Medical Ethics: Principles and Importance

Dr. Chandresh Tailor
Asst. Prof.
FMT, GMC,Surat
Introduction
Ethics is a science of moral values or principles.
Medical Ethics is 
moral principles
 which should
guide the members of medical profession in their
dealing with the patients, their relatives, community,
and with colleagues in profession.
The principle objective of medical profession is to
render 
service to humanity 
with full respect for
dignity of human beings.
Every doctor whatever his or her specialty, has to
discharge medicolegal responsibilities
 and to solve
medicolegal problems from the 1
st
 day of his or her
practice.
  
Everything a doctor does in a practice of medicine
is governed by legal system.
Why  study of ethics is essential?
Ignorance about medical law & ethics by young medicos
leads to 
consequence of negligent behavior,
 failure to
discharge compulsory duties towards the patient & state,
amounting to infamous conduct or negligent charges.
Members of 
general public are increasingly aware of
their rights
 due from a doctor, questioning the legality of
issues.
Doctors should also know who are the authorities
proposing these 
rules and what penalties
 one is likely to
be punished with in the event of breach of them.
Medical Ethics
The  word ethics= 
Greek term “ethikos” 
= rules of conduct that
govern natural disposition in human beings.
Deals with 
moral principles 
which should guide member of the
medical profession in their dealing with each other, their patients
and the state.
The word Moral= 
Latin term “mores” 
concerning with 
Goodness
or 
Badness
 of a human character or behavior.
Moral = sexual or social behavior and Ethics= professional
behavior.
The contemporary construction of 
 BIOETHICS 
was first well
formulated in United States in 1970 by statement of 4 principles:
 
        
contd…
 
 
1.  
Non-malfeasance
 
{
duty to Endeavour to do no harm
}
 
2
. Beneficence           { 
duty to do good, be caring, etc.
}
 
3. 
Respect to autonomy {
 duty to respect the human dignity,
 
freedom and free choice of the individual and more
 
importantly, to facilitate in every reasonably possible
 
manner  to the making of such a free choice 
}
 and
 
4. 
Natural and distributive justice  {
ensuring equal share in the
 
distribution of health care ( Equality) and priority to be
 
given to those who are in need, in proportion to their
 
need
}
  Medical Etiquette
Deals with 
conventional law of courtesy 
observed between
members of the medical profession. A doctor should behave
with his colleagues  as  he would have them behave with
himself.
Origin of Medical Ethics
Firstly it is describe by CHARAKA’s Oath in 7
th
 century
BC then
Arthashastra of KAUTILYA in 3
rd
 -5
th
 century BC
SUSHRUTA which composed SUSHRUTA SAMHITA
(200-300 AD)
MEDICAL COUNCIL Of INDIA ( founded in 1933)
formulates the modern code of medical law and ethics in
India
The Indian Medical Council
The act of 1933 was repealed and the act of 1956 was passed.
The medical council consist of following member.
1.
One member from each state
 nominated by central govt. in
consult with state govt. concerned.
2.
One member from each university 
elected from among
member of medical faculty of university, by member of the
senate or the member of court of university.
3.
One member of each state
 in which state medical register
maintained.
4.
Seven member  elected from 
among themselves by person
enrolled on any of the State Medical Registers.
5.
Eight members 
nominated by central govt.
Members of IMC
Hold office for 5 yrs. A 
president 
and 
vice-president
 are elected
from among these members.
Council also appoint  a 
Registrar 
who act as secretary & may
also act as treasurer, who look after day to day work.
Executive committee consist of president, vice president and 7
to  10  members.
The 1
st
 schedule of act contained recognized medical
qualification granted by universities in India.
The 2
nd
 schedule those granted outside India.
Part 1 of 3
rd
 schedule contained those granted by medical
institutions not included in 1
st
 schedule.
Part 2 of 3
rd
 schedule those granted outside india but not
included in 2
nd
 schedule.
Functions of Indian Medical Council
1.
Medical Register
  
Maintained medical practitioners register known as Indian medical
Register.
  
Contained name of all person enrolled in State Medical Reg.
  
If name of person removed from State Medical Reg. then it also
removed from Indian Medical Register.
2.
Medical Education
  
It prescribe standard of postgraduate medical education for guidance
of  the universities.
  
Advice univ. to maintained uniform standard for PG medical
Education throughout India.
  
A PG Committee consist of 9 members.
  
Prior  approval of IMC necessary before starting  PG course.
  
If mandatory regulation is not followed, the qualification will  not
 
be recognized by IMC.
  
