Presentation at a medical ethics course held at the
Security Forces Hospital Riyadh May 14, 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