code of professional ethics by therine a. hadji taib

7/29/2019 Code of Professional Ethics by Therine A. Hadji Taib

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CODE OF PROFESSIONAL ETHICS

A.) HIPPOCRATIC OATH

The Hippocratic Oath is an oath historically taken by physicians and otherhealthcare professionals swearing to practice medicine honestly. It is widely

believed to have been written either by Hippocrates, often regarded as the father

of western medicine, or by one of his students. The oath is written in Ionic

Greek (late 5th century BC), and is usually included in the Hippocratic Corpus.

Classical scholar Ludwig Edelstein proposed that the oath was written
http://en.wikipedia.org/wiki/Physicianhttp://en.wikipedia.org/wiki/Hippocrateshttp://en.wikipedia.org/wiki/Ionic_Greekhttp://en.wikipedia.org/wiki/Ionic_Greekhttp://en.wikipedia.org/wiki/Hippocratic_Corpushttp://en.wikipedia.org/wiki/Physicianhttp://en.wikipedia.org/wiki/Hippocrateshttp://en.wikipedia.org/wiki/Ionic_Greekhttp://en.wikipedia.org/wiki/Ionic_Greekhttp://en.wikipedia.org/wiki/Hippocratic_Corpus


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by Pythagoreans, a theory that has been questioned because of the lack of

evidence for a school of Pythagorean medicine. Of historic and traditional value,

the oath is considered a rite of passage for practitioners of medicine in many

countries, although nowadays the modernized version of the text varies among

them.

The Hippocratic Oath (orkos) is one of the most widely known of Greek medical

texts. It requires a new physician to swear upon a number of healing gods that he

will uphold a number of professional ethical standards. The Hippocratic Oath

() is perhaps the most widely known of Greek medical texts. It requires a

new physician to swear upon a number of healing gods that he will uphold a

number of professional ethical standards. It also strongly binds the student to his

teacher and the greater community of physicians with responsibilities similar to

that of a family member. In fact, the creation of the Oath may have marked the

early stages of medical training to those outside the first families of Hippocratic

medicine, the Asclepiads of Kos, by requiring strict loyalty.

Over the centuries, it has been rewritten often in order to suit the values of

different cultures influenced by Greek medicine. Contrary to popular belief, the

Hippocratic Oath is not required by most modern medical schools, although some

have adopted modern versions that suit many in the profession in the 21st

century. It also does not explicitly contain the phrase, "First, do no harm," which is

commonly attributed to it.

OATH TEXT

ENGLISH TRANSLATIONS VERSION 1

Apollo Physician and Asclepius and Hygieia and Panacea and all the gods

and goddesses, making them my witnesses, that I will fulfill according to

my ability and judgment this oath and this covenant:
http://en.wikipedia.org/wiki/Pythagoreanshttp://en.wikipedia.org/wiki/Pythagoreans


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To hold him who has taught me this art as equal to my parents and to live

my life in partnership with him, and if he is in need of money to give him a

share of mine, and to regard his offspring as equal to my brothers in male

lineage and to teach them this art if they desire to learn it without fee

and covenant; to give a share of precepts and oral instruction and all the

other learning to my sons and to the sons of him who has instructed me

and to pupils who have signed the covenant and have taken an oath

according to the medical law, but to no one else.

I will apply dietetic measures for the benefit of the sick according to my

ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody if asked for it, nor will I make a

suggestion to this effect. Similarly I will not give to a woman an abortive

remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw

in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick,

remaining free of all intentional injustice, of all mischief and in particular of

sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of

the treatment in regard to the life of men, which on no account one must

spread abroad, I will keep to myself holding such things shameful to be

spoken about.

If I fulfill this path and do not violate it, may it be granted to me to enjoy life

and art, being honored with fame among all men for all time to come; if I

transgress it and swear falsely, may the opposite of all this be my lot.

ENGISH TRANSLATION VERSION 2


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I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take

to witness all the gods, all the goddesses, to keep according to my ability

and my judgment, the following Oath and agreement:

To consider dear to me, as my parents, him who taught me this art; to live

in common with him and, if necessary, to share my goods with him; To

look upon his children as my own brothers, to teach them this art; and that

by my teaching, I will impart a knowledge of this art to my own sons, and to

my teacher's sons, and to disciples bound by an indenture and oath

according to the medical laws, and no others.

I will prescribe regimens for the good of my patients according to my ability

and my judgment and never do harm to anyone. I will give no deadly

medicine to any one if asked, nor suggest any such counsel; and similarly I

will not give a woman a pessary to cause an abortion.

