Medical Ethics , Consent,Euthanasia

8/6/2019 Medical Ethics , Consent,Euthanasia

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MEDICAL ETHICS ,

CONSENT,EUTHANASIA


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MEDICAL ETHICS

Code of conduct

CHARAKAS OATH

HIPPOCRATIC OATH DECLARATION OF GENEVA


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Values in medical ethics

Autonomy- the patient has the right to refuse

or choose their treatment. (Voluntas aegroti

suprema lex.

Beneficence - a practitioner should act in the

best interest of the patient. (Salus aegroti

suprema lex.)

Non maleficence-"first, do no harm" (primum

non nocere)


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Justice- concerns the distribution of scarce

health resources, and the decision of who gets

what treatment (fairness and equality).

Dignity-the patient (and the person treating

the patient) have the right to dignity

Truthfulness & Honesty


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Code of medical ethics in india

Declaration

Duties-

uphold the dignity and honour of hisprofession.

service to humanity

No one is allowed to practice medicinewithout having proper qualification


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Maintaining good medical practice

service to humanity with full respect for the

dignity of profession and man.

Maintain the confidence of patient Try continuously to improve knowledge and

skill

Practice founded on scientific basis Cme


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Maintain medical records of in/outpatients

If required may be given to pt

Display registration number


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PROFESSIONAL MISCONDUCT

Association with unqualified persons

Advertising

Adultery Abortion (illegal)

Addiction

Alcohol


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Advertising

Direct-unusually big name plate

Notification in press- unless start of new

practice,change or resumed after shortbreak,type of practice

Indirect-freq tv appearance, use of name in

publicity materials

Canvassing- using agents


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Adultery

Should not abuse his / her position to seduce

the pt.


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Abortion

Assisting or attempting illegal abortion


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Addiction

Supply or sale of addiction forming drugs

other than on medical grounds


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Alcohol

Attending under effect of alcohol

Avoiding consult in life saving situation

Issuing false certificates

Writing prescription in secret formula

Refusing treatment on religious grounds

Talking disparagingly of colleagues


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Professional secrecy

Consent of pt to disclosure

Disclosure under order of court of law

In the interest of commuity

In criminal matters- dying declaration, rape

victim,murderer

Disclosure about servant to master

Life insurance reports


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CONSENT

It is the ethical precept that allows the patient

to make the invasion of privacy lawful

It is defined as a voluntary agreement ,compliance or permissiion

Types- implied consent: consent presumed to

be given when the pt enters the consulting

room

Expressed consent: oral or written


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Oral consent- witness

Written consent- specific procedure,special

form,witness,explanation, Rules of consent: voluntary, > 12 yr, mentally

sound, not intoxicated.


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Informed consent

Exceptions- doctrine of therapeutic privilege

doctrine of emergency

doctrine of locoparentis


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Consent and medicolegal

Sterilisation both partners consent

Pregnancy womens consent

MTP- only the womens consent

Intercourse age < 16 is considered rape

Autopsy- must

Organ transplantation-consent witnesses


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Medical negligence

Negligence is defined as want of reasonable

degree of care and skill on part of medical

practitioner in treating a pt.

Doctrine of res ipsa loquitor-the thing speakes

for itself eg : foreign bodies post surgery,

overdose,wrong site, radiation

burns,mismatched blood transfusion


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Euthanasia

Practicing euthanasia shall constitute unethical conduct.

However on specific occasion, the question of withdrawingsupporting devices to sustain cardio-pulmonary function even afterbrain death, shall be decided only by a team of doctors and notmerely by the treating physician alone.

A team of doctors shall declare withdrawal of support system. Suchteam shall consist of the doctor in charge of the patient, ChiefMedical Officer / Medical Officer in charge of the hospital and a

doctor nominated by the in-charge of the hospital from the hospitalstaff or in accordance with the provisions of the Transplantation ofHuman Organ Act, 1994.

Documents

Medical Ethics , Consent,Euthanasia