Medicine

AETCOM
VON-

Medicine 8 Marks
P1= 4 M
P2= 4 M

Surgery 4 Marks

OBGY 10 Marks

Pediatrics 5 Marks
Q. Demonstrate ability to communicate to patients in a patient, VON
respectful, non-threatening, non- judgmental and empathetic manner.
When communicating with patients, it is important to be patient, respectful,
non-threatening, non-judgmental and empathetic. Here are some tips to
help you communicate effectively with patients:
1 Use simple language: Use language that is easy to understand and
avoid using medical jargon. This will help patients understand their
condition and treatment options better.
2 Listen actively: Listen to your patients carefully and try to understand
their concerns. This will help you build trust and rapport with them.
3 Be empathetic: Try to put yourself in your patient’s shoes and
understand their feelings. This will help you provide better care and
support.
4 Be respectful: Treat your patients with respect and dignity. This will
help them feel valued and appreciated.
5 Be non-judgmental: Avoid making assumptions or judgments about
your patients. This will help you provide unbiased care and support.
Remember, effective communication is key to building strong relationships
with your patients and providing high-quality care.

Q. Communicate diagnostic and therapeutic options to patient

and family in a simulated environment.
- Use clear, simple, and jargon-free language to explain the diagnosis,
prognosis, and treatment plan to the patient and family¹.
- Use open-ended questions, active listening, and empathy to elicit the
patient and family's concerns, preferences, and values².
- Provide realistic and honest information, but also express hope and
optimism when appropriate³.
- Involve the patient and family in shared decision-making and respect
their autonomy and choices.
- Address any barriers or challenges to the treatment plan, such as cost,
access, side effects, or adherence issues.
- Provide written or visual materials to reinforce the information and
instructions given verbally.
- Check the patient and family's understanding and ask for feedback or
questions.
- Document the communication and the agreed-upon treatment plan in
the patient's record.
Q. 1. Demonstrate empathy in patient encounters
2. Communicate care options to patient and family with a terminal illness in a
simulated environment
Points for discussion:
1. The role of a doctor as a healer.
2. Failure of treatment and its implications for the doctor-patient relationship. 3. Empathy
and patient care.
4. Can the doctor-patient relationship be terminated?
5. Hospice care.
1. The role of a doctor as a healer.
- A doctor is not only a provider of medical services, but also a healer who aims to restore
the physical, mental, and spiritual well-being of the patient¹.
- A healer's role involves using medical knowledge, skills, and experience to diagnose and
treat the patient's illness, as well as respecting the patient's autonomy, dignity, and
preferences¹.
- A healer's role also requires empathy, compassion, and sincerity, which are essential for
building trust, rapport, and a therapeutic alliance with the patient².
- A healer's role should be guided by the ethical principles of non-maleficence,
beneficence, justice, and respect for persons, as well as the goals of medicine, which are to
prevent disease, relieve suffering, and promote health.

2. Failure of treatment and its implications for the doctor-patient relationship.

- Failure of treatment can occur when the medical intervention does not achieve the desired
outcome, or when the patient's condition worsens or becomes incurable⁴.
- Failure of treatment can have negative implications for the doctor-patient relationship,
such as loss of trust, confidence, and satisfaction, increased distress and dissatisfaction, and
potential conflict and litigation⁴⁵.
- To prevent or manage the negative implications of failure of treatment, the doctor should
communicate honestly and empathetically with the patient, explain the reasons and risks of
failure, acknowledge the patient's emotions and expectations, and involve the patient in
shared decision making about the next steps of care⁴⁶.
- The doctor should also provide emotional support, reassurance, and hope to the patient,
and refer the patient to appropriate resources, such as palliative care, counseling, or peer
support groups, if needed.