But I will preserve the purity of my life and my arts. I will not cut for stone,

even for patients in whom the disease is manifest; I will leave this

operation to be performed by practitioners, specialists in this art.

In every house where I come I will enter only for the good of my patients,

keeping myself far from all intentional ill-doing and all seduction and

especially from the pleasures of love with women or men, be they free or

slaves.

All that may come to my knowledge in the exercise of my profession or in

daily commerce with men, which ought not to be spread abroad, I will keep

secret and will never reveal.

If I keep this oath faithfully, may I enjoy my life and practise my art,

respected by all humanity and in all times; but if I swerve from it or violate

it, may the reverse be my life.

MODERN USE AND RELEVANCE


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The Oath has been modified multiple times, in several different countries.

One of the most significant revisions is the Declaration of Geneva, first

drafted in 1948 by the World Medical Association; it has since been

revised several times. While there is currently no legal obligation for

medical students to swear an oath upon graduating, 98% of American

medical students swear some form of oath, while only 50% of British

medical students do.

However, the vast majority of oaths or declarations sworn have been

heavily modified and modernized for example, the oath's prohibition on

abortion predates modern laws. In a 1989 survey of 126 US medical

schools, only three reported usage of the original oath, while thirty-three

used the Declaration of Geneva, sixty-seven used a modified Hippocratic

oath, four used the Oath of Maimonides, one used a covenant, eight used

another oath, one used an unknown oath, and two did not use any kind of

oath. Seven medical schools did not reply to the survey. In France, it is

common for new medical graduates to sign a written oath.

The majority of osteopathic medical schools use the Osteopathic Oath in

the United States. The oath was first used in 1938, and the current version

has been in use since 1954.

It has been suggested by Sir Joseph Rotblat in his acceptance speech for

the Nobel Peace Prize in 1995 that a similar oath should be undertaken by

scientists, a Hippocratic Oath for Scientists.

B.) ICN CODE OF ETHICS

The ICN Code of Ethics for Nurses, most recently revised in 2012, is a guide for

action based on social values and needs. The Code has served as the standard

for nurses worldwide since it was first adopted in 1953.


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The Code is regularly reviewed and revised in response to the realities of nursing

and health care in a changing society. The Code makes it clear that inherent in

nursing is respect for human rights, including the right to life, to dignity and to be

treated with respect.

C.)PRINCIPLE OF MEDICAL ETHICS

Preamble

The medical profession has long subscribed to a body of ethical

statements developed primarily for the benefit of the patient. As a member

of this profession, a physician must recognize responsibility to patients first

and foremost, as well as to society, to other health professionals, and to

self. The following Principles adopted by the American Medical Association

are not laws, but standards of conduct which define the essentials of

honorable behavior for the physician.

Principles of medical ethics

I. A physician shall be dedicated to providing competent medical care, with

compassion and respect for human dignity and rights.


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II. A physician shall uphold the standards of professionalism, be honest in

all professional interactions, and strive to report physicians deficient in

character or competence, or engaging in fraud or deception, to appropriate

entities.

III. A physician shall respect the law and also recognize a responsibility to

seek changes in those requirements which are contrary to the best

interests of the patient.

IV. A physician shall respect the rights of patients, colleagues, and other

health professionals, and shall safeguard patient confidences and privacy

within the constraints of the law.

V. A physician shall continue to study, apply, and advance scientific

knowledge, maintain a commitment to medical education, make relevant

information available to patients, colleagues, and the public, obtain

consultation, and use the talents of other health professionals when

indicated.

VI. A physician shall, in the provision of appropriate patient care, except in

emergencies, be free to choose whom to serve, with whom to associate,

and the environment in which to provide medical care.


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VII. A physician shall recognize a responsibility to participate in activities

contributing to the improvement of the community and the betterment of

public health.

VIII. A physician shall, while caring for a patient, regard responsibility to the

patient as paramount.

IX. A physician shall support access to medical care for all people.

D.)PATIENTS BILL OF RIGHTS

American Hospital Association

MANAGEMENT ADVISORY

A Patients Bill of Rights

A Patient's Bill of Rights was first adopted by the

American Hospital Association in 1973.


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This revision was approved by the AHA Board of Trustees on October 21, 1992.

INTRODUCTION

Effective health care requires collaboration between patients and

physicians and other health care professionals. Open and honest

communication, respect for personal and professional values, and

sensitivity to differences are integral to optimal patient care. As the setting

for the provision of health services, hospitals must provide a foundation for

understanding and respecting the rights and responsibilities of patients,

their families, physicians, and other caregivers. Hospitals must ensure a

health care ethic that respects the role of patients in decision making about

treatment choices and other aspects of their care. Hospitals must be

sensitive to cultural, racial, linguistic, religious, age, gender, and other

differences as well as the needs of persons with disabilities.