The council  appoints Medical Inspector to attend at any or all
examination held by univ. Institution in India for purpose of
recommend to central govt, recognition of medical
Qualification.
The inspector   has no power to interfere with examination.
The inspector report to the council on the adequacy of
standard of medical education including 
 Staff
, 
Equipment
,
Accommodation
, 
Training
, Other facilities prescribed for
giving  Med. Education.
The council forward copy of report to medical institute/ univ.
The copy with remark of univ. sent to the central govt.
If council is not satisfied with standard, it can make a
representation to the central govt. to withdraw recognition of
medical qualification of any univ.
After considering , central govt. may send it to the concerned
state govt. for submitting  an explanation.
3.
Recognition of Foreign Medical  Qualification
  
If Indian national obtains a foreign qualification which is not
included in part 2 of 3
rd
 schedule, he can apply to the Central Govt.
 
      The candidate has to provide full information regarding course of
study, syllabus, duration of the course, etc. This is forwarded to IMC
which has authority to enter into negotiation with any of the Medical
Council of the Foreign Authority and can recognize such foreign
qualification on reciprocal basis.
  
The central govt may by notification in Official Gazette, amend
the part 2 of 3
rd
 schedule so as to include such qualification therein.
4.
Appeal Against Disciplinary Action
  
If the name of any person is removed from the State Medical
Register, he may appeal to the Central Govt, after exhausting all
remedies in State Medical Council Act.
5.
 
Recommend Central Govt
 for amendment, change or introduction
of new rules & regulation for teaching, modalities in teaching,
training, examinations, and services in teaching  & training insti.
5.
Warning Notice
  
The council may prescribe Standard of professional
conduct and etiquette and code of ethics for medical
practitioners.
  
It can issue Warning Notice containing certain practices
which are regarded as falling within the meaning term,
      
Serious Professional Misconduct.”
State Medical Council
Medical teachers from different universities of the State
elected by the teachers of the different medical institution.
Consist of members elected by the registered medical
practitioners .
Some members nominated by the State Governments.
Functions of State Medical Council
1.
Medical Register
   
It appoints  a Registrar, keeps Register of medical
practitioners.
   
Any person having any recognized medical
qualification can get his or her name entered.
   
The name, residence, qualification and the date
on which each qualification was granted of every person
who is registered under this act are entered in the Register
on payment of prescribed fees.
   
After passing the qualifying examination it is
necessary to undergo a period of training, before
qualification was granted to him.
   
First provisional registration is given so they can
practice medicine in approved institution for the required
period.
2.
Disciplinary Control
   
They have power to remove the names of medical
practitioner permanently or for a specific period due to
Serious Professional Misconduct. 
 
   
Also authorized for restoration of name so
removed.
3.
Warning Notice
   
Also issue warning notice similar to IMC
Disciplinary function of SMC
Erasure of Name
  
The name of doctor is removed from the Medical Register:
 
1. After the death of the registered practitioner.
 
2. Entry which are made in error or as a result of fraud.
 
3. 
Penal Erasure
.
  
Due to Serious Professional   Misconduct the name of
doctor is removed from Medical Register for temporary or
permanent period.
  
when name of doctor is removed from Medical Register
permanently then it is known as 
“The Professional Death
Sentence”. 
It deprives the practitioner of all the privilege of a
registered practitioner.
Serious Professional Misconduct ( Infamous Conduct)
  
Any conduct of a doctor which might reasonably be
regarded as disgraceful  or dishonorable. It involves an abuse of
professional position.
 
Warning Notice
Warning Notice
 
  
If any one is found guilty of any of the following  offences
mentioned in the warning notice issued by Medical Council of India,
his name can be removed from the Medical Register.
1.
Adultery
2.
Improper conduct with the patient or with member of pt. family.
3.
Conviction by court of law for offence involving moral turpitude.
4.
Issuing a false certificate in connection with sick benefit, insurance,
passport, attendance in court, public service, etc.
5.
Withholding  information of notifiable disease to health authority.
6.
Performing or enabling unqualified person to perform abortion.
7.
Prescribing steroids/psychotropic drugs when no indication.
8.
Not displaying the registration no. given to him in clinic,
prescription and certificate etc. issued by him.
9.
Dichotomy 
or fee splitting.( receiving or giving commission)
10.
Using of touts or agents for procuring patients.
  
