1. 6/15/20151 1. Principles of ethics in medical practice in
Ethiopia 2. Principles of Ethics for Health Officers in Ethiopia 3.
Patients Right & Responsibility
2. 6/15/20152 Principles of ethics in medical practice in
Ethiopia
3. 6/15/20153 What should be the relation between physician and
community? In what conditions the physician has the right to refuse
to attend a patient? What is the importance of being sympathetic
during rendering a service? What is abortion? What are the criteria
to perform abortion according to our country law?
4. 6/15/20154 What is medical secrecy? What is informed
consent? How do we handle secrete information of the patient? In
what condition we disclose secret information of the patient? What
is Obligation of health personnel?
5. Physician- patient and physician- community relationship
6/15/20155 13 articles Art1 rendering service to the individual and
the community with full respect for life and the dignity of man.
Art2 -maximum possible care, devotion and conscientiousness to his
patient. Respect the dignity of his her patient and sympathetic
friendly and helpful.
6. 6/15/20156 Art3 -practice without discrimination Art4- Help
patient the family and the whole community in the prevention of
disease Art5 -Cooperate with the public authorities in the
prevention of disease. Art6 -use of every opportunity to teach the
patient and his family the prevention of disease and promotion of
health.
7. 6/15/20157 Art7 in case of emergency the physician shall
extend all possible assistance to the patient without fail. Art8 in
the event of public danger the physician shall not abandon
patients. Art9 the physician shall do nothing wasteful or without
justification for the health of the individual or the community.
Art10 -shall be the defender of the child when he/she judges the
health of the child isnt well protected.
8. 6/15/20158 Art 11 obliged to consult colleagues when it is
necessary to do so, and shall inform the patient and/or his
relatives about the consultations. Art12 Has the right to refuse to
attend a patient on reasonable grounds except in emergency
situations, If a. The patient will have adequate care b. A
colleague will replace him/her c. All necessary information will be
conveyed to the replacing colleague. Art13 the physician patient
relationship shall not be used as a means of developing
intimacy.
9. 6/15/20159 Every health professional have a duty to render
service to his community with full respect to human life and
dignity of man, even though there are public dangers. If you refuse
to render your assistance, you punished according to the revised
criminal code 2004 of our country, which is stated in article 420
and 537
10. Art420 of criminal code:- Crimes Committed in Dereliction
of Duty. 6/15/201510 1. Any public servant who fails to carry out
his duties in a proper manner and to the prejudice of State, public
or private interest, is punishable with fine not exceeding 1,000
Birr or simple imprisonment not exceeding six months. 2. Where
substantial damage has resulted from the crime, both simple
imprisonment and fine may be increased up to the general legal
maximum.
11. Art 537 of criminal code:- Refusal to Provide Medical
Assistance 6/15/201511 Any health professional lawfully entitled to
render professional attention and care, who, contrary to his duty
and without just cause refuses to provide his services in a case of
serious need, whether from indifference, selfishness, cupidity,
hatred or contempt or any other similar motive, is punishable with
fine, or, where the crime is repeated, with simple imprisonment not
exceeding six months.
12. The physician as a professional 6/15/201512 Art15 the
responsibility of the physician shall be strictly personal. Art 18
the physician shall use recognized scientific methods in his/her
practice Art 19 the physician shall not administer unjustified
treatment
13. Medical secrecy 6/15/201513 Medical secrecy is secret
information of the patient that should not be out of the patient.
Any health professional including students found with physician
have obligation to medical secrecy. Art20 shall maintain his her
professional secrecy in respect for all matters except in those
situations clearly stipulated by the law or when the patient gives
written consent for the release of information.
14. Medical secrecy. 6/15/201514 Art 21 in case of minors and
unconscious patients physician may reveal professional secret to
the patients relatives when such a revelation would serve for the
cure of the patient. Art 22 -See to it that persons working with
him/her respect medical secrecy. Art23 -Not disclose the
identification of patient in scientific publications or lectures
unless there is a written consent of the patient.
15. 6/15/201515 Art399- Breaches of Professional Secrecy. 1.
Medical personnel, who disclose a secret, are punishable, upon
complaint, with simple imprisonment or fine. 2. Students,
probationers or apprentices who disclose a secret, which they have
learned in the course of their professional training, are liable to
the punishment prescribed under sub article (1) above. 3. Where the
breach is committed negligently, it is punishable, upon complaint,
with fine not exceeding 1000 Birr or simple imprisonment not
exceeding 1 year.
