lOMoARcPSD|50131128
Medical Ethics AND Legal Issues
, lOMoARcPSD|50131128
MODULE: HEALTH SYSTEMS MANAGEMENT (HSM)
UNIT: MEDICAL ETHICS & MEDICO LEGAL FUNCTIONS
Carey Francis Okinda
April 2018
UNIT OBJECTIVES
1. Demonstrate appropriate understanding, attitudes to ethical responsibilities in regard to the profession
2. Describe factors that influence ethical practise
3. Describe and perform the different medical legal functions
Outline
Topic Duration (hours)
1. Introduction to Professional Ethics (Medical Ethics) 2
2. Professional Practice 2
3. Ethical Issues in Clinical Practice 2
4. Conventions and Declarations 1
5. Medical Legal Issues 2
6. Keys Laws and Legislation 1
TOTAL 10
Lesson 1: INTRODUCTION TO PROFESSIONAL ETHICS
Objectives
At the end of the lesson the learner should be able to
1) Define basic terms
2) Explain the clinician-patient relationship
3) Explain the international code of medical ethics
1.0 INTRODUCTION AND DEFINITIONS/TERMINOLOGY
1. Ethics
The word ethics - ethics [eth′iks]; Etymology: Gk, ethikos, moral duty
Ethics
o is not the same as feelings, religion, following the law, following culturally accepted norms and is not
science
o are moral principles, what is good and bad, what is right and wrong
o are Based on value system
Ethical norms are not universal 3 depends on the sub culture of the society
Ethics is
a) Branch of philosophy that deals with the distinction between right and wrong, with the moral consequences
of human actions
b) The science or study of moral values or principles, including ideals of autonomy, beneficence, and
justice
c) Study of fundamental principles that define values and determine moral duties and obligations
d) Moral codes of practice concerned with: behaviour (moral conduct)4e. g. unprofessional behaviour, such
as direct discrimination; legal, religious, social and personal concerns (moral issues); and debates within
society4e.g. euthanasia vs. prolonging the life of a terminally-ill person
e) The standards of conduct that direct a group or individual. In particular, it relates to the appropriate use of
the power held by a group or individual.
1
, lOMoARcPSD|50131128
f) Ethics is the study of morality 3 careful and systematic reflection on and analysis of moral decisions and
behaviour (past, present or future)
2. Profession
An occupation, practice, or vocation requiring mastery of a complex set of knowledge and skills through
formal education and/or practical experience
A disciplined group of individuals who adhere to ethical standards. This group positions itself as possessing
special knowledge and skills in a widely-recognized body of learning derived from research, education and
training at a high level, and is recognized by the public as such
Key issues are dual loyalty, public health, global health, the environment and resource allocation
Medicine is a profession that is characterized by dedication to the wellbeing of others, high moral standards,
a body of knowledge and skills and a high level of autonomy and involves relationship with the patients,
colleagues and other health professionals as well as the society
3. Professional
A member of a profession
Professionals are governed by codes of ethics, and profess commitment to competence, integrity and
morality, altruism, and the promotion of the public good within their expert domain
Professionals are accountable to those served and to society
4. Professionalism
Comprises the personally held beliefs about one9s own conduct as a professional. It9s often linked to the
upholding of the principles, laws, ethics and conventions of a profession as a way of practice.
5. Professionalization
Pattern of how a profession develops, as well as the process of becoming a profession
2.0 BENEFITS OF PROFESSIONS
An important feature of professions is that individual professionals benefit from the respect and community
trust in their expertise
Benefits of professions also encompass the following areas:
1) The community 3
Consumers face a complex array of professional services choices, from medical and health to
business and financial services
Provide trusted expertise founded on established standards that are policed to ensure community
expectations of good practice and social purpose are met
2) The economy
Professions improve consumers9 access to services and support economic activity by encouraging
confidence and trust in the services offered by professionals
3) Regulators
Burden of regulation and supervision by government can be reduced by improving the standards of
practice of professionals and regulatory capacity of professional communities
2
, lOMoARcPSD|50131128
Professions create and maintain distinct professional values or moral obligations (codes of ethics).
