Ethical and deontological features of the work of nursing staff. Lecture. "Nursing Ethics and Deontology". Deontological aspects of student learning

Medical ethics is a section of the philosophical discipline of ethics, the object of study of which is the moral and ethical aspects of medicine. Deontology (from the Greek depn - due) is the doctrine of the problems of morality and ethics, a section of ethics. The term was introduced by Bentham to designate the theory of morality as a science of morality.

Subsequently, science narrowed down to characterizing the problems of human duty, considering duty as an inner experience of coercion, given by ethical values. In an even narrower sense, deontology was designated as a science that specifically studies medical ethics, the rules and norms for the interaction of a doctor with colleagues and a patient.

The main issues of medical deontology are euthanasia, as well as the inevitable death of the patient. The goal of deontology is to preserve morality and combat stressors in medicine in general.

There is also legal deontology, which is a science that studies questions of morality and ethics in the field of jurisprudence.

Deontology includes:

1. Questions of observance of medical confidentiality
2. Measures of responsibility for the life and health of patients
3. Relationship problems in the medical community
4. Problems of relationships with patients and their relatives

Medical deontology is a set of ethical standards for the fulfillment of professional duties by health workers. Those. deontology predominantly provides for the norms of relationships with the patient. Medical ethics provides for a wider range of problems - the relationship with the patient, health workers among themselves, with the patient's relatives, healthy people. These two directions are dialectically related.

Understanding medical ethics, morality and deontology

In the early 19th century, the English philosopher Bentham used the term "deontology" to define the science of human behavior in any profession. Each profession has its own ethical standards. Deontology comes from two Greek roots: deon-due, logos-teaching. Thus, surgical deontology is a teaching about what should be done, it is the rules of conduct for doctors and medical personnel, it is the duty of medical workers to patients. For the first time, the basic deontological principle was formulated by Hippocrates: "One must pay attention so that everything that is applied is beneficial."

The word "morality" comes from the Latin "togyz" and means "disposition", "custom". Morality is one of the forms of social consciousness, which is a set of norms and rules of behavior characteristic of people of a given society (class). Compliance with moral norms is ensured by the power of social influence, traditions and personal conviction of a person. The term "ethics" is used when they mean the theory of morality, the scientific substantiation of a particular moral system, this or that understanding of good and evil, duty, conscience and honor, justice, the meaning of life, etc. However, in a number cases, ethics, like morality, means a system of norms of moral behavior. Consequently, ethics and morality are categories that determine the principles of human behavior in society. Morality as a form of social consciousness and ethics as a theory of morality change in the process of development of society and reflect its class relations and interests.

Despite the difference in class morality characteristic of each type of society of people, medical ethics at all times pursues universal non-class principles the medical professiondetermined by its humane nature - the desire to alleviate suffering and help a sick person. If this primary obligatory basis for healing is absent, then one cannot speak of observance of moral standards in general. An example of this is the activities of doctors and scientists in fascist Germany and Japan, who during the Great Patriotic War made many discoveries that mankind uses to this day. But as experimental material they used living people, as a result of this, by the decisions of international courts, their names were consigned to oblivion both as doctors and as scientists - “Nuremberg Code”, 1947; International Court of Justice in Khabarovsk, 1948.

There are different views on the essence of medical ethics. Some scientists include in it the relationship between the doctor and the patient, the doctor and society, the doctor's professional and civic duty, others consider it as a theory of medical morality, as a section of the science of moral principles in the activity of a doctor, the moral value of the doctor's behavior and actions in relation to patients. According to S. S. Gurvich and A. I. Smolnyakov (1976), medical ethics is "a system of principles and scientific concepts about the norms and assessments of the regulation of the doctor's behavior, the coordination of his actions and the methods of treatment chosen by him with the interests of the patient and the requirements of society."

The given definitions, despite their apparent difference, do not so much differ from each other as complement the general ideas about medical ethics. Defining the concept of medical ethics as one of the varieties of professional ethics, the philosopher G. I. Tsaregorodtsev believes that it is "a set of principles of regulation and norms of behavior of physicians, due to the characteristics of their practical activities, position and role in society.

According to modern concepts, medical ethics includes the following aspects:

Ш scientific - section medical sciencestudying the ethical and moral aspects of the activities of medical workers;
Practical - area medical practice, whose tasks are the formation and application of ethical norms and rules in professional medical practice.

Medical ethics studies and defines the solution to various problems of interpersonal relationships in three main areas:

Medical worker is a patient
Medical worker - the patient's relatives,
Medical professional - a medical professional.

The four universal ethical principles are: mercy, autonomy, fairness and completeness of health care.

The principle of mercy says: "I will do good to the patient, or at least I will not harm him." Compassion implies a sensitive and attentive attitude towards the patient, the choice of treatment methods proportional to the severity of the condition, the patient's willingness and ability to cope with the prescribed medical intervention. The main thing is that any action medical worker was aimed at the benefit of a particular patient!

The principle of autonomy requires respect for each patient's personality and decisions. Each person can only be viewed as a goal, not as a means to achieve it. Associated with the principle of autonomy are such aspects of health care delivery as confidentiality, respect for the patient's culture, religion, political and other beliefs, informed consent to medical intervention and joint planning and implementation of a care plan, as well as the patient's independent decision-making or decision-making by a legal representative. this patient.

The principle of fairness without causing harm requires equal treatment medical workers and the provision of equal care to all patients, regardless of their status, position, profession or these external circumstances. This principle also stipulates that no matter what kind of help a health worker provides to a patient, his actions should not harm either the patient himself or others. When faced with a situation of conflict between a patient and his relatives or other medical workers, guided by this principle, we must be on the patient's side.

The principle of completeness in the provision of medical care implies the professional provision of medical care and a professional attitude towards the patient, the use of the entire available arsenal of health care for high-quality diagnostics and treatment, the implementation of preventive measures and the provision of palliative care. This principle requires absolute compliance with all legal norms related to health care, as well as all provisions of the code of ethics.

The moral responsibility of a healthcare professional includes adherence to all principles of medical ethics.

ETHICAL, MORAL, PROFESSIONAL STANDARDS OF BEHAVIOR

The duty of a medical worker provides for the qualified and selfless fulfillment by each medical worker of his professional duties, provided for by the norms of moral and ethical and legal regulation medical activity, in other words, the duty of a health worker:

· Moral - the provision of medical care, regardless of social status, religion, etc.
· Professional - never, under any circumstances, perform actions harmful to the physical and mental state of people.

Rules of conduct for a medical worker in a team medical institution.

External culture of behavior:

· appearance (clothes, cosmetics, hairstyle, shoes),
· Observance of external decency: the tone, which they say, do not use swear words, rude words.
Internal culture of behavior:
· Attitude to work,
Observance of discipline,
· Friendliness, observance of subordination.

