Medical Ethic Presentation 5

lec:5 Medical ethics
Assist. Prof.
Dr Rukhosh H. Abdulrahim
BDS, MSc.
Medical profession and colleagues
• objectives:
• describe how medical professional should behave towards one
another.
• justify reporting unethical behavior of colleagues.
• identify the main ethical principles relating to cooperation with
others in the care of patients.
• explain how to resolve conflicts with other medical professional
providers
Medical professional and Colleagues
➢Medicine has become complex with the rapid growth in scientific

knowledge and its clinical applications.
➢Ethical issues may arise between medical professional colleagues and
with other health care.
➢Individual physicians need(Dentist) the assistance of other specialists
and skilled health professionals such as pharmacists, laboratory
technicians, hygienists, physicians, and speech therapists.
Relationships among medical professional colleagues
The following two relationships between medical professional have
generally been considered( forbidden) :
1- fee- splitting: paying or receiving any fee or any other consideration
to obtain the referral of a patient. So, fee-splitting is forbidden
2- luring(stealing) patients from colleagues( advertising): advertising by
medical professional is no longer forbidden. However various national
medical association place restriction on advertising for their members
since advertising can be used for unethical purposes.
Medical professional and colleagues
• In the relationships between physicians and other medical

professionals, they see themselves as professionals with specific
ethical responsibilities towards patients.
• As a member of medical professions, a medical professional
should treat their colleagues respectfully and work
cooperatively to maximize patient benefit.
Relationships among healthcare colleagues, teachers
and students
• Medical student should :

• grateful to their teachers.
• show high standards of ethical behavior.
• treat other students as colleagues and be prepared to offer
help when it is needed.
• also contribute fully to shared projects and duties such as
study assignments.
Relationships among medical professional
colleagues, teachers and students
Teachers have an obligation:

1- To treat their students respectfully and to serve as good role models in
dealing with patients.
2- Not to encourage or allow students to engage in unethical practices,
such as providing treatments that meet the students’ educational needs
rather than the patients’ clinical needs.
Reporting unsafe or unethical practices:
The medical professional has an obligation to report :
➢ incompetence
➢ misconduct or wrongdoing
➢ impairment
The WMA states that a medical professional shall report to the
appropriate authorities those who :
a) practice unethically.
b) practice incompetently.
c) engage in fraud or deception.
The application of this principle is not easy, and it should be a last resort
after alternatives.
Reporting unsafe or unethical practices:
• The alternatives of reporting unsafe or unethical practice are:

➢ Approach the colleague and say that you consider his or her behavior
unsafe or unethical.
➢If the matter can be resolved at that level, there may be no need to go
further.
➢If not, then it may be necessary to take the next step of informing the
disciplinary authority.
Despite the reporting wrongdoing ,the medical professional is responsible
for maintaining the good reputation of their profession.
Relationships with other medical professional
As with patients, the great important in relationship between medical
professional and their colleagues are:
1- Respect and equal treatment with coworkers.
2- Non-discrimination is passive characteristics of relationships
3- An appreciation of their skill and experience as these can contribute
to the care of patients.
4- willing to assist colleagues and maintain respect for divergence of
professional opinion
When terminate a relation ships with another
healthcare provider
• Medical professional can terminate a relationship with another

healthcare. These include :
1- Lack of confidence in the ability or integrity of the other person
2- Serious personality clashes.
Cooperation
• Cooperation is working together for common purpose or benefit.
• Dentistry is highly complex and specialized, thus requiring close cooperation
among practitioners.
• Disappearance of the belief that dentists ‘own’ their patients
• Right of patients to ask for a second opinion
Relationships between dentists and other healthcare professionals are in a state of
flux and there is some disagreement.
Cooperation
• Many other medical professional favors a team approach for patient
• Many dentists, on the other hand, feel that even if the team approach is adopted,
there must be one person in charge
• It is stated that the dentist must accept full responsibility for all treatment
undertaken, and the dentist is also responsible for the support, guidance, and
supervision of auxiliaries within the dental team
• Dentists will have to be able to justify their recommendations to others
• Communication skills, dentists will need to be able to resolve conflicts that arise
among the different participants in the care of the patient.
Conflict
• Conflict defines as: to be different , or opposed, to fail to be in an agreement.
• Ideally, medical professional decisions will reflect agreement among the
patient, physicians and all others involved in the patient’s care.
• The most factors that give rise to conflict are :
1)Uncertainty
2) diverse viewpoints
3)Limited medical professional resources
4)organizational policies.
Conflict
Types of conflict may arise

1- Disagreements among medical professional providers about
the goals of care and treatment should be clarified and
resolved by the members of the medical professional team .
2- Disagreements between medical professional providers and
administrators about the allocation of resources should be
resolved and not be debated in the presence of the patient.
• Since both types of conflicts are ethical in nature, their
resolution can benefit from the advice of a clinical ethics
committee or an ethics consultant .
Conflict resolution
The following guidelines can be useful for resolving such conflicts:
1- Conflicts should be resolved as informally as possible, e.g., through

negotiation, then moving to formal procedures .
2- The opinions of all those directly involved should be respected .
3- The informed choice of the patient should be the primary consideration in
resolving conflict or disagreement.
Conflict resolution
4- If the (conflict) is about which options the patient should be offered, a
broader rather than narrower range of options is usually preferable. The
patient should be informed if there is a limitation in resources.
5- If, after reasonable effort, agreement cannot be reached, the decision of
the person with the right or responsibility for making the decision should be
accepted.
6- If it is unclear or disputed who has the right or responsibility to make the
decision, mediation, arbitration, or judgment should be sought.
CASE STUDY
• You are a student at this university. One day in the teaching lab, you
see your fellow students putting medical equipment from the stock
room into their bag. When you ask them about it, they say they only
want to practice their clinical skills and not to tell anyone. What would
you do?

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lec:5 Medical ethics

➢Medicine has become complex with the rapid growth in scientific

• In the relationships between physicians and other medical

• Medical student should :

Teachers have an obligation:

• The alternatives of reporting unsafe or unethical practice are:

• Medical professional can terminate a relationship with another

Types of conflict may arise

1- Conflicts should be resolved as informally as possible, e.g., through

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