3. Empathy and patient care.

- Empathy is the ability to understand and share the feelings of another person, and to
communicate this understanding and intention to help⁸.
- Empathy is an important component of patient care, as it can improve patient satisfaction,
adherence, and outcomes, as well as reduce patient anxiety, distress, and complaints⁸⁹.
- Empathy can also benefit the doctor, as it can enhance professional satisfaction, reduce
burnout and stress, and foster personal growth and resilience⁸ [^10^].
- Empathy can be expressed through verbal and non-verbal communication, such as active
listening, open-ended questions, reflection, validation, eye contact, facial expression, and
touch⁸¹¹.
- Empathy can be learned and improved through training, feedback, self-awareness, and
practice⁸¹².
4. Can the doctor-patient relationship be terminated?
- The doctor-patient relationship can be terminated by either the doctor or the
patient, under certain circumstances and with proper notice and justification¹³.
- The doctor can terminate the relationship if the patient is non-compliant,
abusive, fraudulent, or unreasonably demanding, or if the doctor is unable to
provide the appropriate level of care for the patient's condition¹³¹⁴.
- The patient can terminate the relationship if the patient is dissatisfied,
distrustful, or uncomfortable with the doctor, or if the patient wants to seek a
second opinion or a different treatment option¹³¹⁵.
- The termination of the relationship should be done in a respectful and ethical
manner, following the state laws and regulations, and ensuring the continuity and
quality of care for the patient¹³¹⁶.

5. Hospice care.
- Hospice care is a type of care that focuses on the quality of life for people
who have a terminal illness and their caregivers¹⁷.
- Hospice care provides physical, emotional, social, and spiritual support for
the patient and the family, and aims to relieve pain and suffering, and enhance
comfort and dignity¹⁷.
- Hospice care does not cure the illness, but rather accepts death as a natural
part of life, and helps the patient and the family cope with the end-of-life
process¹⁷.
- Hospice care can be provided in various settings, such as home, hospital,
nursing home, or hospice center, and involves a team of professionals, such as
doctors, nurses, social workers, chaplains, and volunteers¹⁷.
- Hospice care can start when the patient has a life expectancy of six months or
less, and when the patient and the family agree to stop treatments that aim to
prolong life¹⁷.
Q. Identify and discuss and defend medico-legal, socio-cultural, professional and ethical
issues in physician - industry relationships
Points for discussion:
1. The influence of pharmaceutical industry on doctor’s prescription behavior.
2. The limits of doctor - industry engagement.
1. The influence of pharmaceutical industry on doctor’s prescription behavior.

This is a complex and controversial issue that has been debated for decades. Some
studies have suggested that interactions between physicians and the pharmaceutical
industry, such as gifts, samples, sponsored events, and sales representatives, can affect
physicians' attitudes and prescribing habits, and may lead to irrational or inappropriate
use of the company's drugs¹². However, other studies have argued that these
interactions are beneficial for physicians' knowledge, education, and patient care, and
that physicians are able to maintain their professional autonomy and integrity³⁴. The
extent and impact of the influence of the pharmaceutical industry on doctor’s
prescription behavior may vary depending on factors such as the type, frequency, and
value of the interactions, the characteristics of the drugs, the specialty and experience
of the physicians, and the regulatory and ethical guidelines in place⁵.

2. The limits of doctor - industry engagement.

Given the potential benefits and risks of doctor - industry engagement, there is a need
to establish clear and consistent limits and boundaries for these interactions. Some of
the principles and recommendations that have been proposed by various organizations
and experts include:

- Transparency and disclosure: Physicians should disclose any financial or non-

financial relationships or conflicts of interest with the pharmaceutical industry to their
patients, colleagues, employers, and regulators.
- Evidence-based and patient-centered prescribing: Physicians should base their
prescribing decisions on the best available scientific evidence and the individual needs
and preferences of their patients, rather than on the influence or incentives of the
pharmaceutical industry.
- Professionalism and ethics: Physicians should uphold the values and standards of
their profession and act in the best interests of their patients and the public health,
while respecting the autonomy and dignity of their patients and colleagues.
- Education and training: Physicians should seek independent and unbiased sources of
information and education on drugs and therapeutics, and avoid relying on the
promotional materials or activities of the pharmaceutical industry.
- Accountability and oversight: Physicians should comply with the relevant laws,
regulations, and codes of conduct that govern their interactions with the
pharmaceutical industry, and be subject to monitoring and evaluation by their peers,
employers, and regulators.
Q. Identify conflicts of interest in patient care and professional relationships and VON
describe the correct response to these conflicts
Points for discussion:
1. Fee splitting and other practices.
2. Can doctors become entrepreneurs?
3. Can doctors own pharmacies or hold stock in pharmaceutical companies? 4.
What comprises professional conflict of interest?

