Transcript Medical ethics and professionalism 1

Medical ethics and
professionalism 1
‫األخالق الطبية‬
1 ‫والمهنية‬
Rationale
‫الداعى‬
Gender and religion
‫التنوعات الجنسية والدينية‬
diversities are sensitive
‫اصبحث قضايا حساسة‬
issues that crisscross
‫تتقاطع مع مزاولة مهنة‬
during the practice of
medicine.
.‫الطب‬
On the other hand values,
‫من ناحية أخرى القيم‬
ethics and sophisticated ‫واألخالق واآلداب الرفيعة‬
graceful morals govern
‫هى التى تحكم الممارسة‬
the scope the
.
‫الطب‬
‫فى‬
‫المعاصرة‬
contemporary practice of
medicine.
Rationale
‫الداعى‬
This course answer the
question: what does the
‫هذا المقرر يقدم اإلجابة على‬
doctor need to know, and
‫ ماذا يريدالطبيب ان‬:‫السؤال‬
how to behave when he
‫ وكيف يتصرف عندما‬،‫يعرف‬
enters the hospital as a
‫يدخل المستشفى كمتعلم‬
learner and future
‫وممارس قى المستقبل؟‬
practitioner? In essence, this
course, present the necessary ‫هذا المقرر يقدم المعرفة الالزمة‬
knowledge, skills and
‫فى المهارات والسلوكيات التي‬
behaviours that protect the
‫تحمي الطالب والممارس من‬
student and the practitioner
‫االنزالق فى الدعاوى القضائية‬
against litigations, and
slippage toward prosecution.
Objectives:
:‫األهداف‬
By the end of this course the student
will be able to:
‫بنهاية هذه الدورة سوف يكون الطالب‬
1- Enumerate the international
:‫قادرا ً على‬
codes of ethics that he/she must
abide with during his practice of ‫تعداد القوانين الدولية لألخالقيات التي‬
‫يجب أن يلتزم بها أثناء ممارسته‬
medicine like:
‫ يمين "أبقراط" واللوائح‬:‫للطب مثل‬
A- The Hippocrates oath
:‫المعاصرة لألخالقيات مثل‬
B- Contemporary codes for ethics:
C- Human Rights in Islam
‫• حقوق اإلنسان في اإلسالم‬
D- Geneva Convention
‫• إعالن هلسنكي‬
E- Helsinki Declaration
‫• اتفاقية جنيف" الدولية‬
F- The international declaration of
‫• اإلعالن العالمى لحقوق اإلنسان‬
the Basic Human Rights
‫• قسم الطبيب المسلم‬
G- The Muslim doctor oath
‫• قسم الطالب‬
H- The medical student oath ethics:
Objectives:
:‫األهداف‬
"‫يعرف ”المهنية‬-2
2- Define clearly "professionalism"
:4 ‫يعدد أركان المهنية ال‬-3
3- Enumerate the 4 pillars of
professionalism:
‫ العدالة‬-‫ اإلنضباط الذاتي ب‬-‫أ‬
A- Self –integrity B- Justice
‫ إستقاللية المريض‬-‫ت‬
C- Patient's autonomy
‫ العمل المفيد والكفاءة‬-‫ث‬
D- Beneficence and malefficience
‫يعدد وثائق الكفاءة المهنية الطبية‬- -4
4- Enumerate the contemporary
‫المعاصرة‬
medical professionalism
documents
‫ وثيقة كندا الطبية‬-‫ ب‬،‫ طبيب الغد‬-‫أ‬
a- Tomorrow's doctor, b- CanMed
‫ وثيقة المجلس الطبى البريطاني‬-‫ت‬
c- The General Medical Council
‫للممارسة األفضل‬
Code of Best Practice
d- Sudan Medical Council Code of ‫ وثيقة المجلس الطبى السودانى‬-‫ث‬
‫للممارسة الطبية األفضل‬
Best Practice
Objectives:
:‫األهداف‬
• Also, by the end of this
‫المقرر‬
‫هذا‬
‫نهاية‬
‫قبل‬
،‫أيضا‬