Examples 3 COC, KMDPB, KMLTTB,
4) Professionals
Professions improve employment and career longevity
Provide an important community purpose and empowerment
Enhance their reputations and skills by adhering to the professional standards and requirements of
their professional bodies
3.0 SPECIAL ASPECTS OF MEDICAL ETHICS (CORE VALUES)
1) Compassion - understanding and concern for other person9s distress
2) Competence - a high degree of competence
3) Autonomy (Self Determination)
Be free to determine the standards of medical education and medical practice
Value clinical and professional autonomy and try to preserve it as much as possible
4) Declaration of Geneva
4.0 HISTORY
Medical ethics may be traced to guidelines on the duty of physicians such as the Hippocratic oath
A physician must recognize responsibility to patients first and foremost, as well as to society, to other health
professionals, and to self.
These are not laws, but standards of conduct which define the essentials of honorable behavior for the
physician
5.0 BASIC PRINCIPLES OF MEDICAL ETHICS
1) Autonomy
Patient has freedom of thought, intention and action when making decisions regarding health care
procedures
For a patient to make a fully informed decision, she/he must understand all risks and benefits of the
procedure and the likelihood of success.
The patient must be informed clearly the consequences of his action that may affect him adversely.
Desiring to "benefit" the patient, the physician may strongly want to intervene believing it to be a clear
"medical benefit. <
The physician has a duty to respect the autonomous choice of the patient, as well as a duty to avoid harm
and to provide a medical benefit.
But the physician should give greater priority to the respect for patient autonomy than to the other duties.
However, at times this can be difficult because it can conflict with the paternalistic attitude of many health
care professionals.
In the case of a child, the principle of avoiding the harm of death, and the principle of providing a medical
benefit that can restore the child to health and life, would be given precedence over the autonomy of the
child's parents as surrogate decision makers.
2) Beneficence
The practitioner should act in <the best interest= of the patient - the procedure be provided with the intent of
doing good to the patient
This needs health care provider to,
o Develop and maintain skills and knowledge by continually updating training
o Consider individual circumstances of all patients
3
Medical Ethics AND Legal Issues
, lOMoARcPSD|50131128
MODULE: HEALTH SYSTEMS MANAGEMENT (HSM)
UNIT: MEDICAL ETHICS & MEDICO LEGAL FUNCTIONS
Carey Francis Okinda
April 2018
UNIT OBJECTIVES
1. Demonstrate appropriate understanding, attitudes to ethical responsibilities in regard to the profession
2. Describe factors that influence ethical practise
3. Describe and perform the different medical legal functions
Outline
Topic Duration (hours)
1. Introduction to Professional Ethics (Medical Ethics) 2
2. Professional Practice 2
3. Ethical Issues in Clinical Practice 2
4. Conventions and Declarations 1
5. Medical Legal Issues 2
6. Keys Laws and Legislation 1
TOTAL 10
Lesson 1: INTRODUCTION TO PROFESSIONAL ETHICS
Objectives
At the end of the lesson the learner should be able to
1) Define basic terms
2) Explain the clinician-patient relationship
3) Explain the international code of medical ethics
1.0 INTRODUCTION AND DEFINITIONS/TERMINOLOGY
1. Ethics
The word ethics - ethics [eth′iks]; Etymology: Gk, ethikos, moral duty
Ethics
o is not the same as feelings, religion, following the law, following culturally accepted norms and is not
science
o are moral principles, what is good and bad, what is right and wrong
o are Based on value system
Ethical norms are not universal 3 depends on the sub culture of the society
Ethics is
a) Branch of philosophy that deals with the distinction between right and wrong, with the moral consequences
of human actions
b) The science or study of moral values or principles, including ideals of autonomy, beneficence, and
justice
c) Study of fundamental principles that define values and determine moral duties and obligations
d) Moral codes of practice concerned with: behaviour (moral conduct)4e. g. unprofessional behaviour, such
as direct discrimination; legal, religious, social and personal concerns (moral issues); and debates within
society4e.g. euthanasia vs. prolonging the life of a terminally-ill person
e) The standards of conduct that direct a group or individual. In particular, it relates to the appropriate use of
the power held by a group or individual.