The American Hospital Association presents A Patient's Bill of Rights with

the expectation that it will contribute to more effective patient care and be

supported by the hospital on behalf of the institution, its medical staff,

employees, and patients. The American Hospital Association encourages

health care institutions to tailor this bill of rights to their patient community

by translating and/or simplifying the language of this bill of rights as may

be necessary to ensure that patients and their families understand their

rights and responsibilities.


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BILL OF RIGHTS

These rights can be exercised on the patients behalf by a designatedsurrogate or proxy decision maker if the patient lacks decision-making

capacity, is legally incompetent, or is a minor.

The patient has the right to considerate and respectful care.

The patient has the right to and is encouraged to obtain from

physicians and other direct caregivers relevant, current, and

understandable information concerning diagnosis, treatment, and

prognosis.

Except in emergencies when the patient lacks decision-making

capacity and the need for treatment is urgent, the patient is entitled

to the opportunity to discuss and request information related to the

specific procedures and/or treatments, the risks involved, the

possible length of recuperation, and the medically reasonable

alternatives and their accompanying risks and benefits.

Patients have the right to know the identity of physicians, nurses,

and others involved in their care, as well as when those involved are

students, residents, or other trainees. The patient also has the right


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to know the immediate and long-term financial implications of

treatment choices, insofar as they are known.

The patient has the right to make decisions about the plan of care

prior to and during the course of treatment and to refuse a

recommended treatment or plan of care to the extent permitted by

law and hospital policy and to be informed of the medical

consequences of this action. In case of such refusal, the patient is

entitled to other appropriate care and services that the hospital

provides or transfer to another hospital. The hospital should notify

patients of any policy that might affect patient choice within the

institution.

The patient has the right to have an advance directive (such as a

living will, health care proxy, or durable power of attorney for health

care) concerning treatment or designating a surrogate decision

maker with the expectation that the hospital will honor the intent of

that directive to the extent permitted by law and hospital policy.

Health care institutions must advise patients of their rights under

state law and hospital policy to make informed medical choices, ask

if the patient has an advance directive, and include that information

in patient records. The patient has the right to timely information

about hospital policy that may limit its ability to implement fully a

legally valid advance directive.


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The patient has the right to every consideration of privacy. Case

discussion, consultation, examination, and treatment should be

conducted so as to protect each patient's privacy.

The patient has the right to expect that all communications and

records pertaining to his/her care will be treated as confidential by

the hospital, except in cases such as suspected abuse and public

health hazards when reporting is permitted or required by law. The

patient has the right to expect that the hospital will emphasize the

confidentiality of this information when it releases it to any other

parties entitled to review information in these records.

The patient has the right to review the records pertaining to his/her

medical care and to have the information explained or interpreted as

necessary, except when restricted by law.

The patient has the right to expect that, within its capacity and

policies, a hospital will make reasonable response to the request of

a patient for appropriate and medically indicated care and services.

The hospital must provide evaluation, service, and/or referral as

indicated by the urgency of the case. When medically appropriate

and legally permissible, or when a patient has so requested, a

patient may be transferred to another facility. The institution to

which the patient is to be transferred must first have accepted the

patient for transfer. The patient must also have the benefit of

complete information and explanation concerning the need for,

risks, benefits, and alternatives to such a transfer.


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The patient has the right to ask and be informed of the existence of

business relationships among the hospital, educational institutions,

other health care providers, or payers that may influence the

patient's treatment and care.

The patient has the right to consent to or decline to participate in

proposed research studies or human experimentation affecting

care and treatment or requiring direct patient involvement, and to

have those studies fully explained prior to consent. A patient who

declines to participate in research or experimentation is entitled to

the most effective care that the hospital can otherwise provide.

The patient has the right to expect reasonable continuity of care

when appropriate and to be informed by physicians and other

caregivers of available and realistic patient care options when

hospital care is no longer appropriate.

The patient has the right to be informed of hospital policies and

practices that relate to patient care, treatment, and responsibilities.

The patient has the right to be informed of available resources for

resolving disputes, grievances, and conflicts, such as ethics

committees, patient representatives, or other mechanisms available

in the institution. The patient has the right to be informed of the

hospital's charges for services and available payment methods.


