Medical deontology and ethics: fundamentals, principles and methods

Deontology and ethics in medicine have always been of great importance. This is due to the specifics of the work of the personnel of medical institutions.

Fundamentals of medical ethics and deontology today

At present, the problem of mutual relations (both within the work collective and with patients) has acquired special significance. Without the coordinated work of all employees, and also in the absence of trust between the doctor and the patient, it is unlikely to achieve serious success in the medical field.

Medical ethics and deontology are not synonymous. In fact, deontology is a kind of separate branch of ethics. The fact is that it is an inferior complex of only professional moral norms of man. At the same time, ethics are a much broader concept.

What can be deontology?

Currently, several variants of this concept are singled out. Here everything depends on what level of the relationship is brought up for discussion. Among their main varieties are:

• Doctor - patient;
• Doctor - nurse;
• Doctor - doctor;
• A nurse is a patient;
• Nurse - nurse;
• Doctor - administration;
• Doctor - junior medical staff;
• Nurse - junior medical staff;
• Junior medical staff - junior medical staff;
• Nurse - administration;
• Junior medical staff - patient;
• Junior medical personnel - administration.

Doctor's relationship with the patient

It is here that medical ethics and medical deontology are of the greatest importance. The fact is that without their observance, trust between the patient and the doctor is unlikely, and in this case the process of recovery of the sick person is considerably delayed.

In order to win the trust of the patient, according to deontology, the doctor should not allow himself unprofessional expressions and jargon, but he should also give the patient a clear idea of the nature of his illness, and about the main activities that must be carried out in order to achieve a full recovery. If the doctor does this, then he will certainly find a response from his ward. The fact is that the patient will be able to trust the doctor 100%, only if he is really confident in his professionalism.

Many doctors forget that medical ethics and medical deontology prohibit confusing the patient and are expressed unnecessarily difficult, without informing the person of the essence of his condition. This gives rise to additional fears in the patient, which do not contribute to a speedy recovery and can be very detrimental to the relationship with the doctor.

In addition, medical ethics and deontology do not allow the doctor to spread about the patient. This rule should be followed not only with friends and family, but even with those colleagues who do not participate in the treatment of a particular person.

Nurse-patient interaction

As you know, it is the nurse who contacts the patients more than other health workers. The fact is that most often after a morning detour the doctor during the day the patient can not even see. The nurse also several times pills him, makes injections, measures the level of blood pressure and temperature, and also performs other appointments of the attending physician.

The ethics and deontology of the nurse dictates that she be polite and responsive to the patient. At the same time, she should not in any case become an interlocutor for him and answer questions about his illnesses. The fact is that a nurse may misinterpret the essence of a particular pathology, as a result of which the preventive work done by the treating doctor will be harmed.

Relations between nursing staff and patients

Often it happens that the patient is not rude about the doctor and not the nurse, but the nurse. In a normal healthcare institution, this should not be. The junior medical staff should take care of the patients, doing everything (within reasonable limits) so that their stay in the hospital is as convenient and comfortable as possible. At the same time, it is not worthwhile to enter into conversations on excluded topics and even more so to answer medical questions. The junior staff does not have medical education, so they can judge the essence of the diseases and the principles of fighting them only at the philistine level.

Relationship between a nurse and a doctor

Professional ethics and deontology calls for respectful attitude of personnel to each other. Otherwise, the team will not be able to work together. The main link of professional relations in the hospital is the interaction of doctors with average medical personnel.

First of all, medical sisters need to learn to observe subordination. Even if the doctor is very young, and the nurse has worked for more than 1 decade, she should still treat him like an elder, fulfilling all his instructions. These are the fundamental principles of medical ethics and deontology.

Especially strictly such rules in the relationship with doctors nurses should be adhered to in the presence of the patient. He should see that the appointment is made by a respected person, who is a kind of leader, able to manage the team. In this case, he will have a particularly strong confidence in the doctor.

In this case, the basics of ethics and deontology do not prohibit a nurse, if she is experienced enough, to hint to a beginning doctor that, for example, his predecessor acted in a particular situation in a certain way. Such advice, expressed in an informal and polite way, will not be perceived by a young doctor as an insult or an understatement of his professional capabilities. In the end, he will be grateful for prompt advice.

