P&E 7. SDL Honesty and Integrity in Medicine and Medical Training

primum non-nocere

“first, do no harm” — must prioritize patient well-being

6 principles of medical ethics

1. Beneficence

2. Nonmaleficence

3. Autonomy

4. Justice

5. Fidelity

6. Utility

Beneficence

The belief of something done when trying to do good and benefit others

Non-malfeasance

The duty to avoid doing harm “primum non nocere”, is defined broadly as: not to kill, cause physical/emotional suffering or deprive others of beneficial things

Autonomy

means to “self-rule” suggesting a moral principle the importance of respecting others right to personal self-governance

Justice

The moral principle of treating people fairly and w/o prejudice

Fidelity

The idea of “faithfulness” in the steadfast role of the healer where one does not abandon or exploit patients and that the interest of self/third parties is not placed above the patient’s needs

Utility

The duty to act in a way that provides the greatest positive consequences and the least negative consequences

Lying

stating something that one knows, or thinks is untrue/misleading

Deception

stating something that when used in a narrow or literal definition is correct, but is intentionally used to mislead/deflect from the truth

Misrepresentation

Stating something intentionally or unintentionally that when presented in a certain context or manner is correct, but is either not completely relevant or fully transferrable/applicable to the situation at hand

Nondisclosure

not providing relevant info which bears on the situation

Veracity

devotion to the truth — “it is what you believe and commit to as a physician”

Honesty

Quality of communicating and acting truthful and with fairness as best as one is able — “how, as a physician, you display and implement truth to others ina. fair way”

Integrity

Concept of consistency, actions, values, methods, measures, principles, expectations, and outcomes. In ethics, integrity is regarded as the honesty and truthfulness or accuracy of one’s actions — “building a reputation of having good character. Doing what you say you are going to do when you said you were going to do it”

Duty

conveys a sense of moral commitment/obligation to someone or something. This commitment should result in action. It’s not a matter of passive feeling or mere recognition. Theoretically, it’s a commitment of self to fulfilment of a commitment with our consideration of own self interest — “Being available and doing your best for those who trust you as their physician to care for them”

The importance of duty in medicine and medical education

Patients are allowing you to learn on them → important to embrace patient welfare as your primary professional responsibility

Duties of a Medical Student

Always perform the duties to which you’re committed/assigned

Always respond promptly and expertly without prejudice or partiality to care for a patient

Benchmarks of Clinical Competence Used by Clinical Faculty

1. Communication

2. Professionalism & Ethics

3. The Physical Examination

4. The Oral Case Presentation

5. The Medical Write-Up

6. Clinical Reasoning

Responsibilities of a Medical Student as a contributor to the medical profession’s self-regulation in assuring honesty and integrity in student behavior

1. Communicate truthfully with patients (Secure informed consent for Tx, unless the urgency of pt’s condition demands an immediate response)

2. Respect patient privacy

3. Deal fairly and honestly with colleagues

Identify the relationship in honesty and integrity in medical school, residency, and in later medical practice

1. respect the law and medical regulations

2. work cooperatively with others who care for and abt patients

3. engage in continuing study to maintain the knowledge and skills necessary to provide high quality care for patients