PRINCIPLES OF ETHICS IN ANESTHESIOLOGY.pptx

It deals with the principles of Anesthesiology

1. PRINCIPLES OF ETHICS IN ANESTHESIOLOGY & ANESTHESIOLOGY AS CAREER Dr Sangmesh Kunkeri Associate Prof BRIMS Bidar

2. ETHICS Study of moral principles governing or influencing the conduct of a person and his profession

3. It describes the right responsibilities of a person and his profession. Ethics is study of moral standardsand how they affect conduct.

4. Ethicsdesribes highestsatndards of behaviour than does the law and occasionally ethics requires that physccians dis

5. Non rational approaches Obedience Limitation Feeling or desire Intuition habit

6. Rational approaches Deontoly – seacrh for well founded rules Conseqentialism- analysis of consequences Principlism – basic moral principles Virtue ethics --- finding the best practice

7. Basic principal of medical ethics Autonomy/ respect for persons – the principle simply means that an informed, competent adult patient can refuse or accept treatment, drugs, and surgeries according to their wishes Beneficence – all healthcare providers mst strive to improve their patients health, top do good to the patient. Non maleficence – beneficence without harm Justice - Equality in treatment

8. Medical ethics and law Medical ethics is closely related to law. In most countries there are laws that specify how HPs are required to deal with ethical issues in patient care and research. In addition the medical licensing and regulatory officials in each country can do and punish HPs for ethical violations.

9. Ethics in clinical anaesthesia Pre operative ethics Perioperative Post operative

10. Who decides what is ethical for HPs? In many not most, countries medical association have been responsible for developing and enforcing the applicable ethical standard. Depending on the countries approach medical law, these standards may have legal status.

11. Does medical ethics change?... “The relationship between HPs, their patients and broader society has undergone significant changes in recent times. While a physician should always act according to his/her conscience, and always in the best interests of the patient, equal effort must be made to guarantee patient autonomy and justice.”

12. Does medical ethics differ from one country to another? Just as medical ethics change over time in response to development in medical science and technology as well as in societal values so does differ country to country depending on these some factors; On euthanasia, for example, there is a significant difference of opinion among national medical associations. Some condemn it while others like Royal Duch Medical Association and some USA states support it.

13. Unethical… Bone, nerve, muscle transplantation from one person to another. Sea water experiment – subjects deprived of food and given chemically treated water. Sterilization of subjects by means of x ray, surgery and drugs. Spotted fever (typhus) germs infected healthy subjects to develop vaccine.

14. Declaration of Helsinki Originally adopted 1964. was developed by the World Medical Association for use by the medical community following dissemination of the Nuremberg Code. 1 st significant attempt by the medical community to regulate itself.

15. Dealing with & Protecting Confidentiality / Privacy Disclosure during informed consent Applicable law Anonymization Means of ensuring data security Limiting data access Investigator integrity!

16. Medical malpractice Medical malpractice is improper, illegal or negligent professional procedure or treatment in the health care service. Negligence is the most common medical malpractice. Medical negligence is a failure to give proper care over patients.

17. Negligence There are four elements to negligence. They include: duty, breach, injury, and damages.

18. Informed Consent Informed consent is the process by which the treating health care provider discloses appropriate information to a competent patient so that the patient may make a voluntary choice to accept or refuse treatment. Consent is based on the ethical principle of respect for persons. Acknowledge the person’s autonomy Protect those with diminished autonomy

19. Anesthetic record… Accurate record keeping should be considered as a core skill for all anesthetic trainees. A comprehensively written chart should; Enable effective communication Permit care to be transferred safely Ensure postoperative orders and prescriptions are given. The anesthetic chart are used as a legal record of intra operative record of events.

20. Quality of care It may be deemed to reflect the quality of care given to a patient. A poorly written and illegible chart may be seen to be an indicator of a poor standard of care. These charts may also be used in fitness to practice proceedings. During legal procedures the anesthetic charts may be intimately examined by lawyers, expert witnesses and lay people.

21. ANAESTHESIOLOGY AS CAREER Giving anesthesia inside operation theater – general anesthesia and regional anesthesia Monitor patient vital functions and continue administering the anesthetic through out the surgery

22. Management of acute and chronic pain Intubation and Ventilation in intensive care units. Research to help treat and cure disease make new medicines and discover new techniques

23. Recording medical history Manage a critical care centre – open ICU , Closed ICU and Semi Open ICU Specialise in cardiac anesthesia , neuro anesthesia oncoanesthesia paediatric anesthesia , geriatric anesthesia .

24. Hazards… Anesthetists spends longer time in an environment which is filled with many hazards. There is a potential exposure to vapors from chemical radiations and infectious agents. Their is also psychological stress.

25. Hazards… Physical hazards Infectious hazards Psychological stress

26. T hank you