ETHICS IN FAMILY MEDICINE

Dr. Hanan Abbas

Ethics is a generic term for various ways
of understanding and examining the
moral life.
Morality refers to social conventions
about right and wrong conduct that are
so widely shared that they accepted by
.the majority of people
The purpose of ethical theory is to enhance
clarity, systematic order, and the precision
.of argument in our thinking about morality
Another definition of ethics

An attempt to arrive at an understanding

of :
*The nature of human values.
*How we ought to live.
.* What constitutes right conduct
In practical terms, when we are faced with
two or more equally important but
competing values, how do we make the
?right choice
principles to make ethical theories 4
more applicable to clinical dilemmas:

* Autonomy.
* Beneficence.
*Non-malficence.
.* Justice
Autonomy
means self-rule
it refers to the right of every individual to
make his or her own decision.
In health care, this means allowing the
patient to make the final decision regarding
his or her treatment after having been given
.all the necessary and relevant information
Informed consent

Before subjecting a patient to any

investigation or treatment, we need to
obtain his or her agreement.
*Firstly it is important that the patient is
competent to consent and the consent is
voluntary. The pt must not be manipulated
.or coerced into consenting
Then the pt is given all the relevant
information related to the procedure or
treatment in language that is easily
understandable.
The risks and benefits of the intervention
.must be clearly stated
It is important to ensure that the*
information given has been correctly
understood.
* Finally the pt will make a decision.
*Truly informed consent is a process and
may be unavoidably time consuming. In
practice, constraints limit the essential
.acquisition of fully informed consent
 Confidentiality

* Medical confidentiality is another way of

respecting the pt’s autonomy.
* In the context of doctor-patient
relationship,confidentiality is always
maintained,except if the pt consents to the
disclosure.
Truth telling:

Respect to the pt’s autonomy requires us not to

deceive them. This means telling them the truth
about their illness unless they specifically
indicate that they do not wish to know.
* This is especially important where terminal
.illness is concerned
Concealing the diagnosis from the pt is
clearly unacceptable unless there are very
.good and exceptional reasons for doing so
Communication:

The pt’s centred approach used in family

medicine is in keeping with the principal of
.respect for autonomy
 Listening to the pt enables the family
physician to decide what information the
pt needs, how this information should be
transmitted to the pt, and what the pt’s
* preferences are. It can be seen that good
communication in the context of doctor-
patient relationship is an ethical
requirement.
Beneficence:
Refers to doing good, while non-
malficence literally means “ do no harm”.
Whenever we try to help others, we
inevitably risk harming them.
In medicine, it is essential to balance these
principles to achieve the net benefit for the
.pt
In order to fulfill the requirements of these
principles, we have certain obligations to
our pts.
* We need to be able to provide the
benefits to our pts that we profess we are
able to provide. This is why it is essential to
have rigorous and effective education and
training before and during our professional
.lives
We also need to be clear about risk and *
probability when we make our assessments
of harm and benefit.
* Finally,empowerment of the pt to take
control of her or his health care is also seen
.as an obligation of beneficence
Justice:

This principle deals with the fair treatment

of pts.
Obligations of justice may be divided as
follows:
* Respect for people’s rights- rights- based
.justice
 justice.

Fair distribution of limited resources-

distributive justice.
Respect for morally acceptable laws-legal
justice.
Final comment:
*Some people feel that the principles are
too abstract.
*Others find them difficult to interpret.
*In some situations,principles may be in
conflict with each other.
*Some critics say that the principles just
.are not enough in all situations of choice
Conclusion:

Solving ethical dilemmas is never easy.

Doing the right thing is a matter of

conscience and sometimes requires
great moral courage.
Ultimately we are guided by *
fundamental principles common to all
of humanity and by our personal value
.systems
Thank you