Lecture 9 - Health Education and The Medical Ethics

HEALTH EDUCATION AND
MEDICAL ETHICS
 Declaration of Geneva
“The health of my
patient will be my
first consideration”
OBJECTIVES
1.Define ethics and values.

2. Distinguish law from ethics.
3. Compare and contrast the different ethical
theories that underlie ethical nursing practice.
4. Define the ethical principles of autonomy,
beneficence, non beneficence, Veracity, justice,
paternalism, and respect.
5. Discuss the importance and role of hospital
ethics committees and ethics grand rounds.
WHY ETHICS ?
• In medicine we deal with confidential issues (related directly to people’s

lives, history, behavior, body, health & disease).
• Patients put their trust in medical professionals & expect high ethical
standards.
WHY ETHICS ?
• Health providing teams are expected to know & maintain a high level of
ethical standard.
• Most ethical issues are standard.
• Some special ethical issues are related to:
• religion, culture, …etc
• Deficiencies in practical application of known ethical standards exist.
WHY ETHICS ?
• Ethical issues are always of concern to the public.

• Any breach of ethical standards leaves harmful
effects shaking the confidence in the system.
( media controls the public opinion)

WHY ETHICS ?
• Ethics encompasses a process of determining right from
wrong conduct. Ethics is the branch of philosophy
concerned with evaluating human action or behavior.
• Morals are personal principles that are acquired from life
experiences. e.g. from culture, religion, and law.
• Morals can resolve routine decision but are not adequate for
resolving complex issues arising in clinical settings.
• Medical Ethics: Is a set of moral principles that apply the
values and judgments in the context of medicine practice,
and help health professional to make their decision
• Code of ethics: Principles that adopted by an
organization that help employees to make their
decision through understanding the difference
between right or wrong. It focuses on social issues.
• Bioethics: is the study of controversial ethical issues
brought about by advances in biology and medicine.
Ethical questions that arise in the relationships among
life sciences, biotechnology, medicine, politics, law,
and philosophy.
• The legal system is founded on rules and regulations that
guide society in a formal and binding manner and give
guidance to health care providers regardless of personal
views and value system.
• Many health care providers have difficulty in areas that
transect a system of rights and values such as death,
genetics, etc.
ETHICAL PRINCIPLES
• Autonomy : it is based on the assertion that individuals

have the right to determine their own actions and the
freedom to make their own decision. A mentally competent
adult patient has the right to give or withhold consent to any
diagnostic procedure or therapy. The patient has the right to
the information necessary to make his/her decisions. The
patient should understand clearly what is the purpose of any
test or treatment, what the results would imply, and what
would be the implications of withholding consent.
• Beneficence—actions one takes should promote “good.” a
practitioner should act in the best interest of the patient.
ETHICAL PRINCIPLES
• Nonmaleficence— first , do no harm, then looks for do good. This

principle is not absolute
• Double effect is a concept describe the state of balance between harm
action and not harm action (doing good or harm). One single action
has a two types of consequences. E.g. using morphine in the dying
patients.
• Four conditions necessary are:
• The action must be “good.”
• The practitioner must intend only a good effect.
• There is a proportional balance between the desirable and the
undesirable effect of the action.
ETHICAL PRINCIPLES
• Veracity—individuals should always tell the

whole truth. How about if the diagnosis is
Cancer???
• Fidelity—keeping one’s promises or
commitments
• Paternalism—(also known as parentialism)
making the final decisions for others. Seen
as undesirable.
•“ Competent patients have
the right to refuse
treatment, even when the
refusal will result in
disability or death”
ETHICAL PRINCIPLES
• Justice—people should be treated fairly and equally.

• Respect—the highest principle, incorporates all other
principles.
CODES OF ETHICS
Common areas of agreement among different codes

of ethics (which are areas of agreement with
other professional codes of ethics) are:
1- The responsibility for practice competence,

2- The need for good relations with coworkers,
3- The commitment to respect for the life and dignity
of the patient,
4- The responsibility for protection of patient
confidentiality
5- The moral position of nondiscrimination
ETHICS COMMITTEE
• Institution ethical committee(IEC) is necessary to

solve ethical issues.
• Provide structure and guidelines.
• Serve as an open forum for discussion.
• Function as a true patient advocate.
ETHICS COMMITTEE
An ethics committee should be composed of:

• Nurses
• Physicians
• Clergy
• Clinical social workers
• Nutritional experts
• Pharmacists
• Administrative personnel
• Legal experts
• Patients and/or family members (only after committee has become active)
SUMMARY OF MEDICAL
ETHICS
• I. A health professional shall be dedicated to providing competent

health care, with compassion and respect for human dignity and rights.
• II. A health professional shall uphold the standards of professionalism,
• III. A health professional shall respect the law and also recognize a
responsibility to seek changes in those requirements which are contrary
to the best interests of the patient.
• IV. A health professional shall respect the rights of patients, colleagues,
and other health professionals, and shall safeguard patient confidences
and privacy within the constraints of the law.
• . A health professional shall continue to study, apply, and
advance scientific knowledge, maintain a commitment to
medical education, make relevant information available to
patients, colleagues, and the public, obtain consultation, and
use the talents of other health professionals when indicated.
• VI. A health professional shall, in the provision of appropriate
patient care, except in emergencies, be free to choose whom to
serve, with whom to associate, and the environment in which to
provide medical care.
• VII. A A health professional shall recognize a responsibility to
participate in activities contributing to the improvement of the
community and the betterment of public health.
• VIII. A health professional shall, while caring for a patient,
regard responsibility to the patient as paramount.
• IX. A health professional shall support access to medical
care for all people

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HEALTH EDUCATION AND

1.Define ethics and values.

• In medicine we deal with confidential issues (related directly to people’s

• Ethical issues are always of concern to the public.

( media controls the public opinion)

• Autonomy : it is based on the assertion that individuals

• Nonmaleficence— first , do no harm, then looks for do good. This

• Veracity—individuals should always tell the

• Justice—people should be treated fairly and equally.

Common areas of agreement among different codes

1- The responsibility for practice competence,

• Institution ethical committee(IEC) is necessary to

An ethics committee should be composed of:

• I. A health professional shall be dedicated to providing competent

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