ETHICS AND PROFESSIONALISM IN THE HEALTH SECTOR CURRENT CHALLENGES Dr.Apollo O.Epuwatt, Consultant Physician, Kinics of St.Francis,Tororo Dr P.T. Lecturer - BUSHS

Definition - ETHICS Ethics – moral principals that control or influence a persons behavior - The branch of philosophy that deals with moral principals Ethical: morally correct or acceptable (Oxford ALD)

Definition - PROFESSIONALISM Profession: type of job that needs special training or skill, especially one that needs a high level of education: medical/legal/teaching/nursing Professionalism: the high standard that you would expect from a person who is well trained in a particular job: we were impressed by the professionalism of the staff (Oxford ALD)

Based on the Hippocratic Oath AREAS OF FOCUS 1)Doctor to Profession 2)Doctor to Doctor 3)Doctor to Patient 4)Doctor to Community 5)Doctor to Profession 6)Doctor to Self 7)Doctor Other Health Professionals

Doctor to Profession A doctor has cardinal obligation to the profession that ‘makes’ us, to UPHOLD: 1)The highest moral reputation, honor and dignity of the profession and the doctor 2)Highest standards of medical practice 3)Advancement of knowledge and technology 4)Teaching and mentorship of others in/for the ‘propagation’ of the profession

Doctor to Doctor Regard with the highest esteem: 1)Each Others Work 2)Each Others Person 3)Each Others Family 4)Each Others Welfare

Doctor to Patient Sworn Obligation to: 1)To give informed care 2)Point to better care early 3)Guide to the best care 4)Always give dignified care 5)Never to do harm to patient or family

Doctor to Community We have an obligation to: 1)Inform and educate the community on best health practices and other health related issues 2)Protect our communities from disease, and the effects thereof, and from exploitation 3)Advocate for the best health care services for ALL – we cannot afford to be partial

Doctor to Self A doctor has an obligation or responsibility to himself with regard to the profession to: 1)Conduct and present himself to colleagues and society in a manner worthy of the trust and honor of them and the honorable profession 2)Constantly update, develop and equip him/herself for excellence in service 3)Take care of himself and those under his social care 4)Observe the Law

Doctor to Other Health Professionals 1) Training & Supervision 2) Guidance and Mentorship 3)Leadership 4)Balanced Partnership & Cooperation 5)Cautiously/respectfully - but firmly and surely [re]poses Team Leader Role

Emerging Trends 1)Distance Between Doctors - Costly 2) Dwindling Trust from Community 3) Growing ‘Autonomy’ of the other health professions - ? less interdependence 4) Near Anarchy in the health sector –’Things fall apart – the centre cannot hold’ (CA)

Emerging Situations – Proliferation of Training Institutions Concerns: 1)Selection for training 2)Quality of Training 3)Qualification – ‘money vs. marks’ 4)Quality of Internship & Doctor 5)Deployment 6)Supervision

Evolving Situations - Technological Advancement Concerns: 1)Effectiveness 2)Usefulness 3)Harmful/Side Effects 4)Affordability 5)Rational Use and Operator Competence

Evolving Situations - Medical Tourism 1)Inappropriate terminology 2) Positive Aspect 3) Negative Aspects 4) Need for regulation and accreditation (UMA- 7S)of centers

AREAS OF CHALLENGES Summary 1)Doctor Solidarity 2)Health Training 3)Commercialization 4)Health Regulation

WAY FOWARD 1)Vigilance,Cooperation, and Involvement by ALL Doctors in matters of Ethics & Professionalism 2) Harmonized Regulation - NHRA 3) Inter-Professional Cooperation within the health sector acknowledging that we ALL deal with dear SACRED LIFE 4) Emphasize the teaching and practice of ethics in all disciplines in the health sector 5) Stem the invasion by non-professionals and non- professionalism from undermining ethics, trust,and good practice and professionalism in the health sector

INSIST ON 1)ETHICS is part and parcel of all health professions, and greatly influences the quality of service provision. 2)Professionalism has to do with HIGH STANDARDS in training and practice, and must never be compromised in selection, training, assessment, qualification, internship, supervision and accreditation – and saves lives. 3)A clear effective National Health Regulatory Authority – without duplication - must be put in place.

ROLES FOR UMA 1)General Advocacy and Policy Advice 2)Prevent Exploitation 3)Rational use of meager resources 4)…… 5)…… 6)…… 7)……

EYALAMA ! Mbale THANK YOU!