The main qualities of the internal culture of behavior:

Modesty,
Justice,
Honesty,
· Kindness.
The basic principles of nursing ethics and deontology are set out in the F. Nightingale Oath, the Code of Ethics of the International Council of Nursing and the Code of Ethics for Nurses in Russia:
- 1. Humanity and mercy, love and care.
- 2. Compassion.
- 3. Benevolence.
- 4. Unselfishness.
- 5. Hard work.
- 6. Courtesy, etc.

Ethical foundations of modern medical legislation:

The ethical foundations define the ethical code of a nurse in each country, including Russia, and are the standards of nursing behavior and a means of self-government for a professional nurse.

Awareness of responsibility for the patient's life requires special sensitivity and attention from the nurse. Sensitivity is not only empathy, deep penetration and understanding of the patient's experiences, but also the ability to selflessness and self-sacrifice. However, sensitivity and kindness should not turn into sentimentality, which deprives the nurse of composure and creative activity in the struggle for the health, and often the life of the patient.

Patients often ask nurses about your diagnosis and prognosis. In no case should the patient be informed about the presence of an incurable disease, especially a malignant tumor. With regard to the forecast, you should always express firm confidence in a favorable outcome. At the same time, one should not assure a seriously ill patient that his illness is "trifling" and that he will "be discharged soon", since often patients are well aware of the nature of their illness and, with overly optimistic answers, they lose confidence in the staff. It is better to answer something like this: “Yes, your illness is not easy and it will take a long time to be treated, but in the end everything will be fine!” However, all information that a nurse gives to patients must be agreed with the doctor.

Often, patients enter into conversation with junior medical personnel, receiving unnecessary information from him. A nurse should stop such conversations and at the same time constantly educate nurses, technicians, barmaids, explaining to them the basics of medical deontology, that is, relationships with patients. In the presence of the patient, one should not use obscure and frightening terms: "arrhythmia", "collapse", "hematoma", as well as such characteristics as "bloody", "purulent", "fetid", etc. It must be remembered that sometimes patients who are in a state of narcotic sleep and even superficial coma can hear and perceive conversations in the ward. The patient must be protected in every possible way from mental trauma, which can worsen his condition, and in some cases lead to refusal of treatment or even an attempt at suicide.

Sometimes patients become impatient, negative about treatment, suspicious. They may have impaired consciousness, hallucinations, delusions may develop. In dealing with such patients, patience and tact are especially necessary. It is unacceptable to enter into an argument with them, but it is necessary to explain the need for therapeutic measures, try to carry them out in the most gentle way. If the patient is untidy in bed, in no case should you blame him for this, show your disgust and displeasure. No matter how often you have to change bedding, you need to do it so that the patient does not feel guilty.

At the same time, some patients, as a rule, are not in serious condition, show indiscipline, violate the treatment regimen: they smoke in wards, drink alcohol. In such cases, the nurse should resolutely suppress violations of discipline, be strict, but not rude. Sometimes it is enough to explain to the patient that his behavior is harmful not only to him, but also to other patients (however, if a conversation about the dangers of smoking is conducted by a nurse who smells of tobacco, such a conversation is unlikely to be convincing). All cases of improper behavior of the patient must be reported to the doctor, as this may be caused by a deterioration in the patient's condition and it is necessary to change the treatment tactics.

A nurse - a nurse is bound to always be self-possessed, friendly, and contribute to the creation of a normal working atmosphere in a medical institution. Even if she is upset or anxious about something, the patients should not notice it. Nothing should be reflected in her work, in her tone in conversations with colleagues and patients. Excessive dryness and formality are also undesirable, but frivolous jokes are also unacceptable, and even more so familiarity in relations with patients.

The behavior of a nurse should inspire respect for her, create confidence in patients that she knows everything and can do everything, that she can be safely entrusted with her health and life.

The appearance of the nurse is of great importance. Arriving at work, she changes into a clean, ironed robe or the uniform adopted in this institution, exchanges street shoes for slippers or special shoes that are easily sanitized and do not make noise when walking. Covers the hair with a hat or scarf. The nurse leaves all work clothes and shoes in a special locker.

A neat, smart employee inspires the patient's confidence, in her presence he feels calmer and more confident. And, on the contrary, untidiness in clothes, a dirty dressing gown, hair sticking out from under a cap or kerchief, abuse of cosmetics, long nails covered with varnish - all this makes the patient doubt the professional qualifications of a nurse, her ability to work accurately, cleanly and accurately. These doubts are most often justified.

A nurse must strictly follow the doctor's instructions and accurately observe not only the dosage of the medicine and the duration of the procedures, but also the sequence and time of manipulations. When appointing the time or frequency of administration of drugs, the doctor takes into account the duration of their action, the possibility of combination with other drugs. Therefore, negligence or error can be extremely dangerous for the patient and lead to irreversible consequences. For example, a missed injection of heparin can cause a sharp increase in blood clotting and coronary artery thrombosis. For the same reasons, a nurse should in no case independently cancel a doctor's prescription or do anything at her own discretion.

Modern medical institutions are equipped with new diagnostic and treatment equipment. Nurses should not only know what this or that device is for, but also be able to use it, especially if it is installed in the ward.

When performing complex manipulations, a nurse, if she does not feel sufficiently prepared for this or has doubts about something, should not hesitate to ask for help and advice from more experienced comrades or doctors. In the same way, a nurse who is well versed in the technique of one or another manipulation is obliged to help her less experienced comrades master this technique. Self-confidence, arrogance and arrogance are unacceptable when it comes to human health and life!

Sometimes a sharp deterioration may occur in the patient's condition, but panic or confusion should not be allowed. All actions of a nurse must be extremely clear, collected and confident. Whatever happens (profuse bleeding, sudden heart rhythm disturbance, acute laryngeal edema), it is impossible for the patient to see frightened eyes or hear a trembling voice. Loud shouts to the entire department are also inadmissible: "Hurry, the patient has cardiac arrest!" The more alarming the situation, the quieter the voices should sound. First, the patient himself, if his consciousness is preserved, reacts badly to the cry; secondly, it sharply disturbs the peace of other patients, who can be seriously damaged by anxiety; thirdly, shouts, continuous rushing and often arising nervous squabble exclude the possibility of providing the patient with timely and qualified assistance.

In case of emergencies, orders are given by the head of the department or the most experienced doctor, and before the arrival of the doctor - by the nurse who works in this ward or office. The instructions of these persons must be followed immediately and without question.

Silence in the department should be observed at all times, especially at night. A sparing regimen is a prerequisite for successful treatment, and no medication will help a patient if he cannot fall asleep due to. loud conversations and clatter of heels in the corridor.

