Medical Ethics And Professionalism

MEDICAL ETHICS AND PROFESSIONALISM

PROFESSIONALISM AND ETHICS IN MEDICAL PRACTICE

Learning Objectives

• By the end of this session, students are expected to be able to:
• Explain the term ethics in medical practice
• Explain professionalism in medical practice
• Explain characteristics of a profession
• Describe medical code of ethics
• Explain the social role of a profession
• Explain the roles of professional associations and licensing bodies

Buzz(02 mins)

What are the Common ethical dilemmas??

Introduction

Ethics is the system of moral standards that govern behavior of a group of people or members of a profession.

Ethics provide guiding principles on how good and wise people ought to live and relate to each other within professional groups and otherwise.

Medical ethics pertain to a system of moral standards for people in the healing profession.

Introduction

• Profession
• Meaning

Refer to a job that needs a high level of education and training Refer to occupation requiring advanced education and training, and involving intellectual skills, Eg. Radiography, law, theology, engineering, teaching, etc.

Professions are groups which declare in a public way that their members promise to in certain ways and that the group and the society may discipline those who fail to do so.

The profession usually issues a code of ethics stating the standards by which its members can be judged.

Its members profess a commitment to competence, integrity, morality, humanity, and the promotion of the public good within their domain.

Profession

Medical profession differs from other professions in both content and motivation.

Medical profession is a service profession dedicated to patients, centering on the doctor-patient/ Radiographer-patient relationship.

The true professionalism in medicine will always put in first place the well-being of the patient and the community as principal objective.

It attempts to make tangible certain attitudes, behaviors, and characteristics that are desirable among the medical profession. Hence.

Professionalism is defined as the behavior, excellence and competence expected to be shown by a professional person.

Characteristics of a Profession

• 1.Body of knowledge

Usually the knowledge is not easily understood by the public.

Professions have an obligation to transmit their knowledge by teaching it to future practitioners, the general public, and their patients.

Characteristics of a Profession

• Service

The knowledge is used in the service of others.

Radiographer usually use their knowledge primary in diagnosing patient by using different diagnostic modalities.eg ultrasound machine and x-ray machine.

Clinicians use their knowledge primarily to benefit (treatment) individual patient.

Characteristics of a Profession

• Altruism

Concern for the well-being for others Is the attitude of caring about others and doing acts that help them although you do not get anything by doing those acts.

There is agreement that the trust placed in the professions and their privileged status are only justified by the expectation that they will be altruistic.

For radiographer this means consistently placing the interests of individual patients and society above their own.

Professions must be devoted to the public good.

Characteristics of a Profession

• Autonomy

Ability to act and make decision independently without being controlled by external force.

This is another important characteristic of a profession which shows respect for client’s right to be self-governing Individually, radiographer are granted sufficient autonomy to act in the best interests of their patients.

In the early days, autonomy was expressed in a paternalistic fashion, but modern society, recognizing patient autonomy, now views the radiographer-patient relationship as a partnership.

Characteristics of a Profession

• Medical Code of ethics

A written set of guidelines issued by an organization to its workers and management to help them conduct their actions in accordance with its primary values and ethical standards An agreement on ethical standards for a profession Professions have codes of ethics which specify the obligations arising from their duty.

Professionalism requires the practitioner strive for excellence in the following areas which should be modelled by mentors and teachers and become part of the attitudes, behaviors, and skills integral to patient care:

Altruism: Radiographer is obligated to attend to the best interest of patients, rather than self-interest.

ii. Accountability: Radiographer are accountable to their patients, to society on issues of public health, and to their profession.

Medical Code of ethics

iii. Excellence: Radiographer are obligated to make a commitment to life-long learning.

iv. Duty: Radiographer should be available and responsive when ‘on call,’ accepting a commitment to service within the profession and the community.

• Honor and integrity: Radiographer should be committed to being fair, truthful and straightforward in their interactions with patients, relatives and the profession.

vi. Respect for others: Radiographer should demonstrate respect for patients and their families, other physicians and team members, medical students, residents and fellows.