16. 6/15/201516 Secrete information of the patient is disclosed
only under the following conditions; If it is clearly stipulated by
the law. If the patient give written consent for the release of the
information If the information released is important for the health
the patient especially in case of minors, unsound mind or un
conscious patients.
17. Art 400- Authorized Disclosure. 6/15/201517 1. Any
disclosure shall not be punishable: where it is made with the
express consent of the person interested in keeping the secret;
where, at the suggestion or request of the possessor of the secret,
the competent higher professional or supervisory body has given its
written permission for disclosure. where it is made ff an express
decision of a Court of justice in a specific case; or Where special
provisions of the law permit or impose the duty, in the interests
of public order, to give evidence before a Court of justice or to
inform a public authority.
18. Art 400.. 6/15/201518 2. Where law, by a Court of justice
or by the competent authority, expressly orders disclosure the
possessor of the secret cannot invoke his professional obligation
to maintain secrecy. The secrecy of religious confession is at all
times inviolable.
19. Patients informed consent 6/15/201519 Art 24 it is the duty
of the physician to inform the patient about the treatment
(including surgical procedures) obliged to obtain a written consent
of the patient before carrying out procedures in the case of minors
or persons who are unconscious, the necessary consent should be
surrogates. Article 25 on legitimate grounds, left to the
discretion of the physician information about serious diagnoses
and/or prognosis may be withheld unless the patient demands it.
However, it is desirable to inform the nearest relative when the
outcome is likely to be unfavorable.
20. 6/15/201520 Torture and punishment Art26 Not participate in
the practice of torture or other cruel, inhuman or degrading
procedures. The physician shall not provide premises instruments
substances or knowledge to facilitate the practice of torture.
Certificates, prescriptions and signatures Art 27 any document or
certificate issued by the physician bear legible name and
signature. .
21. 6/15/201521 Art28 the issuance of a tendentious report or a
false certificate is unethical. Art29 upon request of the patient
or legal authorities the physician shall issue certificate Art30
Formulate his prescriptions with the necessary clarity. The patient
or family have well understood prescription.
22. Art387- Issuing False Medical Certificate. 6/15/201522 1.
Any health professionally to issue certificates of a medical nature
who makes out a certificate which is untrue and calculated to
procure an unlawful advantage for, or to injure the legitimate
interests of, another person, knowing that such certificate will be
used, is punishable with simple imprisonment or fine 2. Where the
false certificate has been issued for a consideration, a promise of
a consideration, or other benefit, the punishment shall be rigorous
imprisonment not exceeding ten years and fine not exceeding 50,000
Birr
23. 6/15/201523 3. Where the person who has made the false
medical certificate is a public servant and has acted in his
official capacity, the punishment shall be simple imprisonment for
not less than 3 yrs, or, where the case is serious, rigorous
imprisonment not exceeding 10 yrs in respect of a crime under
sub-art (1); and rigorous imprisonment not exceeding 15 yrs and
fine not exceeding 100,000 Birr in respect of a crime under
sub-art(2). 4. Whoever knowingly makes use of a false certificate
to deceive another is punishable with the penalty prescribed under
sub- article (1) of this Art.
24. Undisclosed gain 6/15/201524 Art31 it is unethical to
accept any indirect gain based on a principle of dichotomy or
undisclosed division of professional fees for a medical act such as
for prescriptions of drugs laboratory investigations, appliance
etc. with a medical partnership publicly known to exist. Art32
complicity intended to get directly or indirectly any material
benefit is forbidden between physicians themselves, and between
physicians and other health workers and between physicians and any
other person. Art33 the physician shall not allow a patient to
obtain illegal or unjustified gains.
25. Advertisement and publicity 6/15/201525 Art34 the physician
in his/her practice shall avoid direct or indirect self
advertisement. Art35 the physician shall not use his/her mandate or
administrative position in order to promote his/her practice. Art36
the physician shall conduct himself herself in a loyal, fraternal
and courteous way towards other members of his/her profession.
26. 6/15/201526 Art37 Never discredit the acts or words of a
colleague except where immoral words or acts directly harmful to
the health of a patient or the community. No tolerance to disparage
(Criticize) if immoral. Art38 disputes b/n members of the medical
profession, must be resolved quickly and amicably within the
profession itself. If this fails the dispute shall be brought
before the body administering this code of medical ethics.
