Islamic and modern medical codes of ethics emphasize compassionate, competent and confidential care for all patients. Physicians must respect patient autonomy, maintain professionalism, and continue learning and advocacy. Community health is also an important responsibility through education, reporting diseases, and participating in health system development. Both rights and duties of physicians aim to optimize medical practice and serve society.
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Overview of doctor’s roles and duties ghaiath
1. Presentation to 4th year medical students, FOM-KFMC (Feb. 27, 2012)
Ghaiath M. A. Hussein
Asst. Prof., Dept. of Medical Ethics
King Fahad Medical City – Faculty of Medicine
King Saud Bin Abdul-Aziz University for Health Sciences
Email: ghaiathme@gmail.com; ghussein@kfmc.med.sa
Office: 01-2889999 Ext.7588, Mob.: 0566511653
2. Doctor
Educator Guards
Manager
Patient Lab./X-
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Social
Paramedics
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Nurses
3. Ishaq ibn „Ali Al-Rahawi (9th century CE) wrote a book
entitled Adab al-Tabib or „The Ethics of the Physician‟ .
Al-Tabari, the chief physician in 970 A.D., described also the
Islamic code of ethics in his book Fardous Al Hikma stated:
“… The physician should be modest, virtuous and merciful… He
should wear clean clothes, and have well- groomed hair and beard.
He should not hesitate to ask forgiveness if he has made an error….
He should be forgiving and never seek revenge…. He ought not
loose his temper when his patient keeps asking questions, but
should answer gently and compassionately… He should treat alike
the rich and the poor, the master and the servant ….
He should be punctual and reliable…He should be decent
towards women and should not divulge the secrets of his patients…
He should speak well of his colleagues….He should not honor
himself by shaming others…. “
4. “I swear by God ...The Great ..
To regard God in carrying out my profession;
To protect human life in all stages and under all circumstances, doing
my utmost to rescue it from death, malady, pain and anxiety;
To keep peoples' dignity, cover their privacies and lock up their secrets ;
To be, all the way, an instrument of God's mercy, extending my medical
care to near and far, virtuous and sinner and friend and enemy;
To strive in the pursuit of knowledge and harnessing it for the benefit but
not the harm of Mankind;
To revere my teacher, teach my junior, and be brother to members of
the Medical Profession;
To live my Faith in private and in public, avoiding whatever blemishes
me in the eyes of God, His apostle and my fellow Faithful… And may
God be witness to this Oath.”
Any thoughts?
5. Based on CanMED Framework
(http://www.rcpsc.edu/canmeds/CanMEDS2005/index.php)
6. Definition: As Medical Experts, physicians integrate all of the
doctor‟s roles, applying medical knowledge, clinical skills, and
professional attitudes in their provision of patient-centered care.
Key Competencies: Physicians are able to…
1. Function effectively as consultants, integrating all of their roles
to provide optimal, ethical and patient-centered care;
2. Establish and maintain clinical knowledge, skills and attitudes
appropriate to their practice;
3. Perform a complete and appropriate assessment of a patient;
4. Use preventive and therapeutic interventions effectively;
5. Demonstrate proficient and appropriate use of procedural
skills, both diagnostic and therapeutic;
6. Seek appropriate consultation from other health professionals,
recognizing the limits of their expertise.
7. Definition: As Communicators, physicians effectively facilitate
the doctor-patient relationship and the dynamic exchanges
that occur before, during, and after the medical encounter.
Key Competencies: Physicians are able to…
1. Develop rapport, trust and ethical therapeutic relationships
with patients and families;
2. Accurately elicit and synthesize relevant information and
perspectives of patients and families, colleagues and other
professionals;
3. Accurately convey relevant information and explanations to
patients and families, colleagues and other professionals;
4. Develop a common understanding on issues, problems and
plans with patients and families, colleagues and other
professionals to develop a shared plan of care;
5. Convey effective oral and written information about a
medical encounter.
8. Definition: As Collaborators, physicians effectively work within a
healthcare team to achieve optimal patient care.
Key Competencies: Physicians are able to…
1. Participate effectively and appropriately in an interprofessional
healthcare team;
2. Effectively work with other health professionals to prevent, negotiate,
and resolve interprofessional conflict
4. Manager
Definition: As Managers, physicians are integral participants in
healthcare organizations, organizing sustainable practices, making
decisions about allocating resources, and contributing to the
effectiveness of the healthcare system.
Key Competencies: Physicians are able to…
1. Participate in activities that contribute to the effectiveness of their
healthcare organizations and systems;
2. Manage their practice and career effectively;
3. Allocate finite healthcare resources appropriately;
4. Serve in administration and leadership roles, as appropriate.
9. Definition: As Health Advocates, physicians
responsibly use their expertise and influence to
advance the health and well-being of individual
patients, communities, and populations.
Key Competencies: Physicians are able to…
1. Respond to individual patient health needs and
issues as part of patient care;
2. Respond to the health needs of the communities that
they serve;
3. Identify the determinants of health of the populations
that they serve;
4. Promote the health of individual patients,
communities and populations.