course the student will
‫سوف يكتسب الطالب‬
acquire the following
:‫المهارات التالية‬
skills:
‫يقيم المعضالت األخالقية‬
• Set expectations: Value
systems, ethical dilemmas ‫يقترح الممارسة األخالقية‬
• Provide the right ethical
‫والسلوكية الصحيحة‬
and behavioural
‫قية‬
‫األخال‬
‫للحجج‬
‫تقييم‬
‫يصمم‬
judgments
• Design assessment ethical
arguments
‫التوضيح للطالب ان المراد‬
‫تعريف الطالب بهذه الوثائق‬
‫وليس اإلمتحان في تفاصيلها‬
Methods of learning:
‫طرق التعلم‬
1- Interactive lectures
‫المحاضرات التفاعلية‬-1
2- Task-based learning
(Simulation): Application ‫المهمة على أساس التعلم‬-2
from the book "The
‫ تطبيق من‬:)‫(المحاكاة‬
Muslim Doctor Figh"
”‫كتاب ”فقه الطبيب مسلم‬
3- Seminars
‫ السمنارات‬-3
4- Designing and crafting
‫تصميم وصياغة القيم‬- 4professional values and ‫ والحجج األخالقية‬،‫المهنية‬
ethical arguments from
‫من كتاب ”فقه الطبيب‬
the book "The Muslim
"‫المسلم‬
Doctor Figh"
‫جدول األسبوع األول‬
‫الساعة ‪10-9‬‬
‫الساعة ‪12-11‬‬
‫األحد‬
‫مدونات األخالقيات‪ -1 :‬يمين‬
‫أبقراط ‪ -2‬قوانين نورمبرج‬
‫‪ -3‬إعالن هلسنكي ‪ -4‬اتفاقية‬
‫جنيف‬
‫‪ -1‬توزيع المجموعات‬
‫‪ -2‬حقوق اإلنسان فى اإلسالم‬
‫اإلثنين‬
‫اإلعالن العالمى لحقوق اإلنسان‬
‫أخالقيات المهنة‪ :‬قسم الطبيب المسلم‬
‫قسم الطالب‬
‫الثالثاء‬
‫االحترافية‪:‬‬
‫ا‪ -‬اإلنضباط الذاتي‬
‫ب‪-‬العدل‬
‫ج‪-‬االستقالل الذاتي للمريض‬
‫د‪ -‬العمل المفيد والكفاءة‬
‫الوثائق المهنية‪ :‬طبيب الغد‪ ،‬كانميد‬
‫وثيقة المجلس البريطانى للممارسة‬
‫السليمة‬
‫وثيقة المجلس الطبى السودانى‬
‫للممارسة السليمة‬
‫جدول األسبوع األول‬
‫اليوم‬
‫الساعه ‪10-9‬‬
‫الساعة ‪12-11‬‬
‫األربعاء اساسيات الممارسة المهنية‪:‬‬
‫استقاللية المريض‬
‫العدالة االجتماعية‬
‫رعاية المريض‬
‫االستجابة للمجتمع‬
‫عالقة الطبيب مع المريض‬
‫العالقة مع الزمالء‬
‫قيم الرعاية الصحية‪:‬‬
‫الرحمة‪ ،‬والصدق‪ ،‬النزاهة‬
‫واإلنضباط الذاتى‬
‫الخميس المسؤوليات تجاه المريض‬
‫‪ -1‬قول الحقيقة‬
‫‪ -2‬حفظ السر‬
‫‪ -3‬اإلقرار المستنير ‪ -4‬كفاءة األداء‬
‫‪ -5‬المسؤوليات االئتمانية‬
‫تطبيقات ودراسة حاالت‬
‫األسبوع الثاني‪ :‬إرشادات للطالب‪:‬‬
‫يتم تقسيم الطالب الى ‪ 10‬مجموعات‪.‬‬
‫كل مجموعة ال تزيد عن ‪ 15‬طالبا‪.‬‬
‫يتم تخصيص باب واحد فقط من الكتاب ”فقه الطبيب المسلم'‬
‫لكل مجموعة‪.‬‬
‫ينبغي تطبيق المجموعة ديناميات الجماعة (رئيس وحارس‬
‫الوقت‪ ،‬ومقرر‪ ،‬وأعضاء فريق الطالب في المجموعة)‬
‫ينبغي قراءة الفصل المخصص والعمل على تقديمه للطالب‬
‫بأفضل الوسائل التعليمية‬
‫ينبغي على الطالب‪:‬‬
‫‪ -1‬تحديد المعلومات والمشكالت األخالقية‬
‫‪ 2‬تحديد الوقائع التى تشترك فى المبادئ األخالقية؟‬
‫‪ -3‬كتابة قائمة باإلجراءات التي يمكن اتخاذها (ما يمكن أن‬
‫تفعله؟)‬
‫‪ -4‬كتابة قائمة بالنتائج المحتملة من اإلجراءات الممكنة (ماذا‬
‫ينبغى ان تفعل؟)‬
‫‪ -7‬ينبغي أن يتفق الطالب على طريقة مبتكرة للعرض‬
‫التقديمي‬
‫‪ -8‬يجب التمرن على الطريقة المتفق عليها‬
‫‪ -9‬ينبغي عرض أعمالهم في شكل ممارسة واقعية‬
‫‪ -10‬ينبغي اإلشارة إلى وضوح نتائجهم‬
