The scope of medical ethics is a medical ethics concept that reflects the most basic relationships between doctors and patients, between medical staff, and between medical staff and society. The basic categories of medical ethics mainly include rights and obligations; emotions, conscience; prudence, confidentiality, etc.
1. Rights and Obligations
Rights in the category of medical ethics refer to the rights that doctors and patients can exercise and the benefits they should enjoy within the scope permitted by medical ethics. It not only refers to the rights and obligations that medical staff exercise, but also includes the benefits that patients should enjoy.
1. Doctors’ moral rights and obligations
(1) Doctors’ moral rights
Generally speaking, legal rights themselves are also moral rights. The legal rights stipulated in Article 21 of the Medical Practicing Law of the People's Republic of China are the moral rights of doctors. Physicians enjoy the following rights in their practice activities: ① Within the registered scope of practice, conduct medical examinations, disease investigations, medical treatments, issue corresponding medical certification documents, and choose reasonable medical, prevention, and health care plans; ② In accordance with the health administration department of the State Council ③ Engage in medical research, academic exchanges, and participate in professional academic groups; ④ Participate in professional training and receive continuing medical education; ⑤ In practice activities, personal dignity, personal safety Be inviolable; ⑥ Receive wages, remuneration and allowances, and enjoy welfare benefits stipulated by the state; ⑦ Make suggestions on the medical, prevention, health care work and the work of the health administration department of the institution where you work, and participate in the democratic management of the institution where you work in accordance with the law.
Doctors have three distinctive characteristics when exercising their rights: ① Autonomy in exercising their rights. A doctor's right to diagnose and treat patients is not subject to the instruction and control of others, but is based on the medical purpose of safeguarding the patient's health and the entire society, and is completely autonomous. ②The authority to exercise rights. Authoritativeness is determined by the seriousness of a doctor's profession and the scientific nature of his medical skills. ③The particularity of exercising rights. For the purpose of diagnosis and treatment, doctors have the right to obtain information about the patient's current medical history, past medical history, genetic history, lifestyle, and even personal privacy information related to the diagnosis of the disease. Doctors have the right to declare a patient's death, and this right is protected by law.
2. Emotion and Conscience
1. Emotion refers to the attitude experience when people perceive and evaluate the behavior of individuals and others based on social moral concepts and norms under certain social conditions. . Medical ethics emotions refer to the inner experience and natural expression of medical staff's relationship between themselves and other people's behaviors in medical activities. The moral emotions of medical staff are closely linked to their obligations and are based on a high degree of responsibility for the health of patients.
The content of medical ethics emotions includes sympathy, responsibility and career. Compassion is the heartfelt emotion of medical staff. When an upright medical staff faces a patient suffering from a disease and looking forward to treatment, he will sympathize with the patient and be willing to relieve the pain. This is the most basic moral emotion of a medical staff. Sense of responsibility is the dominant medical ethics emotion. It has risen to the level of professional responsibility and is a conscious moral consciousness. The sense of career is a sublimation of the sense of responsibility and a higher level of medical ethics, that is, career is more important than personal interests and life.
Medical ethics are based on a high degree of responsibility for the patient's health and are not premised on the satisfaction of personal interests and needs. Medical ethics and emotions are of a rational nature. Medical staff’s love for patients is not blind impulse, but is based on medical science. The urgency and pain of patients must also be within the scope allowed by medical science. To meet the requirements of patients and their families.
As the most basic moral emotion, sympathy in medical ethics has a relatively large physiological component, manifested as deep sympathy for patients, and is the original motivation for medical staff to serve patients; a relatively large rational component A sense of responsibility can make up for the lack of empathy (that is, empathy may gradually fade over time), making medical staff's behavior stable and able to truly fulfill their moral responsibilities to patients; a strong sense of career can motivate medical staff to do their best. In the development of the medical profession, we should work hard, regardless of personal gains and losses, and be able to take risks for the benefit of patients, and truly realize the moral principle of serving the people's health wholeheartedly.
2. Conscience is people’s sense of moral responsibility and self-evaluation ability to fulfill their obligations to others and society. It is people’s conscious awareness of their moral responsibilities. The conscience of medical staff is the deepening of medical ethics. It is the strong sense of moral responsibility and self-evaluation ability for patients and society that exists in the consciousness of doctors during medical activities and comes from the bottom of their hearts.
Conscience has an active role. Before acting, conscience affirms the motivations of actions that meet moral requirements, and inhibits or denies the motivations of actions that do not meet moral requirements; during actions, conscience plays a supervisory role in human behavior, supervising emotions and will that meet moral requirements. , beliefs, and behavioral methods and means should be encouraged and strengthened, and emotions, desires, or impulsive behaviors that do not meet moral requirements should be corrected and overcome; after the behavior, conscience has a role in evaluating the consequences and impact of the behavior. The main function of medical ethics conscience is that medical staff feel proud, satisfied and gratified for their actions that have fulfilled their medical ethics obligations and produced good consequences and impact; on the contrary, they will have guilt, shame, self-condemnation and regret.
3. Prudence and Confidentiality
1. Prudence is a moral quality and attitude of a person who carefully investigates people and things and acts prudently. In essence, prudence is an expression of wisdom and is based on knowledge, skills and calm, objective analysis. Prudence, as a person's moral quality, although related to personal character, is mainly formed by acquired education and personal cultivation. Prudence in medical activities refers to the doctor's careful thinking before acting and the careful and careful operation during the act.
The content of medical prudence means that doctors should be careful in their words and actions in all aspects of medical activities, consciously follow operating procedures, be serious, responsible, cautious, conscientious and meticulous, and constantly improve themselves. business capabilities and technical level, and strive for excellence.
The role of medical prudence is conducive to the improvement of medical quality and the prevention of medical errors and accidents; it is conducive to the update of medical staff's knowledge and improvement of their technical level; it is conducive to the cultivation of good professional ethics.
2. Confidentiality means keeping secrets and not leaking them. Confidentiality is usually related to privacy, but privacy generally only involves an individual's physiology, psychology, and behavior, while confidentiality may be related to the behavior or relationships of multiple people. As long as it does not endanger the interests of others or society, confidentiality should be maintained at the request of the person concerned. Confidentiality in medical activities refers to the confidentiality of medical secrets obtained by medical personnel in the medical activities of diagnosing and treating diseases for patients. It usually includes the privacy of patients and their families, unique signs or deformities, conditions that patients do not want others to know, and poor diagnoses. and prognosis, anything the patient doesn’t want others to know. Keeping medical secrets generally includes two aspects: first, keeping confidentiality for patients. Inquiries about medical history and physical examinations are based on the needs of disease diagnosis and do not intentionally inquire into the patient's privacy; do not disclose the patient's privacy learned during diagnosis and treatment. Second, certain diagnoses and prognosis that may bring a heavy mental blow to the patient should be kept confidential.
Medical confidentiality plays a particularly important role in medical practice. It is the oldest and most vital category of medical ethics in medical ethics, from the Hippocratic Oath to the Declaration of Geneva, the Patient's Bill of Rights, etc. , Keeping medical confidentiality is a very important moral requirement, because patients are people who live in a certain social environment and have thoughts and psychological activities. Medical staff's respect for patients also includes respect for patients' confidentiality requirements. If medical staff leak medical secrets at will, it may cause some people in society to discriminate against patients, cause patients pain, and also cause patients to distrust medical staff and medical measures.