1. Fee splitting and other practices.

Fee splitting is the practice of sharing fees with professional colleagues, such
as physicians or lawyers, in return for being sent referrals¹¹. This is considered
unethical and unacceptable in most parts of the world, as it may compromise
the quality and appropriateness of patient care, create a conflict of interest,
and increase the cost of health services¹². The correct response to fee splitting
is to avoid any arrangement that involves paying or receiving a commission or
a percentage of the fee for referring patients, and to disclose any potential or
actual conflicts of interest to the patients, employers, and regulators¹³.

Other practices that may pose a conflict of interest in patient care and
professional relationships include:

- Accepting gifts, incentives, or sponsorships from pharmaceutical or medical

device companies that may influence prescribing or purchasing decisions⁶.
- Having a financial or personal stake in a health care facility, laboratory, or
pharmacy that may affect referral or utilization patterns⁷.
- Providing services or products that are outside the scope of one's
professional competence or license¹⁴.
- Having a dual or multiple role or relationship with a patient, such as being a
friend, relative, or business partner¹⁵.

The correct response to these practices is to adhere to the ethical principles

and standards of one's profession, to act in the best interests of the patients
and the public health, and to disclose and manage any potential or actual
conflicts of interest in a transparent and accountable manner¹⁶.
2. Can doctors become entrepreneurs?

Yes, doctors can become entrepreneurs, as long as they do not compromise their
professional obligations and ethics. There are many examples of doctors who have
successfully launched and scaled businesses in the health care sector, such as creating
innovative products, services, or solutions, or establishing clinics, hospitals, or
networks¹². Some of the benefits of being a doctor entrepreneur include:

- Having a deep understanding of the health care needs, challenges, and opportunities
in the market⁹.
- Having the credibility and trust of the customers, partners, and investors[^10^].
- Having the passion and motivation to make a positive impact on the health and well-
being of the society¹¹.

Some of the challenges of being a doctor entrepreneur include:

- Balancing the time and energy between clinical practice and business management¹².
- Facing the regulatory, legal, and financial hurdles and risks in the health care
industry¹³.
- Dealing with the ethical dilemmas and conflicts of interest that may arise from
combining the roles of a doctor and an entrepreneur¹⁴.

The correct response to these challenges is to seek guidance and support from mentors,
peers, and experts, to comply with the relevant laws and regulations, and to uphold the
ethical values and standards of the medical profession¹⁵.

3. Can doctors own pharmacies or hold stock in pharmaceutical companies?

The answer to this question may vary depending on the jurisdiction and the context. In
some countries, such as the United States, doctors are allowed to own pharmacies or
hold stock in pharmaceutical companies, as long as they disclose their financial
interests and do not engage in self-referral or kickback schemes¹⁸¹⁹. In
other countries, such as India, doctors are prohibited from owning pharmacies or
selling medicines, as it may create a conflict of interest and compromise the rational
use of drugs⁸. Similarly, doctors are discouraged from holding stock in pharmaceutical
companies, as it may influence their prescribing behavior and undermine their
professional integrity[^10^]. The correct response to these situations is to follow the
applicable laws and ethical codes of conduct, and to avoid any actions that may harm
the patients or the public health.
Q. 1. Identify conflicts of interest in patient care and professional relationships and
describe the correct response to these conflicts.
2. Demonstrate empathy to patient and family with a terminal illness in a simulated
environment.
Points for discussion:
1. How should doctors deal with the emotions of patients and family facing death?
2. What does the patient experience when he/she is dying? Can physicians make the
process of death comfortable?
3. What are the emotions faced by doctors when confronting death in patients? Is
death a defeat for the doctor? Should the doctor be emotionally detached from a
dying patient?
4. What are the cultural aspects of dying?

1. How should doctors deal with the emotions of patients and family facing
death?

This is a challenging and sensitive issue that requires compassion,

communication, and professionalism from the doctors. Some of the strategies
that doctors can use to deal with the emotions of patients and family facing
death are¹²:

- Acknowledge and validate the feelings and concerns of the patients and
family, such as sadness, anger, fear, guilt, or hopelessness.
- Listen actively and empathetically, and avoid interrupting, judging, or giving
false reassurance.
- Provide clear and honest information about the diagnosis, prognosis,
treatment options, and goals of care, and respect the preferences and decisions
of the patients and family.
- Involve other members of the health care team, such as nurses, social
workers, chaplains, or palliative care specialists, to provide additional support
and guidance.
- Offer referrals to appropriate resources, such as counseling, support groups,
or hospice care, to help the patients and family cope with the emotional,
practical, and spiritual aspects of death and dying.
- Take care of their own emotional well-being, and seek help from colleagues,
mentors, or professionals if they feel overwhelmed, stressed, or burned out.
2. What does the patient experience when he/she is dying? Can physicians make
the process of death comfortable?

