Code Of Medical Ethics Research Articles

Doctor’s Legal Liability Against Consultation Via Online if a Patient Experiences Loss

Health is need of every human being in living his/her life. Health is also crucial because without good health, it will be difficult for every human being to carry out his/her daily activities. Entering an era of rapid development, the world is faced with the emergence of new technologies in the medical field that allow doctors to practice in a virtual space. To analyze the legal basis of online medical services as well as to analyze the legal liability of doctors in providing online medical services if a patient experiences loss. Until now, there have been no detailed regulations regarding online-based medical services, both in statutory provisions and in the provisions of the medical code of ethics. Law Number 36 of 2009 concerning Health and Law Number 29 of 2004 concerning Medical Practice so far have not been used as a reference for the administration of medical practice using online-based medical services. Furthermore, Law Number 11 of 2008 concerning Electronic Information and Transactions also cannot be used as a reference.

Emerging issues related to the management of patients in custody during the COVID-19 outbreak in France

PurposeThis paper aims to give an overview of emerging issues relating to the management of patients in custody during the COVID-19 outbreak in France.Design/methodology/approachDuring custody in France, a medical consultation is provided for any patient who requests it. In the Paris area, this consultation is carried out by a practitioner in forensic medicine, based in a general hospital. Usually, most medical consultations for patients in custody take place directly in police stations. With the COVID-19 outbreak, the authors chose to suspend this activity, asking law enforcement to bring patients directly to their hospitals. Patients presenting with severe infections or indicative symptoms of the severe acute respiratory syndrome Coronavirus 2 infection and a comorbidity are tested for COVID-19. Such patients remain hospitalized until results of the test are received. If the result is positive, they are hospitalized for the length of their custody. If sent to prison, they are transferred to a medical facility in detention.FindingsFrom the onset of the outbreak, the authors observed increased pressure from law enforcement to obtain medical information. According to the French Code of Medical Ethics, no medical information should be disclosed regarding the authors’ patients’ medical situations. The authors are also concerned about sending a potentially infected patient back to a police station, to prison or to his/her home.Originality/valueThis paper provides a snapshot of issues relating to the management of patients in custody during the COVID-19 outbreak in France. Unfortunately, the current situation in France does not permit a wider range of testing for the specified population in this paper.

AMA Code of Medical Ethics' Opinions Related to "Ending the HIV Epidemic: A Plan for America".

The AMA Code of Medical Ethics offers guidance on HIV screening that respects patient autonomy and protects public health in Opinion 8.1, "Routine Universal Screening for HIV." This article examines the relationship between this opinion and the Ending the HIV Epidemic: A Plan for America initiative and discusses the Code's guidance on the role that physicians can play in diagnosing and treating patients with HIV and mitigating the stigma surrounding the disease.

KAJIAN HUKUM PENGHENTIAN TERAPI BANTUAN HIDUP (WITHDRAWING OF LIFE SUPPORT) DALAM PERAWATAN PALIATIF

Abstract— Withdrawing of life support was chosen as a preventive measure for the suffering of a person with an incurable disease. This action was taken because there is no other way that can help a person to escape the terrible suffering at the end of his life. Withdrawing of life support should observe the principle of Palliative Care, it does not aim to accelerate or prolong the patient's life. This research analyzes the legal norms of Withdrawing of life support using a statute approach, a conceptual approach and a comparative approach. The aim is to examine whether this action can be classified as an illegal act and what is the legal responsibility for the doctor who did it. Withdrawing of life support as Palliative Care is still continuing the normal treatment as a form of maintaining the quality of life for patients, while extraordinary treatments that are felt to be useless and futile. Determining what is ordinary or extraordinary is very important so that doctors and nurses can be sure that their professional actions do not violate ethics or law. Doctors as perpetrators of withdrawing of life support in Indonesia cannot be classified as a criminal crime against life. In outward acts (actus reus), these actions can result in the loss of a person's life. But the mental attitude (mens rea) to Withdrawing of Life Support is very different from murder. Civil liability arises when there is a violation of the rights of others, a violation of the perpetrator's legal obligations, violates decency and morality and violates the behavior of a good citizen. Good citizen behavior for a doctor refers to professional standards, standard operating procedures, medical code of ethics and the behavior of other colleagues.Keyword: legal aspect; responsibility; withdrawing of life support; palliative care

