150406P - INTRODUCTION: THEORY AND PRINCIPLES OF ETHICS

Presentation at a training program at ARAMCO ‘Applying the Principles of Ethics to Clinical Practice:’ April 6, 2015  by Professor Omar Hasan Kasule Sr. MB ChB (MUK). MPH (Harvard), DrPH (Harvard) Chairman of the Ethics Committee King Fahad Medical City.

European ethical theories

·        Utilitarian consequence-based theory (balance of good and bad)

·        Obligation-based theory (moral obligations)

·        Rights-based theory based on respect for human rights (individual rights)

·        Community-based theory (community decides)

·        Relation-based theory (family and physician-patient relations)

·        Case-based theory (practical case by case decision)

European ethical principles (Beauchamp and Childress 1994))

·        Autonomy (patient decides)

·        Beneficence (bring benefit)

·        Non maleficence (do no harm)

·        Justice (equity vs equality)

 

Alternative ethical theory (purposes of medicine)

·        Protection of Morality, hifdh al ddiin

·        Protection of Life, hifdh al nafs

·        Protection of Progeny, hifdh al nasl

·        Protection of the Mind, hifdh al ‘aql

·        Protection of Wealth / resources, hifdh al maal

Alternative ethical principles (principles of medicine)

·        The Principle of Intention (actions are judged by the intentions behind them), qasd

·                                                                                                                                      The Principle of Certainty (no action is taken in extreme uncertainty), yaqiin

·        The Principle of Injury (medical intervention should cause no injury), dharar

·        Principle of Hardship (in case of difficulty the usual legal restrictions are relaxed), mashaqqat

·        The Principle of Custom or Precedent (follow usual procedures unless there is evidence to the contrary), urf

Disclosure and truthfulness

·        Obligation to Tell the Truth (doctors should not lie to patients)

·        What is Disclosed (full disclosure unless there is a valid reason)

·        Partial Disclosure and White or Technical Lies

·        Disclosures to Others about the Patient (not generally allowed without patient consent)

·        Giving Bad News

Privacy and confidentiality

·        Privacy

·        Confidentiality

·        Medical Records

·        Release of Confidential Information

Fidelity

·        Definition of Fidelity

·        Conflicts Regarding Fidelity