Contd…
 
11.  
Disclosing secrets of the patient.
12. 
Covering, i.e. assisting someone who has no medical qualification to
attend, treat or perform an operation on some person.
13. 
Write prescription in private formulae of which only he or a
pharmacy has a key.
14.  
Advertising
15. 
Running an open shop for sale of medicines, for dispensing
prescription of other doctors.
16. 
 
Drunk
 
and disorderly so interfere with proper skilled practice.
17.  
Having involvement in physical or mental torture to other person
18.  
Doing sex determination test.
19.  
Failure to obtain consent of both husband and wife in an operation
which may result in sterility.
20. 
Failure to obtain consent of the female pt.,her husband and donor
in act of in vitro fertilization.
21.  
Violation of ICMR guidelines.
Professional Misconduct -- ADVERTISING
Doctor’s name plate,
signboard(large) with consultancy
rates, lab test rate, medicine rates
displayed in heart of city area
Notification in Lay Press
 Professional Misconduct
Canvassing: Use of touts or
agents for procuring patients
Supplying or selling drugs of
Addiction
Seducing a female Patient
Attending patient while on
Alcohol
 Professional Misconduct
Issuing a False Certificate
Dichotomy
 Professional Misconduct
 Professional Misconduct
Talking
Disparaginingly
of
a
Colleague
Hippocratic Oath
The modernised version of the Hippocratic oath are
the Declaration of Geneva, as  adopted by the 3
rd
General Assembly of World Medical Association at
Geneva, Switzerland, in September,1948, (amended
in 1983), and the International  Code of Medical
Ethics, as adopted by 
the General Assembly of the
World Medical Association held in London , in
October, 1948
.
The Declaration of Geneva
 
At the time of Registration, each applicant shall be given a
copy of the following declaration by the Registrar concerned
an d the applicant shall read and agree to abide by the same.
 
1.
I solemnly pledge myself to consecrate 
my life to the
service of Humanity.
2.
I will maintain the  utmost 
respect for human life
 
from
the time of conception.  Even under threat, I will not use
my medical knowledge contrary to the law of humanity.
3.
I will not permit 
consideration of religion, nationality,
race, party politics or social  standing 
to intervene
between my duty and my patient.
 
4.
I will practice my profession with 
conscience and
dignity.
5.
The 
health of my patient 
 will be my first
consideration.
6.
I will 
respect  the secrets 
 which are confided in me.
7.
I will 
give to my teachers the respect
 and gratitude
which is their due.
8.
I will maintain by all the means in 
my power, the
honour and noble traditions
 of the medical profession.
9.
I will 
treat my colleagues with all respect
 
and dignity.
10.
I shall 
abide  by the Code of Medical ethics
 
as
enumerated in the Indian Medical Council  Regulation,
2002.
   
I make these promises solemnly, freely and
upon my honour.
 
 
Thank you
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Ethics in medicine is vital for guiding healthcare professionals in their interactions with patients, colleagues, and society. It encompasses moral values, legal responsibilities, and principles such as non-malfeasance, beneficence, autonomy, and justice. Ignorance of medical ethics can lead to negligent behavior and legal consequences, highlighting the significance of ethical awareness in the practice of medicine.

  • Medical Ethics
  • Healthcare
  • Principles
  • Importance
  • Responsibilities

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  1. Dr. Chandresh Tailor Asst. Prof. FMT, GMC,Surat

  2. Introduction Ethics is a scienceof moral valuesor principles. Medical Ethics is moral principles which should guide the members of medical profession in their dealing with the patients, their relatives, community, and with colleagues in profession. The principle objective of medical profession is to render service to humanity with full respect for dignity of human beings. Every doctor whatever his or her specialty, has to discharge medicolegal responsibilities and to solve medicolegal problems from the 1stday of his or her practice. Everything a doctor does in a practice of medicine is governed by legal system.

  3. Why study of ethics is essential? Ignorance about medical law & ethics by young medicos leads to consequence of negligent behavior, failure to discharge compulsory duties towards the patient & state, amounting to infamousconductor negligentcharges. Members of general public are increasingly aware of their rights due from a doctor, questioning the legality of issues. Doctors should also know who are the authorities proposing these rules and what penalties one is likely to be punished with in the eventof breach of them.

