Q1.

What is medical Ethics and why it is important:

Medical ethics involves examining a specific problem, usually a clinical case, and using values, facts, and
logic to decide what the best course of action should be.
Some ethical problems are fairly straightforward, such as determining right from wrong. But others can also
be more complex, such as deciding between two "rights" two values that are in conflict with each other or
deciding between two different value systems, such as the patient's versus the doctor's.
Doctors may deal with a great variety of perplexing ethical problems even in a small medical practice. Here
are some common problems identified in a 2016 Medscape survey, where at least some physicians held
different opinions
 Withholding treatment to meet an organization's budget, or because of insurance policies;
 Accepting money from pharmaceutical or device manufacturers;
 Upcoding to get treatment covered;
 Getting romantically involved with a patient or family member;
 Covering up a mistake;
 Reporting an impaired colleague;
 Cherry-picking patients;
 Prescribing a placebo;
 Practicing defensive medicine to avoid malpractice lawsuits;
 Dropping insurers; and
 Breaching patient confidentiality owing to a health risk.
Professional standards are a way to provide some guidance on ethical problems, but they cannot address
every issue, and they may not address troubling nuances, such as reconciling two conflicting values.Many
professional ethicists recommend using four basic values, or principles, to decide ethical issues:
1. Autonomy: Patients basically have the right to determine their own healthcare.
2. Justice: Distributing the benefits and burdens of care across society.
3. Beneficence: Doing good for the patient.
4. Nonmalfeasance: Making sure you are not harming the patient.
However, ethical values are not limited to just these four principles. There are other important values to
consider, such as truth-telling, transparency, showing respect for patients and families, and showing respect
for patients' own values.
In addition, medical ethics is not just a thought process. It also involves people skills, such as gathering the
facts needed to make a decision and presenting your decision in a way that wins over the confidence of all
parties.
Q2. Nursing ethics
Nursing ethics is a branch of applied ethics that concerns itself with activities in the field
of nursing. Nursing ethics shares many principles with medical ethics, such as beneficence, non-
maleficence and respect for autonomy
Nurses work in a fast-paced, technical environment. They must make quick decisions about patient care
and effectively communicate with other healthcare personnel.
Patients depend on a nurse’s honesty and adherence to ethical standards of ethics. A nurse should develop
trust with patients while exhibiting compassion and empathy.

The Role of Ethics in Nursing

Nurses work alone and with other healthcare professionals. This collaboration between nurses, colleagues
and physicians is important to the safety and quality of patient care. Nurses perform duties based on
physicians’ instructions and use their own judgment as necessary. Ethics in nursing includes fair and
equable treatment of all patients regardless of the following:
 Economic status.

 Age.

 Ethnicity.

 Citizenship.

 Disability.

 Sexual orientation.

The Ethical Responsibilities of Nurses

Nurses must maintain professional competency by continuing their education and participating in
professional development. The ethical responsibilities of nurses include promoting health, preventing
disease and alleviating suffering.
According to the Code of Ethics, nurses are responsible for the care not only of patients but also their
families and associated groups. The Code emphasizes that sometimes the patient is more than an
individual. Thus, nurses need to inform families, business associates or communities about a patient’s
treatment and progress when it is appropriate under patient privacy laws.

Morality and Ethics in Nursing

Nurses have a responsibility to report any immoral professional behavior. They should notify staff leaders
about healthcare professionals who engage in illegal activities, demonstrate incompetence or work while
impaired. In addition, nurses must intervene when they come in contact with a patient who is a victim of
child, elder, sexual or domestic abuse. They must also report cases of tuberculosis and other infectious
diseases.

Q3. Organ donation

Organ donation is the process of removing an organ from one person and surgically placing it in another
person. Many organs can be donated. Donations include the liver, kidney, pancreas, and heart.
Ethics of organ transplantation refers to the ethical concerns on organ transplantation procedures . Both
the source and method of obtaining the organ to transplant are major ethical issues to consider, as well as
the notion of distributive justice.
Organ harvesting from live people is one of the most frequently discussed debate topic in organ
transplantation. The World Health Organization argues that transplantation promote health, but the notion
of “transplantation tourism” has the potential to violate human rights or exploit the poor, to have
unintended health consequences, and to provide unequal access to services, all of which ultimately may
cause harm. Thus WHO called to ban compensated organ transplanting and asked member states to
protect the most vulnerable from transplant tourism and organ trade. However, as disincentives becomes a
must, adding incentives back, such as improving life condition for organ donors after donation, becomes
difficult.
There is also a powerful opposing view, that trade in organs, if properly and effectively regulated to ensure
that the seller is fully informed of all the consequences of donation, is a mutually beneficial transaction
between two consenting adults, and that prohibiting it would itself be a violation of Articles 3 and 29 of
the Universal Declaration of Human Rights.
Controversies also raise on how to assume consent of organ donation for dead people. In practice most
countries, have legislation allowing for implied consent, asking people to opt out of organ donation instead
of opt in, but allow family refusal

