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Should The Four Principles Of Medical Ethics Be Used To Judge Doctors' Behaviour In The Legal Context?

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Fuseworks Media
Fuseworks Media
Should The Four Principles Of Medical Ethics Be Used To Judge Doctors' Behaviour In The Legal Context?

Recent attempts to use a breach of medical ethics to censure doctors have been unsuccessful in Court.

The issue is debated by Dr John Kennelly, a Senior Lecturer in the Department of General Practice and Primary Health Care at the University of Auckland in the Ethics column of the latest issue of the Journal of Primary Health Care (JPHC). He says the four principles of medical ethics are widely used but there is controversy over their meaning and recent attempts by medical regulatory authorities to use them to judge a doctor's behaviour in a legal context have proved unsuccessful.

The article refers to J Harris' concern in praise of unprincipled ethics, (J Med Ethics 2003), that the four ethics principles being taught as a checklist to medical students are "pointless and at worst dangerous, allowing massive scope in interpretation and not wonderful as a means of detecting errors and inconsistencies in argument." Dr Kennelly argues the principles are relevant, but they can not stand alone as justification for disciplinary decisions.

The JPHC looks at two cases - the failure of a GP to complete an ACC form for a suspected work-related disease and a GP charged with having a sexual relationship with a former patient. Dr Kennelly says that the behaviour in one of the cases was described by the presiding Judge as "shabby if not immoral conduct" but that this alone was not enough to charge a doctor in Court.

In both cases, breaching the four principles was not enough to provide a legal reason for disciplining a doctor and Dr Kennelly argues that standard texts need to be developed to provide guidance when applying these principles in disciplinary procedures.

He says the four principles may have a place in disciplinary proceedings, but they need to be backed up by solid reasoning.

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