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The collaborative nature of health care requires that patients, or

their families/surrogates, participate in their care. The effectiveness

of care and patient satisfaction with the course of treatment depend,

in part, on the patient fulfilling certain responsibilities. Patients are

responsible for providing information about past illnesses,

hospitalizations, medications, and other matters related to health

status. To participate effectively in decision making, patients must

be encouraged to take responsibility for requesting additional

information or clarification about their health status or treatment

when they do not fully understand information and instructions. Patients are also responsible for ensuring that the health care

institution has a copy of their written advance directive if they have

one. Patients are responsible for informing their physicians and

other caregivers if they anticipate problems in following prescribed

treatment.

Patients should also be aware of the hospital's obligation to be

reasonably efficient and equitable in providing care to other patients

and the community. The hospital's rules and regulations are

designed to help the hospital meet this obligation. Patients and their

families are responsible for making reasonable accommodations to

the needs of the hospital, other patients, medical staff, and hospital

employees. Patients are responsible for providing necessary

information for insurance claims and for working with the hospital to

make payment arrangements, when necessary.


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A person's health depends on much more than health care services.

Patients are responsible for recognizing the impact of their life-style

on their personal health.

CONCLUSION

Hospitals have many functions to perform, including the

enhancement of health status, health promotion, and the prevention

and treatment of injury and disease; the immediate and ongoingcare and rehabilitation of patients; the education of health

professionals, patients, and the community; and research. All these

activities must be conducted with an overriding concern for the

values and dignity of patients.

PHILIPPINES PATIENTS BILL OF RIGHTS

Title 111: Declaration of Rights

Sec. 4. The Rights of Patients. - The following rights of the patient shall be

respected by all those involved in his care:

1.) Right to Appropriate Medical Care and Humane Treatment.


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Every person has a right to health and medical care corresponding

to his state of health, without any discrimination and within the limits

of the resources, manpower and competence available for health

and medical care at the relevant time. The patient has the right to

appropriate health and medical care of good quality. In the course of

such care, his human dignity, convictions, integrity, individual needs

and culture shall be respected. If any person cannot immediately be

given treatment that is medically necessary he shall, depending on

his state of health, either be directed to wait for care, or be referred

or sent for treatment elsewhere, where the appropriate care can be

provided. If the patient has to wait for care, he shall be informed of

the reason for the delay. Patients in emergency shall be extended

immediate medical care and treatment without any deposit, pledge,

mortgage or any form of advance payment for treatment.

2.) Right to Informed Consent.

The patient has a right to a clear, truthful and substantial

explanation, in a manner and language understandable to the

patient, of all proposed procedures, whether diagnostic, preventive,

curative, rehabilitative or therapeutic, wherein the person who will

perform the said procedure shall provide his name and credentials

to the patient, possibilities of any risk of mortality or serious side

effects, problems related to recuperation, and probability of success

and reasonable risks involved: Provided, That, the patient will not be

subjected to any procedure without his written informed consent,

except in the following cases:

a. in emergency cases, when the patient is at imminent risk

of physical injury, decline or death if treatment is withheld or

postponed. In such cases, the physician can perform any


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diagnostic or treatment procedure as good practice of

medicine dictates without such consent;

b. when the health of the population is dependent on the

adoption of a mass health program to control epidemic;

c. when the law makes it compulsory for everyone to submit

to a procedure;

d. when the patient is either a minor, or legally incompetent,

in which case, a third party consent is required;

e. when disclosure of material information to patient willjeopardize the success of treatment, in which case, third

party disclosure and consent shall be in order;

f. when the patient waives his right in writing.

Informed consent shall be obtained from a patient concerned if he is

of legal age and of sound mind. In case the patient is incapable of

giving consent and a third party consent is required, the following

persons, in the order of priority stated hereunder, may give consent:

i. spouse;

ii. son or daughter of legal age;

iii. either parent;

iv. brother or sister of legal age, or

v. guardian

If a patient is a minor, consent shall be obtained from his parents or

legal guardian.


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If next of kin, parents or legal guardians refuse to give consent to a

medical or surgical procedure necessary to save the life or 1imb of

a minor or a patient incapable of giving consent, courts, upon the

petition of the physician or any person interested in the welfare of

the patient, in a summary proceeding, may issue an order giving

consent.

3.) Right To Privacy and Confidentiality.

The privacy of the patients must beassured at all stages of his

treatment. The patient has the right to be free from unwarranted

public exposure, except in the following cases:

a) when his mental or physical condition is in controversy and

the appropriate court, in its discretion, orders him to submit to

a physical or mental examination by a physician;

b) when the public health and safety so demand; and

c) when the patient waives this right.

