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Presented at the orientation of Postgraduates KAAUH on October 12, 2025 at the Main Hospital Auditorium. By: Prof. Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard), Chairman, Ethics Committee, KAAUH
Code of Ethics for Healthcare Practitioners
European Ethical Principles (Beauchamp and Childress 1994)
- Autonomy (patient decides).
- Beneficence (bring benefit).
- Non-maleficence (do no harm).
- Justice (equity vs equality).
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.
Informed Consent
- Practical expression of autonomy.
- Full disclosure about what is to be done.
- Voluntary approval.
- The right to withdraw consent.
- Types of consent: implied, oral, and written.
Ethical Consultations
- When in an ethical dilemma.
- Regulations and guidelines.
- Use principles.
- Consult the ethics committee.
Case Scenario #1
- Noticing a threefold increase in the diagnosis of late-stage colon cancer that was fatal within a year, the city council passed a resolution requiring all men and women above 40 to undergo colonoscopy screening once every 5 years, with the warning that those who refused screening would not be treated for free if they got cancer. What do you think of this? What is your moral reasoning?
Case Scenario #2
- A mentally retarded Down syndrome youth aged 15 years had been to court several times for sexual attacks on toddlers. The judge ordered the doctors to suppress his sexual aggression by the use of hormones, and if that was not effective, to remove his testes.
Case Scenario #3
- A urologist with 20 years’ experience in renal transplant refused to donate one of his kidneys to his identical twin brother, who had found no other matching kidney. The Saudi Council for Health Specialties started de-registration proceedings for failure to give benefit obligatory for all physicians.
Case Scenario #4
- A new company in Riyadh advertised on TV and in newspapers, offering direct genetic testing services. Consumers would pay for a kit using a credit card, and they would use the kit to collect a sample of blood by finger prick and send it back by mail. Results would be sent back after a week.
Case Scenario #5
- A nurse manager has just discovered that his colleague, a surgeon, is HIV+ve, but has kept the information secret and continued operating on patients, taking infection control precautions. An emergency case requiring immediate surgery is wheeled into the emergency room at midnight, and there is no other surgeon available.
Case Scenario #6
- A 90-year-old, 100% dependent on a respirator with no hope of independent life, asks the doctor to disconnect the machines so that he can die in peace, but the doctor refuses. He has no serious disease; he had become dependent on the respirator during a prolonged and poorly managed episode of pneumonia.
Case Scenario #7
- To save lives, a senior medical officer allowed surgery under unclean conditions at the site of a major natural disaster with too many patients who could not be transported to the hospital in a reasonable time.