Medical Ethics and Professional Conduct

Medical Ethics and Professional Conduct

Introduction

·       Medicine is not only a science but also an art guided by morality, values, and humanistic principles. The doctor–patient relationship is based on trust, responsibility, and accountability.

·       Medical ethics serves as the moral compass for physicians, ensuring that they prioritize patient welfare while balancing professional duties and legal responsibilities. Professional conduct and etiquette further define the standards of behavior expected from doctors in society.

·       In modern healthcare, where technological advancements, commercialization, and complex legal cases are common, a strong ethical framework is vital for safeguarding patient rights, maintaining professional dignity, and promoting justice.

Basic Principles and Issues of Medical Ethics

Core Ethical Principles

1. Autonomy – Respecting a patient’s right to make decisions about their health.
2. Beneficence – Acting in the best interest of patients and promoting well-being.
3. Non-Maleficence – Avoiding harm and minimizing risks (“Do no harm”).
4. Justice – Ensuring fairness and equality in healthcare delivery.
5. Veracity – Truthfulness and honesty in doctor–patient communication.
6. Confidentiality – Safeguarding patient information and records.

Major Ethical Issues in Medicine

• Informed consent and patient autonomy.
• End-of-life care (euthanasia, withdrawal of life support).
• Organ donation and transplantation.
• Abortion and reproductive rights.
• Scarcity of resources (ICU beds, ventilators, organ allocation).
• Clinical trials and research ethics.
• Influence of pharmaceutical companies and conflicts of interest.

Importance of Ethics in Healthcare

• Protects Patients: Safeguards rights, dignity, and safety.
• Maintains Trust: Strengthens doctor–patient relationship.
• Guides in Dilemmas: Provides moral clarity in complex cases.
• Ensures Professional Integrity: Prevents misconduct, corruption, and malpractice.
• Promotes Social Justice: Encourages fair and equal treatment.
• Legal Safeguard: Reduces risk of litigation and protects doctors in court.

Developing and Implementing Ethics in Institutions

Process Steps

1. Need Assessment – Identifying ethical challenges in practice.
2. Formulating Ethical Codes – Based on national/international guidelines.
3. Training and Education – Through CME, seminars, and case-based discussions.
4. Ethics Committees – Hospital Ethics Committees (HECs) and Institutional Ethics Committees (IECs) to resolve dilemmas.
5. Implementation – Integrating ethics into policies, patient rights charters, grievance redressal.
6. Monitoring & Review – Continuous assessment and updating policies.

Declaration of Geneva

The World Medical Association’s Declaration of Geneva (1948, revised) is considered the modern version of the Hippocratic Oath.

Main Highlights

• Health of the patient is the first consideration.
• Gratitude and respect toward medical teachers.
• Commitment to serve humanity with conscience and dignity.
• Patient confidentiality and respect for autonomy.
• No discrimination on grounds of age, sex, race, religion, political affiliation, or social status.
• Obligation to share medical knowledge for community welfare.
• Rejection of corruption, exploitation, or human rights abuse.

MCI (Now NMC) Regulations – Professional Misconduct of Doctors

·       The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 (framed by MCI, now under NMC) lay down rules of conduct for doctors.

Examples of Misconduct

1. Sexual misconduct or exploiting patients.
2. Advertising or soliciting patients through self-promotion.
3. Endorsing commercial products or drugs.
4. Prescribing secret or unscientific remedies.
5. Running a medical shop for profit.
6. Covering or helping unqualified practitioners (quacks).
7. Breach of patient confidentiality.
8. Issuing false certificates/reports.
9. Performing illegal abortions or prenatal sex determination (PNDT Act violation).
10. Accepting commissions, kickbacks, or gifts from pharmaceutical companies.
11. Negligence leading to patient harm.
12. Failure to maintain medical records for at least 3 years.

Punishment: Warning, suspension, temporary or permanent removal from the Medical Register.

Medical Jurisprudence, Professional Conduct, Etiquette, and Ethics

Medical Jurisprudence

• The legal aspects of medical practice.
• Covers consent, negligence, medico-legal cases, forensic responsibilities, medical documentation.

Professional Conduct

• Standards of behavior expected of doctors in their professional role.
• Includes honesty, punctuality, diligence, accurate record-keeping, and respect for patients.

Medical Etiquette

• Social customs and manners in medical practice.
• Example: greeting patients, respecting seniors and colleagues, proper referral practices, professional dress code.

Medical Ethics

• The moral philosophy guiding decisions where the law is silent.
• Focused on “what is right” rather than “what is legal.”

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