Medical Ethics, Deontology and Patient Safety
Ethical principles
Know the four principles: autonomy, beneficence, non-maleficence, and justice. Understand informed consent, confidentiality, truth-telling, and the doctor-patient relationship. Deontology emphasizes duty-based obligations and professional conduct.
Patient safety
Concepts: adverse events, near misses, and preventable harm. Understand the Swiss cheese model, root cause analysis, and the importance of reporting systems. Know the principles of safe medication practice (right patient, drug, dose, route, time), hand hygiene, and surgical safety checklists.
Traps
- Confusing autonomy (patient's right to decide) with beneficence (doing good).
- Misidentifying a near miss as an adverse event.
- Overlooking the duty to report errors.
Rule of thumb
When an ethical dilemma arises, ask: What does the patient want (autonomy)? What is medically best (beneficence)? What could harm (non-maleficence)? What is fair (justice)? Document the reasoning.
Worked example
A competent patient refuses a recommended procedure: the correct response is to respect the refusal after ensuring informed understanding and documenting it - not to proceed against their will.