The patient has the right to demand that all information,

communication and records pertaining to his care be treated as

confidential. Any health care provider or practitioner involved in the

treatment of a patient and all those who have legitimate access to

the patient's record is not authorized to divulge any information to a

third party who has no concern with the care and welfare of the

patient without his consent, except:

a) when such disclosure will benefit public health and safety;


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b) when it is in the interest of justice and upon the order of a

competent court; and

c) when the patients waives in writing the confidential nature

of such information;

d) when it is needed for continued medical treatment or

advancement of medical science subject to de-identification

of patient and shared medical confidentiality for those who

have access to the information.

Informing the spouse or the family to the first degree of the patients

medical condition may be allowed; Provided, That the patient of

legal age shall have the right to choose on whom to inform. In case

the patient is not of legal age or is mentally incapacitated, such

information shall be given to the parents, legal guardian or his next

of kin.

4.) Right to Information.

In the course of his/her treatment and hospital care, the patient or

his/her legal guardian has a right to be informed of the result of the

evaluation of the nature and extent of his/her disease, any other

additional or further contemplated medical treatment on surgical

procedure or procedures, including any other additional medicines to

be administered and their generic counterpart including the possible

complications and other pertinent facts, statistics or studies, regarding

his/her illness, any change in the plan of care before the change is

made, the persons participation in the plan of care and necessary

changes before its implementation, the extent to which payment maybe

expected from Philhealth or any payor and any charges for which the


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patient maybe liable, the disciplines of health care practitioners who will

furnish the care and the frequency of services that are proposed to be

furnished.

The patient or his legal guardian has the right to examine and be given

an itemized bill of the hospital and medical services rendered in the

facility or by his/her physician and other health care providers,

regardless of the manner and source of payment. He is entitled to a

thorough explanation of such bill.

The patient or his/her legal guardian has the right to be informed by the

physician or his/her delegate of his/her continuing health care

requirements following discharge, including instructions about home

medications, diet, physical activity and all other pertinent information to

promote health and well-being. At the end of his/her confinement, the

patient is entitled to a brief, written summary of the course of his/her

illness which shall include at least the history, physical examination,

diagnosis, medications, surgical procedure, ancillary and laboratory

procedures, and the plan of further treatment, and which shall be

provided by the attending physician. He/she is likewise entitled to the

explanation of, and to view, the contents of the medical record of

his/her confinement but with the presence of his/her attending

physician or in the absence of the attending physician, the hospitals

representative.

Notwithstanding that he/she may not be able to settle his accounts by

reason of financial incapacity, he/she is entitled to reproduction, at

his/her expense, the pertinent part or parts of the medical record the

purpose or purposes of which he shall indicate in his/her written

request for reproduction. The patient shall likewise be entitled to

medical certificate, free of charge, with respect to his/her previous

confinement.


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The patient has likewise the right not to be informed, at his/her explicit

request.

5.) The Right To Choose Health Care Provider and Facility.

The patient is free to choose the health care provider to serve him as

well as the facility except when he is under the care of a service facility

or when public health and safety so demands or when the patient

expressly or impliedly waives this right.

The patient has the right to discuss his condition with a consultantspecialist, at the patients request and expense. He also has the right to

seek for a second opinion and subsequent opinions, if appropriate,

from another health care provider/practitioner.

6.) Right to Self-Determination.

The patient has the right to avail himself/herself of any recommended

diagnostic and treatment procedures. Any person of legal age and of

sound mind may make an advance written directive for physicians to

administer terminal care when he/she suffers from the terminal phase

of a terminal illness: Provided, That

a) he is informed of the medical consequences of his choice;

b) he releases those involved in his care from any obligation relative

to the consequences of his decision;

c) his decision will not prejudice public health and safety.

7.) Right to Religious Belief.


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The patient has the right to refuse medical treatment or procedures

which may be contrary to his religious beliefs, subject to the

limitations described in the preceding subsection: Provided, That

such a right shall not be imposed by parents upon their children who

have not reached the legal age in a life threatening situation as

determined by the attending physician or the medical director of the

facility.

8.) Right to Medical Records.

The patient is entitled to a summary of his medical history and

condition, He has the right to view the contents of his medical

records, except psychiatric notes and other incriminatory

information obtained about third parties, with the attending physician

explaining contents thereof. At his expense and upon discharge of

the patient, he may obtain from the health care institution a

reproduction of the same record whether or not he has fully settled

his financial obligation with the physician or institution concerned.

The health care institution shall safeguard the confidentiality of the

medical records and to likewise ensure the integrity and authenticity

of the medical records and shall keep the same within a reasonable

time as may be determined by the Department of Health.