Relations between nurses and junior staff

The ethics and deontology of the nurse instructs her to treat the junior staff of hospitals with respect. At the same time, there should be no familiarity in their relations. Otherwise, it will disintegrate the team from the inside, because sooner or later the nurse can start to make claims about certain instructions of the nurse.

If a conflict situation arises, the doctor can help in resolving it. Medical ethics and deontology do not prohibit this. However, the average and junior staff should try to burden the doctor with such problems as rarely as possible, because the resolution of conflicts between employees is not part of his direct job duties. In addition, he will have to give preference in favor of one or another worker, and this can cause the latter to complain to the doctor himself.

The nurse should unquestioningly carry out all adequate orders of the nurse. In the end, the decision to conduct this or that manipulation is not made by herself, but by the doctor.

Interaction of nurses with each other

As with all other hospital employees, nurses in their relationships should behave with restraint and professionalism. The ethics and deontology of the nurse dictates that she always look neat, be polite to her colleagues. Emerging disputes between employees may be decided by the senior nurse of the department or hospital.

At the same time, each nurse must perform her duties. Facts hazing should not be. This is especially necessary to be followed by senior medical sisters. If you overstress the young specialist with additional job duties, for which he will not get anything, he will hardly stay on such a job long enough.

Relationship between doctors

Medical ethics and deontology are the most complex concepts. This is due to the variety of possible contacts between doctors of one and the same profile.

Doctors should treat each other with respect and understanding. Otherwise they risk ruining not only the relationship, but also their reputation. Medical ethics and deontology do not recommend doctors to discuss their colleagues with anyone, even if they do not do it quite right. This is especially true in cases where the doctor communicates with a patient who is observed with another doctor on a regular basis. The fact is that he can forever destroy the trusting relationship between the patient and the doctor. Discussion of another doctor in the patient, even if a certain medical error was committed , is a dead-end approach. This, of course, can raise the status of one doctor in the eyes of the patient, but it will significantly reduce the credibility of him from his colleagues. The fact is that sooner or later the doctor will find out that they discussed it. Naturally, he will not treat his colleague the same way as before.

It is very important for the doctor to support his colleague, even if he made a medical mistake. This is how the professional deontology and ethics prescribe. Even the most highly qualified specialists are not insured against mistakes. Moreover, the doctor, who sees the patient for the first time, does not always fully understand why his colleague acted in this or that situation in this way, and not otherwise.

The doctor should also support his young colleagues. It would seem that in order to start working as a full-fledged doctor, a person must be weaned for many years. During this time, he does receive a lot of theoretical and practical knowledge, but even they are not enough to successfully treat a particular patient. This is due to the fact that the situation in the workplace is significantly different from what is taught in medical universities, so even a good young doctor who paid great attention to his training will not be ready to contact a more or less complex patient.

The ethics and deontology of the doctor prescribes him to support his young colleague. At the same time, talk about why this knowledge was not obtained even while training, are meaningless. This can embarrass the young doctor, he will no longer seek help, preferring to take chances, but not seek help from the person who condemned him. The best option is simply to suggest what to do. For several months of practical work, the knowledge that was obtained at the university will be supplemented by experience and the young doctor will be able to cope with almost any patient.

Relations between administration and health workers

Ethics and deontology of medical personnel are also relevant in the framework of such interaction. The point is that the representatives of the administration are physicians, even if they do not take a special part in the treatment of the patient. Still, they need to adhere to strict rules in communicating with their subordinates. If the administration does not quickly make decisions on those situations where the basic principles of medical ethics and deontology were violated, it may lose valuable employees or simply make their attitude to their duties formal.

The attitude of the administration with its subordinates should be trustworthy. It is really unprofitable for the hospital management when their employee makes a mistake, therefore, if the head physician and the head of the medical unit are in their places, they will always try to protect their employee, both morally and legally.

General principles of ethics and deontology

In addition to particular moments in the relationships between different categories, somehow related to medical activity, there are also general, which are relevant for everyone.

First of all, the doctor must be educated. Deontology and ethics of medical personnel in general, not only the doctor, prescribes in no case to cause harm to the patient. Naturally, knowledge gaps exist for everyone, but the doctor should try to eliminate them as quickly as possible, because the health of other people depends on this.