In addition to contacts with patients, a nurse often has to come into contact with their relatives and close people. There are also many factors to consider. Medical workers, hiding from the patient that he has an incurable disease or a deterioration in his condition, should inform his relatives about this in an understandable and accessible form, But even among them there may be sick people, in a conversation with whom great care and tact should be exercised. It is also impossible to inform even the closest relatives, and even more so to the patient's colleagues, about carrying out some mutilation operations on him, especially when it comes to a woman. Before talking with visitors, you should consult a doctor, and sometimes ask the patient what you can tell them about, and what is better to keep silent about.

It is especially necessary to give information over the phone, it is better not to give any serious, especially sad information at all, but to ask to come to the hospital and talk to the doctor in person. When you approach the phone, the nurse must first of all name the department, her position and last name. For example: "The fourth therapy department, nurse Petrova." Answers like "Yes!", "I'm listening!" etc. talk about the low culture of medical personnel.

Very often, visitors ask for permission to help in caring for seriously ill patients. Even if the doctor allowed relatives to stay in the ward for some time, they should not be allowed to perform any nursing procedures. Relatives should not be allowed to feed seriously ill patients. Practice shows that no care of close people can replace the supervision and care of qualified medical personnel for a seriously ill patient.

Medical ethics and deontology determine the attitude of the medical professional to the patient, society and the relationship of medical professionals with each other.

In this article, you will learn:

Ethics and deontology of healthcare professionals: general principles

Ethics and deontology in medicine is one of the sections of bioethics, the meaning of which is manifestation of humanism in all areas of medical activity ... Medical ethics and deontology determine the attitude of the medical professional to the patient, society and the relationship of medical professionals with each other.

Deontology in medicine, i.e. its fundamental principles are set out in the oath of the English sister of mercy and public figure Florence Nightingale:

humanity;
compassion;
benevolence;
unselfishness;
hard work;
courtesy, etc.

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Ethics

Under medical ethics involve a combination of ethical standards that health care workers must follow in the performance of their professional duties. At the same time, it is closely related to medical deontology - the doctrine of the problems of morality and ethics, which is a section of ethics.

Deontology mainly determines the norms of the relationship between a medical professional and a patient. For the first time the term "deontology" was introduced into everyday life by the British philosopher I. Bentham at the beginning of the 19th century, implying by it the doctrine of the norms of behavior of a representative of any profession. The word "deontology" is derived from two Greek roots: deon, "ought," and logos, "doctrine." Consequently, medical deontology is the doctrine of the duty of medical professionals to patients.

Ethics and deontology of a nurse

Nursing ethics and deontology are of particular importance.

How to deal with an aggressive patient?

An aggressive person can be recognized by their specific communication style. Most likely, he will try to manipulate health workers, allow himself personal accusations and even insults against them.

The patient can be predetermined by his behavior when a conflict is brewing:

impulsive and abrupt movements, a nervous blush on the face, a glance from under the brow, sharp and piercing;
raises his voice.

The personality of a nurse, the ability to handle patients, mastery of the technique of psychological work with them - all this in itself can serve as a medicine, have a healing effect. When building a nurse-patient relationship, individual work style and personal characteristics a nurse.

Deontology in medicine presupposes the presence of certain qualities that are very important in the work of a nurse. The most important are:

respectful attitude towards patients;
desire to help;
attention;
tolerance;
kindness;
politeness;
soulfulness.

Everything in a nurse should have a patient's disposition, and only then a confidential dialogue arises, during which the nurse learns the information she needs about the patient, his personality traits, his opinion about the disease, hospitalization, and plans for the future.

He talks about how to resolve the conflict

Conflict Resolution Ways in Practical Health Care

If you are faced with conflicting patients in the course of your work, psychologists recommend adhering to the following rules of behavior:

Remember, your patient in the process of communication satisfies his psychological needs and needs (associated with personal problems) through communication with you. You are for him an environment where he can throw negative emotions. Be patient, do not let yourself be dragged into the conflict (!);

It is extremely important for the health worker to remember that it is also necessary to manage his own emotions in working with such patients, avoiding rudeness or insults;

The ethics and deontology of a nurse also includes appearance, facial expressions, and her speech. A nurse's speech is a characteristic of a specialist and must comply with the norms. It is necessary to communicate with the patient in a language that is understandable to him, without using "unnecessary" medical terminology.

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Medical deontology

It is necessary to be attentive to all patients, because for any patient his illness is always serious and difficult. And therefore, any disregard for the disease or the patient can lead to the loss of contact with the patient, so necessary in surgical activity. Expressions that are incomprehensible to patients should be avoided, for example, "hook-shaped stomach", "transverse position of the heart", "epithelial cells in the urine", "drip heart", etc., since patients often begin to think about severe symptoms, in fact absent diseases. It is not necessary in the ward to discuss with patients the symptoms that indicate a favorable course of the disease, when there are patients with the same diseases nearby, but without these symptoms. All comments should be given by only one person - the attending (ward) doctor.

Thus, one of the most important tasks of surgical deontology is the protection of the patient's psyche.

In this regard, we consider unjustified the rule of transmitting information about the diagnosis in a sealed envelope, which is handed out to patients for handing over to oncologists and other specialists. This should not be done, since such envelopes especially pique the curiosity of patients.

In no case should one discuss with the patients the choice of diagnostic procedures, the nature of the studies carried out, the tactics of treatment, the need for surgical interventions, the choice of the method of pain relief, etc. The patient should only be informed of reasoned decisions. Doubting is the business of the physician, but not the patient. Sometimes a patient may refuse surgery based on misinformation made for deontological reasons. For example, in case of stomach cancer, the patient is often told the diagnosis: "gastric ulcer". The patient, knowing that peptic ulcer disease can be treated conservatively, refuses the operation. In such cases, it is necessary to convince the patient that the refusal of the operation is dangerous because of the possibility or the presence of signs of cancerous degeneration of the ulcer, because otherwise the principles of deontology are reduced to naught, and it puts the interests of the patient above all else.

It is necessary to be extremely careful when talking in transport, elevators, where persons who know the patient may be present, during telephone conversations with close relatives of the patient, since in the latter case it may be the patient himself. In addition, not all relatives should be informed about the true situation of the patient. All conversations with the patient and his relatives should be conducted by the ward doctor or be present at the same time.

Medical deontology

Communication with a patient requires maximum tact. Examination of the oral cavity, trunk, extremities of the patient can cause an unfavorable impression on the nurse, however, under no circumstances should one show disgust, but it is necessary to explain in a friendly tone the need for hygiene for a favorable outcome of treatment.

Knowledge of deontology in surgery is especially important. The mental state of a surgical patient undergoes many tests, and this requires his objective assessment and consideration during individual work with the patient. The surgical patient differs from all others in that he has to undergo radical treatment. At the same time, almost all patients are afraid of something: some - operations, others - pain relief, and others - just suffering, which they may feel during the operation or after it. Patients, as a rule, are extremely sensitive to everything negative, every thoughtless word, deed, unfulfilled appointment can become a reason for refusing even a vital operation for them. Thus, the appearance and clothing of medical personnel, their punctual performance of personal hygiene is just as important as highly qualified care for a seriously ill patient in the pre- and postoperative period, the ability to painlessly, gently carry out this or that procedure.

