Файл: Реферат по теме Этические аспекты работы медицинских специалистов Специальность 31. 02. 04.doc

Recently, the problem of animal experiments has become acute; a modern doctor is required to reduce the number of experimental animals, conduct alternative studies using modern technologies. If, nevertheless, an animal is used, the experiment must be humane: it is important to minimize the suffering of the animal when it comes to causing him pain, physical or mental discomfort.

After the research, the doctor must acquaint his colleagues with the results, adhering to the norms on the protection of copyright and intellectual property. All scientific research materials must also be free from self-promotion and not violate medical confidentiality. This rule contains both the principle of beneficence and justice, and the prince of collegiality, which we will consider in more detail in the next section of the work. If the doctor is also engaged in educational work, then he should be as careful as possible in his public statements. And if he proposes a little studied method, then he is obliged to present all warnings on its use.

In his practice, a doctor cannot engage in other activities that interfere with the performance of his professional duty, that is, activities that put him in legal, material or moral dependence on third parties. However, this does not mean that a doctor does not have the right to engage in scientific activities, creativity, have a hobby or take part in public life. On the contrary, all this contributes to his self-improvement. But the doctor must always remember that even his personal interests, not to mention the interests of third parties, are less important than the interests of the patient.

If in his practice a doctor is faced with the problem of resource allocation, then he should be guided by the principle of the severity of the patient's condition: most of the resources are directed to the most "severe" patients. It is desirable that all patients receive equal attention from the medical staff. First of all, medical assistance is provided to children, pregnant women and the elderly. When working with the elderly, the physician must be particularly sensitive and respectful. If a doctor fixes in relation to his patients of childhood and senile age the wrong attitude on the part of other persons or organizations, then he must report this, even despite the preservation of confidentiality.

A trembling issue is the provision of assistance to pregnant women. A doctor or obstetrician should surround a pregnant woman with double care, so to speak, so as not to cause psychological stress and thereby harm the child. Medical workers should also remember that, to the extent of natural processes and increased psychological stress, a pregnant woman may show incontinence, inadequate emotional reaction, but the doctor must remain calm, friendly, responsive and reassure the patient.

Abortions are allowed in our country, however, a doctor should not insist on an abortion, especially for the purpose of obtaining benefits. On the contrary, he must correctly explain to the patient all the possible consequences of this operation for her health. In some cases, taking into account the moral and mental state of a woman, a doctor can and should have a heart-to-heart conversation with a woman. This is especially valuable if the doctor himself is older than the patient and has experience and authority. The results of such conversations are often the birth of healthy children and deep gratitude to the mother for being dissuaded from terminating the pregnancy and giving her the happiness to enjoy motherhood. Of course, the doctor should not impose his point of view, but every time he can try to save the life of a born person. Thus, he helps himself, because abortion, as a very dubious ethical procedure, negatively affects the psyche and spiritual state of the medical workers themselves. When working with a minor pregnant patient, the doctor makes a decision together with her parents. If a pregnancy is terminated for medical reasons, the doctor must carefully recheck the diagnostic data to avoid a false diagnosis. The life of the fetus should be fought for and accounted for in the same way as the life of the mother.

Telling a pregnant woman or a woman in labor disturbing, disappointing news, the doctor should be as careful and tactful as possible, showing sympathy and providing moral support. If it is necessary to perform a caesarean section, the doctor must take the consent of the patient or her relatives (if the mother is in a severe terminal or mental state). When a woman herself insists on an operation, the doctor must carefully weigh all the pros and cons, in particular the degree of the woman's neuroticism, her readiness for motherhood, etc. and in case of refusal, try to reasonably convey your opinion to the woman and her relatives. Recently, the so-called. partner childbirth with a husband or other family member. When there are no visible threats to a woman's health and the pregnancy is proceeding normally, the medical staff may well allow the husband or relative to be present at the birth of the child (subject to prior preparation, including psychological).

