This action might not be possible to undo. Are you sure you want to continue?
Prof.DR.Dr. H Soewadi, MPH, SpKJ (K)
conduct and policy-of life sciences and health care.Definition int-prog medicine Bioethics in the systematic study of the moral dimensions including moral vision. employing a variety of ethical methodologies in an inter-disciplinary setting. decisions. 2000) 2 . (Kuganse and Sheldon.
Beneficence. Justice (threat each people morally right and proper) 3 . Respect for Others (autonomy.Basic Moral / Ethical Principle int-prog medicine 1. self-determination) 2. Non – Maleficence. privacy. do no harm 3. dignity. confidentiality.
int-prog medicine Bioethics Health Ethics Medical Ethics Clinical Ethics Ethics in Services Research Education 4 .
etc. Psychology. Nursing. Health.Disciplines. Philosophy. Field of Studies int-prog medicine Medicine. Anthropology. Departments. Midwifery. 5 . etc Sociology.
II.disclosure .American College of Physician. 2000 int-prog medicine Principles : . III.inform consent Manual of Ethics I.Non-maleficence .Autonomy – truth –telling . Patient and Physician The Physician and Society The Physicians Relationship to other clinician 6 .Beneficence .
7. Patient and Physician int-prog medicine 1. 5. Physician Relationship Confidentiality The Patient and the Medical Record Disclosure Informed Consent Decisions about Reproduction Genetic Testing 7 . 6.I. Initiating and discounting Patient – 2. 3. 4.
15. Friends and Employees Sexual Contact between Physician and Patient Care of Patients Near the End of Life Patients Need the End of Life Making Decisions Near the end of life Advanced Care of Planning 8 .int-prog medicine 8. 16. 13. 12. Medical Risk to Physician and Patient Alternative Treatment Disability Certification Care of the Physician’s Family. 9. 11. 10. 14.
Problems of life-sustaining Treatment With drawing or with holding Treatment Do Not Resuscitate Orders (DNR) Determination of death Organ donation Irreversible loss of Consciousness Intra venous fluids and Artificial feedings Physician assisted suicide and euthanasia 18. The ethics of practice The changing practice environment Financial arrangement Financial conflict of interest Advertising 9 .int-prog medicine 17.
4. 5.int-prog medicine II. 7. The Physician and Society Obligation of the Physician to society Resources allocation Relations of the Physician to government Ethics Committees and Consultation Medicine and Law Expert witnesses Strike by physician 10 1. . 6. 2. 3.
Conflicts among members of Health care team 6. Scientific publication 10. Public announcement of research Discoveries 11 . Attending Physicians and Physician in Training 2. Innovative Medical Therapy 9. Consultations 3. Clinical investigation 8. Research 7. The impared physician 4.The physician’s Relationship to the other Clinicians int-prog medicine 1. Peer Review 5.
Shared Decision Making 3. Two Rules: a. Basic Ethical Principles 1.Clinical Ethics (Forrow. 1999) int-prog medicine I. Fundamental Principle: A clinical intervention is justified if and only if the expected benefits outweigh the expected burdens from the perspective of the patient 2. Patient is not competent . et. A competent patient 12 b. Shared Decision Making a. Al. Paternalism Complete patient autonomy b.
II. country has their own judicial guidance Brain death-specific criteria-patients legally dead 13 . have a legal right-to accept or refuseIncompetent adult. 4. 2. Medico-Legal Perspective int-prog medicine 1. 3. 5. Competent adult. have the same rightSurrogate decision maker (“proxy” or “healthcare agent”)Each state.
Think about who should decide as well as what decision is best 14 .III. Seek out win-win solution – and be creative 3. Good decisions require good data 2. An Approach for Specific Cases int-prog medicine 1.
if any. The Ethics Work-Up int-prog medicine 1. 6. 5. 3. are in conflict? POSSIBLE COURSES of ACTION DECISION AND JUSTIFICATION FURTHER REFLECTION – Preventive ethics 15 . FACTS = What are the important facts in the case? VALUES = What are the most important value at stake? CONFLICTS = What values. 4. 2.IV.
How to weigh different values .V. Resolving ClinicalEthical Disagreements int-prog medicine Disagreement about : .Fact .Values .Where decision-making authority lies? 16 .
VI. 17 . Preventive Ethics int-prog medicine a. often and realistically about goals and end points. Communicate early. Establish a trust worthy partnership with patient and family b.