KhlOWLEDGE WITHOUT SKILL = incompetent

KNOWLEDGE & SKILLS WITHOUT ETHICS

—
— Ł/ftfiiCpM@MİOMS
Legal - Ethical - Moral
Overlap?

Ethica Lega
l l
 Legal - Ethical -
Moral
• Legal: What the
Society accepts
as Good or Bad

•Ethical: What a
body of Professionals
accept as Desirable
Acts
•Moral: What an Individual
decides for oneself based on
personal value system
Nurse charged with murder in Romanian
hospital fire
i:, the CAN Wire Staff

{ANN) - A nurse a a Romanian hospital has

been charged .' ith murder in the deaths of five
ne'. bo ns killed in a fire in an nierisive care
unit, prosecutors said klonday.

Florentina Daniela Cirstea 'z.’ill remain in police

custody for 24 hours and appear before a
judge Tuesday. said k\afius IacoD. chief p
oseculor in charge of the investigalion.
Prosecutors ','/iII ask the judge lo place her
under arresl so she can be held
 Nurses Dismissed Over Cell
Phone Photos of Patient on
FaceBook
• In February 2009, two Wisconsin nurses
were dismissed for posting pictures of a
patient on Facebook taken on a cell
phone.
 Historical
Development
• Bioethics and human rights: conceived in the
aftermath of the Nazi Atrocities, when moral
outrage reenergized "bioethics," and "human
rights"
• 1948 Universal Declaration of Human Rights:
prompted by Nuremberg trials of ’47, at which
doctors, lawyers, scientists, and soldiers were
indicted for "crimes against humanity."
 What is Bioethics?
• Ethics refers to standards of conduct,
derived from principles of right and wrong
• We must be able to distinguish right from
wrong, good from evil, and propriety from
impropriety — af ffmes di 'icult
• We must commit ourselves to do what is
right, good and proper
• Ethics is therefore an action concept &
NOT simply an idea to argue about
• Universal principles :
— Patient Autonomy — freedom of
choNon-
— ice — do not cause

maleficence harm
- Beneficence — do good

— Justice — fairness &

equality
Principles can overlap as well as
compete with each other for priority
• treating a patient according to the
patient's desires, within the bounds of
accepted treatment
• involving patients in treatment decisions
• considering the patient's needs, desires
and abilities
• safeguarding the patient's privacy
• duty to protect the patient from harm
• keeping knowledge and skills current
• knowing one's own limitations and when
to refer to other specialists
• knowing when delegation of patient care
to assistants or trainees is
appropriate
• primary obligation is service to the
patient and the public-at-large
• duty to promote the patient's welfare
• competent and timely delivery of
health care
• obliged to become familiar with the
signs of abuse and neglect and to
report suspected cases
• duty to be fair in their dealings with
patients, colleagues and society
• delivering health care without prejudice
— shall not deny service to patients because of
the patient's race, creed, color, sex or
nationality
— not to provide treatment to an individual
infected with HIV, HBV, HCV solely on
that fact is unethical
 Ethical Dilemmas
• Occur when the core principles compete or
are
point to different decisions
• Some examples —
— Beneficence versus Non-maleficence
• Risky surgery
— Autonomy versus Beneficence
• Treating one who has attempted suicide
— Justice versus Autonomy
• Fetal sex determination by USG
 Biomedical
ethics: classification
Practical
• Ethics in biomedical research
• Ethics in clinical practice
• Ethics in public health, medical law,
and health policy
• Methodology in bioethics

Bær0e et a1. BMC Medical Ethics (2017) 1B:30 DOI 10.1186/s1291O-017-

0193-x
Nurse Refuses To Give CPR; Senior
Dies: Ethical Problem or Legal
Issue?
• A licensed nurse refuses to give CPR
to an 87 year old woman who
collapsed in an old-age home where
the nurse worked because of "cDmpany
policy” of not resuscitating those older
than 85 years of age...