TANGGUNG JAWAB HUKUM DOKTER TERHADAP KONSULTASI VIA ONLINE APABILA PASIEN MENGALAMI KERUGIAN

Health is the need of every human being in living his life. Health is also very important because without good health, it will be difficult for every human being to carry out his daily activities. Entering an era of rapid development, the world is faced with the emergence of new technologies in the medical field that allow doctors to practice in a virtual space. The legal basis of online medical services as well as to analyze the legal responsibility of doctors in providing online medical services if a patient experiences a loss. Type of research is a normative juridical research and analysis of legal materials. The approach used in this study is a statutory approach and a conceptual approach. Until now, there have been no detailed regulations regarding online-based medical services, both in statutory provisions and in the provisions of the medical code of ethics. Law Number 36 of 2009 concerning Health and Law Number 29 of 2004 concerning Medical Practice have so far not been used as a reference for the implementation of medical practice using online-based medical services. Furthermore, Law Number 11 of 2008 concerning Electronic Information and Transactions also cannot be used as a reference.

Revision of §64 of the German Penal Code from a psychiatric perspective-Position paper of a task force of the German Association for Psychiatry, Psychotherapy and Psychosomatics

In Germany every second offence occasioning bodily harm and every fourth sexual offence occur under the influence of alcohol or drugs. Untreated substance use disorders are a risk factor for further offences. The §64 of the German Penal Code (StGB) regulates the commitment of offenders to a Forensic addiction treatment unit as a result of an addiction to excessive consummation of intoxicating substances. The previous regulation has come under criticism because too many patients are committed, the sentence is often given to the wrong persons, the treatment is often terminated without success and the sentence consumes to many resources. From a psychiatric perspective the reform of commitment to a Forensic addiction treatment unit (§64 StGB) must fulfil the principles of medical ethics, in particular the respect for the autonomy of the patient, the principle of distributional justice and the code of medical professional ethics. The commitment according to §64 must be restricted to the treatment of people with a clinically relevant substance use disorder. From a psychiatric perspective, decisive for the prospect of success are the willingness to be treated and self-determination for admission to the clinic. In order to release the treatment from the extrinsic influences of the enforcement law, on admission to treatment a sufficient amount of the sentence should have already been served that the commitment only serves the purpose of the treatment and resocialization, so that the risk of further substance-related offences is reduced. The legal term "Entziehungsanstalt" should be replaced by "Forensic Clinic for Dependancy Diseases".

When Research Serves Good Purposes

When Research Serves Good Purposes

The position of the polish bishops’ conference on LGBT+ – philosophical, theological, clinical and political aspects

IntroductionPracticing medicine cannot disregard cultural conditions. Philosophy and religion are elements of culture. For several years in Poland, various circles have discussed the extensive LGBT issues. A document of Polish Bishops on this subject appeared on 28.08.2020. In 2018, 91.8% of people over 16 years old in Poland declared affiliation to the Roman Catholic Church (Statistics Poland 2020).ObjectivesThe aim of the study is to present different perspectives of effects of that publication, including ethical evaluation and references to clinical practice.MethodsStatements of protagonists and antagonists of this document in Polish were analyzed. Collected arguments were divided into types: philosophical – by philosophy branches (e.g. ethics, philosophical anthropology), theological and clinical.ResultsAs of 29.09.2020 – 85,200 results in the Google Search after typing (in Polish) “Polish Episcopal Conference LGBT”. The use of philosophical arguments by both parties results from the adaptation of different systems, e.g. regarding philosophical anthropology, some assume the immutability of human nature, others – its variability and susceptibility to shaping, e.g. human sexuality. Some emphasize the importance of non-discrimination, while others indicate the need to consider human essence in determining directions of actions.ConclusionsProfessionals should help everyone, regardless of conditions, in accordance with conscience and contemporary medical knowledge [Polish Code of Medical Ethics]. They should try to understand patients and the context of symptoms. Familiarizing oneself with arguments of both sides helps in this. But polemical language makes dialogue difficult. What for one is a “venerable tradition”, for another is a “stereotype” or “discrimination”.

