-play session

Breaking Bad News

To minimize the mental trauma to patients and to enhance the acceptance in

Guidelines for breaking bad news

4. Sharing the information.

Faculty of Medicine in Rabigh, KAU, 1439-40(H) / 2018 (G)