‫‪ -11‬كل عضو في الفريق ينبغي أن يكون قادر على الرد على‬
‫استفسارات الطالب‪.‬‬
‫جدول األسبوع الثانى‪ :‬السمنارات‬
‫الساعة ‪10-9‬‬
‫الساعة ‪12-11‬‬
‫األحد‬
‫المرض والمريض‬
‫فقه التشريح‬
‫اإلثنين‬
‫فقه الجراحة‬
‫فقه الباطنية واألطفال‬
‫الثالثاء فقه النساء والتوليد‬
‫قضايا طبية معاصرة‬
‫األربعاء زراعة األعضاء‬
‫التجارب الطبية‬
‫الخميس فقه الجنائز‬
‫دور المستشفى‬
‫طرق التقويم‬
‫= ‪ 50‬درجة‬
‫‪ -1‬السمنارات‬
‫= ‪ 30‬درجة‬
‫‪ -2‬أسئلة الخيار الواحد‬
‫‪ -3‬اسئلة المشكالت المبرمجة = ‪ 20‬درجة‬
‫= ‪ 100‬درجة‬
‫‪ -4‬الدرجة الكاملة‬
‫المراجع‬
‫مدونات قواعد السلوك‪:‬‬
‫‪ -1‬يمين أبقراط‬
‫‪ -2‬إعالن هلسنكي‬
‫‪ -3‬اتفاقية جنيف‬
‫‪ -4‬اإلعالن العالمى لحقوق اإلنسان‬
‫‪ -5‬طبيب الغد‬
‫‪ -6‬وثيقة المجلس الطبى البريطانى ألفضل ممارسة‬
‫‪ -7‬وثيقة المجلس الطبى السودانى ألفضل ممارسة‬
‫شكرا ً لحسن اإلستماع‬
‫اهداف المحاضرة‪:‬المحاضرة األولى‬
‫‪ -1‬تعريف الطالب بنشأة وتطور‬
‫األخالق الطبية والمهنية‬
‫اإلحترافية‬
‫‪ -2‬الحضارة اإلغريقية القديمة‪:‬‬
‫عرض صورة لقسم ابوقراط‬
‫باللغة اليونانية القديمة‬
‫عرض واستعراض اجزاء من‬
‫ترجمة قسم ابوقراط بالتركيز‬
‫على األجزاء المترجمة‬
‫‪ -3‬تعريف الطالب بمحاكمة نورمبرج‬
‫‪ -4‬استعراض جزء من قانون‬
‫نورمبرج‬
‫‪ -5‬تعريف الطالب بإتفاقية جنيفا‬
‫‪ -6‬استعراض جزء من إتفاقية جنيفا‬
‫‪ -7‬تعريف الطالب بإعالن هلسنكى‬
‫‪ -8‬استعراض جزء من إعالن‬
‫هلسنكى‬
‫‪ -9‬التوضيح للطالب ان المراد تعريف‬
‫الطالب بهذه الوثائق وليس‬
‫اإلمتحان في تفاصيلها‬
‫قسم ابوقراط‬
Hippocrates Oath
Written 400 B.C.
•
I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and
goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to
reckon him who taught me this Art equally dear to me as my parents, to share my substance with him,
and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers,
and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept,
lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and
those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine,
but to none others. I will follow that system of regimen which, according to my ability and judgment, I
consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will
give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not
give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and
practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men
who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the
sick, and will abstain from every voluntary act of mischief and corruption; and, further from the
seduction of females or males, of freemen and slaves. Whatever, in connection with my professional
practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of
abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this
Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men,
in all times! But should I trespass and violate this Oath, may the reverse be my lot!
