2. Forms of professional relationship:
• 1. Between student and teacher.
2. Between doctors (including specialists) in
the same discipline.
3. Between general practitioner (GP) and
consultant.
4. Between two doctors in differing
specialities.
5. Between the doctor and his doctor-patient.

3. Principles governing the
relationship between doctors:
 the International Code of Ethics (3)
states the following:
.1
.2

4. Student and teacher:



5. The doctor- doctor
relationship:
professional criticism

6. Professional criticism



7. Professional
criticism


8. When your patient sees another doctor during
an emergency, or because you are otherwise
not available, do not criticise the other
professional’s decisions. Be thankful to the
doctor for having taken care of your case in
your absence.

9. When you see negligence ?

10. 

11. The Declaration of Geneva
(World Medical Association, 1948

12. 1. I solemnly pledge to consecrate my life to the service
of humanity.
•
2. I will give to my teachers the respect and gratitude
which is their due.
•
3. I will practice my profession with conscience and
dignity.
•

13. 5. I will respect the secrets which are confided in me,
even after the patient has died.
•
6. I will maintain by all means in my power, the honor
and the noble traditions of the medical profession.
•
7. My colleagues will be my brothers
•

14. 8. I will not permit considerations of religion,
nationality, race, party politics, or social
standing to intervene between my duty and my
patient.
9. I will maintain the utmost respect for human
life from its beginning even under threat and I
will not use my medical knowledge contrary to
the laws of humanity .
•
10. I make these promises solemnly, freely, and
upon my honour.

15. International Code of Medical
Ethics
(World Medical Association, 1949, 1968, 1983)

16. :General Duties of Physicians in
1.A physician shall always maintain the
highest standards of professional conduct.
2.A physician shall not permit motives of
profit to influence the free and independent
exercise of professional judgement on
behalf of all patients.


18. :General Duties of Physicians in
3. A physician shall deal honestly with patients
and colleagues, and strive to expose those
physicians deficient in character or
competence, or who engage in fraud or
deception.


19. 5.The following practices are deemed to be
unethical conduct:
a) Self advertising by physicians, unless
permitted by the laws of the country and the
Code of Ethics of the National Medical
Association.

20. b) Paying or receiving any fee or any other
consideration solely to procure the
referral of a patient or for prescribing or
referring a patient to any source.


21. 6. A physician shall respect the rights of patients,
of colleagues, and of other health professionals,
and shall safeguard patient confidences.

7. A physician shall act only in the patient's interest
when providing medical care which might have
the effect of weakening the physical and medical
condition of the patient.

22. 8. A physician shall use great caution in
divulging discoveries or new techniques or
treatment through non-professional channels.

9. A physician shall certify only that which he
has personally verified.


23. Regulations in Time of Armed Conflict
 Medical ethics in time of armed conflict are
identical to medical ethics in time of peace .
The primary task of the medical profession is to
preserve health and save life. Hence it deemed
unethical for physicians to:
o Give advice or perform prophylactic, diagnostic, or
therapeutic procedures that are not justifiable in the patient's
interest.
o Weaken the physical or mental strength of a human being
without therapeutic justification.
o Employ scientific knowledge to imperil health or destroy life.

24. Rights of those in need of care
A patient/prisoner has the right to refuse to eat
or to refuse treatments. The nurse may need to
verify that the patient/prisoner understands the
implications of such action but she should not
participate in the administration of food or
medications to such patients.

25. Rights and duties of nurses
It is a duty to have informed consent of patients
relative to having research done on them and
in receiving treatments such as blood
transfusions, anesthesia, grafts, etc. Such
informed consent is a patient's right and must
be ensured.

26. AMA Principles of
Medical Ethics
2001

27. I. A physician shall be dedicated to
providing competent medical care, with
compassion and respect for human
dignity and rights.


28. II. A physician shall uphold the standards of
professionalism, be honest in all professional
interactions, and strive to report physicians
deficient in character or competence, or
engaging in fraud or deception, to
appropriate entities.


29. III. A physician shall respect the law and also
recognize a responsibility to seek changes in
those requirements which are contrary to the
best interests of the patient.