  4. Medical Ethics The word ethics= Greek term ethikos = rules of conduct that govern natural disposition in human beings. Deals with moral principles which should guide member of the medical profession in their dealing with each other, their patients and the state. The word Moral= Latin term mores concerning with Goodness or Badnessof a human characteror behavior. Moral = sexual or social behavior and Ethics= professional behavior. The contemporary construction of formulated in United States in 1970 by statementof 4 principles: BIOETHICS was first well contd

  5. 1. Non-malfeasance {duty to Endeavour todo no harm} 2. Beneficence { duty todo good, be caring, etc.} 3. Respect to autonomy { duty to respect the human dignity, freedom and free choice of the individual and more importantly, to facilitate in every reasonably possible manner to the making of such a free choice } and 4. Natural and distributive justice {ensuring equal share in the distribution of health care ( Equality) and priority to be given to those who are in need, in proportion to their need} Medical Etiquette Deals with conventional law of courtesy observed between members of the medical profession. A doctor should behave with his colleagues as he would have them behave with himself.

  6. Origin of Medical Ethics Firstly it is describe by CHARAKA s Oath in 7thcentury BC then Arthashastraof KAUTILYA in 3rd-5thcentury BC SUSHRUTA which composed SUSHRUTA SAMHITA (200-300 AD) MEDICAL COUNCIL Of INDIA ( founded in 1933) formulates the modern code of medical law and ethics in India

  7. The Indian Medical Council The act of 1933 was repealed and the act of 1956 was passed. The medical council consist of following member. One member from each state nominated by central govt. in consult with state govt. concerned. One member from each university elected from among member of medical faculty of university, by member of the senate or the member of court of university. One member of each state in which state medical register maintained. Seven member elected from among themselves by person enrolled on any of the State Medical Registers. Eight members nominated by central govt. 1. 2. 3. 4. 5.

  8. Members of IMC

  9. Hold office for 5 yrs. A president and vice-president are elected from among these members. Council also appoint a Registrar who act as secretary & may also act as treasurer, who look afterday to daywork. Executive committee consist of president, vice president and 7 to 10 members. The 1st schedule of act contained recognized medical qualification granted by universities in India. The 2ndschedule those granted outside India. Part 1 of 3rdschedule contained those granted by medical institutions not included in 1stschedule. Part 2 of 3rdschedule those granted outside india but not included in 2ndschedule.

  10. Functions of Indian Medical Council Medical Register Maintained medical practitioners register known as Indian medical Register. Contained nameof all person enrolled in State Medical Reg. If name of person removed from State Medical Reg. then it also removed from Indian Medical Register. 1. Medical Education It prescribe standard of postgraduate medical education forguidance of the universities. Advice univ. to maintained uniform standard for PG medical Education throughout India. A PG Committeeconsistof 9 members. Prior approval of IMC necessary beforestarting PG course. If mandatory regulation is not followed, thequalification will not be recognized by IMC. 2.

  11. The council appoints Medical Inspector to attend at any or all examination held by univ. Institution in India for purpose of recommend to central govt, Qualification. The inspector has no power to interferewith examination. The inspector report to the council on the adequacy of standard of medical education including Accommodation, Training, Other facilities prescribed for giving Med. Education. The council forward copyof report to medical institute/ univ. The copywith remark of univ. sent to thecentral govt. If council is not satisfied with standard, it can make a representation to the central govt. to withdraw recognition of medical qualification of any univ. After considering , central govt. may send it to the concerned state govt. forsubmitting an explanation. recognition of medical Staff, Equipment,

  12. Recognition of Foreign Medical Qualification If Indian national obtains a foreign qualification which is not included in part 2 of 3rdschedule, he can apply to the Central Govt. The candidate has to provide full information regarding course of study, syllabus, duration of the course, etc. This is forwarded to IMC which has authority to enter into negotiation with any of the Medical Council of the Foreign Authority and can recognize such foreign qualification on reciprocal basis. The central govt may by notification in Official Gazette, amend the part 2 of 3rdschedule so as to include such qualification therein. 4. Appeal Against Disciplinary Action If the name of any person is removed from the State Medical Register, he may appeal to the Central Govt, after exhausting all remedies in State Medical Council Act. 5. Recommend Central Govt for amendment, change or introduction of new rules & regulation for teaching, modalities in teaching, training, examinations, and services in teaching & training insti. 3.

  13. 5. Warning Notice The council may prescribe Standard of professional conduct and etiquette and code of ethics for medical practitioners. It can issue Warning Notice containing certain practices which are regarded as falling within the meaning term, Serious Professional Misconduct.

  14. State Medical Council Medical teachers from different universities of the State elected by the teachers of the different medical institution. Consist of members elected by the registered medical practitioners . Some members nominated by the State Governments.