Medical Code of ethics

• The four recognized principles that guide medical ethics are:
• Beneficence
• Non-maleficence
• Justice

Autonomy

BENEFICENCE

• Beneficence is one of the moral principles of medical practice.
• It is the basis for the practice of doing good for, and being kind to patients
• The principles of beneficence requires:-
• One should not inflict harm;
• One should prevent harm;
• One should remove what is bad;

One should promote good.

JUSTICE

It is the principle that requires that each person be assured of the things that belong to him/her.

• Refers to just conduct or fair dealing.
• a group of norms for distributing benefits, risks, and cost fairly

It means giving every person what they deserve

AUTONOMY

Respect for autonomy is a norm of respecting the decision- making capabilities of autonomous persons (patient) .

Respect for client’s right to be self-governing

NON-MALEFICENCE

• NONMALEFICENCE is a norm of avoiding causation of harm to others

Doing no harm to patients

PATERNALISM

Definition:

The interference with, limitation of a person’s autonomy justified by reasons referring exclusively to the perceived welfare or needs of the person whose autonomy is being interfered with.

Paternalism implies that the radiographer – like the parent – has the moral authority to make decisions for the patient.

Paternalism is in conflict with the principle of Autonomy, Paternalism violates the principle of Autonomy

Can paternalism be justified?

Paternalism may be justified when the patient’s autonomy is significantly diminished, and she/he is no longer competent:

• Too young
• Disoriented or confused, due to disease/injury
• Is mentally ill

Even the radiographer should attempt to secure a relative’s consent.

SOCIAL ROLES OF A PROFESSION

The social role of a profession is to prepare practitioners with the knowledge and skill necessary for the practice of that profession.

The public must be able to trust the profession and believe that all its members will possess a particular level and quality of knowledge and skill.

Enlighten the public on prevention of epidemic and communicable diseases Notify the public health authorities of every case of communicable disease under his care.

• Improve quality of care
• Improve access of care to the society

Impart Scientific knowledge to society

Roles of Professional Associations and Licensing Bodies

Professional associations and licensing bodies are characteristics of all professions.

They operate under government authority, which may be altered if society becomes dissatisfied with their performance.

The associations and licensing bodies E.g. (MRIPC) have a primary role in guaranteeing the quality of healthcare services.

Medical associations E.g. (TARA and RAOTA )also have an obligation to protect the interests of their individual members.

Function of professional associations is so important; they require the support of their members.

Roles of Professional Associations and Licensing Bodies

Medical professional associations must be extremely wise in how they negotiate for their members.

The privilege of self-regulation entails an absolute obligation to guarantee the competence of members.

The disciplining of unethical or incompetent practitioners must be rigorous, open, and have the support of every practicing radiographer .

Question?

Failure and success are both the results of preparation.

QUESTIONS

• Define the following terms
• Profession
• Ethics
• Code of ethics
• Mention five(5) characteristics of a profession
• Mention five(5) social roles of a profession
• Mention the Roles of Professional Associations and Licensing Bodies

REFERENCE

Mason, J.K., McCall Smith R.A. & Laurie, G.T. (1999). Law and Medical Ethics. London: Butterworths Mellish, J.M. & Paton, F. (1999). An Introduction to the Ethics of Nursing. Capetown: Heinemenn.

Tanzania National Health Research Forum (2001). Guidelines on Ethics for Health Research in Tanzania.

World Medical Association (2009). Medical Ethics Manual (2nd ed.). France: World Medical Association.

REFERENCE

Ham, C. & Alberti, K.G. (2002). The Medical Profession, the Public, and the Government. BMJ.324:838–842.

Kultgen, J.H. (1988). Ethics and Professionalism. Philadelphia: University of sPennsylvania Press.

Devettere, R.J. (1995). Practical Decision Making in Health care Ethics: Cases and Concepts. Washington DC: Georgetown.

Appelbaum PS. Assessment of patient’s competence to consent to treatment. New England Journal of Medicine. 2007; 357: 1834-1840.