2nd edition 2009
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Medical student holding a newborn © Roger Ball/CORBIS
WORLD MEDICAL ASSOCIATION
World Medical Association
Medical Ethics Manual 2nd edition 2009
Medical Ethics Manual – Principal Features of Medical Ethics Medical Ethics Manual
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© 2009 by The World Medical Association, Inc. All rights reserved. Up to 10 copies of this document may be made for your non-commercial personal use, provided that credit is given to the original source. You must have prior written permission for any other reproduction, storage in a retrieval system or transmission, in any form or by any means. Requests for permission should be directed to The World Medical Association, B.P. 63, 01212 Ferney-Voltaire Cedex, France; email:
[email protected], fax (+33) 450 40 59 37. This Manual is a publication of the Ethics Unit of the World Medical Association. It was written by John R. Williams, Director of Ethics, WMA. Its contents do not necessarily reflect the policies of the WMA, except where this is clearly and explicitly indicated. Cover, layout and concept by Tuuli Sauren, Inspirit International Communications, Belgium. Production and concept World Health Communication Associates, UK. Pictures by Van Parys Media/CORBIS Cataloguing-in-Publication Data Williams, John R. (John Reynold), 1942-. Medical ethics manual. 1. Bioethics 2. Physician-Patient Relations - ethics. 3. Physician’s Role 4. Biomedical Research - ethics 5. Interprofessional Relations 6. Education, Medical - ethics 7. Case reports 8. Manuals I. Title ISBN 92-990028-1-9 (NLM classification: W 50)
TABLE OF CONTENTS Acknowledgments. ..................................................................................4 Foreword.........................................................................................................5 Introduction..................................................................................................7 · What is medical ethics? · Why study medical ethics? · Medical ethics, medical professionalism, human rights and law · Conclusion
Chapter One - Principal Features of Medical Ethics .....14 · Objectives · What’s special about medicine? · What’s special about medical ethics? · Who decides what is ethical? · Does medical ethics change? · Does medical ethics differ from one country to another? · The role of the WMA · How does the WMA decide what is ethical? · How do individuals decide what is ethical? · Conclusion
Chapter Two - Physicians and Patients. .................................34 · · · · · ·
Objectives Case study What’s special about the physician-patient relationship? Respect and equal treatment Communication and consent Decision-making for incompetent patients
Medical Ethics Manual – Principal Features of Medical Ethics Medical Ethics Manual – Table of Contents
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Confidentiality Beginning-of-life issues End-of-life issues Back to the case study
Chapter Three - Physicians and Society................................62 · · · · · · · ·
Objectives Case study What’s special about the physician-society relationship? Dual loyalty Resource allocation Public health Global health Back to the case study
Chapter Four - Physicians and Colleagues..........................80 · Objectives · Case study · Challenges to medical authority · Relationships with physician colleagues, teachers and students · Reporting unsafe or unethical practices · Relationships with other health professionals · Cooperation · Conflict resolution · Back to the case study
Chapter Five - Medical Research.................................................94 · Objectives · Case study · Importance of m