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Presentation at Course on Principles of Human, Health and Research Ethics at KFMC on 23 February 2020 by Professor Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Faculty of Medicine, King Fahad Medical City
PHYSICIAN’S ROLES IN THE HOSPITALS
• Healer
• Collaborator
• Manager
• Researcher
PHYSICIAN’S ROLES IN THE MEDICAL COLLEGE
• Medical College
• Educator
• Researcher
• Manager
PHYSICIAN’S ROLE IN THE MINISTRY OF HEALTH
• Manager
• Planner
• Researcher
PHYSICIAN’S ROLE IN THE COMMUNITY
• Health Educator
• Advocate
• Researcher
• Healer
DOCTOR’S PROFESSIONAL DUTIES
• Medical Professional
• Scholar
• Health Advocate
• Manager
• Collaborator
• Communicator
DOCTOR’S DUTY TO THE PROFESSION - 1
• Respect the honor of the profession.
• Develop him/herself to develop the profession.
• Adhere to the standards of practice.
• Abstain from any behavior/action that would question his/her credibility, or establish dishonest affairs with patients or their families.
• Avoid the request for fame on account of professional ethics and standards.
DOCTOR’S DUTY TO THE PROFESSION - 2
• To provide a role model for his colleagues and patients.
• Reflect sincere devotion and dedication to the medical profession.
• Avoid any action that could lead to contempt of the medical profession and to maintain the standards of the medical profession.
DOCTOR’S DUTY TO THE PROFESSION - 3
• The physician should not take advantage of his professional position for obtaining any material or moral gains, which are not in conformity with or violate the laws and tradition.
• Take the appropriate action when he comes to know that one of the members of the health team is sick, ignorant, or negligent of his duties; in furtherance of protecting the patient in the first place and the medical profession next.
• The physician should refrain, when dealing with the patient, from any act or conduct that would infringe his honesty and integrity.
DOCTOR’S DUTY TO THE PATIENT - 1
• Treat your patient as a person, not just a body.
• Respect your patient’s autonomy { XE “autonomy” }
• Treat all patients equally, without discrimination.
• Fear God when dealing with your patients; show respect for their beliefs, religions, and traditions.
• Ask only for the tests needed for the patient without adding any tests not justified by the patient’s case. A doctor should base his whole diagnosis and treatment on the best available evidence and data.
DOCTOR’S DUTY TO THE PATIENT - 2
• Explain honestly to the patient or anyone representing him/her the type, causes, and complications of the illness, and of the usefulness of diagnostic and therapeutic procedures.
• Relieve the patient’s pain and give him the feeling that the physician is eager to give him proper care and attention.
• Respect for Privacy.
• Respect for patient’s autonomy { XE “autonomy” }
• Inform the patient about his/her condition.
• Keep the patients’ secrets (confidentiality).
DOCTOR’S DUTY TO THE PATIENT - 3
• DO NOT hesitate to refer the patient to a more experienced doctor or to a doctor who has more effective equipment whenever the patient’s case calls for such a referral, nor to refer him to a doctor whom the patient wishes to consult.
• Continue to give an emergency patient the proper treatment until it is no longer needed or until care for the patient is taken over by another doctor.
DOCTOR’S DUTY TOWARDS COLLEAGUES
• To deal with, and act towards his/her colleagues in a good manner and in the same way he/she would prefer to be treated.
• To avoid direct criticism to his/her colleague in front of patients.
• Not to indulge in defaming the honor of his/her colleagues.
• To exert every possible effort to educate colleagues.
• Respect the differences with colleagues (gender, culture, belief…).
• The physician should respect another non-physician medical professional colleagues, and appreciate their roles in the healthcare of the patient.
• He/she must report the incidence in which a colleague could be dangerous to the authority concerned.
CASE SCENARIO - 1
The Ministry of Health issued a new policy that all doctors in its hospitals must be engaged in research and that research would be included in professional performance evaluation. There was great protection by physicians who said they hardly had enough time for their patients where would they find the time to do research? How would you solve this problem?
CASE SCENARIO - 2
The hospital manager disciplined a physician who was 2 hours late for his cardiac follow-up clinic because he was in a community program on the prevention of cardiovascular disease. What do you think about this? What principles will you use?
CASE SCENARIO - 3
The hospital director wanted to discipline a doctor who refused to treat a patient with chronic bronchitis and had refused to give up smoking with the result that he had to come to the emergency room 2 or 3 times a week.
NOTE:
* The text was reproduced from Ghaiath MA Hussein Module 3 Doctor’s professional relationships and duties in Professionalism and ethical education for residents (PEER) handbook published by SCHS 2014. The case scenarios are from the author