Ethicsand
communication
ETHICS 1
Why study ethics and law applied to medicine? 1
The nature of medical mistakes 3
Respect for autonomy 3
Ethical and legal boundaries of the duty to protect life and
health 6 The duty of a doctor to be fair
and just 7
COMMUNICATION 8
Communication in healthcare 8
Poor communication between doctors and patients
The medical interview 11
Interviews in which difficulties in communication can be
expected 14 Dealing with adversity 16 Patients
with impaired faculties for communication 16
Improving communication 17
ETHICS
WHY STUDY ETHICSAND LAW APPLIED TO
MEDICINE?
Professional concern about ethics and
law_______
_____
Many clinical choices created by advances in medical
technology are essentially ethical rather than scientific.
Doctors may be expert in understanding and applying
clinical science, yet this expertise does not in itself answer
many ethical questions about the circumstances in which
such science should and should not be applied. For
example, they may know a great deal technically about
advanced life-support systems or the termination of preg-
nancy. Their knowledge, however, will not tell them
whether or not it is ethical to withdraw ventilatory sup-
port from a severely brain-damaged patient who will not
otherwise die or to perform a termination on a 13-year-
old girl who does not want her parents to know that she
is pregnant. Answers to these questions derive from
moral beliefs and arguments.
Patients are increasingly aware of what theybelieve to
be their human rights and expect doctors to respect them.
■Rightsareclaims forspecific typesof goodsor services
that individuals are believed to be entitled to make on
others (e.g. free speech, access to primary and
secondary education, access to an acceptable standard
of medical care).
■ In the UK, if patients believe their rights have been
ignored by doctors, theymayformallycomplain to the
General Medical Council (GMC) or seek legal redress.
■As it pertains to medicine, the law establishes
boundaries for what government and the