We often hear that a nurse is a doctor's assistant. However, should she always be an uncomplaining performer? If an experienced nurse sees the doctor's mistakes, she should not discuss them with her colleagues, but tactfully and, if necessary, quietly tell the doctor about it.

Medical deontology

The word "deontology" means the doctrine of the due (Greek deon - due, logos - word, science, teaching). As applied to medicine, deontology is understood as the principles of behavior of medical personnel aimed at maximizing the usefulness of treatment and eliminating the harmful consequences of defective medical work. At the same time, great importance is attached to the creation of a certain psychological climate in the team, where the attitude of medical personnel to the patient, relations between team members, regardless of their rank, are important. Deontological rules have developed in various fields of medicine: surgery, obstetrics, oncology, venereology, etc., but they have common principles and, of course, professional differences. The book "Questions of Surgical Deontology" (1945) by the founder of Russian oncology NN Petrov (1945), which laid the foundation for the regulation of professional relationships, played a great role in the development of deontology. Practical deontology is a system of thoughtful, scientifically grounded behavior and specially developed specific measures of psychological impact on the patient.

In deontology as a science, there are many unresolved, sometimes controversial, for example, how much detail should be said to a patient about his illness, given the rapidly growing medical literacy of the population, how to explain to a patient or his relatives the need to give a receipt for an operation? etc. There are no ready-made recipes for all occasions, and here a lot depends on the general culture of the medical worker and on his life experience.

Ethicsmedical
The philosophical discipline that studies morality and ethics is called ethics.

Professional ethics are principles of behavior in the process professional activity person. It is believed that the basic principles of medical ethics were formulated by Hippocrates.

That part of ethics, the subject of which is the doctrine of a person's duty to another person and society as a whole, is called deontology.

Medical deontology is the teaching about the proper behavior of health care providers to create the most favorable environment for the patient to recover. The term medical deontology was introduced by the outstanding surgeon N.N. Petrov, extending its principles to the activities of nurses.

Thus, the theoretical basis of deontology is medical ethics, and deontology, manifested in the actions of medical personnel, is the practical application of medical and ethical principles.

Features of deontology in pediatricsdue to the originality of the child's psyche, as well as the need for contact in work not only with children, but also with theirparents.
The aspects of medical deontology are:

the relationship of medical workers with patients;
the relationship of medical workers with the patient's relatives;
the relationship of medical workers with each other.

The main goals of the professional activity of a nurse are: caring for patients, relieving their suffering, restoring and strengthening their health, preventing diseases.

To achieve these goals while fulfilling their functional responsibilities the nurse must know and observe the following basic ethical principles such as humanity and compassion.

The implementation of ethical principles in medicine includes:

informing the patient about his rights;
informing the patient about the state of his health
humane treatment of the patient;
respect for the human dignity of the patient;
prevention of moral and physical harm to the patient (do no harm);
respect for the patient's right to medical intervention or to refuse it;
respect for patient autonomy;
respect for the patient's right to quality and timely medical care;
the manifestation of respect for the dying patient (distributive justice);
keeping professional secrets;
maintaining a high level of their professional competence;
protecting the patient from incompetent medical intervention;
maintaining respect for their profession;
respectful attitude towards their colleagues;
participation in public health education.

Medicalsister andrightspatient

A nurse must be truthful in relation to the patient, know and respect the patient's rights and act in accordance with these rights in her professional activities.

When seeking medical care and receiving it, the patient has the right to:

1.respectful and humane treatment on the part of medical and service personnel;

2. the choice of a doctor, taking into account his consent;

3. examination, treatment and maintenance in conditions that meet sanitary and hygienic requirements;

4. Conducting, at his request, a consultation and consultations of other specialists;

5. relief of pain associated with the disease and (or) medical intervention, using available methods and means;

6. preservation of professional secrecy by medical workers;

7. informed voluntary consent to medical interventions;

8. refusal of medical intervention;

9. receiving information about their rights and obligations and their health status;

10. receiving medical and other services under voluntary medical insurance programs;

11. compensation for damage in case of harm to his health during the provision of medical care;

12. admission to him of a lawyer or other legal representative to protect his rights;

13. the admission of a clergyman to the patient or the provision of conditions for the performance of religious rites, if this does not violate the internal regulations of the hospital institution.

It is the moral duty of a nurse to inform the patient of his rights. She should inform the patient of the names and positions of those involved in his treatment. Taking into account that the function of informing the patient and his relatives, for the most part, belongs to the doctor, the nurse has the moral right to transmit professional information only in agreement with the attending physician.

Humaneattitude towards the patient, respect for his legal rights

A nurse should prioritize compassion and respect for the patient's life. It has a duty to respect the patient's right to relief from suffering to the extent that the current level of medical knowledge permits. It is the duty of a medical professional never to participate in actions directed against the physical and mental health of people, not to hasten the onset of death and not to contribute to the suicide of the patient.

Respectthe patient's human dignity

A nurse must be constantly ready to provide competent assistance to patients, regardless of their age or gender, the nature of the disease, social or financial status and other differences. In providing care, the nurse must take into account the personal needs of the patient, respect his right to participate in the planning and delivery of treatment. In dealing with patients, one should never forget about following rules: always listen carefully to the patient when asking a question, always be sure to wait for an answer, to express your thoughts clearly, simply, intelligibly. Arrogance, neglect, or demeaning treatment of the patient is unacceptable. When prioritizing medical care for several patients, the nurse should be guided only by medical criteria, without any discrimination.

Beforejust - do no harm

The main ethical principle in medicine is the principle - do no harm. Not causing harm, damage to the patient's health is the primary duty of every medical worker. Neglect of this obligation, depending on the damage to the patient's health, may become the basis for bringing the medical worker to justice.

It is unacceptable to cause moral or physical harm to the patient, either intentionally, or through negligence, or because of professional incompetence. A nurse does not have the right to be indifferent to the actions of third parties seeking to cause such harm to the patient. The actions of a nurse to take care of the patient, any other medical interventions associated with pain and other temporary negative phenomena are permissible only in his interests. The risk associated with a medical intervention cannot be greater than the expected benefit. Having performed medical interventions fraught with risk, the nurse is obliged to provide safety measures to stop the complications that threaten the patient's life and health.