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Any formal attitude towards patients, bureaucracy, incl. when it comes to working with pediatric patients and disabled people with HIV and AIDS. In particular when working with disabled people, the doctor should support them morally and explain their social rights. Ultimately, the ethics of communication with a patient comes down to the principle: «to love your profession means to love a person».

3. Maintaining relationships with colleagues as part of ethics of the medical profession

The relationship of a medical worker with colleagues is based on the principle of collegiality, that is, in conditions of goodwill, mutual support and joint decision-making when necessary. The first collegiate society for a physician is his teachers and fellow students. A medical worker should treat teachers with special respect, because in the Hippocratic oath, a teacher of medicine was equated with a parent. In the future, a doctor or other medical worker should do everything possible to increase the authority of his profession in society.

When communicating with colleagues, first of all, it is required to avoid doubts and criticism regarding their competence. And make any comments in a polite manner and with reason. More experienced doctors have the right to give advice to less experienced colleagues, but this does not mean that the responsibility for the decision passes to them. Any doctor has the right to refuse the advice of a colleague. Heads of medical institutions, as part of their duties, take care of the professional growth of their subordinates, but do not have the moral right to unreasoned criticism. Just as unacceptable is the attitude of superiority in relation to medical personnel of the lowest qualification.

All the above ethical rules for the conduct of physicians, built on the ethical principles of the medical profession, do not replace legislative acts, but supplement them. In case of violation of professional ethics, the doctor may not be subject to administrative punishment, but be called to account through the means of public influence - the staff of the medical institution, the ethics commission, the media, public meetings, etc. In fact, a good friendly team of medical professionals is the best regulator of the ethical activity of a medical professional, so building positive relationships with colleagues is very important for a medical professional.

Equality, honesty, fairness, decency, willingness to share one's knowledge are key qualities in the medical community. Doctors should help each other if misunderstandings arise in their work. It is necessary, as when working with a patient, to avoid rudeness and anger, but to defer the issue to a group of doctors or an ethical committee. Analyzing his own mistakes and the mistakes of colleagues, the doctor must express his opinion in the absence of patients, their relatives and third parties. It is highly unethical to gain authority through public criticism of colleagues. At the same time, the moral duty of the doctor is to fight against unscrupulous medical workers, charlatans, etc. The doctor must notify the higher authority, as well as law enforcement agencies in case of violations, abuses and negligence, report the identification of unspecified side effects of drugs.

If the doctor has provided emergency assistance to the patient, who will subsequently be treated by another physician, then he must give him the detailed necessary information. When providing emergency care, it is also impossible in a fit of emotions to criticize the activities of other medical workers, preventing professional and personal conflicts.

If necessary, the doctor can and should consult with his colleagues or allow the patient to independently consult with another doctor. The consulting physician must respect his colleague, guided by the principle of the supremacy of the interests of the patient. All controversial issues are discussed without the patient. The patient is informed of the final agreed decision of the doctors. If the patient does not agree with the decision, doctors do not have the right to impose their opinion, to enter into an argument with the patient, his relatives and with each other. The consultant does not have the right, on his own initiative, to call the patient for examination without informing the attending physician (except in emergency situations), nor does the attending physician have the right to withhold a patient who wants to switch to treatment with a consultant. In case of disagreement between the consultant and the attending physician regarding the diagnosis and further treatment, their point of view is fixed in writing.

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When providing medical services by a group of doctors, each of them takes equal responsibility, communicates with the patient and informs him. The patient should not suffer from the disagreements of the medical staff. Each of the doctors has the right to refuse treatment if it does not harm the patient and his colleagues are informed. To optimize the work of groups of doctors, a personal doctor can be appointed, who communicates the decision of the entire group of doctors to the patient and conveys the opinion of the patient to them. The attending physician and the physician involved in the hospitalization of the patient must also maintain a close professional relationship.