Legal Liability for Euthanasia Actions in the Perspective of the Medical Code of Ethics in Indonesia

Introduction: Euthanasia which is done by doctors to their patients is considered as a part of the act ofhuman rights violations, this matter would raise a dilemma for those who are pursuing a medical profession.Therefore, it is necessary to conduct research concerning legal liability related to euthanasia from theperspective of a medical code of ethics in Indonesia.Purpose: This research aims to acknowledge and analyze the legal liability related to euthanasia from theperspective of a medical code of ethics in Indonesia.Research Methodology: This research uses qualitative method with a normative juridical approach. Thedata collection technique is done through literature study.Conclusion: Doctors must not neglect the obligation to always protect human life, as regulated in themedical code of ethics in Indonesia so that the act of euthanasia is contrary to professional and legal ethicsand if it continues to be carried out, it can create criminal liability as regulated in the Criminal Code.

Derecho a morir dignamente desde la perspectiva del derecho disciplinario en Colombia

En Colombia, la protección jurisprudencial al derecho a morir con dignidad impuso al médico tratante nuevas responsabilidades y deberes en su ejercicio profesional, debido a la preponderancia del respeto por la dignidad, autodeterminación y autonomía de la voluntad del paciente terminal.
 Establecer si estas exigencias vulneran el código deontológico médico no ha sido sencillo, pues tuvieron que considerarse aspectos como el principio de legalidad, la reserva de ley y la objeción de conciencia en relación con las garantías constitucionales, que elevaron tal derecho a la categoría de fundamental.
 Este artículo presenta un análisis normativo y jurisprudencial del cambio de paradigma del derecho a la vida como absoluto e inviolable, para relativizarlo y analizar el paso al surgimiento del derecho fundamental a morir dignamente; además, se verifican elementos objetivos y subjetivos de este derecho, para concluir en qué circunstancias se presentaría responsabilidad médica disciplinaria.

Letter to the Editor RE: Reasons to Accept Vaccine Refusers in Primary Care

I read with interest the Pediatrics Perspective from Drs. Navin, Wasserman, and Opel regarding refusal to accept vaccine refusers in primary care.1 I myself am a general pediatrician and have practiced primary care for almost 22 years in a community which is home to one of the most active anti-vaccine organizations in my state. This experience obviously informs my perspective on this important topic.While I appreciate the approach taken by the authors to categorize the values and motivations which are relevant to the question of accepting patients whose parents refuse vaccinations, it is my opinion that their arguments are perilously reliant on semantics and faulty casuistry. For example, the authors assert that the accepted freedom to select one's patients [American Medical Association Code of Medical Ethics (§1.1.2)] does not permissibly extend to the freedom to refuse patients whose parents do not vaccinate. Such a refusal to accept such patients would putatively be based upon the parents' demand for medically inappropriate care, the inability of the clinician to provide competent care, or the compromising of care of existing patients by accepting said new patients who refused vaccinations.They state that the refusal to vaccinate is not an example of demanding medically inappropriate care but rather a refusal of appropriate care. I do not think that this is a meaningful difference and I find the argument unconvincing. One can also reasonably argue that being prevented from providing recommended vaccinations significantly reduces the ability to provide competent, good quality care. Being compelled to participate in care which is categorically substandard would also potentially injure the professional integrity of the clinician in question. Finally, there is the question of the clinician's duty to existing patients, which cannot be superseded by the clinician's duty to a possible new patient. While the quantity of risk of accepting patients who do not vaccinate may be debatable, that risk is not zero. The choice to not vaccinate one's child is not equivalent casuistically to a choice to provide poor nutrition to one's child. And, if the clinician makes an affirmative choice to accept patients who do not vaccinate and that results in transmission of a serious disease to existing patients in the practice, then that clinician is partly responsible for the morbidity or mortality that might arise from that occurrence.Let me say that I quite agree that every opportunity should be undertaken to educate and counsel families who are vaccine-hesitant; I do this regularly and am successful in the vast majority of these encounters. This is a heterogeneous population and most may be educable and receptive to that counsel. However, there are some families who will be unreceptive and hostile to such counsel. If a primary care practice determines that a family is firm in their refusal to accept vaccinations and will be hostile to counsel on this topic, then it should be permissible to determine that beginning a doctor patient relationship will be fraught with risk and untenable.

