Ethical considerations for better health 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan,

Ethics: What is it? That branch of philosophy that examines the basis for right and wrong, good and bad, and attempts to provide reasons for recommending norms for behaviour. Please note: morality refers to what people believe is right or wrong about relationships, and that a wide range of ‘local morality’ can be observed around the world. 2016CMDA Biennal Conference, College of Medicine, University of Ibadan

Basic principles of ethics. Respect for persons: autonomous and be protected Autonomy - informed consent - voluntariness - disclosure of information and understanding reasonable person or reasonable physician/reasonable volunteer standard? - competence 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

Basic principles of ethics. Nonmaleficence Beneficence justice (Beauchamp and Childress (1994) A set of values, principles, and beliefs that guides the behaviour of a specified group – business people, engineers, health administrators, journalists, lawyers, manufacturers, monks, physicians, surgeons. “What we should do” Standards of conduct 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

Further explanations :- Beneficence refers to the ethical obligation to maximize benefits and to minimize harms. This principle gives rise to norms requiring that research or treatment risks be reasonable in the light of the expected benefits, 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

Demands of beneficence contd. that the research design or treatment plan be sound, the investigators or those who treat be competent to conduct the research and treat competently to safeguard the welfare of the research subjects. proscribes the deliberate infliction of harm on persons; this aspect of beneficence is sometimes expressed as a separate principle, non-maleficence (do no harm). 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

Justice Justice refers to the ethical obligation to treat each person in accordance with what is morally right and proper, to give each person what is due to him/her. In the ethics of research involving human subjects the principle refers primarily to distributive justice, which requires the equitable distribution of both the burdens and the benefits of participation in research. 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

Justice contd… Differences in distribution of burdens and benefits are justifiable only if they are based on morally relevant distinctions between persons; one such distinction is vulnerability. "Vulnerability" refers to a substantial incapacity to protect one's own interests owing to such impediments as lack of capability to 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

Justifiable differences in distribution of Justice.. give informed consent, lack of alternative means of obtaining medical care or other expensive necessities, or being a junior or subordinate member of a hierarchical group. Accordingly, special provision must be made for the protection of the rights and welfare of vulnerable persons. 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

Ethics Law Policy ‘should’ ‘must’ ‘usually’ 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

What are patient’s rights? “bill of rights” in most cases include these:- Patient has the right to……. Considerate and respectful care Obtain complete and current information concerning his/her diagnosis, treatment and prognosis in terms patients can be reasonably expected to understand. Necessary information to give informed consent prior to the start of any procedure. 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

Patient’s rights contd. The patient has the right to…… Refuse treatment to the extent permitted by law, and to be informed of the medical consequences of his/her actions according to the law. Privacy (what of when spouses health is concerned? Duty to warn? Expect that all communications concerning him/her shall be treated confidentially 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

The patient has the right to…… Expect that within its capacity, a hospital must make reasonable response to the request of the patient Obtain any information as to the relationship of his/her hospital to other health care and educational institution in so far as her health is concerned. Know if the hospital proposes to engage in or perform human experimentation affecting his/her treatment 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

The patient has the right to…… Reasonable continuity of care Has the right to receive an explanation of his/her bill regardless of who is paying Know what hospital rules and regulations apply to his/her conduct as a patient. Be informed what to do in the event of an emergency Freedom of choice except in the case of emergency care 2016CMDA Biennial Conference, College of Medicine, University of Ibadan

As Christians where do we stand? Romans 6: 14 ..”…For sin shall not have dominion over you for you are not under the law, but under grace..” Romans 6: 16 “Know ye not to whom ye yield yourselves servants to obey, his servants ye are .....” Romans 7: 5 For when we were in the flesh the motions of sins which were by the law did work in our members to bring forth fruit unto death” Romans 7: 11For sin taking occasion by the commndment, deceived me, and by it slew me” 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

What is expected of us? 1 Corinthians 7: 20 “Let every man abide in the same calling wherein he was called” Which is our calling?: 2 Timothy 1: 9 “Who hath saved us, and called us with an holy calling, not according to our works, but according to his own purpose and grace, which was given us in Christ Jesus before the world began Matthew 5:6 Let your light so shine before men, that they may see your good works and glorify your Father which is in heaven” 2016 CMDA Biennial Conference, College of Medicine, University of Ibadan

What is expected of us? We are the Jesus many people will see until the judgment day We are the Bible many will read We may be passing judgment on people before God’s judgment day by our actions As is commonly said. “Why cause the darkness?” Light your little light in your corner God bless you 201 6CMDA Biennial Conference, College of Medicine, University of Ibadan

Olayemi Omotade Institute of Child Health College of Medicine University of Ibadan Ibadan 2016CMDA Biennial Conference, College of Medicine, University of Ibadan