introduction of ethics and bioethics in medicine

As we learned in the previous class on the introduction of ethics and bioethics in medicine, ethics and bioethics is a very big field in medicine and in my opinion every medical student should be a wear of it from the early stage.  I realised that this field is important as any other subjects in medicine. And there might be big problems if any of medical students is not aware of it, due to several reasons many of these students will practice clinically on the patients and we will deal with them in reality. Hence unawareness in this subject can lead to many problems to the learners in future

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In today’s class, we learned the first bioethical principle of Human dignity and Human rights. This principle enabled me learn about several things I was not aware of it in the past. I learned that there are some medical practices where the human dignity is demanded. For example in case of the police and pre doctor demanded the prisoner.

In some situation, if I was the doctor, I will not handcuff the prisoner with the anaesthetic, because he is not able to do any harm, he is not  aware of himself, he can’t even move.  In addition, the big demand on his dignity is when he was asked for provide semen sample and his hand was cuffed in the presence of the prison officer. The doctor should ask the prison officer to open the patient hands and give the patient his support. In my opinion the prisoner is human and they have to respect his right. Considering a prisoner as a high risk does not give the right to take his right as a patient.

Beside the example, my thoughts went on thinking heavily about the principle in My sisters film. I think the parents should not decide of about getting  another child to save their older child, the small daughter even when she is not in the legal age but still she has the right to decide about her life and I think they should wait her until she get older to decide if she want to donate for her older sister or not. These examples opened my mind and widen comprehension on how to employs the ethical principle in the cues.

The Human variability and vulnerability principle we learned in class such as Biological, corpored   and social Imd as am medical student and future doctor we should and respected. In utilizing it in a number of cases, I realised that in medicine, the vulnerability is reduced as much as successful in same ways and not ion others as any principle of the ethical principle.

Essay 2

In today’s class we learned that there is some group of people who are unable to consent and decide for themself. Moreover, as we are adults, educated and conscious we can loss our capacity to consent in many different situations, like if we did an accident and we are unconscious we lose the ability to content and decide the treatment. I realised that this ethical principle will save the patents right in many different situations, for instance, if the patient has difficulty in learning or mentally ill and in many more situations they cannot make the right dissections and they need someone to make it or help them making it.

In addition, I learned that the patient did not understand the information of the consent and she signs it, it will not consider as legal sign. For example, if the patient decided to do a and the patient did not understand how it will be done or what is the consequences of it or even any single point was misunderstood then it would be considered as an illegal sign. And it is the doctor responsibilities to make sure that the patient did understand everything or not. The different cases we discussed helped me cultivate my principles and more principled. In the second case, I think there are several actions the doctor can do for this patient. First, I think the physician and the patient’s parents send him to psychiatrist because even if he is mentally well but the psychiatrist can change his believes as their job is to. The patient might not response to the psychiatrist because he does trust the doctors. I think talking to someone who he loves, respect or anyone that can effect would be as his psychiatrist and he might change his opinions about the food. And about the fact the patient refused to take any medicine in my opinion is that the parents can mix medicine and put it on his food. In this situation, we do not cross the patient autonomy and we cannot get over the patient right to consent, he is mentally well, adult and not unconscious but we can treat him as his parents by asking after him he is well and back to his normal situation. We can tell him about this step and tell him about that his parents’ consent. That’s one cause which shows us about the complexity of this ethic principle.

These inspired my thoughts about other similar situations and motivate me to open and search in ethical web sites about other situations. For example, if the patient has cancer and he is 19 years old with his mother visiting the physician to follow up his chemotherapy and suddenly he decided to stop his therapy so what the physician should do? I thought that the doctor should not stop it and force the patient to complete it but after this class I learned that the doctor should respect the patient decision and he is in legal age so the doctor should only informed him with all the consequences of stopping the treatment.

Essay 3 

In today’s lecture we learned about the basics four principles of medical practice. I learned that even with basic principles for each physician to follow it around the world there are some situations that can be broken and ruled by other principles. For example the law, each country has their own law, and in some countries it can be broken but in other it cannot. So the law changes some of the principles to be and make it suitable for their culture, religion and beliefs.