Rightthe patient agree to or refuse medical intervention

A very important principle in modern healthcare is the principle of informed voluntary consent. This principle means that the healthcare professional should inform the patient as fully as possible and give him optimal advice. Only after that the patient must choose his own actions. At the same time, in our country, the law gives the patient the right to receive all information. Providing incomplete information is fraudulent. The nurse must respect the right of the patient or his legal representative (when she is dealing with a child or mentally disabled person) to agree to or refuse any medical intervention. The nurse must be sure that consent or refusal was given by the patient voluntarily and knowingly, that is, without any coercion or deception and with a clear understanding of the nature of the impact on his physical or mental health. The moral and professional duty of a nurse is, to the extent of her qualifications, to explain to the patient the consequences of refusing a medical procedure. Refusal of medical intervention indicating possible consequences is drawn up by an entry in the medical documentation and signed by the citizen or his legal representative, as well as by a medical professional. If the patient is unable to express his will, the nurse has the right to carry out the urgent medical intervention shown to him, within the limits of her competence, based on her own decision.

Rightpatient for qualityandtimelymedicalhelp(distributionjustice)

IN modern conditions especially important is the principle of distributive justice, which means the obligation to provide and equal access to health care. Unfortunately, distributive injustice is especially common in the distribution of expensive drugs, complex surgical interventions, etc. At the same time, huge moral damage is inflicted on those patients who, for a number of reasons, are deprived of this or that type of medical care. A nurse is obliged to provide the patient with quality medical care that meets the principles of humanity and professional standards... She is morally responsible for her activities to the patient, colleagues and society. The professional and ethical duty of a nurse is to provide, to the best of her competence, emergency medical care to anyone who needs it.

Medicalsister and dying patient

The nurse must respect the dying patient's right to humane treatment and dignified death. The nurse must have the necessary knowledge and skills in the field of palliative care to enable the dying patient to end life with the greatest physical, emotional and spiritual comfort attainable. Primary moral and professional duties Nurses: Preventing and alleviating the suffering usually associated with the dying process; providing the dying patient and his family with psychological support. Deliberate actions by a nurse to end the life of a dying patient, even at his request, are unethical and unacceptable.

Dutykeep professional secrecy

A nurse must keep secret from third parties information that is entrusted to her or that has become known to her due to the performance of her professional duties: about the fact of seeking medical help, the patient's health status, diagnosis, treatment, prognosis of his disease, as well as about the patient's personal life, even after the patient dies. Information about physical disabilities, bad habits, property status, circle of acquaintances, etc. is also not subject to publicity. The purpose of maintaining professional secrecy is to prevent possible moral or material damage to the patient. The nurse is obliged to strictly fulfill her functions of protection confidential information about patients, in whatever form it is stored. A nurse may only disclose confidential information about a patient to any third party with the patient's consent. The right for the nurse to share information with other professionals and healthcare professionals providing medical care to the patient requires his consent. A nurse has the right to transfer confidential information without the patient's consent only in the following cases provided by law:

for the purpose of examining and treating a citizen who, due to his condition, is unable to express his will,
with the threat of the spread of infectious diseases,
at the request of the bodies of inquiry and investigation, the prosecutor's office and the court in connection with an investigation or trial,
in case of rendering assistance to a minor under the age of 15 to inform his parents or legal representatives,
if there are grounds to assume that harm to the health of a citizen was caused as a result of illegal actions.

But even under the above circumstances, the patient should be made aware of the inevitability of the disclosure of confidential information. In all other cases, the nurse bears personal moral and sometimes legal responsibility for the disclosure of professional secrets.

Professionalcompetence

The nurse must always maintain a professional level of her work. The constant accumulation of special knowledge and skills is the professional duty of a nurse. She must be competent about the patient's moral and legal rights. Professional competence gives a nurse the moral right to independently make appropriate decisions in extraordinary situations and supervise junior medical personnel.

Protectionpatient from incompetent medical intervention

A nurse, faced with illegal, unethical or incompetent medical practice, must defend the interests of the patient. She must be familiar with the legal provisions governing nursing, the health care system in general, and the application of traditional medicine in particular. It is a moral duty of a nurse to actively discourage the practice of dishonest and incompetent colleagues, other persons engaged in questionable medical practice. A nurse may seek support from government bodies health care, the Nurses Association, taking steps to protect the interests of the patient from questionable medical practices.

Respectto your profession

The nurse must maintain the credibility and reputation of the nursing profession. She has a personal moral responsibility to maintain and improve nursing standards. A nurse should critically assess her professional training and practical skills and not claim a degree of competence that she does not possess. The right and duty of a nurse is to defend her moral, economic and professional independence. She should refuse gifts and flattering offers from the patient if it is based on his desire to achieve a privileged position compared to other patients. A nurse has the right to accept gratitude from a patient if it is expressed in a form that does not humiliate the human dignity of both, does not contradict the principles of justice and decency and does not violate legal norms. A nurse should not abuse her professional position and knowledge. Intimate relations with the patient are frowned upon by medical ethics.

However, there are also general ruleswhich must always be followed:

a) everyone must know and strictly fulfill their duties;

b) constantly improve their professional level;

c) teach a friend what you know yourself;

d) a nurse must be a versatile (manipulative, dressing, procedural, etc.);

e) do not disdain the so-called dirty work.

DEONTOLOGY MEDICAL (Greek, deon, deontos due, proper + logos teaching) - a set of ethical norms and principles of behavior of a health worker in the performance of professional duties, involving the provision of the patient with the greatest possible assistance, with the goal of excluding the possibility of harm to him and contributing to an increase in the effectiveness of patient treatment and prevention diseases.

Medical deontology reflects the humanistic essence of medicine and includes the rules that have developed as a result of historical experience for the fulfillment of their professional duties by physicians, the principles and forms of relationships with the patient, his relatives and friends, with colleagues in the profession. A health worker who meets the requirements of Medical Deontology has such qualities as the ability to be compassionate, the willingness to sacrifice his interests and comforts, if necessary to save the life or alleviate the suffering of the patient; tolerance, sensitivity, consideration; striving to improve professional knowledge; persistence in helping the patient. The field of medical deontology also includes important moral and legal problems, including those related to the responsibility of a medical worker for the life and health of a patient, issues of medical confidentiality, and prevention of iatrogenic diseases.

At different stages of historical development, the moral requirements for representatives of honey. professions changed in accordance with the peculiarities of the ethics of society (see Medical Ethics), but even in ancient medicine they acquired a humanistic orientation. A particularly important role in determining the moral principles of honey. activity belongs to Hippocrates. The deontological principles set forth in his "Oath" are still relevant today, and to a large extent they can be attributed to the activities of not only doctors, but also paramedics. The formation of domestic deontology was influenced by the humanistic ideas of the Russian revolutionary democrats A.I. Herzen, N.G. Chernyshevsky, the high moral principles of honey. activities of M. Ya. Mudrov, N. I. Pirogov, S. P. Botkin and other outstanding Russian clinicians.

