Professionalism and Ethical Principles

Professionalism and Ethical Principles

In modern medicine, professionalism is based on updated versions of the Hippocratic Oath. The principle of “first, do no harm” requires the physician to act carefully in surgical, pharmacological, or diagnostic decisions. The physician must prioritize the patient’s benefit in all situations. Confidentiality, accurate record-keeping, respect for patient privacy, and informed consent are fundamental components of modern professionalism.

Informed Consent

Consent is based on an individual’s right to autonomous decision-making. The patient must be provided with sufficient information, including risks and alternatives, explained in a clear, non-technical language. For most procedures, verbal explanation is sufficient; however, for invasive procedures, written consent is essential. True informed consent requires adequate information, the patient’s understanding, and voluntariness. The patient has the right to make their own decisions, even if they are contrary to the physician’s recommendation.

Complications and Peer Review

Surgical complications are inevitable but should be rare. Honest disclosure of errors to patients or their families reduces litigation risk. The possibility of complications must be discussed during the consent process. Peer review is an educational process to evaluate physician errors, which should be informative and developmental rather than punitive.

Industry Relations

Physician–industry relationships are not inherently negative; however, financial interests may increase bias risk. Research contracts between academic institutions and companiesgenerally safeguard publication and intellectual property rights. NIH projects require declaration of financial interests. Since 2013, the Sunshine Act mandates public disclosure of all payments made to physicians.

Ethics Committees (IRB)

Research involving human subjects is evaluated by committees for scientific validity and ethical standards. In the U.S., the Common Rule and FDA regulations apply. The Belmont Report codifies the principles of respect, beneficence, and justice. All studies involving human subjects must be approved by an institutional review board (IRB).

Cultural Competency

Medical decisions are influenced by cultural values. Physicians should respect diverse cultures and help patients make informed decisions. In cases of language barriers, a professional interpreter should be used. Awareness of the power imbalance between physician and patient is essential to ensure voluntary consent.

Elder and Child Abuse

Physicians are obligated to report suspected abuseto social services. Legal protections cover such reports; malicious reporting carries liability. Failure to report is considered neglect.

End-of-Life Decisions

In most states, advance directives (living wills) are recognized. These documents indicate the patient’s treatment preferencesif they lose consciousness. Their legal binding is limited, and unforeseen clinical scenarios may lead to discussion. Appointment of a proxy decision-maker is important.

Care of Uninsured Patients

Physicians are not obligated to provide care to uninsured patients; however, emergency departments must provide emergency care under EMTALA. For patients unable to pay, discharge planningmust be careful, and referral to appropriate institutions should be arranged. Treatment should continue until a new physician is available.

Sports Medicine Issues

Team physicians may face conflicts of interestbetween player and club. Confidentiality rules may be unclear; since HIPAA may not apply, professional ethics become paramount. Players must make decisions with awareness of risks and have the right to a second opinion. Return-to-play decisions, especially after head trauma, should be made with caution.

References

1. Varkey B. Principles of clinical ethics and their application to practice. Med Princ Pract. 2021;30(1):17-28. doi:10.1159/000509119

2. Desai MK, Dilipkumar J. Medical professionalism and ethics: an overview. J Med Ethical Hist J. 2022;