Health workers are called upon to show respect and benevolence also to representatives of other professions, both related to health and non-health. Doctors can cooperate with multidisciplinary teams, public associations, organizations to improve patient care, especially in pre-terminal condition, the disabled, the elderly, low-income patients. A medical worker is the face of a medical institution and all medicine, therefore, when communicating with other specialists, he must be polite, attentive, interested, avoiding actions that discredit his reputation and the image of a physician. Cooperation with humanitarian charitable organizations and participation in humanitarian actions are strongly encouraged. However, such activities should not violate the basic ethical principles and rules, such as medical confidentiality, collegiality, etc.

It should also be remembered that the medical profession is one of the military. If a medical worker is called up for military service, then he must obey the military leadership and build relationships with the team. And in relation to patients - in the conditions of hostilities, to fulfill all their duties to the fullest, that is, to help even those who are classified as enemies, prisoners of war; stop illegal and inhuman acts of the parties, for example, torture, experiments on prisoners. When "sorting" the wounded, the doctor must correctly determine the degree of "severity" of the patient. This also applies to the activities of medical workers in penitentiary institutions. There is a special international union of doctors and lawyers, to which a physician can turn to stop violations of human rights.

If the doctor is engaged in expert activities, then he should not be interested in the results of the examination, therefore it is prohibited for the attending physician to conduct an examination in relation to the patient, and also if the subject is a relative or acquaintance of the doctor conducting the examination. The doctor may refuse to conduct an examination if he considers it contrary to the law or unethical. Before the start of the examination, the doctor is obliged to inform the person being examined (his relatives or guardians) about the goals of his work.

If the doctor cooperates with organizations that sponsor research, then he can mention them, but without explicit advertising. All collaboration must be voluntary, non-commercial, and ethical.

In the case of participation in social activities, a medical worker does not have the moral right to justify his opinion with the authority of the profession. But he can and should share his experience on how to preserve and protect the health of the population.

Carrying out diagnostics, prevention and treatment, the doctor does not have the right to give recommendations in areas in which he is not competent, as this violates the ethical principles of no harm and collegiality. Just as he cannot resort to actions that limit the activities of his colleagues, representatives of other professions. The doctor must consciously, soberly assess his capabilities: intellect, knowledge, circumstances, external conditions in the treatment of the patient. At the same time, the doctor must take care of the equipment of his workplace, compliance with hygiene requirements, professional standards, labor protection rules, incl. junior medical staff. It is especially important to create safe working conditions, in which neither the patient nor the medical workers themselves will be at risk of contracting diseases or injuries.

Therefore, we can be convinced that the ethics of interaction between a doctor and colleagues and representatives of other professions also lies in deep love and respect for a person, and, therefore, depends on the constant moral and spiritual improvement of medical workers.

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The conclusion
Ethical principles are very important in the professional activity of medical workers, which has been noticed since antiquity. A whole section of medicine, deontology, is dedicated to them. Modern deontology is based on the principles of fulfillment of duties and honesty of a physician, his autonomy, not causing harm to patients, beneficence and justice, collegiality in building relationships in a professional team. That is, a doctor or other medical worker is obliged, both by law and by following the code of ethics, to help all patients without exception, treat people and animals humanely, refusing actions that can harm people and the living shell of the planet. And also - to be in solidarity with colleagues, with citizens in the struggle for peace, to maintain medical secrecy and confidentiality of information, to fight in every way to preserve people's health, to avoid actions that may adversely affect his reputation.

When providing medical care, a physician is called upon to remain patient, tactful, attentive, to show sympathy and mercy, increased tact when working with the disabled, the elderly, and pregnant women. He must avoid rudeness, anger, destructive criticism, both in dealing with patients and with their relatives, colleagues, representatives of other professions. Any decision should be balanced, possibly collegial, so as not to harm patients.

In each case, a medical worker has to apply all his knowledge, skills, and sometimes moral sense to find the right approach to a person. Therefore, physicians should be well aware of ethical principles and rules, apply them in their practice, improve morally, follow the development of deontology in the light of the emergence of new biomedical technologies.
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