• THE END
‫نظرة فاحصة لقسم ابوقراط‬
‫يقسم ابوقراط بآلهة اإلغريق القديمة ان‪:‬‬
‫‪ -1‬يحافظ على العالقة الجيدة مع زمالئه ومن علموه وان يبذل‬
‫جهده فى تعليم ابناءهم وتعليم تالميذه‬
‫‪ -2‬يقدم للمرضى العمل المفيد (‪ )Beneficence‬وبكفاء جيدة‬
‫(‪)non-maleficence‬‬
‫‪ -3‬يحرم اإلجهاض (‪)Abortion‬‬
‫‪ -4‬يتحلى باإلخالص واإليثار (ِ‪)Altruism‬‬
‫‪ -5‬يتحلى باألمانة وحفظ أسرار المرضى‬
‫(‪)Honest , truthful and ,trustful‬‬
Hippocrates Oath
Written 400 B.C.
I SWEAR by Apollo the physician, and Aesculapius,
and Health, and All-heal, and all the gods and
goddesses, that, according to my ability and
judgment, I will keep this Oath and this
stipulation- to reckon him who taught me this Art
equally dear to me as my parents, to share my
substance with him, and relieve his necessities if
required; to look upon his offspring in the same
footing as my own brothers, and to teach them
this art, if they shall wish to learn it, without fee or
stipulation; and that by precept, lecture, and every
other mode of instruction, ( ‫)العالقة مع الزمالء‬
Hippocrates Oath
Written 400 B.C.
I will impart a knowledge of the Art to my own
sons, and those of my teachers, and to
disciples bound by a stipulation and oath
according to the law of medicine, but to none
others. I will follow that system of regimen
which, according to my ability and judgment,
I consider for the benefit of my patients, and
abstain from whatever is deleterious and
mischievous (‫)العمل المفيد والكفاء‬.
Hippocrates Oath
Written 400 B.C.
I will give no deadly medicine to any one if asked,
nor suggest any such counsel; and in like manner I
will not give to a woman a pessary to produce
abortion. (‫)اإلجهاض‬With purity and with holiness I
will pass my life and practice my Art (‫)اإليثار‬. I will
not cut persons laboring under the stone, but will
leave this to be done by men who are practitioners
of this work. Into whatever houses I enter, I will go
into them for the benefit of the sick, and will
abstain from every voluntary act of mischief and
corruption (‫ ;)األمانه‬and, further from the seduction
of females or males, of freemen and slaves.
Hippocrates Oath
Written 400 B.C.
Whatever, in connection with my professional
practice or not, in connection with it, I see or
hear, in the life of men, which ought not to
be spoken of abroad, I will not divulge, as
reckoning that all such should be kept secret
(‫)حفظ السر‬. While I continue to keep this Oath
unviolated, may it be granted to me to enjoy
life and the practice of the art, respected by
all men, in all times! But should I trespass
and violate this Oath, may the reverse be my
lot!
‫قوانين نورمبرج‬
‫‪The Nuremberg Code‬‬
‫)‪(1947‬‬
‫‪ -1‬كان هتلر وجهازه النازي يأمر األطباء بإجراء التجارب غير‬
‫اإلنسانية على البشر‬
‫‪ -2‬عندما إنتهت الحرب العالمية الثانية إنتحر هتلر وتمت محاكمة‬
‫اعوانه فى مدينة نورمبرج األلمانية بواسطة الحلفاء‬
‫‪ -3‬أصدرت المحكمة عقوبات تجرم التجارب على البشر‬
‫‪ -4‬خلصت المحاكمة على ‪ 10‬شروط ينبغى على الطبيب ان يتقيد‬
‫بها إذا اراد ان يجرى بحثا ً على البشر‬
‫‪ -5‬من يريد اإلطالع على الوثيقة فهى موجودة فى اإلنترنت تحت‬
‫إسم ‪ Nuremburg Code‬لإلطالع وليس حفظ المواد‬
The Nuremberg Code (1947)
•
•
•
•
•
•
•
•
•
•
•
•
Permissible Medical Experiments
The great weight of the evidence before us to effect that certain types of medical experiments on human beings, when kept within reasonably welldefined bounds, conform to the ethics of the medical profession generally. The protagonists of the practice of human experimentation justify their
views on the basis that such experiments yield results for the good of society that are unprocurable by other methods or means of study. All agree,
however, that certain basic principles must be observed in order to satisfy moral, ethical and legal concepts:
The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent;
should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress,
overreaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject
matter involved as to enable him to make an understanding and enlightened decision. This latter element requires that before the acceptance of an
affirmative decision by the experimental subject there should be made known to him the nature, duration, and purpose of the experiment; the method
and means by which it is to be conducted; all inconveniences and hazards reasonably to be expected; and the effects upon his health or person which
may possibly come from his participation in the experiment.