Ethical Considerations in Living Donation

The demand for solid organs far exceeds the number of organs available from deceased donors. Not
surprisingly, instead of facing years on the transplantation waiting list, some patients, often with the
encouragement of transplantation teams, seek to identify relatives or others who would be willing to
donate the needed organ or partial organ directly or, in some cases, through a donor exchange program.
Still other donors offer a kidney or a partial organ to patients whose stories have become known to them,
perhaps through the media, whereas still others make a nondirected donation of a kidney to the
transplantation system for use by any patient who needs it.
Organ donation by living donors clearly saves lives, improves transplantation outcomes under some
circumstances, and reduces recipients’ waiting times. It also increases opportunities for patients without
living donors to receive organs from deceased donors. However, it raises a series of ethical questions that
have not been fully addressed.
The transplantation of organs from living donors seems to violate the traditional first rule of medicine
“do no harm” because it involves the removal of a healthy organ from one person for implantation into
another person. One person becomes a patient to benefit another person who is already a patient. In a
survey of 100 liver transplant surgeons, Cotler and colleagues (2003) found that 77 percent experienced a
moral dilemma in placing a living donor at risk. Nevertheless, 72 percent also agreed that transplant
centers had a duty to offer their patients the possibility of transplantation using living donors. Because the
committee’s mandate calls for primary attention to ways to increase the rates of organ donation from
deceased donors, this report will not provide a detailed discussion of the scientific, clinical, and ethical
issues involved in organ donation by living donors. However it is important that living donation be the
subject of intense discussion and study.

Q4. Malpractice

Medical malpractice occurs when a hospital, doctor or other health care professional, through a negligent
act or omission, causes an injury to a patient. The negligence might be the result of errors in diagnosis,
treatment, aftercare or health management.
Characteristics:

 A violation of the standard of care - The law acknowledges that there are certain medical standards
that are recognized by the profession as being acceptable medical treatment by reasonably prudent
health care professionals under like or similar circumstances. This is known as the standard of care. A
patient has the right to expect that health care professionals will deliver care that is consistent with
these standards. If it is determined that the standard of care has not been met, then negligence may
be established.
 An injury was caused by the negligence - For a medical malpractice claim to be valid, it is not
sufficient that a health care professional simply violated the standard of care. The patient must also
prove he or she sustained an injury that would not have occurred in the absence of negligence. An
unfavorable outcome by itself is not malpractice. The patient must prove that the negligence caused
the injury. If there is an injury without negligence or negligence that did not cause an injury, there is
no case.
 The injury resulted in significant damages - Medical malpractice lawsuits are extremely expensive
to litigate, frequently requiring testimony of numerous medical experts and countless hours of
deposition testimony. For a case to be viable, the patient must show that significant damages resulted
from an injury received due to the medical negligence. If the damages are small, the cost of pursuing
the case might be greater than the eventual recovery. To pursue a medical malpractice claim, the
 patient must show that the injury resulted in disability, loss of income, unusual pain, suffering and
hardship, or significant past and future medical bills.

Examples of Medical Malpractice

Medical malpractice can take many forms. Here are some examples of medical negligence that might lead
to a lawsuit:

 Failure to diagnose or misdiagnosis

 Misreading or ignoring laboratory results
 Unnecessary surgery
 Surgical errors or wrong site surgery
 Improper medication or dosage
 Poor follow-up or aftercare
 Premature discharge
 Disregarding or not taking appropriate patient history
 Failure to order proper testing
 Failure to recognize symptoms

Q5. Ethics for vendors n contractors

Fair treatment
Employees are expected to act fairly at all times. This includes not allowing undue external factors to
interfere with the implementation of our fair-treatment policy and avoiding actions that might create a
perception that suppliers or contractors have “a friend at Bechtel” who could exert improper influence on
their behalf.

No misrepresentation
Honesty is an integral part of ethical behavior, and trustworthiness is essential for strong, lasting
relationships. employees may not misrepresent themselves, including their level of authority, or the
company to anyone. We expect the same of our suppliers.

Proprietary and confidential information

Respects the confidentiality of proprietary information received from suppliers and contractors, and
employees will not improperly use or disclose such information. Likewise, when suppliers have access to
information that is proprietary, we expect them to protect and maintain its confidentiality as well.