Voluntary informed consent

This article discusses voluntary informed consent (VIC), a prerequisite for any medical intervention. The article touches upon the history of this issue in modern health care and medical science. The role of the Nuremberg Code is emphasized, which is the basis for the Universal Declaration of Human Rights, the Code of Medical Ethics of the World Medical Association, and the Declaration on Bioethics and Human Rights. These documents helped define the world order after the end of World War II. The first part of the article reflects the history of the concept of VIC, while the second outlines the modern ethical views on this issue.

New age issues in medical ethics - time to address

Medical technology advancements and understanding along with constricted resources in provision of care to the needed, has arised ethical dilemmas. These are associated with the necessity of making decisions dependent on conflicting priorities, in the absence of established polices about the choice of the decision maker and the guiding principles checklist. Varying values and ethical models conflict current code of medical ethics making it inadequate. This article summarises key issues in contemporary medical ethics and a special note of medical negligence.

Cannabinoids: A new friend or just another pandemic?

Cannabinoids: A new friend or just another pandemic?

AMA Code of Medical Ethics' Opinions Related to the Legacies of the Holocaust in Health Care.

Two concerns about information from unethical experimentation are its legitimacy and trustworthiness. This article explores guidance about information use from the AMA Code of Medical Ethics.

Medical students in the COVID-19 pandemic response in Brazil: ethical reflections

Abstract: Introduction: In times of pandemics, the uncertainties and lack of evidence allow each country to conduct its response as it deems the most appropriate. This setting also facilitates the approval of public measures without adequate ethical analysis, due to its inherent urgency. With that said, the objective of this study is to promote a hermeneutical approach to the Brazilian Government proposals of including medical students in the fight against COVID-19 (Coronavirus Disease 2019) pandemic through an ethical perspective. Development: The governmental resolutions, published in the Brazilian Official Gazette, were discussed in the light of the Universal Declaration on Bioethics and Human Rights (UDBHR) and the Brazilian Medical Student Code of Ethics (CEEM), as the first one guides the debate through a pluralist, multi-, inter- and transdisciplinary bioethics, and the latter brings specified guidance to the studied population group. To better articulate the discussion, the main measures were subdivided into 3 sections: about the risk assessment; about the participation of 5th- and 6th-year students; about the early graduation. In the first one, the creation of participation alternatives has been proposed, including remote participation, without direct contact with patients, aiming to ensure the students’ integrity and to maximize the potential positive effects with minimum harm. After that, the predicted obligatory enrollment for undergraduate students attending the final years of medical school and the possibility of obtaining credit hours for the curricular internship in exchange for participation in the strategic action “O Brasil Conta Comigo” were assessed. Finally, the graduation anticipation and the need for a guarantee that the new graduates have the required knowledge and expertise for the medical profession were questioned. Conclusions: For an effective response against the disease, it’s necessary to collectively structure the adopted measures, benefiting from the capabilities that the students already have, while respecting their limitations, vulnerabilities, and freedoms. It should also be emphasized that any ethical decisions in the context of Medicine and of future generations of professionals can have immeasurable consequences for these individuals, their patients, and communities and thus, one must ensure that the benefits will be the best and greatest possible.

Medical students in the COVID-19 pandemic response in Brazil: ethical reflections

