RESPONSIBILITY OF PHYSICIANS Assist.Prof.Dr. Mehmet KARATAS Dept. of History of Medicine & Ethics

Responsibility Complying with ethical rules and regulations Taking care of patients health Complying with physician associations’ regulations of ethics Pursuing scientific studies Knowing how other physicians would behave in decision making in similar situations Making the right choice

Aim To protect physician’s “health” “employee rights” To sustain professional dignity

Legal Basis International Documents The Law on the Practice of Medicine and Medical Sciences Medical Ethics Charter Turkish Medical Association Code of Professional Ethics in Medicine Patients' Rights Directive Turkish Penal Code

Turkish Medical Association Code of Professional Ethics in Medicine The primary role of the physician is to protect the life of the patient by working on preventing diseases and treating the patient. Guarding the patient’s dignity is also the primary role of the physician.

Geneva Declaration (1949) At the time of being admitted as a member of the medical profession: 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.

Problems that Arise in the Health Care Presentation Physician/Patient Physician/Colleague Physician/Medical Professional Physician/Administration Physician/Pharmaceutical Company

Relationship with Colleagues Physicians should treat each other as members of family Physicians should not take charge from colleague’s family/spouse Physicians should not try to obtain his/her colleage’s patient Physicians should do their best to clarify their colleagues who fraud, lack in proficiency and professionalism

Medical Ethics Charter “Doctors and dentists, except in emergency situations, due to professional or personal reasons, may refuse to treat the patient” (charter)

Relationship between Physicians and Pharmaceutical Companies Presents should be given without expectations The receiver should not have an expectation The gift should not be used as investment The gifts should be given within moral values

Relationship between Physicians and Pharmaceutical Companies Relationship between physicians and pharmaceutical companies results in unfair increase in the price of the medication. This occurs without the knowledge of patients and it is inconsistent with one of the basic ethical rules: the principle of justice Physicians should give patients medications that are effective, cheap, fast resulting and that have fewer side effects.

Principles of the Turkish Medical Association on Physician and Drug Promotion Physicians should not accept high valuable gifts that in return would affect them in prescribing If the promotional material has an educational purpose or content, it can be accepted by physicians. If lower priced promotional materials contribute to physicians’ education, or beneficial for patients, they can be accepted.

Relationship between Physicians and Pharmaceutical Companies Application to Medical Charters can be made. After the research of Medical Charters; The ones doesn’t follow the principles may be declared in Turkish Medical Association’s Broadcast May be referred to the Board of Honor May be notified to the Ministry of Health (Regulation on Medicinal Products for Human Promotion Activities)

Advertisement ‘‘Medical doctors, dentists and treatment institutions can not have a commercial aspect. Medical doctors and dentists are obliged to keep the honor of medicine superior and are not allowed in any case to advertise themselves in their writings. Medical doctors and dentists cannot have appreciation announcements in newspaper for advertisement purposes.’’(charter)

References F. Başak ÇAKMAK/Bilal GÜNENÇ, İnönü Üniversitesi Tıp Fakültesi, translation Tolga GÜVEN, Marmara Üniversitesi Tıp Tarihi ve Etik AD ders notları Gürkan SERT, Hasta Hakları Robert M VEATCH, Medical Ethics Emine ATABEK, Mebrure DEĞER, Tıbbi Deontoloji Konuları Hasta Hakları Yönetmeliği, 1998 Klinik Araştırmalar Hakkında Yönetmelik, 2011 Çağlar Boyu Tıp, Roche Yayınları http://en.wikipedia.org/wiki/Main_Page