The experience of dying varies from person to person, depending on the cause and
manner of death, the physical and mental condition of the patient, and the cultural
and spiritual beliefs of the patient. Some of the common physical and
psychological changes that may occur in the dying process are³⁴:

- Reduced appetite and thirst, and weight loss.

- Increased fatigue and sleepiness, and decreased responsiveness.
- Confusion, agitation, or hallucinations.
- Changes in breathing, such as rapid, shallow, or irregular breaths, or periods of
no breathing.
- Changes in circulation, such as cold, pale, or mottled skin, or weak or irregular
pulse.
- Changes in sensory perception, such as blurred vision, impaired hearing, or
altered sense of smell or taste.
- Changes in consciousness, such as calmness, peace, or acceptance, or fear,
anxiety, or denial.

Physicians can make the process of death more comfortable for the patient by
providing palliative care, which is the care that focuses on relieving pain and
suffering, and improving the quality of life, for patients with serious or life-
limiting illnesses. Some of the ways that physicians can provide palliative care
are⁵⁶:

- Assessing and treating the physical symptoms of the patient, such as pain,
nausea, shortness of breath, or constipation, using medications, oxygen, or other
interventions.
- Addressing the emotional, social, and spiritual needs of the patient, such as
providing counseling, support, or comfort, or respecting the patient's values and
beliefs.
- Communicating effectively and compassionately with the patient and family,
such as explaining the patient's condition and prognosis, discussing the goals and
preferences of care, and facilitating advance care planning and decision making.
- Collaborating with other members of the palliative care team, such as nurses,
pharmacists, social workers, chaplains, or hospice workers, to coordinate and
deliver comprehensive and holistic care.
- Respecting the dignity and autonomy of the patient, and honoring the patient's
wishes and choices, such as the place of death, the presence of loved ones, or the
use of life-sustaining treatments.
3. What are the emotions faced by doctors when confronting death in patients? Is
death a defeat for the doctor? Should the doctor be emotionally detached from a
dying patient?

Doctors may face various emotions when confronting death in patients, such as
sadness, grief, guilt, anger, frustration, or helplessness. These emotions are normal
and natural, and reflect the human and caring side of the doctors. However, these
emotions can also affect the doctors' well-being and performance, and lead to stress,
burnout, or depression. Therefore, doctors need to find healthy and effective ways
to cope with the death of patients, such as⁷⁸:

- Expressing and sharing their emotions with others, such as colleagues, friends,
family, or counselors, and seeking support and feedback.
- Taking time to reflect and learn from the experience, such as reviewing the case,
acknowledging the positive aspects, or identifying the areas for improvement.
- Maintaining a balance between work and personal life, such as taking breaks,
engaging in hobbies, exercising, or meditating.
- Developing a positive and realistic attitude towards death, such as recognizing the
limits of medicine, accepting the inevitability of death, or finding meaning and
purpose in their work.

Death is not necessarily a defeat for the doctor, although it may feel like one. Death
is a natural and inevitable part of life, and sometimes it is beyond the control or
influence of the doctor. Doctors should not blame themselves or others for the death
of patients, but rather focus on the quality of care they provide, and the difference
they make in the lives of patients and families. Doctors should also celebrate the
successes and achievements they have, and appreciate the gratitude and recognition
they receive.

Doctors should not be emotionally detached from a dying patient, as this may
impair their ability to provide compassionate and empathetic care, and to establish a
trusting and respectful relationship with the patient and family. However, doctors
should also not be emotionally overwhelmed or attached to a dying patient, as this
may impair their ability to provide objective and professional care, and to cope with
the loss and grief. Doctors should strive to find a balance between being
emotionally involved and emotionally detached, and to adjust their level of
emotional engagement according to the needs and preferences of the patient and
family, and their own personal and professional boundaries.
4. What are the cultural aspects of dying?

