Ethics and Integrity in Medicine: A Comprehensive Overview
Explore the ethical principles, moral excellence, and ethical approaches in the field of medicine. Delve into the importance of upholding professional conduct, maintaining integrity, and adhering to ethical codes such as the WMA International Code of Medical Ethics. Learn about the significance of virtue and the ethical responsibilities of healthcare professionals in providing compassionate and competent medical care while upholding moral values and respecting human dignity.
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University of Split School of Medicine Ethics Mario Mali ki
MORAL principle of conduct good vs. bad "reaction
Virtue moral excellence A virtuous doctor is a good doctor Morality has exceptions the LAW does not Human behavior attempt to preserve consistency between image of self and ones actions There is a difference between moral expert and moral superiority
Ethical approaches: 1. Metaethics 2. Normative ethics 3. Applied ethics
Deontology duty (normative ethics)
WMA International Code of Medical Ethics always exercise his/her independent professional judgment and maintain the highest standards of professional conduct. respect a competent patient's right to accept or refuse treatment. not allow his/her judgment to be influenced by personal profit or unfair discrimination. be dedicated to providing competent medical service in full professional and moral independence, with compassion and respect for human dignity. deal honestly with patients and colleagues, and report to the appropriate authorities those physicians who practice unethically or incompetently or who engage in fraud or deception. not receive any financial benefits or other incentives solely for referring patients or prescribing specific products. recognize his/her important role in educating the public but should use due caution in divulging discoveries or new techniques or treatment through non-professional channels. respect the local and national codes of ethics. A physican shall:
KODEKS MEDICINSKE ETIKE I DEONTOLOGIJE 10. lipnja 2006. Hrvatska lije ni ka komora
School of Medicine all types of plagiarism, falsification and other ways of breaking the academic integrity attending the educational process under the influence of alcohol or narcotics deliberately disturbing or interrupting lectures, research or other academic activities cheating with the usage or intention of usage of notes and data during exams, except if explicitly allowed helping other students during knowledge assessment if student is expected to solve the problem alone intentional misrepresentation of somebody else s work as one s own abuse of information systems, technological equipment, email, or internet-based programs for intolerable purposes any kind of assault, maltreatment, disruption, blackmail, threat, harassment, degradation, intimidation, mocking, insulting and similar.
Croatian Laws Physican s Act Health Care Act Act on Protection of Population from Infectious Diseases Blood and Blood Products Act Medically Assisted Fertilization Act Sex Change Act Rules for Examination of the Dead and Establishing the Cause of Death
Trolley problem Phillipa Foot 1967 The New York Times; Illustration by Frank O Connell
Solving dillemas Irrational approaches : obedience imitation feelings intuition habit
Rational approaches Deontology Consequentialism (Utilitarianism) Virtue ethics Principalism
BIOETHICAL PRINCIPLES (Beauchamp and Childress) 1. Autonomy - respect the right of individuals 2. Non maleficence - avoid causing harm 3. Beneficence - help others 4. Justice - fair distribution
Autonomy competent patient's right to accept or refuse treatment
Non maleficence Do no harm
Beneficence Doing best for the patient
Justice cost effectiveness and fair distribution
Lawrence Kohlberg's stages of moral development Level 1 (Pre-Conventional) 3-7 y 1. Obedience and punishment 2. Self-interest orientation Level 2 (Conventional) highschool 3. Interpersonal conformity 4. Authority and social-order Level 3 (Post-Conventional) college 5. Social contract orientation 6. Universal ethical principles I would cheat if I knew I wouldn't get caught I ll let you copy my work, if you give me something in return I wont do it, cause I wont her to like me You cant do it as teacher said no There may be an exception to the rule You shouldn't lie as it violates the principle
Hamlin Social evaluation by preverbal infants 2007 helpers and hinderes
Kanakogi 2013 - Rudimentary Sympathy in Preverbal Infants
Warneken 2006-7 Altruistic helping in human infants and young chimpanzees
Cruelty in animals chimpanzee civil war - Kibale national park in Uganda Tanzaina's Gombe Stream national park split to two tribes
Immanuel Kant -"Perpetual Peace" 1795 democracy, trade and an international community are pacifying forces Bruce Russett and John Oneal. 2001. Triangulating Peace Steven Pinker The surprising decline of violence
Lawrence Kohlberg's stages of moral development Level 1 (Pre-Conventional) 3-7 y 1. Obedience and punishment 2. Self-interest orientation Level 2 (Conventional) highschool 3. Interpersonal conformity 4. Authority and social-order Level 3 (Post-Conventional) college 5. Social contract orientation 6. Universal ethical principles I would cheat if I knew I wouldn't get caught I ll let you copy my work, if you give me something in return I wont do it, cause I wont her to like me You cant do it as teacher said no There may be an exception to the rule You shouldn't lie as it violates the principle
Thorndike 1930s How much would you have to be paid to undergo the following experiences? 1. to have one upper front tooth pulled out? 2. to have one little toe cutoff? 3. to eat a live earthworm six inches long? 4. to live the rest of your life on a farm in Kansas? 5. to choke a stray cat to death with your bare hands?
Utilitarianism revisited 1. 74 000 $ 2. 4,500 $ 3. 100,000 $ 4. 300 000 $ 5. 164 000 $
Reason is weaker then situation David Hume 1738: Reason is, and ought only to be the slave of the passions, and can never pretend to any other office than to serve and obey them. Stanely Milgram experiment 1961 -1963
The bystander effect blog.lib.umn.edu
Disgust as Embodied Moral Judgment fart spray experisments (2005; 2008): legalization of marriage between first cousins (Marriage), approval of sex between first cousins (Sex), moral judgments of driving rather than walking to work (Driving), and approval of a studio s decision to release a morally controversial film (Film). abortion, pornography, premarital seks, homosexual relationship or sex
Moral Universals/Foundations theory Johnathan Haidt Care/harm Fairness/cheating Reciprocity - The Golden Rule, Liberty/oppression Loyalty/betrayal - Ingroup community Authority/subversion - hierarchy Sanctity/degradation - Purity sex, food,
Trolley problem Phillipa Foot 1967 The New York Times; Illustration by Frank O Connell
SOLVING MORAL DILEMMAS Consequentialism - Utilitarianism based on outcome or result. Deontology rules Casuistry according to known cases and solutions Virtue ethics internal motif for action Ethics of care interdependence, relationships and empathy
Physician Payment Sunshine Act Charitable contribution Royalty or license Grant Compensation for services other than consulting Current or prospective ownership or investment interest Consulting fees Honoraria Gift Entertainment Food Travel Education Research
Bristol-Myers Squibb JITENDRA GANDHI Company $270717,70 PATRICIA LORUSSO Eli Lilly and Company $115103,17 DONALD ANDERSON Forest Laboratories, Inc. $75848,00 LAURA CHOW Eli Lilly and Company $60865,00 Janssen Research & MEENAKSHI PATEL Development, LLC $55872,94 MISAL KHAN Daiichi Sankyo Inc. $55866,00 DONALD ANDERSON Forest Laboratories, Inc. $55290,00 MARTIN ROCHE DePuy Synthes Sales Inc. $54490,00 ARAKEL DAVTIAN Forest Laboratories, Inc. $51352,25 THOMAS SHIOVITZ Forest Laboratories, Inc. $45842,25
