Medical Professionalism

Anom Murdhana
 Medical Professionalism

Case 1
A 42 year-old pregnant woman presented at an antenatal
clinic with her husband to discuss the results of her recent
amniocentesis. In addition
to Downs syndrome, echocardiography of he fetus
showed cardiac abnor
malities , including atrioventricular septal defect. After
extensive discussion between the parents and the
obstetrician, the parents decided
that the fetus had too many problems and that it would
be unfair to the unborn child and their other four children to
continue with the pregnancy.
 Medical Professionalism

Case 1
A 42 year-old pregnant woman presented at an antenatal
clinic with her husband to discuss the results of her recent
amniocentesis. In addition
to Downs syndrome, echocardiography of he fetus
showed cardiac abnor
malities , including atrioventricular septal defect. After
extensive discussion between the parents and the
obstetrician, the parents decided
that the fetus had too many problems and that it would
be unfair to the unborn child and their other four children to
continue with the pregnancy.
 Medical Professionalism

The value of life : who decides and how

* Quality, quantity and sanctity of life, and their
advantages
and disadvantages, and application
* Who ought to determine the value of a given life
* External and internal arbiters
* It is always safest to permit people to judge for
themselves
what value to give to their life
* Quality of life : relative value of life, subjective
value of
life, and not all lives are of equal values.
Medical Professionalism
WHAT
WHEN
WHERE
WHY
HOW
 Medical Professionalism

Morale God, reason, rational

Ethics The best consequences Consequentialism

A virtuous agent would do in the circumstances
Virtue

Profesionalism ??? Duty-based

Ethics
 Medical Professionalism

Profesionalism ????
Profession profess to claim to do something
* to be competent to help patient

* to have the patients best interest always in mind

Three dimension of professionalism

1. Personal attributes caring, compassion, integrity,
truthfulness, trustworthiness, lifelong
commitment to maintaining professional
competence
2. Commitment and adherence to the principles of medical
ethics in the provisions of health care
3. Respect and responsiveness to the needs of a diverse
patient population in terms of gender, personal disability,
religion, beliefs, education and socio-cultural backgrounds
Medical Professionalism
WHAT
WHEN
WHERE
WHY
HOW
 1=Knowledge
2=Opinion
3=Attitude
4=Value

1 3
2 4
1
Performanc
e
Behavior
 Medical Professionalism

Medical Professionalism

Attitudes and
Values
Behaviors
 Medical Professionalism

Case 2.
Dear Dr. O. Neil
I recently received a request from you to fill in a questionnaire
regarding the treatment I underwent for breast cancer last year. Since I
regard infor
mation related to my health to be private, I would like to know how
you
discovered that I have breast cancer and how you came to have access
to
this information, including my name and address.
I am generally in favor of medical research and usually consider it
my
duty to participate. However, I believe it is common practice to receive
permission from research subjects before hand, and I do not recall
giving
my consent to having my personal records examined by you.
 Medical Professionalism

Case 2
Dear Dr. O. Neil
I recently received a request from you to fill in a questionnaire regarding
the treatment I underwent for breast cancer last year. Since I regard infor
mation related to my health to be private, I would like to know how you
discovered that I have breast cancer and how you came to have access
to
this information, including my name and address.
I am generally in favor of medical research and usually consider it
my
duty to participate. However, I believe it is common practice to receive
permission from research subjects before hand, and I do not recall
giving
my consent to having my personal records examined by you.
 Medical Professionalism

Medical Research, clinical trial

* Medical research is essential
* Research requires regulation
* Absence of regulation results abuses
* Rules not guarantees morality
* Patient autonomy
* Patient consent following full
information
* Medical record
* Confidentiality
 thank you
wishing you succes
to be a good doctor
with professional competence