Introduction to Medical Ethics: Principles, History, and Professional Standards

Ethics

Refers to guide what humans ought to do, usually in terms of right, obligations, fairness and specific virtue.

Medical Ethics

First dates back to 1803, when English author and physician Thomas Percival published a document describing the requirements and expectations of medical professionals within medical facilities.

Hippocratic Oath

First formal code of conduct for physicians, emphasizing beneficence ('do good') and non-maleficence ('do no harm').

Nuremberg Code

Enshrined efforts to right the wrongs of German doctors working in concentration camps, signaling the beginning of modern medical ethics.

Moral Reasoning

The process of making decisions about what is right or wrong, just or unjust, in human behavior.

Deontological Ethics

Actions are morally right or wrong based on whether they follow a set of rules or duties, not based on the consequences.

Consequentialist Ethics

The morality of an action is judged solely by its consequences; the most ethical choice results in the greatest good for the greatest number.

Virtue Ethics

Morality is based on the development of good character traits (virtues) such as honesty, courage, compassion, and wisdom.

Ethics of Care

Emphasizes the importance of relationships, empathy, and caring for others in moral decision-making.

Thomas Percival

Published 'Medical Ethics' in 1803, laying the groundwork for modern professional codes.

American Medical Association

Established in 1847, adopting formal ethical guidelines for medical professionals.

Declaration of Helsinki

A set of ethical principles regarding human experimentation established in 1964.

Bioethics

A field that arose in the 1970s addressing issues like organ transplantation, reproductive rights, and end-of-life care.

Immanuel Kant

Philosopher associated with Deontological ethics, emphasizing duty-based morality.

Jeremy Bentham

Philosopher associated with Consequentialist ethics, focusing on the outcomes of actions.

John Stuart Mill

Philosopher who contributed to Consequentialist ethics, advocating for the greatest good for the greatest number.

Aristotle

Philosopher associated with Virtue Ethics, emphasizing character development.

Carol Gilligan

Philosopher associated with Ethics of Care, focusing on empathy and relationships.

Nel Noddings

Philosopher associated with Ethics of Care, emphasizing caring for others.

Ancient Foundations of Medical Ethics

Includes the Hippocratic Oath and Greek & Roman philosophy that introduced moral reasoning.

Religious Influences on Medical Ethics

Christian, Islamic, and Jewish traditions stressed compassion, service, and moral responsibility in healing.

Enlightenment Influence on Medical Ethics

Emphasis on reason and human dignity, leading to the development of natural rights and early professional medical codes.

19th to Early 20th Century Medical Ethics

Characterized by the establishment of medical associations and formal ethical guidelines.

Modern Medical Ethics

Influenced by historical codes and contemporary issues in healthcare.

Principlism

A modern bioethics approach that uses four principles: Autonomy, Beneficence, Non-Maleficence, and Justice.

Autonomy

Respecting patient's choices (e.g., allowing a patient to refuse contrast injection).

Beneficence

Acting in the patient's best interest (e.g., providing proper shielding during X-ray).

Non-Maleficence

Avoiding harm (e.g., not exposing patients to unnecessary radiation).

Justice

Fair treatment (e.g., giving equal care regardless of socioeconomic status).

Fidelity

The fifth ethical principle added by Kitchener in 1984.

Integrity

Upholding moral principles even when unobserved.

Respect

Treating patients with dignity, regardless of culture, age, or background.

Habit

A learned pattern of behavior that becomes automatic through frequent repetition.

Custom

Established and traditional ways of behaving accepted by a group or community.

Ideals

Standards of excellence or moral perfection that individuals or societies strive toward.

Etiquette

Proper and respectful behavior in social and professional settings.

Tradition

Transmission of beliefs, values, customs, and practices passed from one generation to the next.

Competence

Commitment to lifelong learning and adherence to professional standards.

Lifelong Learning

Updating knowledge through continuing education, seminars, and certifications.

Professional Standards

Following radiologic practice codes of ethics and complying with legal, institutional, and accreditation standards.

Radiation Protection Measures

Applying correct measures such as lead shielding and the ALARA principle.

Imaging Equipment Handling

Properly calibrating and handling imaging equipment.

Accurate Interpretation

Accurately interpreting and documenting results to support patient diagnosis.

Professional Image

Wearing appropriate attire and identification, communicating clearly, and demonstrating punctuality.

Accountability for Actions

Accepting responsibility for professional decisions and reporting errors or accidents immediately.

Ethical Behavior

Guided by ideals that promote trust, credibility, and ethical leadership.

Patient Privacy

Respecting a patient's privacy while positioning them for an X-ray.

Greek and roman philosophy

introduced moral reasoning, justice, and respect for human life.

Christian, Islamic, and Jewish traditions

traditions stressed compassion, service, and moral responsibility in healing

Medieval physician

followed codes influenced by religion to ensure moral medical practice

Beauchamp and Childress

1979 - identified the core principles of ethical reasoning in healthcare.

integrity

Upholding moral principles even when unobserved.

Honesty

being truthful to patients and colleagues