27. 6/15/201527 Art39 a consulted physician shall not take over
the managing of the patient without the knowledge of the regular
attending physician. Art40 it shall be the duty and privileges of
every physician to attend free of charge any sick colleague or his
dependents.
28. Supervisory role of the physician 6/15/201528 Article 41
the physician shall not allow any medical student to take direct
responsibility of patient care. Article 42 the physician shall
closely supervise the intern in carrying out his duties and
responsibilities.
29. Mind and behavior control 6/15/201529 Article 1 a) The
patient must be given necessary information even if complex, in
order he reaches a decision about whether to accept or refuse the
recommended psychotropic drug. b) In the case of the patient who is
capable of comprehending the information given to him about
psychotropic drugs, the patients right to refuse treatment must be
respected. c) When the patient is regarded as too disordered to
arrive at informed judgments, the physician/ psychiatrist can
assume the duty to prescribe the medication he/she considers
necessary for clinical needs, but it should be properly
documented.
30. 6/15/201530 Art2 in cases of social deviance it is
unethical to use psychotropic drugs as chemical restraint as a form
of social control or as punitive measures in psychiatric hospital,
prison practices or elsewhere. Art3 in the treatment of addicts
suffering from withdrawal symptoms, appropriate care and support
must be provided without discrimination.
31. 6/15/201531 Art5 it is the duty of the physician to explain
the mode and the program of behavioral psychotherapy to the patient
and the patient must give his consent. Art6 aversion treatment may
be used after full interdisciplinary discussion and after obtaining
written consent from the patient. Art7 psychiatrists at times may
find it necessary in order to protect the patient or the community
from imminent danger to reveal confidential information discussed
by the patient.
32. Abortion 6/15/201532 Abortion is the termination of
pregnancy before fetal viability, which is conventionally taken to
be less than 28 weeks from the last normal menstrual period (LNMP).
If the LNMP is not known, a birth weight of less than 1000gm is
considered as abortion. Abortion is most likely to be in the 2nd or
3rd month, when the woman is sure she is pregnant ,before other
people have noticed it.
33. Abortion 6/15/201533 Art1 the first moral principal imposed
upon the physician is respect for human life from its beginning.
Art2 an abortion is justifiable only when it is performed for the
purpose of saving the endangered life or health of a women. Art3
abortion is justifiable if performed by a physician in health
institutions where appropriate facilities are available.
34. Abortion 6/15/201534 Art 4 it is mandatory to treat a
patient who is suffering from the effect of a criminal abortion
induced by another person. Art5 the physician must never disclose
the cause of his patients condition to anyone else without the
consent of the patient unless ordered to do so in court law.
Article 6 a criminal abortion leading to death should be reported
to the concerned authorities by the treating physician.
35. 6/15/201535 Art551 Penal Code: allows termination of
pregnancy under the ff conditions: 1. Termination of pregnancy by a
recognized medical institution within the period permitted by the
profession is not punishable where: a. The pregnancy is a result of
rape or incest; or b. The continuation of the pregnancy endangers
the life/health of the mother or the child. c. The fetus has an
incurable and serious deformity;
36. 6/15/201536 d. The pregnant woman, owing to a physical or
mental deficiency she suffers from or her minority is physically as
well as mentally unfit to bring up the child. 2. In the case of
grave and imminent danger, this can be averted only by an immediate
intervention; an act of terminating pregnancy in accordance with
the provisions of Article75 of this Code is not punishable.
37. Art545 of criminal code. - Principle 6/15/201537 The
intentional termination of a pregnancy, at whatever stage or
however effected, is punishable according to the following
provisions, except as otherwise provided under Article 551. The
nature and extent of the punishment given for intentional abortion
shall be determined according to whether it is procured by the
pregnant woman herself or by another, and in the latter case
according to whether or not the pregnant woman gave her
consent.
38. Art546- Abortion Procured by the Pregnant Woman 6/15/201538
A pregnant woman who intentionally procures her own abortion is
punishable with simple imprisonment. Any other person who procured
for her the means of, or aids her in the abortion, shall be
punishable as a principal criminal or an accomplice, with simple
imprisonment.
39. Art548- Aggravated Cases. 6/15/201539 In cases where the
crime is committed by a person who has no proper medical
profession, the punishment shall be simple imprisonment for
not