The duty and responsibility for ascertaining the quality of the consent rests upon each individual who initiates, directs, or engages in the experiment. It
is a personal duty and responsibility which may not be delegated to another with impunity.
The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random
and unnecessary in nature.
The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or
other problem under study that the anticipated results justify the performance of the experiment.
The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.
No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur; except, perhaps, in those
experiments where the experimental physicians also serve as subjects.
The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment.
Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury,
disability or death.
The experiment should be conducted only by scientifically qualified persons. The highest degree of skill and care should be required through all stages
of the experiment of those who conduct or engage in the experiment.
During the course of the experiment the human subject should be at liberty to bring the experiment to an end if he has reached the physical or mental
state where continuation of the experiment seems to him to be impossible.
During the course of the experiment the scientist in charge must be prepared to terminate the experiment at any stage, if he has probable cause to
believe, in the exercise of the good faith, superior skill and careful judgment required of him, that a continuation of the experiment is likely to result in
injury, disability, or death to the experimental subject.
‫قوانين نورمبرج‬
‫‪The Nuremberg Code‬‬
‫)‪(1947‬‬
‫التزام التجارب الطبية باآلتى‪:‬‬
‫‪ -1‬اإلقرار بالقبول من الشخص العاقل المدرك للمخاطر من‬
‫غير ضغوط او إغراء او غش‬
‫‪ -2‬ال يمكن ان تجرى التجربة بطريق آخر وتكون نتائجها‬
‫لمصلحة اإلنسان‬
‫‪ -3‬تكون مبنية على تجارب معملية ومالحظات فى طبيعة‬
‫المرض وتتسبقها تجارب على الحيوان‬
‫‪ -4‬تنأى التجربة عن إحداث األلم والمعاناة‬
‫‪ -5‬ال تجرى التجربة إذا كان هناك ثمة إحتمال للموت‬
‫قوانين نورمبرج‬
‫‪The Nuremberg Code‬‬
‫)‪(1947‬‬
‫‪ -6‬تجهز افضل التجهيزات لحماية المشاركين من المخاطر‬
‫‪ -7‬احتمالية حدوث مخاطر ال تتعدى المصلحة اإلنسانية‬
‫‪ -8‬تجرى التجربة بواسطة العلماء وان تصاحبها فى كافة‬
‫مراحلها العناية الطبية الفائقة‬
‫‪ -9‬من حق المشارك فى التجربة اإلنسحاب منها فى اي مرحلة‬
‫ومتى اراد ذلك من غير شروط او ضغوط او إغراءات‬
‫‪ -10‬توقف التجربة متى ما رأى الخبراء إحتمال حدوث‬
‫مخاطر على المشاركين فى اإلختبار‬
‫من يريد اإلطالع على الوثيقة فهى‬
‫موجودة فى اإلنترنت تحت إسم‬
‫‪ Nuremburg Code‬لإلطالع‬
‫وليس حفظ المواد بغرض‬
‫اإلمتحان‬
‫اتفاقية جنيف األولى ‪1949‬‬
‫إن الموقعين المفوضين من قبل الحكومات الممثلة في المؤتمر‬
‫الدبلوماسي‪ ,‬المعقود في جنيف من ‪ 21‬نيسان‪ /‬أبريل إلى ‪12‬‬
‫آب‪/‬أغسطس ‪ ,1949‬بقصد مراجعة اتفاقية جنيف لتحسين حال‬
‫الجرحى والمرضى بالجيوش في الميدان‪ ,‬المؤرخة في ‪27‬‬
‫تموز‪/‬يوليه ‪ , 1929‬قد اتفقوا على ما يلي ‪:‬‬
‫إتفاقية من ‪ 64‬مادة وملحق من ‪ 13‬مادة كلها تلزم كافة األطراف‬
‫بحسن معاملة الجرحى واألسرى والمسالمين والمستسلمين‬
‫والمدنيين فى حالة الحرب‬
‫اتفاقية جنيف األولى ‪1949‬‬
‫امثلة من اتفاقية جنيف األولى ‪:1949‬‬
‫حظر‪:‬‬
‫•‬
‫•‬
‫•‬
‫•‬
‫•‬
‫•‬
‫( أ) االعتداء على الحياة والسالمة البدنية‪ ,‬وبخاصة القتل بجميع أشكاله‪,‬‬
‫والتشويه‪ ,‬والمعاملة القاسية‪ ,‬والتعذيب‪,‬‬
‫(ب) أخذ الرهائن‪,‬‬
‫( ج) االعتداء على الكرامة الشخصية‪ ,‬وعلى األخص المعاملة المهينة‬