The health care institution shall issue a medical certificate to the

patient upon request. Any other document that the patient may

require for insurance claims shall also be made available to him

within a reasonable period of time.

9.) Right to Leave.

The patient has the right to leave a hospital or any other health care

institution regardless of his physical condition: Provided, That


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a) he/she is informed of the medical consequences of his/her

decision;

b) he/she releases those involved in his/her care from any

obligation relative to the consequences of his decision;

c) his/her decision will not prejudice public health and safety.

No patient shall be detained against his/her will in any health care

institution on the sole basis of his failure to fully settle is financial

obligations. However, he/she shall only be allowed to leave the

hospital provided appropriate arrangements have been made to

settle the unpaid bills: Provided, farther, that unpaid bills of patients

shall be considered as lost income by the hospital and health care

provider/practitioner and shall be deducted from gross income as

income loss for that particular year.

10.) Right to Refuse Participation in Medical Research.

The patient has the right to be advised if the health care provider

plans to involve him in medical research, including but not limited to

human experimentation which may be performed only with the

written informed consent of the patient. Provided, further, That, an

institutional review board or ethical review board in accordance with

the guidelines set in the Declaration of Helsinki be established for

research involving human experimentation:

Provided, finally, That the Department of Health shall safeguard the

continuing training and education of future health care

provider/practitioner to ensure the development of the health care

delivery in the country.


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11.) Right to Correspondence and to Receive Visitors

The patient has the right to communicate with relatives and otherpersons and to receive visitors subject to reasonable limits

prescribed by the rules and regulations of the health care institution.

12.) Right to Express Grievances.

The patient has the right to express complaints and grievances

about the care and services received without fear of discrimination

or reprisal and to know about the disposition of such complaints.The Secretary of Health, in consultation with health care providers,

consumer groups and other concerned agencies shall establish a

grievance system wherein patients may seek redress of their

grievances. Such a system shall afford all parties concerned with

the opportunity to settle amicably all grievances.

13.) Right to be Informed of His Rights and Obligations as a Patient.

Every person has the right to be informed of his rights and

obligations as a patient. The Department of Health, in coordination

with health care providers, professional and civic groups, the media,

health insurance corporations, peoples organizations, local

government organizations, shall launch and sustain a nationwide

information and education campaign to make known to people their

rights as patients, as declared in this Act. Such rights &d obligations

of patients shall be posted in a bulletin board conspicuously placed

in a health care institution. It shall be the duty of health care

institutions to inform patients of their rights as well as the

institution's rules and regulations that apply to the conduct of the

patient while in the care of such institution.


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E.) NUREMBERG CODE

The Nuremberg Code is a set of research ethics principles for human

experimentation set as a result of the Subsequent Nuremberg Trials at the

end of the Second World War.

BACKGROUND

On August 19, 1947, the judges delivered their verdict in the "Doctors'

Trial" against Karl Brandt and several others. They also delivered their

opinion on medical experimentation on human beings. Several of the

accused had argued that their experiments differed little from pre-war ones

and that there was no law that differentiated between legal and illegal

experiments.

In May of the same year, Dr. Leo Alexander had submitted to the Counsel

for War Crimes six points defining legitimate medical research. The trial

verdict adopted these points and added an extra four. The ten points

constituted the "Nuremberg Code". Although the legal force of the

document was not established and it was not incorporated directly into

either the American or German law, the Nuremberg Code and the related

Declaration of Helsinki are the basis for the Code of Federal Regulations

Title 45 Volume 46, which are the regulations issued by the United States

Department of Health and Human Services governing federally-funded

human subjects research in the United States. In addition, the Nuremberg

code has also been incorporated into the law of individual states such as

California and other countries.


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The Nuremberg code includes such principles as informed consent and

absence of coercion; properly formulated scientific experimentation; and

beneficence towards experiment participants.

10 POINTS OF NUREMBERG CODE

The 10 points are, (all from United States National Institutes of Health)

1. The voluntary consent of the human subject is absolutely essential. This

means that the person involved should have legal capacity to give consent;

should be so situated as to be able to exercise free power of choice, without the

intervention of any element of force, fraud, deceit, duress, over-reaching, or other

ulterior form of constraint or coercion; and should have sufficient knowledge and

comprehension of the elements of the subject matter involved as to enable

him/her to make an understanding and enlightened decision. This latter element

requires that before the acceptance of an affirmative decision by the

experimental subject there should be made known to him the nature, duration,

and purpose of the experiment; the method and means by which it is to be

conducted; all inconveniences and hazards reasonable to be expected; and the

effects upon his health or person which may possibly come from his participation

in the experiment. The duty and responsibility for ascertaining the quality of the

consent rests upon each individual who initiates, directs or engages in the

experiment. It is a personal duty and responsibility which may not be delegated to

another with impunity.