Culture is a broad and complex concept that encompasses the values, beliefs,
norms, practices, and customs of a group of people. Culture influences how
people perceive, understand, and respond to death and dying, and how they
express and cope with grief and mourning. Some of the cultural aspects of
dying that may vary across different groups of people are:

- The meaning and purpose of life and death, and the beliefs and expectations
about what happens after death, such as the existence of an afterlife,
reincarnation, or judgment.
- The attitudes and emotions towards death and dying, such as acceptance,
denial, fear, or hope, and the degree of openness or secrecy about death and
dying.
- The rituals and ceremonies for preparing for and honoring death, such as the
use of symbols, prayers, chants, or music, the presence of family, friends, or
clergy, or the disposal of the body, such as burial, cremation, or donation.
- The rules and roles for coping with and expressing grief and mourning, such
as the duration and intensity of grief, the use of clothing, colors, or objects, the
participation in social or religious activities, or the provision of support and
comfort.

It is important for doctors to be aware of and respectful of the cultural aspects

of dying of their patients and families, and to avoid making assumptions or
judgments based on their own cultural background. Doctors should also be
sensitive and flexible to the individual preferences and needs of their patients
and families, and to the influence of other factors, such as acculturation,
education, or personal experience, on their cultural aspects of dying. Doctors
should also seek to learn from their patients and families, and to ask them
about their cultural aspects of dying, and to accommodate them as much as
possible, as long as they do not harm the patient or violate the ethical
principles of medicine.
Points for discussion:
1. Can patients choose to die? Is there a role for doctors in the death of patients?
Can doctors assist death?

1. Can patients choose to die? Is there a role for doctors in the death of patients?
Can doctors assist death?

This is a complex and controversial question that involves legal, ethical, and personal
issues. The answer may vary depending on the jurisdiction, the context, and the
individual preferences of the patients and doctors. Generally speaking, there are two
main ways that patients can choose to die with medical assistance: withholding or
withdrawing life-sustaining treatment, and physician-assisted dying.

Withholding or withdrawing life-sustaining treatment means that a patient or their

surrogate decision-maker refuses or stops a treatment that is necessary to keep them
alive, such as artificial ventilation, dialysis, or feeding tubes. This is usually
considered a legal and ethical right of the patient, based on the principle of autonomy
and informed consent. However, there may be some situations where this right is
challenged or limited, such as when the patient's wishes are unclear, when the
surrogate decision-maker is in conflict with the health care team, or when the
treatment is deemed to be futile or burdensome¹.

Physician-assisted dying means that a physician provides a patient with a

prescription for a lethal dose of medication that they can use to end their life when
they're ready. This is also sometimes called physician-assisted suicide or euthanasia,
although these terms are not preferred by some advocates and patients. This is a more
controversial and divisive option, as it involves the active participation of the
physician in causing the death of the patient. This is illegal in most countries and
states, except for a few that have legalized it under certain conditions, such as
Oregon, Canada, Switzerland, and the Netherlands². The arguments for and against
physician-assisted dying are complex and multifaceted, involving moral, religious,
social, and medical perspectives³.

The role of doctors in the death of patients is to provide compassionate and

respectful care, and to honor the wishes and values of the patients and their families,
as long as they are consistent with the law and the ethics of the profession. Doctors
can assist death by providing palliative care, which is the care that focuses on
relieving pain and suffering, and improving the quality of life, for patients with
serious or life-limiting illnesses. Doctors can also assist death by respecting the
decisions of the patients or their surrogates to withhold or withdraw life-sustaining
treatment, and by providing comfort and support during the dying process. However,
doctors are not obligated to assist death by providing or administering a lethal
medication, and they can conscientiously object to doing so, as long as they inform
the patients and refer them to another willing physician.
Q. 1. Identify, discuss and defend medico-legal, socio-cultural, professional and ethical
issues pertaining to medical negligence
2. Identify, discuss and defend medico-legal, socio-cultural, professional and ethical
issues pertaining to malpractice

1. Medical negligence is the improper or unskilled treatment of a patient by a medical

practitioner, which results in harm, injury, or death of a patient⁶. Medical negligence is a
form of tort law, which deals with civil wrongs that cause damage to others. Some of the
medico-legal, socio-cultural, professional and ethical issues pertaining to medical
negligence are:

