Updated on 30.10.2016.
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“Good Medical Practice” & Medical Ethics –
themedideas Facts & Figures
The importance of “Good Medical Practice” and Medical Ethics cannot be overemphasised. Every Doctor should have insight into these areas to improve their professional performance. This article discusses these topics to inform the Doctors regarding these issues.
What is meant by “Good Medical Practice”?
According to the guidance from the General Medical Council, London the essential elements of “Good Medical Practice” include “professional competence, good relationships with patients and colleagues, and observance of professional ethical obligations”.
What are the different aspects of
good practice in Obstetrics and Gynaecology?
Different aspects of good practice include: 1. General attitude to patients. * They should be treated with courtesy and respect at all times. * Their status as a person should be respected and formal address should be used. * Adequate privacy should be ensured during history taking and performing examinations. * A chaperone should be used during intimate examinations. * Any third party should be introduced, and any objections to that presence should be respected. * Communications to patients should not be unintelligible or patronising. 2. Consent * Consent to investigation or treatment should be informed and voluntary once the patients understand what is actually involved in, the risks of, the possible consequences, and alternatives to the procedure. * The doctor should document the discussions. * Consent to examination by medical students should be obtained beforehand. It could be taken verbally if the patient is conscious and in writing in case of examination under anaesthesia. 3. Clinical Training * No procedure or operation should be undertaken unsupervised by a doctor who is not capable of doing it without supervision. 4. New Procedures * New procedures for investigation and treatment should be undertaken as part of a research protocol. 5. Research * All research should be performed honestly and responsibly. 6. Use of tissue * Written permission should be obtained for use of tissue for commercial or research use (ethics committee approval is also required for research). 7. Professional Disagreement In case of disagreement between Members or Fellows on a clinical matter affecting their clinical practice, the opinion of an arbiter should be sought. If they do not agree on this matter, the President of the Royal College of Obstetricians & Gynaecologists should appoint an arbiter. Medical Ethics plays a vital role in “Good Medical Practice”. A “Good Doctor” must maintain professional ethics.
What is meant by Medical Ethics?
Medical Ethics is a branch of moral philosophy
There are two main theories in Ethics: I. Deontological – based on a sense of duty II. Utilitarianism– based on the greatest good for the greatest number * Therefore a conflict exists between “duty to the patient” and “duty to patients” * The ethical obligations include what the physician ought to do or not do, because it is the right or correct thing to do or not do.
What are the ethical obligations in Obstetrics?
* These are autonomy-based and beneficence-based obligations of the obstetrician to protect and promote maternal interests, and beneficence-based obligations to the fetus. * As the fetus cannot have a perspective on its interests because of its insufficiently developed central nervous system, autonomy-based obligations to the fetus cannot exist. Therefore the ethical obligations of the obstetrician and the pregnant woman to the fetus are beneficence-based.
What are the possible conflicts among these ethical obligations?
These can be of four types: I. Maternal autonomy-based obligations of the obstetrician vs Maternal beneficence- based obligations of the obstetrician Example A Jehovah’s Witness may refuse blood transfusion following a PPH, as it could jeopardise her eternal salvation. Obstetrician may think that the blood transfusion could save her life. II. Maternal autonomy-based obligations of the obstetrician vs Fetal beneficence-based obligations of the obstetrician. Example A woman in pre-term labour may refuse to have steroid injection. Obstetrician knows that steroid is beneficial for the pre-mature fetal patient. III. Maternal beneficence-based obligations of the obstetrician vs Fetal beneficence-based obligations of the obstetrician Example Use of antiepileptic drugs to prevent seizures in an epileptic pregnant woman. Teratogenic effects of antiepileptic drugs on the fetus. IV. Fetal beneficence-based obligations of the pregnant woman vs Fetal beneficence-based obligations of the obstetrician. Example Uncertainty about the risks of fetal urethral obstruction. Uncertainty about the risks of vesiculoamniotic shunt. References 1. Chervenak FA, McCullough LB. An ethical framework for obstetric practice. In: Studd J, ed. Progress in Obstetrics and Gynaecology Vol 10. Edinburgh: Churchill Livingstone; 1993: 3-11. 2. Ethical considerations relating to good practice in Obstetrics and Gynaecology. RCOG Guidelines – Ethics, No 2, April 1997, RCOG, London. 3. Good Medical Practice. In: Duties of a doctor. Guidance from the General Medical Council, London, 1995. 4. Intimate examinations. A statement by the General Medical Council, London, 1996. 5. McILwain JC. Ethics and English Law. Clinical Risk Management Course, Whiston Hospital, Prescot, 19 March 1999. Notice from themedideas.com to all using paid services/reading All paid services/reading are non-refundable under any circumstances. This is pay per view, pay once read once. The article could be read only once immediately after paying. If the page is closed the article would not open again without paying again. G-Y in Gynaecology – themedideas Facts & Figures Author Further reading G-Y in Gynaecology: Definitions & Terminologies – themedideas Facts & Figures Best Examination Questions: Obstetrics & Gynaecology – The MCQ Bank Best Examination Questions: Obstetrics & Gynaecology – The MCQ Bank No 1 Best Examination Questions: Obstetrics & Gynaecology – The MCQ Bank No 2 Best Examination Questions: Obstetrics & Gynaecology – The MCQ Bank No 3 Best Examination Questions: Obstetrics & Gynaecology – The MCQ Bank No 4 Is age-related decline in female fertility a mitochondrial dysfunction? Uterine fibroids: Alternative treatment to hysterectomy or myomectomy – themedideas Facts & Figures Best Examination Tips: Informed consent in O&G – themedideas Facts & Figures Best Examination Tips: Cardiology Alert!!! Digoxin use linked to increased risk of Death Best Examination Tips: Inherited Thrombophilia in O&G – themedideas Facts & Figures Best Examination Tips: Introduction to Infertility Best Health Tips: What are the reasons for patients’ dissatisfaction and how you could improve your level of satisfaction? Best Health Tips: What is the most appropriate treatment option for you? Best Health Tips: What appears the easiest treatment option may not be the best for you Best Health Tips: What treatment appears cheap is not necessarily cost-effective Best Health Tips: Who is a good Doctor? Best Health Tips: What should you expect during consultation with the Doctor? I-Y in InfertilitY (more than 80 Key points you must know) – themedideas Facts & Figures Best Unbiased Evidence Based Health Information – themedideas Facts & Figures Best Examination Tips: Clinical Risk Management – themedideas Facts & Figures Best Examination Tips: How to Critically Appraise a Research Publication (Paper) – themedideas Facts & Figures Best Examination Tips: How to evaluate a Test – themedideas Facts & Figures Best Examination Tips: Evidence Based Medicine – themedideas Facts & Figures Best Examination Tips: Audit – themedideas Facts & Figures Best Career Tips: Medical Interview Questions & Topics
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