  15. Functions of State Medical Council 1. Medical Register It appoints a Registrar, keeps Register of medical practitioners. Any person having any recognized medical qualification can get his or her nameentered. The name, residence, qualification and the date on which each qualification was granted of every person who is registered under this act are entered in the Register on payment of prescribed fees. After passing the qualifying examination it is necessary to undergo a period qualification was granted to him. First provisional registration is given so they can practice medicine in approved institution for the required period. of training, before

  16. 2. Disciplinary Control They have power to remove the names of medical practitioner permanently or for a specific period due to Serious Professional Misconduct. Also authorized for restoration removed. 3. Warning Notice Also issue warning notice similar to IMC of name so

  17. Disciplinary function of SMC

  18. Erasure of Name The name of doctor is removed from the Medical Register: 1. Afterthe death of the registered practitioner. 2. Entrywhich are made in errororas a result of fraud. 3. Penal Erasure. Due to Serious Professional doctor is removed from Medical Register for temporary or permanent period. when name of doctor is removed from Medical Register permanently then it is known as The Professional Death Sentence . It deprives the practitioner of all the privilege of a registered practitioner. Serious Professional Misconduct ( Infamous Conduct) Any conduct of a doctor which might reasonably be regarded as disgraceful or dishonorable. It involves an abuse of professional position. Misconduct the name of

  19. Warning Notice Warning Notice

  20. Warning Notice If any one is found guilty of any of the following mentioned in the warning notice issued by Medical Council of India, his namecan be removed from the Medical Register. Adultery Improperconduct with the patientorwith memberof pt. family. Conviction by court of law foroffence involving moral turpitude. 4. Issuing a false certificate in connection with sick benefit, insurance, passport, attendance in court, public service, etc. Withholding informationof notifiabledisease to health authority. 6. Performing orenabling unqualified person to perform abortion. Prescribing steroids/psychotropic drugs when no indication. 8. Not displaying the registration no. given to him in clinic, prescription and certificate etc. issued by him. 9. Dichotomy or fee splitting.( receiving orgiving commission) 10. Using of touts oragents forprocuring patients. offences 1. 2. 3. 5. 7. Contd

  21. 11. Disclosing secrets of the patient. 12. Covering, i.e. assisting someone who has no medical qualification to attend, treator performan operation on some person. 13. Write prescription in private formulae of which only he or a pharmacy has a key. 14. Advertising 15. Running an open shop for sale of medicines, for dispensing prescription of otherdoctors. 16. Drunk and disorderly so interferewith properskilled practice. 17. Having involvement in physical or mental torture to otherperson 18. Doing sex determination test. 19. Failure to obtain consent of both husband and wife in an operation which may result in sterility. 20. Failure to obtain consent of the female pt.,her husband and donor in actof in vitro fertilization. 21. Violation of ICMR guidelines.

  22. Professional Misconduct -- ADVERTISING Doctor s name plate, signboard(large) with consultancy rates, lab test rate, medicine rates displayed in heart of city area Notification in Lay Press

  23. Professional Misconduct Canvassing: Use of touts or agents for procuring patients Supplying or selling drugs of Addiction

  24. Professional Misconduct Attending patient while on Alcohol Seducing a female Patient

  25. Professional Misconduct Issuing a False Certificate Dichotomy

  26. Professional Misconduct Talking Disparaginingly of a Colleague

  27. Hippocratic Oath The modernised version of the Hippocratic oath are the Declaration of Geneva, as adopted by the 3rd General Assembly of World Medical Association at Geneva, Switzerland, in September,1948, (amended in 1983), and the International Code of Medical Ethics, as adopted by the General Assembly of the World Medical Association held in London , in October, 1948.

  28. The Declaration of Geneva At the time of Registration, each applicant shall be given a copy of the following declaration by the Registrar concerned an d the applicant shall read and agree to abide by the same. I solemnly pledge myself to consecrate my life to the service of Humanity. I will maintain the utmost respect for human life from the time of conception. Even under threat, I will not use my medical knowledge contrary to the law of humanity. I will not permit consideration of religion, nationality, race, party politics or social standing to intervene between my duty and my patient. 1. 2. 3.

  29. 4. I will practice my profession with conscience and dignity. 5. The health of my patient consideration. 6. I will respect the secrets which are confided in me. 7. I will give to my teachers the respect and gratitude which is their due. 8. I will maintain by all the means in my power, the honour and noble traditions of the medical profession. 9. I will treat my colleagues with all respect and dignity. 10. I shall abide by the Code of Medical ethics as enumerated in the Indian Medical Council Regulation, 2002. I make these promises solemnly, freely and upon my honour. will be my first

  30. Thank you

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