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Lecture 1 Introduction To Medical Ethics

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28 views

Lecture 1 Introduction To Medical Ethics

Uploaded by

Abderrezak SAIDI
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Lecture 1 Introduction to Medical Ethics

Objective of the lecture:

This lecture provides a comprehensive introduction to medical ethics, offering


foundational knowledge and practical examples to illustrate key concepts. It sets the
stage for more in-depth exploration of specific ethical issues in subsequent lectures.
The lecture also aims
to provide an overview of the fundamental principles and theories of medical ethics,
highlighting their importance in medical practice and decision-making.

I. Introduction to Ethics and Medical Ethics

1. Definition of Ethics
o Ethics: The study of moral values and principles that guide human
behavior.
o Medical Ethics: A branch of ethics dealing with moral principles that
apply to the practice of medicine.
2. Importance of Medical Ethics
o Ensures patient safety and well-being.
o Provides a framework for addressing complex moral issues in
healthcare.
o Promotes trust between healthcare providers and patients.

II. Historical Development of Medical Ethics

1. Hippocratic Oath
o An ancient oath historically taken by physicians, emphasizing principles
like non-maleficence ("do no harm") and confidentiality.
2. Nuremberg Code (1947)
o Established ethical principles for human experimentation following the
atrocities of World War II.
3. Declaration of Helsinki (1964)
o A set of ethical guidelines for medical research involving human
subjects, adopted by the World Medical Association.
4. Belmont Report (1979)
o Outlined ethical principles and guidelines for research involving human
subjects in the United States.

III. Core Ethical Principles in Medical Ethics

1. Autonomy
o Respecting patients' rights to make informed decisions about their own
healthcare.
o Example: A patient refuses a blood transfusion due to religious beliefs.
The healthcare provider respects this decision, even if it contradicts
medical advice.
2. Beneficence
o Acting in the best interest of the patient to promote well-being.
o Example: A physician recommends a specific treatment plan that offers
the best chance of recovery, considering the patient's health status and
preferences.
3. Non-Maleficence
o "Do no harm." Avoiding actions that could cause unnecessary harm or
suffering to patients.
o Example: A surgeon decides against a high-risk surgery that could cause
more harm than benefit to an elderly patient with multiple health issues.
4. Justice
o Ensuring fair distribution of healthcare resources and fair treatment of
all patients.
o Example: A hospital follows a standardized protocol for organ
transplants to ensure that all patients have an equal opportunity based on
medical criteria.

IV. Ethical Theories and Frameworks

1. Deontology (Kantian Ethics)


o Focuses on adherence to moral rules and duties. Actions are right or
wrong based on whether they follow a set of rules, regardless of the
consequences.
o Example: A healthcare provider follows strict confidentiality rules, even
if breaking confidentiality could potentially help a patient.
2. Utilitarianism
o Emphasizes the greatest good for the greatest number. The ethical value
of an action is determined by its overall benefit.
o Example: During a pandemic, prioritizing vaccine distribution to high-
risk populations to maximize public health benefits.
3. Virtue Ethics
o Focuses on the character and virtues of the moral agent rather than on
specific actions.
o Example: A compassionate physician listens carefully to a patient's
concerns, demonstrating empathy and care.
4. Principlism
o Combines multiple ethical principles to guide decision-making. Often
involves balancing competing principles.
o Example: A decision-making process that considers patient autonomy,
beneficence, and justice in allocating limited medical resources.
V. Application of Ethical Principles: Case Studies

1. Case Study 1: Refusal of Life-Saving Treatment


o Scenario: A 30-year-old patient with leukemia refuses a blood
transfusion due to religious beliefs.
o Ethical Issues: Balancing respect for patient autonomy with the duty to
provide life-saving care.
o Discussion: Exploring the limits of respecting autonomy when it
conflicts with medical advice.
2. Case Study 2: Confidentiality vs. Public Safety
o Scenario: A psychiatrist learns that a patient is planning to harm
someone.
o Ethical Issues: The duty to maintain patient confidentiality versus the
duty to protect third parties from harm.
o Discussion: The "duty to warn" and the ethical justification for
breaching confidentiality in specific circumstances.
3. Case Study 3: Allocation of Scarce Resources
o Scenario: A hospital has only one ventilator available, but two patients
in critical condition need it.
o Ethical Issues: Determining criteria for prioritizing patients, such as
prognosis, age, and overall health.
o Discussion: Applying principles of justice and utilitarianism in making
fair allocation decisions.

VI. The Role of Ethics Committees and Consultation Services

1. Ethics Committees
o Multidisciplinary groups that provide guidance on ethical issues in
healthcare settings.
o Functions include reviewing complex cases, developing policies, and
offering education on ethical practices.
2. Ethics Consultation Services
o Provide support for healthcare providers, patients, and families facing
ethical dilemmas.
o Facilitate communication and decision-making in ethically challenging
situations.

VII. Conclusion

1. Summary of Key Points


o Understanding core ethical principles and theories is essential for ethical
medical practice.
o Ethical decision-making often involves balancing competing values and
principles.
2. Importance of Ongoing Ethical Education
o Medical ethics is a dynamic field that evolves with societal changes and
medical advancements.
o Continuous learning and reflection are necessary for healthcare
professionals to navigate ethical challenges effectively.

References

• Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th


ed.). Oxford University Press.

• Gillon, R. (Ed.). (1994). Principles of health care ethics. John Wiley & Sons.

• Veatch, R. M., Haddad, A. M., & English, D. C. (2018). Case studies in


biomedical ethics: Decision-making, principles, and cases (2nd ed.). Oxford
University Press.

• Jonsen, A. R., Siegler, M., & Winslade, W. J. (2015). Clinical ethics: A practical
approach to ethical decisions in clinical medicine (8th ed.). McGraw-Hill
Education.

• Pellegrino, E. D., & Thomasma, D. C. (1993). The virtues in medical practice.


Oxford University Press.

• Arras, J. D., & Fenton, E. M. (2015). Ethical issues in modern medicine:


Contemporary readings in bioethics (8th ed.). McGraw-Hill Education.

• DeGrazia, D., Mappes, T. A., & Ballard, J. D. (2011). Biomedical ethics (7th ed.).
McGraw-Hill Education.

• Emanuel, E. J., & Emanuel, L. L. (1998). The Oxford textbook of clinical


research ethics. Oxford University Press.

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