Етика і культура безпеки в медичній практиці

Abstract

Medical practice is connected with the greatest social values - people's health and life. Its subjects and objects are people with numerous social and biological differences and characteristics. It is obvious that under such circumstances it is impossible to normalize all situations of this practice. Therefore, this involves the wide application of moral laws in health care, supplementing the mechanisms of legal regulation of the relationship between the medical worker and the patient with the norms of medical ethics and deontology. That is why none of the professional communities has at the world, regional and national levels so many conventions, codes, declarations, oaths of a moral and ethical plan, which are an integral part of the regulatory and legal framework of medicine. But ethics and law are not identical. Quite often ethics declare standards of behavior higher than the law. There are known cases where ethics require that doctors not obey laws that require unethical behavior (WMA, 2009). Medical ethics puts the patient and his safety above other criteria for the quality of medical care, above the interests of medical workers. None of these moral and ethical documents bypasses the issue of patient safety, starting with the Hippocratic one: "refraining from causing any harm" and ending with the Code of Ethics of a doctor of Ukraine, which emphasizes that "a doctor must carefully analyze the mistakes made and discuss them with colleagues and guidance for the prevention of similar cases in the clinical practice of other doctors." Patient safety is considered an ethical imperative (Vicki D. Lachman, 2007). This is consistent with the concept of safety culture developed by the IAEA after the accident at the Chernobyl nuclear power plant (IAEA, 1991) to prevent emergency situations in the nuclear power sector. The concept of safety culture is considered as a mechanism for identifying hidden safety deficits and puts its level above the requirements of legislation and regulatory bodies (ILO, 2001). The World Health Organization declared its commitment to safety culture principles in 2005 and called on national health care systems to follow suit. In a recent document, the Global Alliance for Patient Safety (HURST, Samia, et al., 2013) emphasizes the need to consider ethical issues in patient safety research. Considering the above, the concept of safety culture, based on the principles of medical ethics, is at the same time its section in the part related to the formation of a safe hospital environment. Today, many countries have successful experience of using safety culture in medicine, and using it and developing it is an urgent task of the domestic medical community. No conflict of interests was declared by the authors.