‫والحاطة بالكرامة‪,‬‬
‫( د) إصدار األحكام وتنفيذ العقوبات دون إجراء محاكمة سابقة أمام محكمة‬
‫مشكلة تشكيالً قانونيا ً‪ ,‬وتكفل جميع الضمانات القضائية الالزمة في نظر‬
‫الشعوب المتمدنة‪.‬‬
‫‪ )2‬يجمع الجرحى والمرضى ويعتني بهم‪.‬‬
‫ويجوز لهيئة إنسانية غير متحيزة‪ ,‬كاللجنة الدولية للصليب األحمر‪ ,‬أن‬
‫تعرض خدماتها على أطراف النزاع‪.‬‬
‫• من يريد اإلطالع على الوثيقة فهى‬
‫موجودة فى اإلنترنت تحت إسم‬
‫اتفاقية جنيف األولى‪1949‬‬
‫لإلطالع وليس حفظ المواد بغرض‬
‫اإلمتحان‬
Declaration of Helsinki ‫إعالن هلسنكى‬
(1964)
Recommendations
guiding physicians
in biomedical
research involving
human subjects.
‫التوصيات لتوجيه األطباء‬
‫في البحوث الطبية‬
‫الحيوية التي تجرى‬
‫على البشر‬
•
•
•
•
•
•
•
•
•
•
•
•
•
Declaration of Helsinki ‫إعالن هلسنكى‬
(1964)
I. Basic Principles
Biomedical research involving human subjects must conform to generally accepted scientific principles and should be based on adequately performed
laboratory and animal experimentation and on a thorough knowledge of the scientific literature.
The design and performance of each experimental procedure involving human subjects should be clearly formulated in an experimental protocol which should
be transmitted to a specially appointed independent committee for consideration, comment and guidance.
Biomedical research involving human subjects should be conducted only by scientifically qualified persons and under the supervision of a clinically competent
medical person. The responsibility for the human subject must always rest with a medically qualified person and never rest on the subject of the research,
even though the subject has given his or her consent.
Biomedical research involving human subjects cannot legitimately be carried out unless the importance of the objective is in proportion to the inherent risk to
the subject.
Every biomedical research project involving human subjects should be preceded by careful assessment of predictable risks in comparison with foreseeable
benefits to the subject or to others. Concern for the interests of the subject must always prevail over the interests of science and society.
The right of the research subject to safeguard his or her integrity must always be respected. Every precaution should be taken to respect the privacy of the
subject and to minimize the impact of the study on the subject's physical and mental integrity and on the personality of the subject.
Physicians should abstain from engaging in research projects involving human subjects unless they are satisfied that the hazards involved are believed to be
predictable. Physicians should cease any investigation if the hazards are found to outweigh the potential benefits.
In publication of the results of his or her research, the physician is obliged to preserve the accuracy of the results. Reports of experimentation not in
accordance with the principles laid down in this Declaration should not be accepted for publication.
In any research on human beings, each potential subject mustbe adequately informed of the aims, methods, anticipated benefits and potential hazards of the
study and the discomfort it may entail. He or she should be informed that he or she is at liberty to abstain from participation in the study and that he or she is
free to withdraw visor her consent to participation at any time. The physician should then obtain the subject's freely given informed consent, preferably
inheriting.