This led me to realise about one of the case of un married pregnant women in western countries who was followed up and late saved her autonym and rights. On the other hand in her country or in any Arab countries if the unmarried women get pregnant, the physician has the right to report her to the police so as to tell her family. When on some countries it will be illegal but in Arab countries it is totally legal. Therefore we can explain that the law can break the ethics principles in some situations.

We learned about justice in the past and through it I comprehended that it is the duty in allocation of resources and it does not mean that we have to treat every patient the same. For example if there was a two treatment for cancer patients, one of them is really expensive and the other one is not expensive, both of them can treat cancer but in different qualities for sure, and the patients’ condition is that one of them is stage one and the other one is in stage four and if the patient in stage one can pay the expansive and the other one cannot its totally fine and does not interfere with the justice the doctor can prescribe the medicine for each one budgets.

Before the class I would conclude that it is not justice but now I learned the right implement of it. As in every class we describe basic methodology in ethical reasoning. In the first case the girl in autonomy to decide her treatment. She is 18 years old and she has the capacity. Even if the doctor, does not see that this is best for her. Her mother was sad and worried that she will stop her treatment. She opted to send her to physician for the reason that maybe she will get better.

In my opinion, the doctor did the bet act, he told her the right situation and she get worst and also he told her all the consequences of stopping treatment. If I was him I will totally do the same but I will keep on my mind that maybe she is depressed after hearing the bad news and her condition , and I’ll request her to give me her final decision on the stop the treatment after  a period of time. In addition I will request her the to visit the psyicatrics before visiting me next time and giving me her final decision.

In the second care, as I mentioned that the law can break the ethical principles depending on the nation beliefs, religion and culture. The doctor respect that the patient is Jehovah’s Witnesses and can’t get blood transfusion even if her condition is in really dangerous situation and he might die. In my case if were him, I will do the same thing but in different way, I will respect not to transfuse and blood but I will try to transfuse the blood cell  speared alone from the lab and it will not be considered as blood as its just cells and not liquid. His family might accept the idea!

To sum it up, I learned that physician should not only follow the ethical principle but he should know the each country or nation deal with them differently and the physician should be aware of it and follow suit.

Essay 4 

In this session we continue talking about what we learned in the last session. I learned new concepts and how to employ the ethical principles. Sometimes the physician want to treat the patient but he can harm him without realising. For example, if the doctor wants to treat the patient with the treatment has side effects. In this case the physician should follow two principles: beneficence and non-malifiance. In non-malificane he should assist if the patient can afford the side effects or following the beneficence principle, he should chose the best drug for his patient, best drug means that the drug which has minimum side effects. So I learned about how more than one ethical principle can interfere with one situation.

We discussed also about confidentiality in this class and how it can be breached in some cases.  This principle opens my mind to think about possible causes that it can breach. For example, if a patient decided to kill someone and he confessed to his psychiatric about it, the physician has the right to breach the patient’s confidentiality because there is the third person will get harmed.

Furthermore, we discussed about different cases to employ the principles. In the first case, the case was on confidentiality. In my opinion the physician action was totally right and I would do the same thing also when in his place. Police man cannot just came in and ask about any patient’s information’s, the physicians cannot share any information about the patient before telling the patient. This  does not meant that the doctor cannot share the patient information to the authority, he can but with an informal paper from the authority not like this case when the police man came in without any informal paper.

In case two, my opinion is that the physician behaved wrongly, if I was his physician and I realized that my patient is hesitant about telling his wife of the HIV positive status, I will immediately inform his wife before things get worst and before she get infected. This is non-malifacene.

In second part of this class we have been discussing about assisted suicide. This topic made a big issue in medical ethical principles, some nations, cultures, religions and law refused it and in some it is totally their right to decide about their life. This really made me think intensively and ponder that if we respect the patient autonomy then why refuses the patient request to die? In western countries it is their patient right to decide but in our country it is not legal as our culture and religion totally does not permit. So here again, the law can break some principles and every physician should be aware of the law, beliefs, religion and culture of the country he is practicing.

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