Professionalism

Professionalism, Humanism & Medical Ethics

Dr. Haitham Bader
Ninevah Medical College

What is the thing that attracted you to this field?

No problem, but be professional

Professionalism is all of this

Steps in history of professionalism

Code of Hammurabi (2000 BC):first written oath for medical ethics
Hippocrates oath (sacred trust of the physician):
To protect & care for the patients
Set of values for physicians
Teaching and learning
Benefiting the sick according to one’s ability and judgment while adhering to high principles and ideals.
These oaths form social contract (what is expected from the physician)


Steps in history of professionalism




The physician Scribonius (47 AD): coined the word “profession” as: commitment to compassion, benevolence, and clemency in the relief of suffering, and emphasized humanitarian values
Sir William Osler: “The practice of medicine is an art; a calling, not a business; a calling in which your heart will be exercised equally with your head; a calling which extracts from you at every turn self-sacrifice, devotion, love and tenderness to your fellow man.”

What is professionalism?

We are trying to created professional standards of faculty, students and staff in respect to patient care, research and education.

Medical Students and Professionalism

"The hardest conviction to get into the mind of a beginner is that the education upon which [he/she] is engaged
is not a college course,
but a life course,
for which the work of a few years under teachers
is but a preparation."


Commitments as a Medical Student
Students obligated as future physicians, to maintain the values of professionalism throughout medical training.
Professional behavior is not only expected in the clinical setting, but is also in the classroom, lunchroom, seminar room, library, etc

What are the thing that
is expected from you?

Commitments as a Medical Student

Respect for professors, preceptors, and peers

Respect for guest speakers and visiting patients
Respect for cadavers and anatomical specimens in the anatomy lab
Respect for the institution of which you are a part
Respect for patients & families at clinical encounters
Respect for patient confidentiality
Respect for all members of the health care team
Respect for administrative and support staff
Respect for the core values of professionalism

What does medical professionalism mean to you?

❶ It is a vocation implies service to others
❷ It has a distinctive knowledge base
❸ It determines its own standards and exams.
❹ It has a special relationship with patients.
❺ It has particular ethical principles

4 Hs.

Head, Hand & Heart, where is the fourth H?

• It has a cognitive base which includes definable attributes

• It is the basis of medicine’s social contract with society
• Both medicine and society have expectations- “each of the other”
• Medicine’s obligations arise from societal expectations
• There are consequences if these expectations are not met
Professional status

• Expectation

• Obligation
Trust =
Consistency
Time
Professionalism in summary

Never go to doctor

Whose
Office
Planets
Have died

Professional status

Professional Status is Not an Inherent RightIT IS GRANTED BY SOCIETY

• :IT CONFERS

•  Prestige and Respect
•  Trust
•  Autonomy in Practice
•  Physician-Led Regulation
•  Financial Rewards
Professional status is important to medicine

Social contract

Society’s Expectations of Medicine

to fulfill the role of the healer

assured competence
altruistic service
morality / integrity / honesty
codes of ethics
accountability
transparency
source of objective advice
promotion of the public good
Medicine’s Expectations of Society


trust
autonomy
self-regulation
health care system
value-laden
adequately funded
role in public policy
patients accept responsibility for health
monopoly
rewards – non-financial
• respect
• status
– financial

Professionalism is beneficial to society

“Neither economic incentives,
nor technology,
nor administrative control has proved an effective surrogate for the commitment to integrity evoked in the ideal of professionalism ”

How we can define medical professionalism?

Constituting those attitudes and behaviors
That place
patient interest above physician Self-interest
Setting and maintaining
standard of competence, integrity, and provide expert advice on a matter of health

Definition of professionalism

"As professionals, physicians are committed to the health and well-being of individuals and society through ethical practice, profession-led regulation, and high personal standards of behaviour."

(الامانة) ❶ Honesty

(الايثار) ❷ Altruism
(الخدمة) ❸ Service
(الالتزام) ❹ Commitment
(التواصل) ❺ Communication
(الالتزام بالبراعة)❻ Commitment to excellence
(المسؤلية) ❼ Accountability
(التعلم المستمر) ❽ Life-long learning
Main Characteristics of Professional Conduct (behavior)

The behavior of professionalism

“Keep it human.”

الطب مهنة انســــــانية

×

Humanism Vs. Professionalism

• Humanism (Values)
• – denotes an intrinsic set of deep-seated convictions about one’s obligations towards others
• • Professionalism (Behaviors)
• – Behaving in accordance to a set of normative values and expectations

Humanism Vs. Professionalism

• Humanism
• – Who you are (when no one is watching)
• • Professionalism
• – What you do (when every one is watching)

Iceberg

Humanism

Professionalism
Experience
Knowledge
Feeling
Expectation
Assumption
Value
Attitude
Beliefs
Doing


Lack of professionalism

Abuse of power

Arrogance
Greed
Misrepresentation
Impairment &
lack of
conscientiousness

Lack of professionalism

Abuse of power (relation, sexual harassment, breach confidentiality)
Arrogance (offensive display of superiority)
Greed (money is the drive)
Misrepresentation (lying)
Impairment (disabilities in doing duties)
Lack of conscientiousness (fail to fulfill responsibility)
Conflicts in interests (unethical collaboration with industry)


How can be taught or learned professionalism

❶ Role modeling

❷ Role Plays

❸ Simulated Patients

❹ Small group discussions

How can be taught or learned professionalism

Do---

Don’t do---
Follow me


How can professionalism be assessed
The assessment of clinical skills/competence/performance.

Professionalism

Knows
Knows core principles if professionalism
Shows how
Demonstrate cultural
sensitivity in interviewing
Knows how
Describe process of
Addressing specific moral conflict
Does
Advocate pt.

Written, Oral or

Computer based assessment

Performance or hands on assessment

Medical ethics

• Is based on philosophical ethics

• It isn’t any special ethics but rather ethics of special cases.
• Medical ethics does not concern only doctors but also patients and society.
• The central question of medical ethics is the doctor-patient relationship.

The moral duties of doctors

• The duty to help, cure

• The duty to promote and protect the patient’s health
• The duty to confidentiality
• The duty to protect the patient’s life
• The duty to respect the patient’s autonomy
• The duty to protect privacy
• The duty to respect the patient’s dignity





The moral rights of the patients

• The right to high quality medical service

• The right to autonomous choice
• The right to decide
• The right to be informed
• The right to privacy
• The right to health education
• The right to dignity

Always remember 1st Hippocrates law

Primum non nocere

First, do no harm
Thank you for your nice listening

احب ان اقدم لكم

في نهاية محاضراتي
مجموعة من لوحاتي
ارجو ان تنال رضائكم

نلتقي ثانية

ان شاء الله
في المرحلة الخامسة