2. The experiment should be such as to yield fruitful results for the good of

society, unprocurable by other methods or means of study, and not random and

unnecessary in nature.

3. The experiment should be so designed and based on the results ofanimal

experimentation and a knowledge of the natural history of the disease or other

problem under study that the anticipated results will justify the performance of the

experiment.
http://en.wikipedia.org/wiki/Consenthttp://en.wikipedia.org/wiki/Essencehttp://en.wikipedia.org/wiki/Legalhttp://en.wikipedia.org/wiki/Randomhttp://en.wikipedia.org/wiki/Animal_experimentationhttp://en.wikipedia.org/wiki/Animal_experimentationhttp://en.wikipedia.org/wiki/Consenthttp://en.wikipedia.org/wiki/Essencehttp://en.wikipedia.org/wiki/Legalhttp://en.wikipedia.org/wiki/Randomhttp://en.wikipedia.org/wiki/Animal_experimentationhttp://en.wikipedia.org/wiki/Animal_experimentation


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4. The experiment should be so conducted as to avoid all

unnecessary physical and mental suffering and injury.

5. No experiment should be conducted where there is a prior reason to believe

that death or disabling injury will occur; except, perhaps, in those experimentswhere the experimental physicians also serve as subjects.

6. The degree of risk to be taken should never exceed that determined by

the humanitarian importance of the problem to be solved by the experiment.

7. Proper preparations should be made and adequate facilities provided to

protect the experimental subject against even remote possibilities of injury,

disability, or death.

8. The experiment should be conducted only by scientifically qualified

persons. The highest degree of skill and care should be required through all

stages of the experiment of those who conduct or engage in the experiment.

9. During the course of the experiment the human subject should be

at liberty to bring the experiment to an end if he has reached the physical or

mental state where continuation of the experiment seems to him to be

impossible.

10. During the course of the experiment the scientist in charge must be

prepared to terminate the experiment at any stage, if he hasprobable cause to

believe, in the exercise of the good faith, superior skill and

carefuljudgment required of him that a continuation of the experiment is likely to

result in injury, disability, ordeath to the experimental subject.

F.) DECLARATION OF GENEVA CONVENTION

The Declaration of Geneva (Physician's Oath) was adopted by the General

Assembly of the World Medical Association at Geneva in 1948, amended in 1968,
http://en.wikipedia.org/wiki/Physical_propertyhttp://en.wikipedia.org/wiki/Mindhttp://en.wikipedia.org/wiki/Injuryhttp://en.wikipedia.org/wiki/Humanitarianhttp://en.wikipedia.org/wiki/Libertyhttp://en.wikipedia.org/wiki/Probable_causehttp://en.wikipedia.org/wiki/Judgmenthttp://en.wikipedia.org/wiki/Disabilityhttp://en.wikipedia.org/wiki/Deathhttp://en.wikipedia.org/wiki/Experimental_subjecthttp://en.wikipedia.org/wiki/Physical_propertyhttp://en.wikipedia.org/wiki/Mindhttp://en.wikipedia.org/wiki/Injuryhttp://en.wikipedia.org/wiki/Humanitarianhttp://en.wikipedia.org/wiki/Libertyhttp://en.wikipedia.org/wiki/Probable_causehttp://en.wikipedia.org/wiki/Judgmenthttp://en.wikipedia.org/wiki/Disabilityhttp://en.wikipedia.org/wiki/Deathhttp://en.wikipedia.org/wiki/Experimental_subject


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1983, 1994 and editorially revised in 2005 and 2006. It is a declaration of a

physician's dedication to the humanitarian goals of medicine, a declaration that

was especially important in view of the medical crimes which had just been

committed in Nazi Germany. The Declaration of Geneva was intended as a

revision of the Hippocratic Oath to a formulation of that oath's moral truths that

could be comprehended and acknowledged in a modern way.

CREATION

The Declaration of Geneva (Physician's Oath) was adopted by the General

Assembly of the World Medical Association at Geneva in 1948, amended

in 1968, 1983, 1994 and editorially revised in 2005 and 2006. It is a

declaration of a physician's dedication to the humanitarian goals of

medicine, a declaration that was especially important in view of the

medical crimes which had just been committed in Nazi Germany. The

Declaration of Geneva was intended as a revision of the Hippocratic Oath

to a formulation of that oath's moral truths that could be comprehended

and acknowledged in a modern way.

