1. Introduction to medical ethics BMS 234 Dr. Maha Al Sedik Dr. Noha Al Said Medical Ethics

2. Outline What is medical ethics? Why study medical ethics? Medical ethics and law. Differences between Islamic and Western medical ethics. Case study. Conclusion.

3. What is medical ethics?

4. Help me please

5. What is medical ethics? Dr. R, a general practitioner in a small rural town, is approached by a contract research organization (C.R.O.) to participate in a clinical trial of a new non steroidal anti-inflammatory drug (NSAID) for osteoarthritis. She is offered a sum of money for each patient that she enrolls in the trial. The C.R.O. representative assures her that the trial has received all the necessary approvals. Dr. R has never participated in a trial before and is pleased to have this opportunity, especially with the extra money. She thinks a lot.

7. Dr. C, a newly appointed anaesthetist in a city hospital, noticed that the behavior of the senior surgeon in the operating room. The surgeon uses out-of-date techniques that prolong operations and result in greater post-operative pain and longer recovery times. Moreover, he makes frequent crude jokes about the patients that obviously bother the assisting nurses. Dr. C think to report him to higher authorities or he must not make this.

8. Ethical challenges we face in our daily practice and find effective ways TO PUT THE PATIENT FIRST.

9. Each of the two cases studies invites ethical reflection. They raise questions about physician behavior and decision making not scientific or technical questions such as how to treat diabetes or how to perform a double bypass, but questions about values, rights and responsibilities. Physicians face these kinds of questions just as often as scientific and technical ones.

10. What is the difference between law and ethics?  Ethics and law relate to “right” and “wrong” conduct. While they are sometimes used interchangeably, they are different.  Just because something is unethical doesn’t mean it’s illegal.

11. Ethics: governs professional and social interactions. Law: governs society as a whole, often dealing with interactions between total strangers.

12. In house In petrol station Pregnant woman Against Law Against Ethics Against Ethics

13. Let’s say someone kills his business partner. Obviously that’s immoral, unethical, and illegal.

14. But, what if a married man has a love relationship with his next door neighbor? That qualifies as unethical. In some societies it’s not unethical. And we all know it’s not illegal (as a general rule).

17. Ethics : is the study of morality. Medical ethics: the branch of ethics that deals with medical practice.

18. Why we study medical ethics?

19. As long as the physician is a knowledgeable and skilful clinician, ethics doesn’t matter. Medical ethics is learned by observing how senior physicians act, not from books or lectures. Ethics is important, but our curriculum is already too crowded and there is no room for ethics teaching. Medical ethics is learned in the family, not in medical school. WHY STUDY MEDICAL ETHICS?

20. The importance of ethics in medical education will become apparent throughout this course. The study of ethics prepares medical students to recognize difficult situations. Ethical principles such as respect for persons, informed consent and confidentiality are basic to the physician-patient relationship. Ethics is also important in physicians’ interactions with society and their colleagues

21. Hippocrates Founder of medical ethicsthe fifth century B.C.E. (before the Christian era)

22.  From Hippocrates: Medicine is a profession, whereby physicians make a public promise that they will place the interests of their patients above their own interests.  In Islamic countries medical ethics are greatly influenced by developments in religion.  Medical ethics is also closely related to law.

24. Are Western & Islamic medical ethics the same ?

25. Case study: Dr. Huda is a Muslim Saudi resident who is doing her rotation in one of the largest women's hospitals in Toronto, Canada. Her consultant asked her to see a patient in the outpatient clinic who was 16 years old, unmarried, and living with her boyfriend. The patient asked Dr. Huda about the best contraception method she could use to avoid getting pregnant. She also asked her for advice on the safest way, and the safest place, to arrange an abortion, in case the contraception failed.

26. The Islamic approach to medical ethics and how it differs from Western approaches? Islamic medical ethics fall under what is known as religious ethics, which refer to the commands of God (Allah) as a reference for telling right from wrong.

27. How do Muslims tell right from wrong? Muslims have two main categories of sources to guide them on what to do and what not to do. 1)the main (primary): the Quran and the Sunnah. 2)the secondary sources: “Ijtihad”.

28. We are lucky to have this book

29. Examples of differences between Islamic and Western medical ethics? Tobacco smoking is unanimously considered as prohibited (haram ) Medically-indicated abortion is permissible by most of the trusted scholars before 40 days if it fulfils given conditions (see Module 16 on abortion by Prof. Kasule). The prohibition of smoking Hashish was made based on likening/comparing its effects to those of other illegal drugs.

30. The health authorities have the right to restrict the movement of a patient with serious contagious disease to prevent its spread to the general public. Male doctors should not casually examine female patients without a chaperone to avoid the possibility of inappropriate physical contact between them. Islam prohibits any reproductive gametes (ova and sperms) donation or exchange. This explains why many of the scholars were reluctant to accept IVF amid the fear of having the gametes messed up mistakenly or on purpose.

31. Removal of an organ from a patient cannot be judged as good or bad, unless the intentions of the doctor are known. For example, if the organ is removed with the intention to protect the rest of the body, then this is good, while if it is removed with the intention to be sold by the doctor to another patient then this is wrong. A surgeon who is expected to have a long surgery is allowed to perform his before the start of the surgery.

32. Conclusion  Medicine is both a science and an art.  Science deals with what can be observed and measured, and a competent physician recognizes the signs of illness and disease and knows how to restore good health.  The art of medicine involves the application of medical science and technology to individual patients, families and communities.  Islam provides us with guidance on how to make decisions about what is ethically acceptable.

34. Reference:  World Medical Association, Medical Ethics Manual, Medical Ethics Manual, 3rd edition 2015  Professionalism and Ethics Handbook for Residents.

35. Dr. Maha Al Sedik …… Dr. Noha Al Said