rights and duties ildikó bán m.d. 2007.. medical ethics & law ethical codex common ethical...

RIGHTS AND DUTIESRIGHTS AND DUTIESRIGHTS AND DUTIESRIGHTS AND DUTIES

Ildikó Bán M.D.Ildikó Bán M.D.2007.2007.

MEDICAL ETHICS & LAW

Ethical CodexCommon ethical

normas/principles• doctor-patient• doctor-doctor• research• doctor-society• doctor as a teacherEthical committee

The LawPrecepts/regulationsMedical responsibiltyHighly dangerous action

(physical, mental well being, health, life)

Medical malpractice Indictable, punishableCriminal/civil right

legal action/lawsuit

ETHICAL PRINCIPLES1. AUTONOMY

1. self determination (thinking, will, action)2. informed consent

2. „DO NOT HARM”1. risk&benefit2. minimaze the danger

3. BENEFICENCE1. what is good for the patient

4. RIGHTFULL/FAIR1. equal medical attendance2. no discrimination(age, sex, colour, education, prejudice..)3. capability

5. RESPONSIBILITY OF PATIENT6. DOCTOR-DOCTOR/STAFF RELATION

1. mutual respect, appreciation2. professional honour

obligatory

Can be donebeyond your range

Your limitsContinous learningOther regulations

THE LAW

• Legal, codified relation between doctor and patient

• Provision=the medical attendace» Prevention» Early diagnosis» Therapy» Follw up» Rehabilitation» Processing medical records

DOCTOR’S SIDE

DUTY FOR GIVING MEDICAL ATTENDANCE

• in urgent need• in that specific circumstance/situation• in required way• with the available tools• with the following expected

arrangements

RIGHT FOR THE FREE CHOICE AMONG THE DIAGNOSTIC AND

THERAPEUTICAL METHODS

This is the right of the physician– Evidence based– With the right personal and technical

background– With consideration the risk/benefit – Consultation with other physicians– Informed consent is needed

RIGHT TO REFUSE TREATMENT

Treatment can be denied– Urgent treatment of other patient– If it is not necessary– Physically it’s not possible– There is no proper technical background

which is needed – The expected treatment is inconsistent with

the doctor’s conscience, ethical or religious conviction

– The patient’s behavior is insulting or threatening (except:if it comes from his disease)

– If the patient does not cooperates

DUTY FOR GIVING INFORMATION

• It’s not replaceable with leaflets, handouts or prospectus

• Carefully• Gradually• Fit/adopt to the patient’s physical and mental

status• To emphasize the side effects and possible

complications and their frequency• To make sure that the patient understood you• Follow up the patient or his/her relatives

DUTY FOR ADMINISTRARTION

• Patient documentation– True– Patient follow up– Could be controlled/checked

up/supervised– Must be retrieval

IT IS PROTECTION FOR THE DOCTOR!

DUTY FOR SECRECY/CONFIDENTIALITY

• Valid for the health status and other conditions as well

• With no time limit• Not depending on the way you got the

information• Except from: exoneration from the

authorities, or it’s endangers someone’s health (ethical problems)

R U STILL AWAKE?

PATIENT’S SIDE

THE ROLE/DUTIES OF THE PERSON/PATIENT

• The patient’s responsibility for his own health status

• Develop the sense of responsibility/ to be aware

• To inform the doctor» Previous diseases» Own and family hystory» Infectious diseases» If he has questions, sg. is not understandable

• To give respect for the medical staff• To keep the regulations of the medical

instituteBased on the collaboration of the patient and the

doctor

PATIENT’S RIGHTS

• Right to get medical attendance• Right to obtain information• Right to self determination• Right to reject treatment or information• Right to human dignity• Right to confidentialiy

HOW CAN PATIENTS EXCESISE THEIR RIGHT?

» GETTING INFORMATION» LEGAL REPESENTATIVES» HOSPITAL REGULTIONS

RIGHT TO GET MEDICAL ATTENDANCE

• Proper medical attendance» Life threatening situation, irreversible

impairment, pain – urgent situation» Regular treatment

• Continuously accessible• With no discrimination• Free choice for doctor

RIGHT TO HUMAN DIGNITY

• basic right for the patient• Basic duty of the doctor

RESPECT THE HUMAN DIGNITY

Waiting timeIntimacy

Privacy - family, community

RIGHT TO OBTAIN INFORMATION

• Individual information• Adopt to the patient

• Fit to the– Age– Qualification– Knowledge– Mental status– Circumstances…

• Diagnostical,theraputical procedures, alternatives, prognosis, consequences of denying the treatment..

RIGHT TO SELF DETERMINATION AUTONOMY

• Informed consent– Oral– Written– With behavior

• When which one is needed?– F.e.: rejecting the treatment – 2 testifier

RIGHT TO REJECT TREATMENT

• Patients in terminal state (passive euthanasia,NOT IN EVERY CASE!)

• Advanced directive• Give information!

• Right to reject to get information» Dying, old patients» Documentation

Exception: life threatening situation

RIGHT TO GET TO KNOW THE PATIENT’S RECORDS

• Copies, explanation of the results and the diagnosis

• Who can be informed?

• In case of death– Legal representatives– Close relative– Inheritor

RIGHT TO CONFIDENTIALITY

• Who can be informed? – declaration

• Information on the phone• Information for relatives

Have a nice day and some rest!