MEDICAL ETHICS

Medical ethics
A system of moral principals that apply values and
judgments to the practice of medicine
Help the doctor to decide what is morally right

Why it is necessary in medicine?

Doctors are dealing with lives of patients
They have the power to cure as well as the power to kill
Ensure highest care to community
Prevent doctors abusing trust and power

Basic principles of medical ethics.

Respect for autonomy
respect the patients ability to take decisions on behalf
of themselves
Beneficence
do good
Non-maleficence
do no harm
Justice
treat equitably and distribute benefits fairly

Evolution of Medical
Ethics

Pre Hippocratic era

Hippocratic era
World War II

Pre-Hippocratic Era
Hindu principles of respect for all life and the virtues
of honesty, generosity, and hospitality provided a
firm ethical foundation for medical practice.
Male doctors were unable to touch female patients according to
examination protocol and hence did not perform obstetrics in
ancient Korea
Mesopotamian and Egyptian society, women healers practiced
medicine. They provided care based on the belief that health was
associated with correct living, being at peace with the gods, spirits
and the dead; illness was a matter of imbalance which could be
restored to equilibrium by supplication, spells, magic, empirical
practices and rituals.
In middle eastern countries physicians believed that they should
practice for the love of mankind but also accept appropriate
fame and rewards.

 In India Caraka Samhita had an oath of initiation similar to

the Hippocratic Oath, but there were some differences : A
pupil in Ayurvedic medicine had to vow to be celibate, to
speak the truth, to adhere to a vegetarian diet, to be free of
envy, and never to carry weapons. He was to obey his
master and pledge himself to the relief of his patients, never
abandoning or taking sexual advantage of them. He was not
to treat enemies of the king or
wicked people, and had to desist
from treating women unattended by
their husbands or guardians. The
student had to visit the patients
home properly chaperoned, and
respect the confidentiality of all
privileged information pertaining
to the patient and his or her household

Hippocratic Era
shift the focus from class-based medical care to selfless
service of individual patients.
He introduced the friendly, sympathetic, pleasing and painless
treatment of patients into medical practice
use his knowledge and craft in a pure and holy way to
succour his patients and keep them from harm and injustice.
The prohibitions against euthanasia, abortion, cutting for
stone, sexual misconduct and breaking patient confidentiality
signal the types of problems that practitioners faced.
They also indicate the behaviour that was expected of a
student of the art of Hippocratic medicine and his
commitment to personal and professional good conduct.

World War II

The Nazi physicians performed brutal

medical experiments upon helpless
concentration camp inmates. These
acts of torture were characterized by
several shocking features: (1) persons
were forced to become subjects in
very dangerous studies against their
will; (2) nearly all subjects endured
incredible suffering, mutilation, and
indescribable pain; and (3) the
experiments often were deliberately
designed to terminate in a fatal
outcome for their victims.

High Altitude
Experiments: Dissect
several of the victims'
brains, while they were
still alive, to
demonstrate that high
altitude sickness
Sulfanilamide Experiments:
Wartime wounds were recreated and
inflicted on healthy Jews designated to
be treated by the new drug.

Freezing Experiments:
Prisoners were immersed
into tanks of ice water

Tuberculosis Experiments:
Injected live tubercle bacilli into the
subjects' lungs to immunize against
TB
Sea Water Experiments: given
unaltered sea water and sea water
whose taste was camouflaged as their
sole source of fluid.

Medical ethics today

The Hippocratic Oath was modernized in 1948 and was
named the declaration of Geneva. It was further
amended in Sydney in 1968 and Stockholm in 1994.
This provides the basis for The International Code of
Medical Ethics(ICME).
The ICME describes medical ethics in terms of duties of
physician in general, duties of physicians to patients
and duties of physicians to colleagues.

New concepts
Bioethics
Deals with typically controversial ethical issues emerging
from new situations arising due to advances in
medicine.