With the development of medicine, the activities of paramedics are constantly becoming more complex. They work with complex honey. technology, perform many responsible manipulations, which until recently were carried out only by doctors. In modern conditions, to take care of the patient, a paramedic, midwife, and nurse must acquire more and more complex scientific and technical knowledge and skills. In this regard, the qualifications of paramedics and the rational organization of their activities at a higher professional level are of particular importance.

The successful implementation of diagnostic and therapeutic measures, quality patient care is possible only when the entire team of honey. institutions and each member of this team constantly comply with the requirements of deontology. It is necessary to establish contact and trusting relationships with the patient. This is facilitated by a healthy psychological climate in a medical institution, an atmosphere of attention to the patient, caring for him, the clarity of the implementation of diagnostic and medical procedures, good business relationships based on mutual respect and trust between employees.

Of great importance is the first acquaintance with a patient who has come to an appointment or admitted to a hospital. Formal attitude, indifference to the patient is unacceptable. Adapting to a hospital environment should not be a big burden for the patient; From the first hours of a patient's stay in a medical institution, the medical staff should surround him with care, ensure his life, and organize full and timely care. It is very important that not only the medical staff, but also the patient was confident in the readiness of the personnel for the timely and qualified provision of medical care. In the behavior of doctors and nurses, in how medications and procedures are prescribed and how the appointments are carried out, the patient should see and feel interested in his fate, a responsible attitude towards his health.

When choosing a form of communication with a patient, one should take into account his emotional state, intellect, education, profession, personality traits. It is important to develop the ability to listen to the patient, relieve stress from him during the conversation, eliminate fears, anxiety, instill confidence in his strength. In a conversation with a patient, it is necessary to monitor not only the content, but also the form of speech, remember that tone, facial expressions, and gestures are important for the patient. The nature and direction of conversations can and should change depending on the period of illness, the patient's mood. Skillful and careful penetration into the patient's world is possible only with sincere sympathy for his suffering. Therefore, it is unacceptable to entrust work with the sick to those health workers who have become mentally hardened, have lost the ability to compassion, and have become formally related to the performance of professional duties. It is bad if the object of care and treatment is an impersonal patient, and not a specific human personality. In such cases, the relationship between the nurse and the patient is formal, formal. Undoubtedly, special professional knowledge and skills are always important, but they may not be enough in the absence of sensitivity, courtesy, attention, and benevolence.

The patient, as a rule, easily picks up any falsehood when addressing him and painfully experiences it. Sympathy, patience, politeness - constituent elements good nursing style. At the same time, tenderness, warmth in the nurse's attitude to the patient should never be of an intimate nature, should not encourage patients to courting, to illicit relationships. The best defense against the danger of being misunderstood is sincerity and benevolence in showing attention to the patient.

The nurse must have a neat appearance, be collected, friendly; inappropriate moodiness, irritability, as well as complaints to the patient about the hardships of his work. Gossip, familiarity, which interfere with the normal relationship between the sister and the patient, are unacceptable.

One of the most important requirements of deontology is the preservation of the patient's secret. The patient, in fear of the disease and its possible difficult outcomes, seeks sympathy, frankness, often shares his innermost thoughts with the nurse, which, like various information about the patient contained in the medical history, should not become the property of other people. The need to keep information about the patient secret is noted in Soviet legislation. The exception applies only to diseases that can pose a threat to society (for example, the spread of inf. Diseases, serious illnesses with visual impairment in transport drivers); health workers should officially notify the relevant organizations about them.

Awareness of the patient about a serious illness, as a rule, reduces the effectiveness of treatment. Therefore, in the documents issued to the patient, the name of the serious illness or the alarming results of the examinations are often not mentioned. In such cases, one of the patient's close relatives receives full information. The relationship between health workers and relatives of patients is also an important problem of medical deontology. In all cases, they should be formed taking into account the patient's interests.

Ministry of Health Chelyabinsk region

GBPOU "Satka Medical College"

AGREED: CONSIDERED

deputy Director for SD: at the CMK "Nursing"

Sevostyanova I.A. protocol ___ ______ Evseeva I.L.

"___" _____________ 20___ "____" _________________ 20 ___

Basic lecture notes

Topic: "Nursing Ethics and Deontology"

PM 04 (07) "Performing work by profession

junior nursing nurse "

MDK. 04. (07) 01. Theory and practice of nursing

Specialty:

34.02.01 "Nursing"

31. 02. 01 "Medicine"

Course 1.2

teacher

first qualification category

Nursing Ethics and Deontology.

THEORETICAL PART

" Ethos" - custom, disposition. ETHICS studies morality, that is, norwe are people's behavior, their moral relations.

DEONTOLOGY ( deontos- due, proper,logos - doctrine) from learns professional relationships. The concepts of ethics and deontology applynims in any field of professional activity: legal, agronomic and so on, including medical. Medical ethics studies the moral relationship between a doctor, a nurse, a patient and his relatives. Medical deontology studies professional relationships in the same block: doctor, sister, patient, relatives.

A brief historical sketch of the development of ethics and deontology .

One might think that the first person who provided medical assistance to his neighbor did it out of a feeling of compassion, aspirationhelp in misfortune, relieve pain, in other words, out of a sense of humanity. Humanity has always been a feature of medicine. Since antiquity andto this day, people were worried about the issues of ethics and deontology: howthere should be a physician's behavior, attitude towards patients, their relatives,relationships with each other. The searches, reflections of doctors of many countries and peoples are evidenced, in particular, by the Babylonian, Egyptian,indian, Chinese, Russian antiquities. But only a thinkerand the doctor Hippocrates in his famous "Oath" for the first time formulated the moral, ethical and ethical standards of the medical profession. GreatnessHippocrates is that he considered man to be the crown of nature. Bannersof course, the participantsI International Congress on Medical Ethicsand deontology (Paris 1969) considered it possible to supplement it with only one phrase: "I swear to study all my life."

The concept of medical deontology was introduced relativelylong ago: at the beginning of the last century by an English scientist and philosopherI. Bentam, as a designation of the science of professional human behaviorcentury. Great influence on the formation of medical ethics and deontologia was provided by domestic scientists: Mudrov, Pirogov, Botkin, Bekhterev.They laid the foundations for ethical and deontological principles. And also withvet scientists and organizers of health care: Semashko, Danilevsky, Kassirsky and many others contributed to the development of ethics and deontology.

Duty and responsibility.

Duty and responsibility are the main problems of both ethics and deontology. In ethics, these problems are considered from the point of view of moral and ethical relations. In deontology - in the aspect of official (professional) duties.

THE MAIN ETHICAL PRINCIPLE - DO NOT HARM!

The duty of a medical worker provides for the qualified and selfless fulfillment by each medical worker of his professional duties, provided for by the norms of moral, ethical and legal regulation of medical activity, in other words, the duty of a medical worker:

moral is the provision of medical care, regardless of social status, religion and so on,

professional - never, under any circumstances, perform actions harmful to the physical and mental state of people.