- Medico-legal issues: Medical negligence cases involve legal aspects such as the duty of
care, the standard of care, the breach of duty, the causation, and the damages. The duty of
care is the obligation that a medical practitioner owes to a patient to provide reasonable
and competent care. The standard of care is the level of skill and care that a similarly
situated professional of the same medical specialty would provide under the
circumstances. The breach of duty is the failure of the medical practitioner to meet the
standard of care. The causation is the link between the breach of duty and the harm
caused to the patient. The damages are the losses or injuries suffered by the patient as a
result of the medical negligence⁶.
- Socio-cultural issues: Medical negligence cases may involve socio-cultural factors such
as the expectations, beliefs, values, and preferences of the patients and their families, as
well as the cultural competence and sensitivity of the medical practitioners. These factors
may influence the perception, communication, and understanding of the medical
situation, the informed consent, the decision making, and the satisfaction of the parties
involved. For example, some patients may have religious or cultural objections to certain
treatments, or may prefer alternative or traditional forms of medicine. Some medical
practitioners may have biases or stereotypes about certain groups of patients, or may lack
the knowledge or skills to deal with diverse populations⁷.
- Professional issues: Medical negligence cases may involve professional issues such as
the education, training, certification, regulation, and accountability of the medical
practitioners. These issues may affect the quality, safety, and effectiveness of the medical
services provided, as well as the reputation, credibility, and trust of the medical
profession. For example, some medical practitioners may have inadequate or outdated
knowledge or skills, or may practice beyond their scope of competence or license. Some
medical practitioners may face disciplinary actions or sanctions from their professional
bodies or regulators, or may lose their license or accreditation⁸.
- Ethical issues: Medical negligence cases may involve ethical issues such as the
principles, values, and standards that guide the conduct and decision making of the
medical practitioners. These issues may relate to the respect for autonomy, beneficence,
non-maleficence, and justice of the patients and their families, as well as the honesty,
integrity, and professionalism of the medical practitioners. For example, some medical
practitioners may violate the informed consent, confidentiality, or privacy of the patients,
or may cause harm, suffering, or injustice to the patients or their families. Some medical
practitioners may lie, cheat, or cover up their mistakes, or may have conflicts of interest
or corruption⁹.
2. Malpractice is a form of professional negligence, which occurs when a
professional fails to render services with the level of skill, care, and diligence that a
reasonable professional would apply under similar circumstances¹. Malpractice can
occur in various fields, such as law, finance, architecture, or engineering, but it is
most commonly associated with medicine. Some of the medico-legal, socio-
cultural, professional and ethical issues pertaining to malpractice are:

- Medico-legal issues: Malpractice cases involve similar legal aspects as medical

negligence cases, such as the duty of care, the standard of care, the breach of duty,
the causation, and the damages. However, malpractice cases may also involve other
legal aspects, such as the contractual obligations, the fiduciary duties, the statutory
requirements, and the criminal liabilities of the professionals. For example, some
professionals may breach their contracts, violate their fiduciary duties, fail to
comply with the laws or regulations, or commit fraud or other crimes in relation to
their services².
- Socio-cultural issues: Malpractice cases may involve similar socio-cultural factors
as medical negligence cases, such as the expectations, beliefs, values, and
preferences of the clients and their families, as well as the cultural competence and
sensitivity of the professionals. However, malpractice cases may also involve other
socio-cultural factors, such as the social status, power, and influence of the
professionals, the public perception and opinion of the professions, and the social
impact and consequences of the malpractice. For example, some professionals may
abuse their authority, exploit their clients, or manipulate the public. Some
professions may face public scrutiny, criticism, or distrust. Some malpractice cases
may cause social harm, outrage, or unrest³.
- Professional issues: Malpractice cases may involve similar professional issues as
medical negligence cases, such as the education, training, certification, regulation,
and accountability of the professionals. However, malpractice cases may also
involve other professional issues, such as the specialization, innovation, and
competition of the professions, the quality assurance and improvement of the
services, and the risk management and insurance of the professionals. For example,
some professionals may have insufficient or excessive specialization, or may adopt
new or unproven methods or technologies. Some professions may have quality
standards, audits, or reviews to ensure the excellence of their services. Some
professionals may have risk assessment, mitigation, or transfer strategies to protect
themselves from malpractice claims⁴.
- Ethical issues: Malpractice cases may involve similar ethical issues as medical
negligence cases, such as the principles, values, and standards that guide the
conduct and decision making of the professionals. However, malpractice cases may
also involve other ethical issues, such as the codes of ethics, the ethical dilemmas,
and the ethical responsibilities of the professionals. For example, some
professionals may have specific codes of ethics that define their roles, duties, and
obligations. Some professionals may face ethical dilemmas that require them to
balance competing interests, values, or principles. Some professionals may have
ethical responsibilities to their clients, their colleagues, their profession, and the
society.