DECLARATION

The Declaration of Geneva, as currently published by the WMA reads:

At the time of being admitted as a member of the medical profession:


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I solemnly pledge to consecrate my life to the service of

humanity;

I will give to my teachers the respect and gratitude that is their

due;

I will practice my profession with conscience and dignity;

The health of my patient will be my first consideration;

I will respect the secrets that are confided in me, even after the

patient has died;

I will maintain by all the means in my power, the honour and the

noble traditions of the medical profession;

My colleagues will be my sisters and brothers;

I will not permit considerations of age, disease or disability,

creed, ethnic origin, gender, nationality, political affiliation, race,

sexual orientation, social standing or any other factor to

intervene between my duty and my patient;

I will maintain the utmost respect for human life;

I will not use my medical knowledge to violate human rights and

civil liberties, even under threat;

I make these promises solemnly, freely and upon my honour.

CHANGES FROM ORIGINAL

The original oath read "My colleagues will be my brothers," later changed to

"sisters and brothers." Age, disability, gender, and sexual orientation have been

added as factors that must not interfere with a doctor's duty to a patient; some


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rephrasing of existing elements has occurred. Secrets are to remain confidential

"even after the patient has died." The violation of "human rights and civil liberties"

replaces "the laws of humanity" as a forbidden use of medical knowledge. The

original declaration stated that a doctor would respect human life "from the time of

conception," and the 1994 revision stated "from its beginning." which was

removed altogether in the editorial revisions in the English version but is still

found in other language versions that have not followed the editorial changes

such as the German Handbuch der rztlichen Ethik. "The health" in general of a

patient is now the doctor's first consideration compared to the "health and life" as

stated in the original declaration. This was apparently changed to free the medical

profession from extending life at all cost.

REFERENCES:

Farnell, Lewis R. (2004-06-30). "Chapter 10". Greek Hero Cults and Ideas of

Immortality. Kessinger Publishing. pp. 234279. ISBN 978-1-4179-2134-8. p.269:

"The famous Hippocratean oath may not be an authentic deliverance of the great

master, but is an ancient formula current in his school."

The Hippocratic oath: text, translation and interpretation By Ludwig Edelstein

Page 56 ISBN 978-0-8018-0184-6 (1943)


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Temkin, Owsei (2001-12-06). "On Second Thought". "On Second Thought" and

Other Essays in the History of Medicine and Science. Johns Hopkins University.

ISBN 978-0-8018-6774-3.

The Hippocratic Oath: Text. Translation. and Interpretation. by Ludwig Edelstein,

Supplements to the Bulletin of the History of Medicine. no. 1 1943).

National Library of Medicine 2006

Sritharan, Kaji; Georgina Russell, Zoe Fritz, Davina Wong, Matthew Rollin, Jake

Dunning, Bruce Wayne, Philip Morgan, Catherine Sheehan (December 2000).

"Medical oaths and declarations". BMJ 323 (7327): 14401.

doi:10.1136/bmj.323.7327.1440. PMC 1121898. PMID 11751345.

Crawshaw, R; Pennington, T H; Pennington, C I; Reiss, H; Loudon, I (October

1994). "Letters". BMJ 309 (6959): 952. doi:10.1136/bmj.309.6959.952. PMC

2541124. PMID 7950672.

World Medical Association, WMA. "WMA Declaration of Geneva". WMA.

Retrieved 4 April 2013.

"World Medical Association (1997) press release 12 May". Wma.net. 1997-05-10.

Retrieved 2013-01-28.

"International Code of Medical Ethics". World Medical Association. Archived from

the original on 2008-09-20.

"WMA History". WMA. Retrieved 2013-06-04.


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"The Oath". Cirp.org. 2002-06-06. Retrieved 2013-06-04.

World Medical Association. "WMA declaration of Geneva". WMA. Retrieved 22

April 2013.

Williams, John R. (2005). Handbuch der rztlichen Ethik. Weltaertztebund. p. 19.

ISBN 92-990028-0-0.

Jones, David Albert. "The declaration of Geneva and other modern adaptations of

the classical doctors' oath". Catholic Medical Association. Retrieved 17 June

2013.

"A Physician's Oath on Retirement". Pubmedcentral.nih.gov. 2011-10-03.

Retrieved 2011-11-23.

http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-

medical-ethics/principles-medical-ethics.page

http://www.icn.ch/images/stories/documents/about/icncode_english.pdf

http://www.nlm.nih.gov/hmd/greek/greek_oath.html

http://www.patienttalk.info/AHA-Patient_Bill_of_Rights.html

code of professional ethics by therine a. hadji taib

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