Question

Reading Comprehension

A. What are the professional codes of physicians or medical societies based upon? Are they ethical codes? If not, what are they? If so, how are they ethical? What purpose (s) do such ethical codes serve?

B. Describe the following models for the doctor-patient or scientist-subject relationship and discuss any problematic characteristics of each.

1. Code

2.Contract

3. Covenant and Consent as a Canon of Loyalty

Answer 1

Four theoretical ethical perspectives on professional-patient relationships—autonomy, justice, virtue ethics, and the ethic of care—are surveyed, and some of their implications for the informed consent requirement in health care are sketched out.

effective ethical code for nursing practice must provide guidance on managing ethical problems that arise at the societal level, the organizational level, and the clinical level.

From political conversations with patients to doctors on TV, the Code has evolved to keep pace with changes in medicine and society.

Serves as the profession’s nonnegotiable ethical standard; and The Code is regularly updated to reflect changes in health care structure, financing, and delivery. It supports nurses in providing consistently respectful, humane, and dignified care.

Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict.Maintain high standards of professional competence, conduct, and ethical practice.

Three Models of the Relationship between Health Care Provider and the Recipient The three models are: 1. Code, 2. Contract, 3. Covenant

1.  CODE :

The model based on Code is one that harkens back to the mediaeval guilds.

The codes that have evolved have tended, however, to focus on the physician-patient relationship, with concerns about confidentiality being pre-eminent. More recently, perhaps motivated by the growth of applied health research, codes have expanded their attention to include issues pertaining to researcher-patient relationships. Because of population-based research, codes now are addressing concerns for researcher-population relationships.

Code Development, Review and Revision:

The process by which codes are developed has consequences for their application.

Content and Structure of Codes:

The content of a code should be user friendly to maximize its utility. Basic conflict- there are two sets of obligations: to guild and to patient

Scope of Codes

The development of a code by any profession has almost invariably tended to be driven by issues having a direct bearing on that profession. Consequently, codes tend to have a focus narrowly defined by each profession’s own concerns.

Contract :

In the contractual model there is a certain symmetry in the relationship of the members of Medical profession and those for whom they render service.They are seen as nearly equal parties engaged in a voluntary association for mutual benefit. This model is one promoted in a time of frequent litigation.

It is a model in which the participants are seen as singularly motivated by self interest and not philanthropy

Eg : informed consent is desired by receipt of care as needed for intelligence decisions making in keeping with goals and values of the receipt care and in acknowledge of the right of self determination.

# Covenant and Consent as a Canon of Loyalty:

The key elements of the Covenant Model are promise and fidelity to the promise. In this model the physician has received a gift of the knowledge and skills needed to practice the healing arts.

Advantage of convenant model is permits possibility of self -discipline not so personal applies to the whole profession ,a covenant with society borderns accountability permits settings professional responsibility for the human good within social limits.