When obtaining informed consent for the research project the physician should be particularly cautious if the subject is in dependent relationship to him or her
or may consent under duress. In that case the informed consent should be obtained by a physician who isn't engaged in the investigation and who is
completely independent of this official relationship.
In case of legal incompetence, informed consent should be obtained from the legal guardian in accordance with national legislation. Where physical or mental
incapacity makes it impossible to obtain informed consent, or when the subject is a minor, permission from the responsible relative replaces that of the
subject in accordance with national legislation. Whenever the minor child is in fact able to give a consent, the minor's consent must be obtained in addition to
the consent of the minor's legal guardian.
The research protocol should always contain a statement of the ethical considerations involved and should indicate that the principles enunciated in the
present declaration are complied with.
Declaration of Helsinki ‫إعالن هلسنكى‬
(1964)
• II. Medical Research Combined with Professional Care (Clinical Research)
• In the treatment of the sick person, the physician must be free to use a new
diagnostic and therapeutic measure, if in his or her judgement it offers hope of
saving life, re-establishing health or alleviating suffering.
• The potential benefits, hazards and discomfort of a new method should be
weighed against the advantages of the best current diagnostic and therapeutic
methods.
• In any medical study, every patient- including those of a control group, if anyshould be assured of the best proven diagnostic and therapeutic method.
• The refusal of the patient to participate in a study must never interfere with the
physician-patient relationship.
• If the physician considers it essential not to obtain informed consent, the specific
reasons for this proposal should be stated in the experimental protocol for
transmission to the independent committee (1, 2).
• The physician can combine medical research with professional care, the objective
being the acquisition of new medical knowledge,only to the extent that medical
research is justified by its potential diagnostic or therapeutic value for the patient.
Declaration of Helsinki ‫إعالن هلسنكى‬
(1964)
• III. Non-Therapeutic Biomedical Research Involving Human
Subjects (Non-Clinical Biomedical Research)
• In the purely scientific application of medical research carried
out on a human being, it is the duty of the physician to
remain the protector of the life and health of that person on
whom biomedical research is being carried out.
• The subjects should be volunteers- either healthy persons or
patients for whom the experimental design is not related to
the patient's illness.
• The investigator or the investigating team should discontinue
the research if in his/her or their judgment it may, if
continued, be harmful to the individual.
• In research on man, the interest of science and society should
never take precedence over considerations related to the
well-being of the subject.
‫من يريد اإلطالع على الوثيقة فهى‬
‫موجودة فى اإلنترنت تحت إسم‪:‬‬
‫إعالن هلسنكى ‪Declaration of‬‬
‫)‪Helsinki (1964‬‬
‫لإلطالع وليس حفظ المواد بغرض‬
‫اإلمتحان‬
‫أهداف المحاضرة األولى‬
‫إلى هنا يكون قد تم ‪:‬‬
‫‪ -1‬تعريف الطالب بنشأة وتطور‬
‫األخالق الطبية والمهنية اإلحترافية‬
‫‪ -2‬الحضارة اإلغريقية القديمة‪:‬‬
‫تم عرض صورة لقسم ابوقراط‬
‫باللغة اليونانية القديمة‬
‫تم عرض واستعراض اجزاء‬
‫من ترجمة قسم ابوقراط‬
‫بالتركيز على بعض القيم‬
‫النبيلة‬
‫‪ -3‬تم تعريف الطالب بمحاكمة‬
‫نورمبرج‬
‫‪ -4‬تم استعراض جزء من قانون‬
‫نورمبرج‬
‫‪ -5‬تم تعريف الطالب بإتفاقية جنيفا‬
‫‪ -6‬استعراض جزء من إتفاقية جنيفا‬
‫‪ -7‬تعريف الطالب بإعالن هلسنكى‬
‫‪ -8‬استعراض جزء من إعالن‬
‫هلسنكى‬
‫‪ -9‬التوضيح للطالب ان المراد تعريف‬
‫الطالب بهذه الوثائق وليس‬
‫اإلمتحان في تفاصيلها‬
‫المحاضرة القادمة‬
‫‪ -1‬توزيع المجموعات‬
‫‪ -2‬حقوق اإلنسان فى اإلسالم‬