10. Definition: As Scholars, physicians demonstrate a lifelong
commitment to reflective learning, as well as the creation,
dissemination, application and translation of medical
knowledge.
Key Competencies: Physicians are able to…
1. Maintain and enhance professional activities through
ongoing learning;
2. Critically evaluate information and its sources, and apply
this appropriately to practice decisions;
3. Facilitate the learning of patients, families, students,
residents, other health professionals, the public, and
others, as appropriate;
4. Contribute to the creation, dissemination, application, and
translation of new medical knowledge and practices.
12. A PHYSICIAN SHALL
Always exercise his/her independent professional
judgment and maintain the highest standards of
professional conduct.
Respect a competent patient's right to accept or refuse
treatment.
Not allow his/her judgment to be influenced by
personal profit or unfair discrimination.
Be dedicated to providing competent medical service in
full professional and moral independence, with
compassion and respect for human dignity.
13. A PHYSICIAN SHALL
Deal honestly with patients and colleagues, and
report to the appropriate authorities those
physicians who practice unethically or
incompetently or who engage in fraud or deception.
Not receive any financial benefits or other
incentives solely for referring patients or prescribing
specific products.
Respect the rights and preferences of patients,
colleagues, and other health professionals.
14. A PHYSICIAN SHALL
Recognize his/her important role in educating the
public but should use due caution in divulging
discoveries or new techniques or treatment
through non-professional channels.
Certify only that which he/she has personally
verified.
Strive to use health care resources in the best way
to benefit patients and their community.
Seek appropriate care and attention if he/she
suffers from mental or physical illness.
Respect the local and national codes of ethics
15. Respect for Patient
Respect for Privacy
Comprehensive care
Respect for patient‟s autonomy
Inform the patient about his/her condition
Protect patient's interests
Keep the patients‟ secrets
Source: Islamic Code of Medical & Health Ethics
16. A physician should:
Listen carefully to the patient’s complaint, sympathizing with
him in his suffering, treat him well, and be gentle while examining
him.
Respect his patient’s opinion, but that should not keep the
physician from giving the appropriate instructions.
Treat all his patients equally, without any discrimination based
on their prestige, their social or moral status, the physician‟s own
feelings towards them, their religious or racial background, their
political orientation, or their gender, nationality, or color.
Fear God when dealing with his patients; show respect for
their beliefs, religions, and traditions
Avoid any violations of Islamic law, such as being alone with
a member of the opposite sex or looking at the private parts
('awra) of a patient except in as much as the process of
examination, diagnosis, and treatment requires; in the presence
of in the presence of a third party; and after obtaining permission
from the patient.
Source: The Islamic Charter of Medical and Health Ethics
17. A physician should
Ask only for the tests needed for the patient, without adding any tests
not justified by the patient‟s case. He should base his whole diagnosis
and treatment on the best available evidence and data.
Honestly explain to the patient or anyone representing him the type,
causes, and complications of the illness, and of the usefulness of
diagnostic and therapeutic procedures.
NOT hesitate to refer the patient to a more experienced doctor or to
a doctor who has more effective equipment whenever the patient‟s case
calls for such a referral, nor to refer him to a doctor whom the patient
wishes to consult.
Continue to give an emergency patient the proper treatment until it is
no longer needed or until care for the patient is taken over by another
doctor.
Continue to extend proper care to patients with incurable, terminal, or
fatal diseases, and to console them and give them hope to the last
minutes of their lives.
Relieve the patient’s pain and give him the feeling that the physician is
eager to give him proper care and attention.
Source: The Islamic Charter of Medical and Health Ethics
18. Positive interaction with the community‟s affairs
Protect the community by reporting
reportable/epidemic diseases
Improve health in the community through
advocacy and health education, and involvement
in community health activities
Rational use of the healthcare institutions‟
resources
Effective contribution to the development of
policies and health systems that respond to the
community needs and facilitates easier access to
health care.
Source: The Islamic Charter of Medical and Health
19. The Doctor has the right to:
Receive his/her complete right to respectful treatment and
civil rights, equal to other community members
Chances to continuous education and training (through
libraries, conferences, workshops, symposia, etc.)
A setup within which s/he can provide healthcare in
compliance with the international guidelines and standards
Not to be coerced by any means to do or abstain from doing
a work related to his/her profession, except within the limits
of law
Not to be suspended or halted from practice, expect within
the limits of law & professional regulations
Defend him/herself in any trial and professional discipline,
or/and to have the right to delegate lawyers (or experts)
20. The Islamic Charter of Medical and Health Ethics.
(www.emro.who.int/PDF/IslamicCharter_MedicalHealthEthics.pdf)
The CanMEDS 2005 Physician Competency Framework
(http://www.ub.edu/medicina_unitateducaciomedica/documentos/CanMeds.pdf)
WMA International Code of Medical Ethics
(http://www.wma.net/en/30publications/10policies/c8/)