Gifts and entertainment

Chooses its suppliers and contractors based on the quality and value of the goods and services that they
are able to provide. It is policy to never solicit or accept gifts or gratuities that may influence or appear to
influence a employee’s decision in the selection of bidders for the supply of equipment or services.
Therefore, suppliers and contractors should refrain from offering anything to employees. Modest
promotion items may be acceptable, but all gifts that exceed nominal value, are given to improperly
influence a employee, or otherwise are prohibited by law will not be accepted by or its employees.
 Conflicts of interest
Employee participation in outside activities should not infringe on an employee’s ability to do his or her
assigned Bechtel job and may require advance approval. employees may not, as a general rule, be a
supplier to or work for a potential supplier while employed.

Raising ethics or compliance questions and concerns

suppliers, subcontractors, and other third party business partners can ask questions about our Code of
Conduct or report any suspected misconduct involving.

Q6. Confidently n health ethics

Confidentiality is central to the preservation of trust between doctors and their patients. The moral basis is
consequentialist, in that it is to improve patient welfare. There is a wider communitarian public interest in
the protection of confidences; thus, preservation of confidentiality is necessary to secure public health.
Failure to maintain this venerable obligation may result in suboptimal treatment. For centuries, doctors
have upheld this ethical principle underpinned by the Hippocratic Oath that has been updated by the
international community assenting to the Declaration of Geneva. The practice of doctors in the UK is
subject to the regulatory authority of the General Medical Council (GMC) who strongly uphold this
professional duty. The British Medical Association (BMA) advises doctors to consider the benefits of
breaching patient confidentiality against the harmful consequences of damaging the professional
relationship and risking public trust in a confidential service. 1
However, medical confidentiality is not absolute in modern medicine. The legitimate exceptions are
specified by the GMC's professional code of conduct:2
 disclosures with consent;
 disclosures required by law;
 disclosures in the public interest.
Characteristics of confidential information

The general principles of what is considered confidential have been outlined in common law. A duty of
confidence arises when one person discloses information to another (e.g. a patient to a doctor) in
circumstances where it is reasonable to expect that the information be held in confidence. To represent a
breach, confidential information must: Enforcement of a legal duty in the UK has to date been relatively
weak. There has to date been no criminal conviction of a doctor for breach of confidence, although civil
claims in negligence have occurred and damages awarded when confidence has been breached by
revealing medical information without explicit consent.
 have the necessary quality of confidence,
 be imparted in circumstances importing an obligation of confidence,
 be disclosed without the permission and to the detriment of the person originally communicating it,
 not already be in the public domain,
 be in the public interest to protect it.
Q7. Research Ethics:

Research that involves human subjects or participants raises unique and complex ethical, legal, social and
political issues. Research ethics is specifically interested in the analysis of ethical issues that are raised
when people are involved as participants in research. There are three objectives in research ethics. The first
and broadest objective is to protect human participants. The second objective is to ensure that research is
conducted in a way that serves interests of individuals, groups and/or society as a whole. Finally, the third
objective is to examine specific research activities and projects for their ethical soundness, looking at issues
such as the management of risk, protection of confidentiality and the process of informed consent.

For the most part, research ethics has traditionally focused on issues in biomedical research. The
application of research ethics to examine and evaluate biomedical research has been well developed over
the last century and has influenced much of the existing statutes and guidelines for the ethical conduct of
research. However in humanities and social science research, different kinds of ethical issues arise. New
and emerging methods of conducting research, such as auto-ethnography and participatory action research
raise important but markedly different ethical issues and obligations for researchers.

Research involving vulnerable persons, which may include children, persons with developmental or
cognitive disabilities, persons who are institutionalized, the homeless or those without legal status, also
raises unique issues in any research context.

Research ethicists everywhere today are challenged by issues that reflect global concerns in other domains,
such as the conduct of research in developing countries, the limits of research involving genetic material
and the protection of privacy in light of advances in technology and Internet capabilities.

In Canada, current debates and challenges in research ethics include the changing notions of what
constitutes research and therefore requires formal ethics review, the oversight and monitoring of the work
of Research Ethics Boards (known as Institutional Review Boards, in the U.S.) at federal and provincial
levels, the jurisdiction of Research Ethics Boards in academic, clinical and corporate settings, the increasing
multidisciplinary of research collaborations and pursuits and challenges created by rigorous federal and
provincial privacy legislation. This is by no means an exhaustive list of the kinds of live issues there are in
research ethics today. Aside from the epistemological and philosophical issues in this dynamic field,
research ethicists also face anecdotal issues at the level of individual research ethics reviews, systemic
issues related to the institutions in which research ethics reviews are carried out and social, legal and
political issues related to governance and oversight of research ethics activities.