Medical deontology

Professional deontology includes the set of ethical rules and duties that govern the practice of a profession. In medicine, more than in any other field, these principles have a fundamental importance.

10 provinces, 3 territories: 13 codes of deontology. That being said, the underlying values and principles are the same—humane medicine that is respectful of patients.

IT ALL STARTED WITH HIPPOCRATES. . .

First, a bit of history. . . While today the value of the Hippocratic oath is purely symbolic, with no legal standing, the various codes of deontology issued by the colleges of physicians were largely drawn from it. The oath was reviewed and revised by a group of U.S. and European physicians* in 2002. The Lancet and Annals of Internal Medicine journals published a new Charter on Medical Professionalism outlining a code of code considered by the medical profession to be more adapted to the modern world. For instance, the Hippocratic oath forbids abortion.

The three fundamental principles of this new Charter: primacy of patient welfare, patient autonomy and social justice. From these stem a set of 10 commitments: professional competence, honesty with patients, patient confidentiality, maintaining appropriate relations with patients, improving quality of care, improving access to care, just distribution of finite resources, scientific knowledge, maintaining trust by managing conflicts of interest, and professional responsibilities.

The Charter was communicated to most medical associations, schools or faculties and regulatory bodies in North America and Europe, with the hope of having it officially adopted.

In Canada, the code of the Canadian Medical Association serves as a national standard. While the Royal College of Physicians and Surgeons of Canada has adopted it, however, it is once again as a “code of honour.” Each code of conduct is set by the provinces; they are the ones who have the right to legislate and to grant or withdraw licences. The only obligation for all practitioners is accordingly to belong to the College of Physicians and Surgeons of their province.

* American Board of Internal Medicine, American College of Physicians-American Society of Internal Medicine and the European Federation of Internal Medicine

FIVE FUNDAMENTAL PRINCIPLES OF MEDICAL DEONTOLOGY:

  • Respect of professional confidentiality
  • Patient consent before any examination or treatment
  • Obligation to seek the good of patients, and not cause harm
  • Maintain independence and avoid any conflicts of interest
  • Ethics in research

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