1
, lOMoARcPSD|50131128
f) Ethics is the study of morality 3 careful and systematic reflection on and analysis of moral decisions and
behaviour (past, present or future)
2. Profession
An occupation, practice, or vocation requiring mastery of a complex set of knowledge and skills through
formal education and/or practical experience
A disciplined group of individuals who adhere to ethical standards. This group positions itself as possessing
special knowledge and skills in a widely-recognized body of learning derived from research, education and
training at a high level, and is recognized by the public as such
Key issues are dual loyalty, public health, global health, the environment and resource allocation
Medicine is a profession that is characterized by dedication to the wellbeing of others, high moral standards,
a body of knowledge and skills and a high level of autonomy and involves relationship with the patients,
colleagues and other health professionals as well as the society
3. Professional
A member of a profession
Professionals are governed by codes of ethics, and profess commitment to competence, integrity and
morality, altruism, and the promotion of the public good within their expert domain
Professionals are accountable to those served and to society
4. Professionalism
Comprises the personally held beliefs about one9s own conduct as a professional. It9s often linked to the
upholding of the principles, laws, ethics and conventions of a profession as a way of practice.
5. Professionalization
Pattern of how a profession develops, as well as the process of becoming a profession
2.0 BENEFITS OF PROFESSIONS
An important feature of professions is that individual professionals benefit from the respect and community
trust in their expertise
Benefits of professions also encompass the following areas:
1) The community 3
Consumers face a complex array of professional services choices, from medical and health to
business and financial services
Provide trusted expertise founded on established standards that are policed to ensure community
expectations of good practice and social purpose are met
2) The economy
Professions improve consumers9 access to services and support economic activity by encouraging
confidence and trust in the services offered by professionals
3) Regulators
Burden of regulation and supervision by government can be reduced by improving the standards of
practice of professionals and regulatory capacity of professional communities
2
, lOMoARcPSD|50131128
Professions create and maintain distinct professional values or moral obligations (codes of ethics).
Examples 3 COC, KMDPB, KMLTTB,
4) Professionals
Professions improve employment and career longevity
Provide an important community purpose and empowerment
Enhance their reputations and skills by adhering to the professional standards and requirements of
their professional bodies
3.0 SPECIAL ASPECTS OF MEDICAL ETHICS (CORE VALUES)
1) Compassion - understanding and concern for other person9s distress
2) Competence - a high degree of competence
3) Autonomy (Self Determination)
Be free to determine the standards of medical education and medical practice
Value clinical and professional autonomy and try to preserve it as much as possible
4) Declaration of Geneva
4.0 HISTORY
Medical ethics may be traced to guidelines on the duty of physicians such as the Hippocratic oath
A physician must recognize responsibility to patients first and foremost, as well as to society, to other health
professionals, and to self.
These are not laws, but standards of conduct which define the essentials of honorable behavior for the
physician
5.0 BASIC PRINCIPLES OF MEDICAL ETHICS
1) Autonomy
Patient has freedom of thought, intention and action when making decisions regarding health care
procedures
For a patient to make a fully informed decision, she/he must understand all risks and benefits of the
procedure and the likelihood of success.
The patient must be informed clearly the consequences of his action that may affect him adversely.
Desiring to "benefit" the patient, the physician may strongly want to intervene believing it to be a clear
"medical benefit. <
The physician has a duty to respect the autonomous choice of the patient, as well as a duty to avoid harm
and to provide a medical benefit.
But the physician should give greater priority to the respect for patient autonomy than to the other duties.
However, at times this can be difficult because it can conflict with the paternalistic attitude of many health
care professionals.
In the case of a child, the principle of avoiding the harm of death, and the principle of providing a medical
benefit that can restore the child to health and life, would be given precedence over the autonomy of the
child's parents as surrogate decision makers.
2) Beneficence
The practitioner should act in <the best interest= of the patient - the procedure be provided with the intent of
doing good to the patient
This needs health care provider to,
o Develop and maintain skills and knowledge by continually updating training
o Consider individual circumstances of all patients
3
