2. ETHICAL DECISION MAKING
• Gather the medical, social, and all other
relevant facts of the case.
• Identify all relevant values including but not
limited to those of the patient, family and
physician, nurse, other health care professionals,
the health care institution, and society.
Determine the values in conflict.
• Propose possible solutions to resolve the conflict.
• Choose the better solutions for the particular
case, justify them, and respond to possible
criticisms.

3. • Dr. C, a newly appointed anaesthetist in a city hospital,
is alarmed by the behaviour of the senior surgeon in
the operating room.
• The surgeon uses out-of-date techniques that prolong
operations and result in greater post-operative pain
and longer recovery times. Moreover, he makes
frequent crude jokes about the patients that obviously
bother the assisting nurses. As a more junior staff
member, Dr. C is reluctant to criticize the surgeon
personally or to report him to higher authorities.
• However, he feels that he must do something to
improve the situation.

4. Relationships With Physician
Colleagues
• As members of the medical profession, physicians
have traditionally been expected to treat each
other more as family members than as strangers
or even as friends.
• The WMA Declaration of Geneva includes the
pledge:
• “My colleagues will be my sisters and brothers.”
• The interpretation of this requirement has varied
from country to country and over time.

5. Relationships With Physician
Colleagues
• WMA International Code of Medical Ethics
contains two restrictions on physicians’
relationships with one another:
• (1) paying or receiving any fee or any other
consideration solely to procure the referral of a
patient
• (2) stealing patients from colleagues.
• A third consideration exists, to report unethical
or incompetent behaviour by colleagues.

6. Relationships With Physician
Colleagues
• Medical students and other medical trainees
owe a debt of gratitude to their teachers,
without whom medical education would be
reduced to self-instruction.
• Teachers have an obligation to treat their
students respectfully and to serve as good role
models in dealing with patients.

7. Professionalism in
the Educational Environment
• Duty:
• is the free acceptance of a commitment to service. This
commitment entails:
• being available and responsive when “on call,”
accepting inconvenience to meet the needs of one’s
patients, enduring unavoidable risks to oneself when
a patient’s welfare is at stake, advocating the best
possible care regardless of ability to pay, seeking
active roles in professional organizations, and
volunteering one’s skills and expertise for the welfare
of the community.

8. Professionalism in
the Educational Environment
• Abuse of Power:
• Using junior colleagues to enhance one’s own
bibliography and advance one’s own academic
career is an abuse of power.
• The gratuitous denigration of junior
colleagues also represents an abuse of power.

9. Thank You
By the way!!
Who wants to give the bad news to my
patient?