INTRODUCTION TO CLINICAL

MEDICINEDr Raj

TOPICS Medical ethics and Professionalism

Basics of History Taking

Recording the vital parameters

Musculoskeletal Examination

Clinical reasoning

Evidence Analysis

EXAMSBlock 1

Spotters 10

Practical Exam 20

Theory 20

Block 2

Spotters 10

Practical Exam 20

Theory 20

Final

Theory 40

MEDICAL ETHICS Medical ethics is a system of moral

principles that apply values and judgments to the practice of medicine.

PROFESSIONALISM

noun pro·fes·sion·al·ism \prə-ˈfesh-nə-ˌli-zəm, -ˈfe-shə-nə-ˌli-\

: the skill, good judgment, and polite behavior that is expected from a person who is trained to do a job well

Hipprocratic Oath

Relevance to modern practice

Declaration of Geneva 1948 by WMA

Modified version of oath Dr Louis Lasagna 1964, Tufts University

“Patients are entitled to good standards of practice and care from their doctors. Essential elements of this are professional competence, good relationships with patients and colleagues and observance of professional ethical obligations.”

From Good Medical Practice, GMC.

WHO: PATIENT RIGHTS UNDERSTOOD AS ONE ASPECT OF BASIC HUMAN RIGHTS

World Health Organisation:

Formalized in 1948, the Universal Declaration of Human Rights recognizes “the inherent dignity” and the “equal and unalienable rights of all members of the human family”. And it is on the basis of this concept of the person, and the fundamental dignity and equality of all human beings, that the notion of patient rights was developed.

In other words, what is owed to the patient as a human being, by physicians and by the state, took shape in large part thanks to this understanding of the basic rights of the person.

PRINCIPLES

1. Beneficence2. Non- Maleficence3. Autonomy4. Truth telling5. Confidentiality6. Preservation of Life7. Justice

Principles of medical ethics by AMA

I. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.

II. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.

III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.

IV. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.

V. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.

VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care

VII. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.

VIII. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.

IX. A physician shall support access to medical care for all people.

THE TRAVISTOCK PRINCIPLES Rights people have a right and health

care

Balance care of the individual patient is central, but the health of populations is also our concern.

Comprehensiveness In addition to treating illness, we have an obligation to ease suffering , minimize disability, prevent disease and promote health

Cooperation Health care succeeds only if we cooperate with those we serve, each other, and those in other sectors.

Improvement Improving health care is aserious and continuing resposibilty

Safety Do no harm

Openness Being open, honest and trustworthy is vital in health care