The rules of ethics and deontology apply to the appearance of medical personnel. Otherwise, the patient is unlikely to have enough respect for such a doctor. This can lead to non-compliance with the recommendations of the doctor, which will exacerbate the patient's condition. At the same time, the purity of the dressing gown is prescribed not only in streamlined formulations of ethics and deontology, but also in health and sanitary norms.

Modern conditions require medical workers to comply with corporate ethics. If it is not guided, the profession of a medical worker, which is currently experiencing a crisis of trust on the part of patients, will become even less respected.

What happens if the rules of ethics and deontology are violated?

In the event that a medical worker has done something that is not very significant, even if it contradicts the basics of ethics and deontology, then the maximum punishment for him can be depression and talking with the head physician. There are also more serious incidents. We are talking about situations when a physician is really doing something out of the ordinary, capable of harming not only his personal reputation, but also the prestige of the entire medical institution. In this case, the commission on ethics and deontology is going to. Almost the whole administration of the medical institution should be included in it. If the commission meets at the request of another medical worker, then it is also obliged to attend.

This event in something very much like a trial. As a result of its conduct, the commission makes a verdict. He can justify the accused employee, and bring him a lot of trouble, up to dismissal from his position. This measure is used only in the most exceptional situations.

Why ethics, as well as deontology is not always respected?

First of all, this circumstance is connected with the banal syndrome of professional burnout, which is so characteristic for doctors. He can arise from employees of any specialty, whose duties include constant communication with people, but it is doctors who have this condition most quickly and reach maximum severity. This is due to the fact that in addition to constant communication with a lot of people, doctors are constantly in a state of tension, because their decisions often depend on a person's life.

In addition, medical education is provided to people who are not always suitable for working as doctors. In this case, we are not talking about the amount of necessary knowledge. It is no less important to have the ability to communicate with people and the desire to do it. Any good doctor, at least to some extent, should care about his work, as well as the fate of patients. Without this, no deontology and ethics will be respected.

Often in the non-observance of ethics or deontology, the doctor himself is not to blame, although the accusations will fall on him. The fact is that the behavior of many patients is really provocative and it is impossible to react to it.

On ethics and deontology in pharmaceutics

In this area, too, the doctor is working and very much depends on their activities. Do not be surprised that there are also pharmaceutical ethics and deontology. First of all, they consist in ensuring that pharmacists produce high-quality drugs, and also sell them at relatively affordable prices.

It is by no means possible for a pharmacist to launch a drug (even in his opinion, simply excellent) into mass production without serious clinical trials. The fact is that any drug can cause a huge number of side effects, the harmful effect of which in aggregate exceeds the useful.

How to improve compliance with ethics and deontology?

As trivial as it may sound, however, a lot of things are limited by monetary issues. It is noticed that in countries where doctors and other medical workers have a sufficiently high salary, the problem of ethics and deontology is not so acute. In many ways, this is due to the slow development (in comparison with domestic doctors) of the syndrome of professional burnout, since foreign specialists in the majority do not have to worry about money, because their wages are at a high enough level.

It is also very important that the administration of the medical institution follows the observance of ethics and deontology standards. Naturally, she herself will have to adhere to them. Otherwise, there will be a lot of facts of violation of ethics and deontology rules by the employees. In addition, in no case can not be demanded from some employees of what is not being asked fully from the other.

The most important moment in maintaining in the team a commitment to the basics of ethics and deontology is the periodic reminder to medical personnel about the existence of such rules. At the same time, it is possible to conduct special trainings, during which the employees will have to jointly solve certain situational tasks. It is better, if such seminars are held not spontaneously, but under the guidance of an experienced psychologist who knows the specifics of the work of medical institutions.

Myths of ethics and deontology

The main erroneous opinion associated with these concepts is the so-called Hippocratic oath. This is due to the fact that in disputes with doctors most people remember it. In doing so, they indicate that you need to be more compassionate towards the patient.

Indeed, the Hippocratic oath has a definite relationship to medical ethics and deontology. But only those who got acquainted with her text will immediately note that almost nothing is said about the patients there. The main focus of the Hippocratic oath is on the promise of the doctor to his teachers that he will treat them and their relatives for free. About those patients who did not participate in his training, nothing is said. Moreover, today the Hippocratic oath is not given in all countries. In the same Soviet Union, it was replaced by a completely different one.

Another point about ethics and deontology in the medical environment is the fact that individual patients must adhere to the rules themselves. They need to be polite to medical staff at any level.