RAAFAT ABUROMMAN. MD
CONSULTANT PSYCHIATRIST
CHILD AND ADOLESCENT PSYCHIATRY
WHAT IS MEDICAL ETHICS?
Moral principles guiding healthcare decisions
Ensures patient rights, trust, and professional integrity
Example: Balancing patient autonomy with medical recommendations
HISTORICAL VIEW
The first major thinker to systematically talk about ethics was the ancient
Greek philosopher Socrates (c. 469–399 BCE). He is considered the founder of
Western ethical philosophy.
However, our knowledge of Socrates’ ideas comes mainly from his student
Plato, who wrote dialogues featuring Socratic discussions about justice, virtue,
and the good life.
After Socrates, Plato and his student Aristotle expanded on ethical theory:
Plato believed that understanding the ideal form of “good” leads to virtuous
living.
ETHICS AND LAW
Definition
Ethics: A system of moral principles that governs what is right or wrong in human
behavior. It is subjective and based on personal, societal, or cultural values.
Law: A system of rules created and enforced by governments to regulate behavior. It
is objective and written.
Source
Ethics: Comes from philosophy, religion, culture, or personal beliefs.
Law: Comes from legislation, constitutions, or legal precedents.
ETHICS AND LAW
Enforcement
Ethics: Enforced through social pressure, personal conscience, or professional codes
(like medical ethics).
Law: Enforced by the state through courts, police, and legal penalties.
Purpose
Ethics: Aims to guide individual behavior toward what is morally right.
Law: Aims to maintain order, justice, and protect rights in society.
MEDICAL DIGNITY
Medical dignity refers to the respect and value given to patients as human
beings within healthcare settings. It means recognizing each person’s worth,
privacy, and autonomy—especially when they are vulnerable due to illness or
dependency on care.
THE 4 CORE PRINCIPLES
- Autonomy: Respecting a patient’s right to make their own decisions about
their body and treatment. - Beneficence: Acting in the best interest of the patient; doing good.
- Non-maleficence: “Do no harm” — avoiding treatments or actions that
could harm the patient. - Justice: Treating patients fairly and distributing medical resources
equitably.
DOCTOR-PATIENT RELATIONSHIP
- Foundation of effective healthcare
- Key elements: – Trust – Communication – Mutual respect
- Poor Doctor Patient relationship leads to non-compliance and lawsuits
KEY ETHICAL CHALLENGES
- Informed consent conflicts
- Cultural/religious objections to treatment
- End-of-life decisions
- Resource allocation dilemmas
COMMUNICATION ESSENTIALS
- Active listening
- Empathy and clarity
- Breaking bad news sensitively
- Avoiding medical jargon
CONFIDENTIALITY AND PRIVACY
- HIPAA requirements (The Health Insurance Portability and
Accountability Act (HIPAA) of 1996 establishes federal standards
protecting sensitive health information from disclosure without patient’s
consent. The US Department of Health and Human Services issued the
HIPAA Privacy Rule to implement HIPAA requirements.) - Exceptions: – Threat to self/others – Infectious disease reporting
- Case example: HIV status disclosure
IMPROVING DOCTOR PATIENT RELATIONSHIP
- Shared decision-making model
- Cultural competence training
- Patient feedback systems
- Time management strategies