Medical Ethics

CONFIDENTIALITY
• People have a right to expect that information about them
will be held in confidence by their authority personal

• Confidentiality is central to trust between doctors and

patients.

• Without assurances about confidentiality, patient must be

reluctant to give doctor the information they need in order to
provide a good care.
 CONFIDENTIALITY

• The information about people you must :

– Disclosure or check information related
– Be satisfied that patients know about disclosures
necessary to provide their care or to provide
clinical audit
– Patient express consent to disclosure of
information, where the identifiable data is needed
for any purposes
 CONFIDENTIALITY
– Keep disclosures to the minimum necessary
– Up-to-date observe the requirements of statute and
common law and including data protection legislation

• The protecting information:

– Personal information effectively protected against
improper disclosure at all time
– Many in proper disclosures are unintentional
Overhead or leave patient’s records (paper or
electronic matter)
Seen by other patients, unauthorized health care staff
or the public
 CONFIDENTIALITY
• Sharing information with patient:
– Patient have right on information about the health
care service available to them, presented in a way
that is easy to follow and use
– Patient also have right to know all information
about any condition or disease which their suffering

– Include all information about diagnosis, treatment

option, outcome from treatment, side effect, cost,
etc.
 CONFIDENTIALITY
• You still have an obligation to keep personal information
confidential after patient dies.

• The extent to which confidential information may be disclosed

after a patient’s death will depend on the circumstance:
– Whether the disclosure of information may cause distress to
or be of benefit to the patient’s partner or family
– Whether the disclosure of information about the patient will
in effect disclose information about the patient’s family or
other people
– Whether the information is already public knowledge or can
be anonymous
– The purpose of the disclosure
 ETHICS AND
MORALITY
• Morality – making choices with reasons
▫ as a social institution that exists prior to moral
reflections of the sort found in philosophical and
theological ethics

• Ethics – the study of HOW the choices are made,

i.e. “ethics is the study of morality”

• Often use “ethics” and “morality”

interchangeably
 Professional Morality and Ethics
• Professional Morality – what we do in our
occupational lives

• Professional Ethics – the study of what we do in

our professional lives
 Ethics

• A term for various ways of understanding and

examining the moral life
• Greek ‘ethica’ – moral philosophy

• Some approaches to ethics are

▫ Normative (inquiry of ethical theory)
▫ non-normative (investigation and analysis of
ethical theory)
 Ethics
• 4 principles of modern bioethics
• Beauchamp and Childress 1979

• Autonomy
• Justice
• Benificence
• Non-maleficence
 Autonomy
• Paramount
• Being self-governing
• Able to exercise free will in making a personal
decision
• A right to withhold consent
• Applicable to anyone who has capacity
 Beneficence
• Literally being charitable or doing good
• Performing care so as to maximise patient
wellbeing
• Exercising clinical judgement
• Going beyond the minimum standards required
 Non-malificence
• Doing no harm
• Avoidance of putting a person
at risk of avoidable harm
• A 1st step towards beneficence
• Defined under the Hippocratic
oath
 Justice
• No single definition
• Usually distributive justice
when applied to medical ethics
• Fairness
• Equity
• Method of righting wrongs
 Limitations
• Very simplistic
• Autonomy trumps the other principles
• Role of justice
• No coherent approach to resolving conflicting
principles
 What is Euthanasia?
• “granting painless death to a hopelessly ill
patient with a non-curable disease.”

• Distinction between euthanasia and murder

 EUTHANASIA
• The term euthanasia comes from the Greek words "eu"-
meaning good and "thanatos"-meaning death, which
combined means “well-death” or "dying well".

• Euthanasia refers to the practice of ending a life in a painless

manner.

• Many different forms of euthanasia can be distinguished,

including animal euthanasia and human euthanasia, and
within the latter, voluntary and involuntary euthanasia.
 Types of Euthanasia

Voluntary euthanasia

Non-voluntary euthanasia

Involuntary euthanasia

Passive euthanasia
 Euthanasia
• Voluntary Active Euthanasia
– Killing someone with their consent for the sake of
relieving suffering.
 Euthanasia
• Involuntary Active Euthanasia:
– killing someone for the sake of relieving suffering without
consent when they are capable of giving consent.
 Euthanasia
• Non-voluntary Active Euthanasia
– killing a person not competent to give consent in
order to relieve suffering
– conducted where the patient is normally
unconscious
 Euthanasia
• Passive Euthanasia
– The patient refuses to take the treatment
that could prevent him/her from dying.
Chantal Sebire
 Euthanasia: Pros
• It provides a way to
relieve extreme pain

• It provides a way of relief

when a person's quality
of life is low

• Frees up medical funds

to help other people
 Euthanasia: Cons
• Euthanasia devalues human life
• Euthanasia can become a means of health
care cost containment
• Physicians and other medical care people
should not be involved in directly causing
death
 MEDICAL MALPRACTICE
• Malpractice definition :

“Medical mistakes which is done by physician

or other health care professional that cause
suffering to a patient due to physical or
economic damages”
 MEDICAL MALPRACTICE

• Factor that must be present to prove medical

malpractice :
– Liability : Professional relationship should
existed between the patient and health care
provider

– Damages : Injury, suffering / economic

damages must be present and must be direct
result of the negligence
 MEDICAL MALPRACTICE
The medical malpractice claim :
The parties
• The plaintiff is or was the patient, or a legally
designated party acting on behalf of the patient, or
in the case of a wrongful-death suit – the executor or
administrator of a deceased patient's estate.

• The defendant is the health care provider. Although

a 'health care provider' usually refers to a
physician, the term includes any medical care
provider, including dentists, nurses, and
therapists
 MEDICAL MALPRACTICE
• May not protect nurses and other non-physicians
from liability when committing negligent acts.

• Relying on vicarious liability or direct corporate

negligence, claims may also be brought against
hospitals, clinics, managed care organizations or
medical corporations for the mistakes of their
employees.
Thank You