30. IV. A physician shall respect the rights of
patients, colleagues, and other health
professionals, and shall safeguard patient
confidences and privacy within the
constraints of the law.

V. A physician shall continue to study, apply,
and advance scientific knowledge,
maintain a commitment to medical
education,

32. VI. A physician shall, in the provision of appropriate
patient care, except in emergencies, be free to
choose whom to serve, with whom to associate,
and the environment in which to provide medical
care.
VII. A physician shall recognize a responsibility to
participate in activities contributing to the
improvement of the community and the
betterment of public health.
VIII. A physician shall, while caring for a patient,
regard responsibility to the patient as paramount.
IX. A physician shall support access to medical care
for all people.

33. CODE OF MEDICAL ETHICS
AND PROFESSIONALISM FOR
ORTHOPAEDIC SURGEONS
Surgeons American Academy of
Orthopaedic

34. I. The Physician-Patient Relationship
A. Both the patient and the orthopaedic surgeon are
free to enter or discontinue the relationship within
any existing constraints of a contract with a third
party.
• An orthopaedic surgeon has an obligation to render
care only for those conditions that he or she is
competent to treat.
• The orthopaedist shall not decline to accept patients
solely on the basis of race, color, gender, sexual
orientation, religion, or national origin or on any basis
that would constitute illegal discrimination.

35. B. The orthopaedic surgeon may choose
whom he or she will serve.
• An orthopaedic surgeon should render
services to the best of his or her ability.
• Unless discharged by the patient, the
orthopaedic surgeon may discontinue
service only after giving adequate notice to
the patient so that the patient can secure
alternative care.

36. C. When obtaining informed consent for
treatment, the orthopaedic surgeon is
obligated to present to the patient or to
the person responsible for the patient, in
understandable terms, pertinent medical
facts and recommendations consistent
with good medical practice. Such
information should include alternative
modes of treatment, the objectives, risk
and possible complications of such
treatment, and the complications and
consequences of no treatment.

37. II. Conflicts of Interest :
a) When a conflict of interest arises, it must be resolved
in the best interest of the patient , If the conflict of
interest cannot be resolved, the orthopaedic surgeon
should notify the patient of his or her intention to
withdraw from the relationship.
b) If the orthopaedic surgeon has a financial or
ownership interest in a durable medical goods
provider, imaging center, surgery center or other
health care facility where the orthopaedic surgeon's
financial interest is not immediately obvious, the
orthopaedic surgeon must disclose this interest to
the patient.

38. C. It is unethical for an orthopaedic
surgeon to receive compensation of any
kind from industry for using a particular
device or medication.


39. VII. General Principles of Care
A. An orthopaedic surgeon should practice
only within the scope of his or her
personal education, training, and
experience.
B. The orthopaedic surgeon should not
perform a surgical operation under
circumstances in which the responsibility
for diagnosis or care of the patient is
delegated to another who is not qualified
to undertake it.

40. Doctors, drugs and ethics

41. GIFTS
 The gift is only of nominal value.
 The gift is not in cash.
 The gift, even one of nominal value, is not
connected to any stipulation that the physician
prescribes a certain medication, uses certain
instruments or materials or refers patients to a
certain facility.
 Gifts should be accepted only if decision-
making is left manifestly unimpaired.

42.  Support for travel to conferences organised
by professional societies should be restricted
to people making formal contributions.
 Entertainment expenses should not be
lavish.

43.  Access of representatives to students and
health services should be limited.
 Sources of commercial funding should not
influence the scientific, educational or public
policy decisions of professional bodies,
which should not associate themselves
directly or indirectly with promotion of
products of commercial sponsors.

44. In conference, The name of a
commercial entity providing financial
support is publicly disclosed in order to
allow the medical community and the
public to assess the information presented
in light of the source of funding.

45. A conference can be recognised for purposes of
continuing medical education/ continuing
professional development (CME/CPD) only if it
conforms to the following principles:
1.The commercial entities acting as
sponsors, such as pharmaceutical
companies, have no influence on the
content, presentation, choice of lecturers, or
publication of results.
2. Funding for the conference is accepted only as a
contribution to the general costs of the meeting.