Abstract: Introduction: In times of pandemics, the uncertainties and lack of evidence allow each country to conduct its response as it deems the most appropriate. This setting also facilitates the approval of public measures without adequate ethical analysis, due to its inherent urgency. With that said, the objective of this study is to promote a hermeneutical approach to the Brazilian Government proposals of including medical students in the fight against COVID-19 (Coronavirus Disease 2019) pandemic through an ethical perspective. Development: The governmental resolutions, published in the Brazilian Official Gazette, were discussed in the light of the Universal Declaration on Bioethics and Human Rights (UDBHR) and the Brazilian Medical Student Code of Ethics (CEEM), as the first one guides the debate through a pluralist, multi-, inter- and transdisciplinary bioethics, and the latter brings specified guidance to the studied population group. To better articulate the discussion, the main measures were subdivided into 3 sections: about the risk assessment; about the participation of 5th- and 6th-year students; about the early graduation. In the first one, the creation of participation alternatives has been proposed, including remote participation, without direct contact with patients, aiming to ensure the students’ integrity and to maximize the potential positive effects with minimum harm. After that, the predicted obligatory enrollment for undergraduate students attending the final years of medical school and the possibility of obtaining credit hours for the curricular internship in exchange for participation in the strategic action “O Brasil Conta Comigo” were assessed. Finally, the graduation anticipation and the need for a guarantee that the new graduates have the required knowledge and expertise for the medical profession were questioned. Conclusions: For an effective response against the disease, it’s necessary to collectively structure the adopted measures, benefiting from the capabilities that the students already have, while respecting their limitations, vulnerabilities, and freedoms. It should also be emphasized that any ethical decisions in the context of Medicine and of future generations of professionals can have immeasurable consequences for these individuals, their patients, and communities and thus, one must ensure that the benefits will be the best and greatest possible.

Submission to the World Medical Association Re: International Code of Medical Ethics revision

This submission responds to the World Medical Association (WMA) request for public feedback about a proposed revision to the International Code of Medical Ethics (ICME). Amendments to Paragraphs 14 (Patient-centred practice) and 27 (“Conscientious objection”) are the principal concern. Paragraph 14 (Patient-centred practice) expresses the central principle of the ICME. Current controversies about freedom of conscience in health care frequently manifest fundamental disagreement about the meaning of terms used here: “care”, “health”, “well-being” and “best interest.” The Project recommends that “care” be replaced with “recommendations and treatment.” What is thought to be in a patient’s “best interest” can be disputed for a variety of legitimate reasons. The ICME should indicate the role and obligations of physicians by specifying that recommendations and treatments must be only those a physician “believes in good faith” to be in a patient’s best interest, “belief” making clear that the judgement is that of the physician, and “good faith” indicating reasonableness, good will and absence of duplicity, prejudice or discrimination. The proposed text of Paragraph 27 (“Conscientious objection”) is anomalous in relation to medical practice because it ignores the role of conscience in medicine and adopts an inadequate and prejudicial analytical framework. It does not attempt or even suggest how to accommodate physician integrity and patient requests when they conflict. It is also anomalous in relation to existing WMA policy and related functionally interdependent paragraphs in the proposed ICME. The Project proposes an amended Paragraph 27 that ∙ reflects the role of conscience in medical practice; ∙ identifies conduct morally relevant to participation in contested procedures; ∙ recognizing the potential for conflict between physicians and state or other authorities, brings other provisions of the ICME into play; ∙ includes brief guidance about physician obligations to provide information and ensure patient safety and continuity of care. The Project recommends that the ICME be supplemented by WMA policy on physician freedom of conscience. It strongly urges that a planned WMA conference should focus on conscience in medical practice, not conscientious objection.

Medical Laws and Ethics - The Conflict between Dual Constancy

The earliest known code of laws called the code of Hammurabi governed the various aspects of health practices including the fees payable to physician for satisfactory services. The first ever code of medical ethics called the Hippocratic oath was laid down 2500 years ago, in the 5th century BC, by Hippocrates—the Greek physician. The modern version of Hippocratic Oath (called the declaration of Geneva), devised by the WHO after the Second World War and is accepted by international medical fraternity.

Self-Defeating Codes of Medical Ethics and How to Fix Them: Failures in COVID-19 Response and Beyond

Statements of the core ethical and professional responsibilities of medical professionals are incomplete in ways that threaten fundamental goals of medicine. First, in the absence of explicit guidance for responding to cases in which there is significant uncertainty or disagreement about the relative therapeutic, prophylactic or diagnostic merits of available interventions they perpetuate self-defeating practices. Second, without addressing the role of advertising in shaping patient and community preferences they risk creating moral loopholes that bypass and undermine professional duties of fidelity, honesty and transparency. In both cases, these flaws are exacerbated by an individualism that ignores the critical role of health systems in managing and reducing uncertainty and conflict over best practices, and in communicating with and shaping the expectations of the public. These points are illustrated with examples from the response to COVID-19 and suggestions for reform are proposed.