Dr.Seyed Ziaoddin Tabei اخلاق در انتقال خون Ethics in Transfusion
Dr.Seyed Ziaoddin Tabei E thics I ndividual Ethics O rganizational Ethics S ocial Ethics (Culture) PP rofessionalism TT ransfusion
Dr.Seyed Ziaoddin Tabei شناخت فضيلت و اراده كردن براي ايجاد آن فضيلت در ناخودآگاه، به نحوي كه انسان بتواند آن فضيلت را بدون هيچ اكراه و مانعي انجام دهد.
Dr.Seyed Ziaoddin Tabei Profession Professions are groups which declare in a public way that their members will act in certain ways and that the group and the society may discipline those who fail to do so. The profession presents itself to society as a social benefit and society accepts the profession, expecting it to serve some important social goal
The traditional professions are medicine law education clergy
The marks of a profession are: competence in a specialized body of knowledge and skill; an acknowledgment of specific duties and responsibilities toward the individuals it serves and toward society; the right to train, admit, discipline and dismiss its members for failure to sustain competence or observe the duties and responsibilities
What is the difference between a profession and a business? professionals may engage in business and make a living by it. However, that professionals have a particularly stringent duty to assure that their decisions and actions serve the welfare of their patients or clients, even at some cost to themselves.
professionalism requires that one strive for excellence in the following areas which should be modeled by mentors and teachers. Altruism: A physician is obligated to attend to the best interest of patients, rather than self-interest. Accountability: Physicians are accountable to their patients, to society on issues of public health, and to their profession. Excellence: Physicians are obligated to make a commitment to life-long learning. Duty: A physician should be available and responsive when "on call," accepting a commitment to service within the profession and the community. Honor and integrity: Physicians should be committed to being fair, truthful and straightforward in their interactions with patients and the profession. Respect for others: A physician should demonstrate respect for patients and their families, other physicians and team members, medical students, residents and fellows.
Dr.Seyed Ziaoddin Tabei Ethical issuues in transfusion medicine
In 1980 the International Society of Blood Transfusion endorsed its first formal code of ethics. A revised code of ethics for donation and transfusion :2000
The practice of transfusion medicine involves a number of ethical issues because blood comes from human beings and is a precious resource with a limited shelf life. It involves a moral responsibility towards both donors and patients.
A code of ethics for blood donation & transfusion
1. Blood donation, including haematopoietic tissues for transplantation shall, in all circumstances, be voluntary and non-remunerated; no coercion should be brought to bear upon the donor. The donor should provide informed consent to the donation of blood or blood components and to the subsequent (legitimate) use of the blood by the transfusion service.
2. Patients should be informed of the known risks and benefits of blood transfusion and/or alternative therapies and have the right to accept or refuse the procedure. Any valid advance directive should be respected.
In the event that the patient is unable to give prior informed consent, the basis for treatment by transfusion must be in the best interests of the patient.
4. A profit motive should not be the basis for the establishment and running of a blood service.
5. The donor should be advised of the risks connected with the procedure; the donor's health and safety must be protected. Any procedures relating to the administration to a donor of any substance for increasing the concentration of specific blood components should be in compliance with internationally accepted standards.
6. Anonymity between donor and recipient must be ensured except in special situations and the confidentiality of donor information assured.
7. The donor should understand the risks to others of donating infected blood and his or her ethical responsibility to the recipient.
8. Blood donation must be based on regularly reviewed medical selection criteria and not entail discrimination of any kind, including gender, race, nationality or religion. Neither donor nor potential recipient has the right to require that any such discrimination be practised.
9. Blood must be collected under the overall responsibility of a suitably qualified, registered medical practitioner. 10. All matters related to whole blood donation and haemapheresis should be in compliance with appropriately defined and internationally accepted standards.
11. Donors and recipients should be informed if they have been harmed. 12. Transfusion therapy must be given under the overall responsibility of a registered medical practitioner. 13. Genuine clinical need should be the only basis for transfusion therapy.
14. There should be no financial incentive to prescribe a blood transfusion. 15. Blood is a public resource and access should not be restricted.
16. As far as possible the patient should receive only those particular components (cells, plasma, or plasma derivatives) that are clinically appropriate and afford optimal safety. 17. Wastage should be avoided in order to safeguard the interests of all potential recipients and the donor.
18. Blood transfusion practices established by national or international health bodies and other agencies competent and authorised to do so should be in compliance with this code of ethics.
Example:Patient, a 44-year-old male, is brought to the emergency room by Emergency Medical Services. He has lost a great deal of blood as a result of a car accident. The ER physician determines that he is in need of an immediate blood transfusion in order to stabilize him for surgery. Patient is conscious and refuses to consent to the blood transfusion. The ER physician informs him that he may not survive unless he has the blood transfusion and the surgery. He still refuses to consent to the blood transfusion. His family cannot be located. Within a short time, Patient lapses into unconsciousness. Determining that Patient will die soon without the blood transfusion, the ER physician orders the transfusion, and Patient is taken to surgery. Patient makes a full recovery, and he sues the ER physician for assault and battery.
Which one of the following statements most accurately reflects the likely outcome of the lawsuit and the rationale behind it?
Patient will lose his lawsuit because consent is unnecessary in an emergency. Patient will win his lawsuit because he did not consent to the blood transfusion. Patient will lose his lawsuit because he was not competent at the time the blood transfusion was administered. Patient will win his lawsuit because he was not informed of the material risks of getting a blood transfusion.