Professionalism, Ethics, and Patient Safety
Principles of Professionalism and Ethics
Candidates must understand medical ethics (autonomy, beneficence, non-maleficence, justice), informed consent, confidentiality, conflict of interest, patient safety (WHO surgical safety checklist, hand hygiene, error reporting), and communication (breaking bad news, shared decision-making).
Key Concepts
- Informed consent: Must include diagnosis, proposed treatment, risks, benefits, alternatives, and consequences of refusal. Patient must have capacity and be free from coercion.
- Confidentiality: Protect patient information; exceptions (public health, legal).
- Patient safety: WHO surgical safety checklist (sign in, time out, sign out) reduces complications. Hand hygiene prevents infections. Error reporting and root cause analysis improve systems.
- Professionalism: Maintain competence, honesty, integrity, respect for diversity. Conflict of interest: Disclose financial relationships.
- Ethical dilemmas: End-of-life care, resource allocation, research ethics (IRB approval, informed consent).
Traps
- Informed consent: Must be obtained by the person performing the procedure; not delegable to junior staff.
- Confidentiality: Do not discuss patient information in public areas; use secure communication.
- Patient safety: Never events (wrong-site surgery) are preventable with checklists.
- Conflict of interest: Undisclosed conflicts can undermine trust.
Worked Example
A surgeon is asked to perform a procedure on a patient who does not speak the same language. Rule of thumb: Use a qualified medical interpreter to obtain informed consent; do not rely on family members. Ensure the patient understands and voluntarily agrees. Document the consent process.