Ethics in primary care

Associate Professor Dr Ooi Chor Yau

Department of Family Medicine
Faculty of Medicine and Health Sciences
UNIMAS
Outline
• History of medical ethics
• The four principles of medical ethics
• Ethical theories
• Case study
History of medical ethics
• The Hippocratic oath (10th – 11th century).
• Thomas Percival (1794).
• Apothecaries Act (1815).
• American Medical Association (AMA) code of
medical ethics (1847).
• Tom Beauchamp and James Childress released
Principles of Biomedical Ethics (1979).

Wikipedia, 2023
The four principles of medical ethics
Concept of best interest – promoting what makes a
person’s life goes well.

Direct harm or failure to act; negligence.

Respecting a patient’s right to have control over her own

body and to make decisions about her medical treatment.
Confidentiality

Considerations of justice are of great importance in

deciding on allocation of resources, including medical
workforce, to different areas of health care.

Gilles, 2009
Ethical theories
• An over-arching theoretical framework for addressing the problem of
how human beings should behave with one another in the world.
• Three theories:
• Deontological
• Consequentialism
• Virtue ethics

Gilles, 2009
Deontological: the importance of intentions
• Duty.
• Right or wrong is determined by
the action itself rather than the
consequences that flow from
this action.
• Code of conduct, what should be
done and not.

Gilles, 2009
Consequentialism: measuring the good and
the not-so-good
• Right action in any situation
should be based on the
consequences of that action.
• The right action in any situation
is therefore that which produces
the greatest good for the
greatest number (benefit vs
harm).
• Evidence-based medicine is the
focal point.
Gilles, 2009
Virtue ethics
• The concept of ‘the good
doctor’.
• The values or qualities that
define the good doctor.

Gilles, 2009
Case study

Gilles, 2009
Conclusion
• The four principles of medical
ethics.
• Ethical theories.
• Not black or white.
• Application of the principles to
guide decision-making.
References
• https://en.wikipedia.org/wiki/Medical_ethics#:~:text=History,-
See%20also%3A%20List&text=The%20term%20medical%20ethics%20first,relying%20heavily%20on%20Perci
val%27s%20words.
• https://journals.sagepub.com/doi/abs/10.1093/innovait/inn189?journalCode=inoa#:~:text=In%20primary%
20care%2C%20ethical%20practice,useful%20in%20analysing%20ethical%20difficulties.
Thank you