Pediatrics medical ethics

Prof .Razzaq J Alrubaee

Pediatrics consultant DCH ,CABP
University of the-Qar college of medicine
Pediatrics department 2022
Objective
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Definition

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Classification or types
Our role as care givers
Definition
⚫ Greek word mean ethikos which mean moral ,

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character
Ethics principles are general statement about what
types of actions are right or wrong including
principles of:
1. autonomy ‫اﻻﺳﺘﻘﻼﻟﻴﻪ‬
2. beneficence ‫ﻓﻌﻞ اﻟﺨﻴﺮ ﻟﻠﻤﺮﻳﺾ‬
3. non maleficence ‫ﻋﺪم اﻻﺿﺮار ﺑﺎﻟﻤﺮﻳﺾ‬
4. justice ( done on 1995)
Factors affecting or influencing
ethics in pediatrics :
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Laws

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Religions

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Scientific studies

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Philosophy
Moral
 Understanding the basis for
clinical ethtics
⚫ Ethical philosophies
⚫ Deontology:
⚫ ( the study of the nature of duty and obligation).
⚫ Consequentialism:
⚫ Virtue( behavior showing high moral standards)
( whether an act is morally right depends only on consequences)

⚫ life.)
Hedonism( pleasure or happiness is the sole or chief good in

⚫ Formalist: is the practice or the doctrine ‫ ﻋﻘﻴﺪه‬of strict

adherence to prescribed or external forms (as in religion or
art);
Clinical ethics last and present
time
⚫ Before 1965 based on traditional professional ethics

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of medicine

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Physician was major decision maker
After 1965 based on patient rights and advanced
medical technology
Clinical ethics

⚫ Medical ethics is primarily a field of applied ethics

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Value of medical ethics

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Confidentiality

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Beneficence

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Non –maleficence

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Autonomy
Conflict of interest futility (conflict between private
interest and the official responsibilities of a person in a
position of trust )
Six values that commonly apply to
medical ethics are:
1. Beneficence :should act in best interest of the patient
2. Non –maleficence : first do no harm
3. Autonomy :the patient has right to refuse or choose
their treatment
4. Justice :distribution the scarce health resources and
decision who gets what treatment (fairness and equality )
5. Dignity :the patient ( and person who treat the patient
)have the right to dignity
6. Truthfulness and honesty :the concept of informed
consent
Principles of medical ethics
⚫ Physician shall be dedicated to providing competent
medical care with respect for human dignity and

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rights
Shall uphold the standard of professionalism ,be
honest and strive to report physician deficient in

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character or competence
Shall respect the law and recognize a responsibility to
seek changes in those requirement which are
contrary to the best
⚫ shall respect the rights of the patient ,colleagues
and other health professional and shall safeguard

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patient confidence and privacy
Shall continue to study ,apply and advance scientific
knowledge ,maintain a commitment to medical
education
Ethical issues in health care
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Confidentiality /privacy

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Maintenance of healthcare provider competence

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Quality of life

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Right to live or die

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Participation in the decision making process

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Abortion
Eutanasia (ending life to relieve pain )
Ethics issues in pediatrics
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Refuse immunization

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Refuse seek care

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Genetic therapy

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Congenital anomalies

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Withhold therapy vs withdrawal of treatment

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End of life decision
Informed consent: one of the founding principles of research
ethics{duty of health care provider to discuss the risk and benefit of
treatment or a procedures to patient prior giving care }
 Futility ‫ال ﻻﺟﺪوى او اﻟﻌﺒﺚ‬
⚫ If reasoning and experience indicate
that the intervention would be highly
unlikely to result in a meaningful
survival for that patient
Who has the authority to make
health care decision
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Parent moral responsibility for their child care

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Their responsibility can over ride a child refusal
legal guardian responsibility acquired by people who

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are not the child`s nature parents
Parents / legal guardian role is not unlimited
Special circumstanses
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Child abuse
Congenital malformation
Cautery for
diarrhea
Delay jaundice
treatment
For hepatitis
Milk and drug companies
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Ordinary and medical formulas (indication )
Breast milk is the best ,no absolute contraindication
medical formulas needed on special occasions :
• {Chronic diarrhea ,regurgitation ,CMPA…..etc}
⚫ Drugs (antibiotics , tonics …….etc ) is needed ?

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Dealing ? Commissions ?
Tha
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