INTRODUCTION TO MEDICAL ETHICS MODULE - 1

OBJECTIVES By the end of this module, STUDENT will be able to: understand the structure and goals of this handbook 2. utilize the cases and discussion points in each module 3. define the basic terminology related to ethics of health care

LECTURE OUTLINES PEHR DEFINITIONS OF TERMINOLOGY AND CONCEPTS. CASE DISCUSSION

PEHR PEHR stands for Professionalism and Ethics Handbook for Residents program that was developed and launched by the Saudi Commission for Health Specialties (SCHS).

Ethics Ethics can be defined as the system of moral principles that govern the conduct of an individual or a group of individuals and according to which human actions are judged as right or wrong, good or bad.

It is generally divided into: Ethics It is generally divided into: META ETHICS NORMATIC ETHICS APPLIED ETHICS

Meta-ethics that seek to understand the nature of ethical properties, statements, attitudes, and judgments

Normative ethics investigate the set of questions that arise when considering how one ought to act, morally speaking. (Normative ethics are distinct from meta-ethics because they examine standards for the rightness and wrongness of actions).

Applied ethics that define how to apply moral standards in various practical fields like health care (bioethics), business (business ethics), environment (environmental ethics)

Bioethics This is the division of applied ethics that helps in defining, analyzing, and resolving ethical issues that arise from the provision of health care or the conduct of health-related research.

Clinical (medical) ethics This is the branch of bioethics that is related to the identification, analysis, and resolution of moral issues that arise in the health care of individual patients.

Research ethics This is the branch of bioethics that is related to the identification, analysis, and resolution of ethical issues that are encountered before, during, and/or after the conduct of health-related research, specifically on humans (or animals).

Public health ethics This is the branch of ethics that is related to the identification, analysis, and resolution of ethical issues that are encountered in the conduct of public health interventions and/or research on a large-scale population.

Islamic bioethics It is: the methodology of defining, analyzing, and resolving ethical issues that arise in health care practice or research based on the Islamic moral and legislative sources (Quran, Sunnah, and Ijtihad) aimed at achieving the goals of Islamic morality (i.e., preservation of human religion, soul, mind, wealth, and progeny)

Why is it important to know about bioethics? Basically, bioethics helps us in answering three main questions that are usually encountered in health care provision, which are as follows: Deciding what we should do (what decisions are morally right or acceptable),

Explaining why we should do it (how do we justify our decision in moral terms), and Describing how we should do it (the method or manner of our response when we act on our decision).

Case (ethical scenario) A resident in her obstetrics and gynecology rotation was faced with a case of a 28-year-old pregnant woman of 13 weeks gestational age, who is already a mother of three healthy children. The woman was diagnosed with ovarian cancer stage 2. The oncologists made a recommendation to the obstetric team to terminate the pregnancy to initiate chemotherapy.

The resident was not sure whether it was lawful, from an Islamic perspective, to terminate the pregnancy. She found no clear guidance from an Islamic perspective in the medical textbooks that she had found in the library, which were all written and published from a Western perspective. She asked her colleagues in the hospital's religious affairs department if they had written a Fatwa- based policy or statements on the issue. She did not find a clear answer, so she started to search the Internet and finally found a few Arabic written Fatwas that allowed similar acts in similar types of patients. However, the resident was not fully satisfied, and was quite frustrated from the time and effort that she had to exert to find an answer to the condition she had faced. Moreover, what she had found was not clear to her, as the Fatwa was full of Fiqhi terminology that she was not familiar with.

Case discussion For any clinical aspect related to the care of patients, the clinical team, including residents, should make sure they offer the patient the care that is compatible with the patient‟s moral values and religious beliefs. In many instances, the patients themselves may ask the doctor about the religious ruling (Fatwa) related to their condition. These questions may be simple, like how to perform Tayamoum, or which drugs can interfere with fasting in Ramadan. This is particularly important when it comes to a very sensitive issue like termination of pregnancy, whose ethical and religious bases are also explained in the module on end-of-life decisions

DO YOU HAVE ANY QUESTIONS?????????