Among the problems of theoretical medicine and practical health care, ethical and deontological issues still do not enjoy prestige. In this regard, there is a large number of complaints from the population about violations of medical ethics and deontology. If the low professional qualifications of a medical worker cannot always be recognized by the patient or his relatives, then the moral character is revealed without difficulty and can receive, kevjadensh, a negative assessment from the population. This means that such moral qualities how empathy and compassion should not be introduced from the outside, but become the moral core of a medical worker, an ethical norm.

There are also certain rules of conduct for a medical worker in the team of a medical institution. Medical etiquette consists of adhering to the rules of the external and internal culture of behavior of the health worker.

External culture of behavior:

appearance (clothes, cosmetics, hairstyle, shoes),

observance of external decency: the tone that they say is not to use abusive, rude words.

Internal culture of behavior:

attitude to work,

discipline,

friendliness, observance of subordination

Subordination is a system of official subordination of a junior to a senior, based on the rules of official discipline. It must be remembered that

intrigues, rudeness lead to discord in the team, to its division into groups, which significantly impairs the work of the medical institution.

You must always follow the main ethical principle - DO NOT HARM! You can harm the patient with your discord in the team. The team should have such an atmosphere that would contribute to the good work of the medical personnel and the speedy recovery of patients. Otherwise, hospitalization may not alleviate the patient's suffering, and even harm. To prevent this from happening, the work of the nurse, the contact between the patient and the nurse, is very important. A nurse can perfectly fulfill her professional duties, achieve automatism in her work: she perfectly makes injections, and so on, but there is no patient behind all this. And she should be with the patient, understand him, be able to keep secrets, inspire confidence. Trust is the path to recovery. If the patient believes in the nurse and the doctor, he feels safe, he knows that he will receive everything he needs to restore his health. Otherwise, he has doubts about the attending staff. They find their expression in a variety of requirements: convening a council, inviting specialists, special studies, and so on. The condition caused by the patient's difficult experiences due to defects in activity, communication of the medical staff, is observed more often in suspicious patients. In such cases, there are:

hasty and unsubstantiated opinion about diagnosis and prognosis;

misinterpretation of medical and diagnostic procedures;

depression from inaction or inattention of staff.

As a consequence of all of the above, the patient may have a fear of any disease (cancer - carcinophobia, disease

It is very important for recovery - with whom the patient communicates at home, in the ward.

The mutual influence of patients can be positive and negative: the patient sees how his roommate with a much worse prognosis is fighting for life, and this instills in him the desire to do the same. But the opposite may also be true: the sight of seriously ill patients acts depressingly, depressingly. Therefore, it is very important to select patients in the ward so that they correspond in character to each other. And it is absolutely ideal if communication with each other will bring them satisfaction.

A nurse should not forget about such a property of the patient's psyche as the influence on himself. The person gets sick. At first, he hides from himself, explains the onset of the symptoms of the disease by various reasons (fatigue, was nervous at work, troubles at home, so his head ached). Then he realizes the fact of illness, but for some, time

hopes to improve quickly. Latently recalls everything that he read, heard, saw at relatives and acquaintances with the same symptoms of the disease. A feeling of fear appears: can I bear it? Will I stay alive? What will happen to the children? The patient has a feeling of guilt, he is looking for what is to blame, what is he paying for? For what sins? Self-accusations are not uncommon. Patients often claim that they are "themselves to blame." We were not careful, they overlooked something somewhere. People who are often sick endure suffering with great humility and calmness. Those patients who fell ill for the first time or for whom a lot in life depends on their physical health: artists, athletes, are subject to extremely serious manifestations of fear. That is, it is very important to know those reactions of the personality that are formed during the disease.

Chronic patients may experience deeper mental changes. The patient can become pessimistic, can become touchy, sensitive, envious, even a hater. Or there may be infantile behavior (like a small child). In these cases, trust and contact between the patient and the doctor, the patient and the nurse is very important. The nurse constantly communicates closely with the patient, while the doctor sees him only on the round, and must orient him towards recovery with her caring, respectful attitude, conversations with the patient. This is especially difficult: to maintain faith in a person in cases of serious illness, with a difficult outcome.

Professional secret.

The concept of professional secrecy also applies to a nurse. She is mentioned in all the oaths and promises of the doctors of the world, starting with Hippocrates. Information about the patient's examination results, the diagnosis and prognosis of the disease is communicated to the patient himself or his relatives only by the doctor himself (this is his competence), or with his permission by the nurse. You need to be especially careful when communicating information over the phone. It is best to ask to come to the hospital and speak with the doctor in person. But this does not mean that the patient has absolutely no right to receive information about his condition from the nurse. The nurse should teach the patient a new way to meet the needs of the change in lifestyle (explain how to follow the prescribed regimen, how to eat depending on the prescribed diet, etc.). The nurse must explain the purpose of the prescribed manipulations, prepare the patient for them, in case of refusal to warn about the negative consequences of this step. In addition, the nurse must orient the patient towards recovery, for this to make good use of the patient's life values. The nurse is independent in caring for the patient and must educate the patient himself, his relatives

some manipulations and care elements. Thus, the range of activities of a nurse is very wide.

ETHICS AND DEONTOLOGY IN RELATION TO AGE

It is very important to take into account the age of patients when communicating. If these are children, they can hardly endure separation from their mother, separation from their usual environment, do not realize the pain, do not know how to formulate complaints, medical and diagnostic procedures frighten them. Defects of character and upbringing appear very clearly: i.e. if the child is capricious, then screams and is capricious even more, if the child is quiet - withdraws into himself, fearful - is constantly afraid of everything, etc. Under these conditions, the mother should be allowed to visit. After she leaves, you need to distract the child, read to him, play with him, do drawing, modeling, etc. Afraid of manipulation - to distract attention. The most important thing is the child's trust in the nurse!

In a teenager, there is a self-affirmation of the personality, hence the bravado, harshness, claims to adulthood, a disdainful attitude towards the disease. It also requires a lot of patience, endurance, respect, the ability to find an approach, it is possible to emphasize an attitude like an adult.

Patients of working age. It all depends on the personal qualities of the patient, on how he perceives the disease, how he relates to the staff. Trust and contact are especially important here.

Elderly and senile patients. They are characterized by a feeling of loneliness, "life has already passed", this is the dominant of their age. Helplessness grows, hearing, vision decreases, it becomes more and more difficult to move "memory decreases, resentment and vulnerability increase. Self-care is impaired, motivation for treatment and recovery is weakened. In these cases, warmth and care are very important. A nurse must warm an elderly person, talk with relatives, with the patient himself, to find what he is still interested in in life (life values) and on this to build motivation for recovery.

