On August 20, 1947, in Nuremberg, Germany, 16 doctors were charged with the charge of conducting inhuman experiments on humans.
The doctors clung to the excuse that there is no international or domestic law stipulating that doctors are prohibited from conducting experiments on patients or people, no matter how outrageous and harmful experiments are.
Therefore, the court was designed with the existence of regulation or constitution for the medical profession to protect patients from corrupt doctors and protect doctors from making similar mistakes.
Therefore, the Nuremberg Code was created. It was the first list of this type that stipulated 10 principles that protect the patient and give him the right to choose, treatment or not.
With this, a new concept entered the world, which is medical ethics.
Medical ethics is an applied branch of ethics that analyzes clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict.
Medical Ethics Assist healthcare workers make the right choices and decisions while facing difficult cases because it is not always clear what the right decision is.
What are the principles of Medical ethics?
1- Autonomy:
- Competent, informed patients have the right to choose among treatment options and refuse any unwanted medication.
-The patient has the right to accept or refuse to take history and examine them while learning.
2-Beneficence:
- Act in the best interest of their patient to Prevent and remove harm.
- Balance possible benefits against the possible risk of an action
3- Confidentiality:
-Limitation of access to information discussed between the patient and the healthcare practitioners.
When it is valid to break?
Upon the patient’s request- Relatives’ health risks- Serious self-harm- Physical, sexual, or serious- emotional abuse
-Violent behavior Mental illness-
-Upon court order Infectious disease-
4-Equality and Fairness:
-Treating all patients equally regardless of their gender race, religion Fairness in the distribution of medical services.
-Fair criteria in treating victims in scarce sources.
Imagine this; a patient comes to you for a plain headache. After you excluding some of the possible causes of this case and Being the professional doctor that you are, you need to dig deeper to get a better idea of what is truly going on. You decide it's most suitable to perform a lumbar puncture!
-Doc: your head CT was negative and according to your complaint I have a couple of different concerns for you.
- Patient: oh! Okay, so what now doctor?
- Doc: I highly suggest we perform a procedure called a lumbar puncture.
- patient: a lumbar what?
- Doc: do not worry, I will thoroughly explain this to you. A lumbar puncture is a procedure where a needle is inserted between two of your vertebrae to obtain a sample of your spinal fluid. This helps us diagnose serious fungal, viral, or bacterial infections around the brain along with other conditions like bleeding and cancers involving the brain and the spinal cord.
- patient: is it dangerous? Will it hurt?
-Doc: it should not be painful as you are first given a local anesthetic. You just might feel the little sting of the local anesthetic and some pressure as the needle goes in.
-Patient: Okay, thank you for explaining this, I think I want to go through with it.
-Doc: You're welcome. Okay, since you're conscious, of the legal age and can understand what I just explained to you, I need you to sign this informed consent form so that we can perform our procedure. But first, do you in any way feel pressured to do this?
- patient: No, Doc, I am willingly doing this. Thank you.
The above scenario gives us a good idea of the elements and principles of medical informed consent. With leaning towards more and more patient-centered health care, it is important to fully grasp and practice the concept of consent. Do you know what medical professionalism is?
= I think what it means is the efficiency of doctors and their interest in patients and the impact on health care and care.
- That's good but do you know how to be professional?
= No, I do not think so.
- To be professional you should follow the CLEAR role.
= But what is it?
- Each letter expresses an abbreviation for a word
C >>> It means connect so that it's a connection between you and the patient. You must make sure to master the communication skills.
L >>> It means listening to every patient's complaint, knowing what he needs, and do not interrupt his speech.
E >>> It means explaining to the patient what he's going through and what he may face in the future and answering his questions.
A >>> it means asking to make sure the patient understands your words if he\she has any more questions.
R >>> It means reconnecting so you can end the conversation nicely, point him out after planning to another meeting, and then prepare yourself to meet another patient.
Medical professionalism has some principles such as:
1- Excellence.
2-Accountability
3-Altruism.
4-Humanitarianism.
5-Respect for Others.
6-Honor and Integrity.
