1) Introduction

• Ethics is a branch of philosophy dealing with morality and it attempts to distinguish between what is right and what is wrong.
• In health and research, we deal with new situations hence ethical reasoning is important.
• The application of ethics to medical, health practice and research is called Bioethics.
• Medical Ethics or Bioethics, study of moral issues in the fields of medical treatment and research.
• The professional fields that deal with ethical issues in medicine include: Medicine, Dental medicine, Nursing, Law, Sociology, Philosophy and Theology.
• Virtue Theory is a theory that actions are right or wrong based on the values they express.
• Dr. Mengele conducted experiments in Nazi Germany that involved infecting one twin with a "germ" when the other twin died, and sewing twins together to create a Siamese twin.
• The Nuremberg code of 1947 and Declaration of Helsinki, adopted by the World Medical Association in 1964, made informed consent a central requirement of ethically conducted research.
• Respect for Autonomy affirms the individual's right to make decisions about their own health and future.
• Deontology states that an act is right if it conforms to an overriding moral duty.
• Kantian theory states that actions are to be based on certain values irrespective of the consequences for the "general good" they produce.
• The Nuremberg Doctors’ Trial in 1946-47 resulted in 23 defendants, 3 non-physicians, 15 found guilty, 7 hanged (4 physicians), 5 sentenced to life in prison, 4 sentenced to 10-20 years in prison, and 7 acquitted and freed.
• Nonmaleficence affirms the need for medical competence.
• Deontology, Kantian, and Rossian Theory are duty or principle based theories.
• Utilitarianism is a theory that actions are right or wrong based on the consequences they produce.
• The four bioethical principles are: Respect for Autonomy, Nonmaleficence, Beneficence, and Justice.
• Justice affirms the fair or just treatment of the wider community in terms of the consequences of an action.
• Beneficence affirms the duty of health care providers to be of benefit to the patient, as well as to take positive steps to prevent and to remove harm from the patient.
• The five prima facie principles of Ethics are: Deontology, Kantian, Rossian Theory, Utilitarianism, and Virtue Theory.
• Today medical ethics is also recognized as its own discipline.
• Medical ethics traces its roots to several early codes of ethics such as the ancient Greek Hippocratic Oath, which required physicians above all to “do no harm”.
• Medical ethics is dedicated to Humanity.
• Future Directions in Medical Ethics include the art of Medicine and the science of Medicine.
• Economic Issues are a significant aspect of medical ethics.
• Ethical theory, ethical principles, and ethical rules are used in decision making process.
• Medical ethical cases are a crucial part of the study of medical ethics.
• Brain death is defined as the irreversible cessation of brain function.
• The advent of new medical and reproductive technologies after the 1950s further complicated the moral and societal issues of medical research and practice.
• Infertility is an important area of medical ethics, with many couples turning to fertility-enhancing technologies for help.
• Professional codes of ethics, such as the one written by English physician Thomas Percival in the 18th century, provide a foundation for the first code of ethics established in 1846 by the founders of the American Medical Association.
• The principle of Justice is used by the society to distribute goods and services, including health care, according to certain criteria such as need, effort, contribution, merit, and free market exchanges.
• Ethical rules in everyday practice include veracity (truth telling, informed consent, respect of autonomy), privacy (a person right to remain private, to not disclose information), confidentiality (only sharing private information on a need to know basis), and fidelity (loyalty, maintaining the duty to care for all no matter who they are or what they may have done).
• Death is the point at which our vital (neurological, respiratory and cardiac) physical functions cease.
• The Hippocratic Oath is a statement of ethical principles for doctors.
• Justice in health care is usually defined as a form of fairness, or as Aristotle once said: “giving to each that which is his due”.
• Society Versus the Individual is a common theme in medical ethics.
• Clinical death is defined as the reversible cessation of circulatory and respiratory functions.
• Values are to consider something to be very important.
• Biological death is defined as “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all the functions of the entire brain, including the brain stem, is dead”.
• Morality is related to relationship with other people – family, friends, patients, students …