TYPES OF NURSES, BY I. HARDY

As part of the contact between the sister and the patient - in addition to the personality of the patient and the emotional threads connecting him with the sister - special attention should be paid to the personality of the sister. In everyday practice, you can meet many excellent sisters with excellent data and professional skills. However, despite this, each sister needs to thoroughly learn about her personality traits in order to know what her style of work is and how she affects the sick.

Let us turn to the characteristics of individual types.

Routine Sister. Most characteristic feature sisters of this type is the mechanical performance of their duties.

The type of "rote role" sister. Such sisters work, consciously playing a certain role, striving for the realization of a certain ideal. Her behavior becomes artificial, ostentatious. All this can interfere with the formation of proper contact between her and the patient.

The type of "nervous" sister. The emotionally labile personality of the sister, prone to neurotic reactions, can serve as a serious obstacle in working with patients. The result of such tension can be rudeness, irritability, irascibility, harmful to the sick.

The type of sister with a masculine, strong personality. This sister is distinguished by persistence, determination, indignation at the slightest disorder. In favorable circumstances, sisters with such a determined personality can become excellent organizers, good teachers. about which their pupils will say: "Strict, but fair" ". With a lack of culture, education, and a lower level of personality development, sisters of this type are too inflexible, straightforward, often rude and even aggressive with patients.

Mother-type sisters perform their work with the utmost care and compassion for the sick. Work for them is a natural condition of existence. Caring for the sick is a vocation in life.

The type of specialist sisters. This should include those sisters who, thanks to some special abilities, personality traits, receive special appointment... Such nurses work in laboratories, X-ray rooms, functional diagnostics rooms.

The profession of a nurse is a difficult profession. You can often hear about tnurses "I'm very tired." Really:

hard work, physically;

heavy emotional and mental stress.

Due to the severity of both physical and moral, a nurse may have a professional deformation of the personality, its main manifestations:

coldness and indifference;

rudeness and irritability

depression from "powerlessness".

To prevent professional deformation, it is necessary to observe ethical standards as a factor of self-regulation of a nurse:

preservation peace of mind sick;

activation of his position on health;

prevention of occupational deformation.

Thus, the range of problems in medical ethics and deontology is extremely wide. Many of them are reflected in the "Ethical Code of Nurses in Russia", adopted in 1997 (carefully read Appendix No. 2).

Medical deontology (from the Greek deontos - due, proper and iogos - doctrine) about the professional behavior of a health worker. The very term "deontology" was introduced into use in the early 19th century by the English philosopher Jeremiah Bentham to refer to the science of professional human behavior. The concept of "deontology" is equally applicable to any area of \u200b\u200bprofessional activity: medical, engineering, legal, pedagogy, etc.

The main tasks of medical deontology are:

studying the principles of behavior of medical personnel aimed at maximizing the effectiveness of treatment;

exclusion of adverse factors in medical activities;

study of the system of relationships that are established between medical personnel and the patient.

Elimination of the harmful effects of inadequate medical work.

One of the main problems of medical deontology is debt. Medical deontology is defined due to the behavior of a medical worker.

Ethical categories. These include the concepts of "duty", "dignity", "conscience", "honor" and "happiness". These concepts are thousands of years old, they were developed in a variety of ethical theories and teachings.

Debt. Literally means a certain range of professional and social obligations in the performance of their duties, formed on the basis of professional or public relations. The concept of "debt" is quite capacious. In order to properly fulfill a duty, it must be fully realized. In these cases, a person has a need to reasonably fulfill his duties. Fulfillment of duty is inextricably linked with the moral qualities of the individual, the level of public consciousness. A honey worker who has high moral qualities and is well aware of his duty, performs it accurately and efficiently.

The moral duty of a medical worker is: high indicators of medicine in the fight against epidemics, infant mortality, constant improvement of the culture and quality of medical services for the population.

The moral duty of a medical worker is to participate in the social life of the team.

The duty of a health worker.- to show humanism and always provide assistance to the patient, never under any pretext not to participate in actions directed against the physical and mental health of people or threatening their lives.

A medical worker never, under any pretext, has the right to hasten the onset of death, even for a hopeless and deeply suffering patient. He must by all possible means reduce the suffering of the patient and fight for every hour of his life. The appointment of a physician is to prolong, not shorten, a person's life.

The concept of "honor" is inseparable from the concept of duty. The concept of honor in its most general form expresses the social significance of a person (as a person, a citizen, a master of his profession, etc.) It expresses the corresponding self-awareness of a person, that is, her desire to maintain her reputation, good fame, her dignity.

Dignity and honor represent not only an individual's awareness of the social significance of his profession, love for her professional pride, but also a constant striving for moral improvement, professional development and quality of work.

A closely related concept with a sense of duty, honor and personal dignity conscience.In the understanding of conscience, an internal moral self-awareness is represented, the consciousness of a person's moral responsibility for his behavior, an assessment of his thoughts, feelings and actions in accordance with the moral norms in force in society. Conscience is the inner moral judge of MAN. Conscience is combined with such moral values \u200b\u200bas honesty and truthfulness, justice and moral purity, respect for the rights of others and for one's duties. In the understanding of people, a medical worker is a person with a clear conscience, crystal honesty, fair and highly moral.

A sense of conscience can truly develop only in people who live by the interests of the collective, the people and who are fighting for these interests. Conscience is linked to self-esteem. It is inseparable from the ideological and conviction of a person. Public opinion is of immense importance for the education of conscience. The opinion of the team awakens a person's conscience, strengthens, helps to understand their shortcomings, subject them to criticism and correct them. Conscience is, first of all, an awareness of one's social duty.

The medical workers are entrusted with a huge social duty - taking care of the preservation of people's health and returning sick people to the stand, i.e. they are entrusted with the most precious - the health and life of people .. The solution of many issues of family, household, production, social nature most of all depends on the conscience, moral culture of a person.

In philosophical and ethical systems, the concept of "happiness" was considered as the starting point for all ethics. The question of happiness is a question about the meaning of life, which people see in giving their strength to society, backgammon.

The concept of happiness, a happy life is inseparable from the concept of health. Without good health, there can be no complete happiness.

Ethical qualities:

Appearance

Accuracy

Tidiness interior

Moral qualities (inner peace)

Take part in the social life of the team

A sense of partiotism

Honesty

Philanthropy

Intellectual qualities:

Versatile development (sociability) to be able to maintain a conversation depends on being well-read.

Heart heal with heart

It is not a place that paints a person, but a person a place.

choosing medicine, give it all

The word heals, the word hurts

Euthanasia, as the act of deliberately killing a patient, is unethical.

Palliative medicine is the active, holistic care of the incurable.

A public institution dedicated to incurable cancer patients with the aim of providing palliative care is a hospice. Medical ethics is the science of morality.

Ethical and deontological features of the work of nursing staff. Lecture. "Nursing Ethics and Deontology". Deontological aspects of student learning

Ethics and deontology of healthcare professionals: general principles

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