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HOW DERMATOLOGISTS LOOK AT DERMATOETHICS?

Prof Ihab Younis

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في هزائمنا إنفي القتال ميادين

سنة الثالثمائةكانت األخيرةأن إال فادحة

ميادين في هزائمناأفدح كانت األخالق

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Values in medical ethics :• The patient has the right to refuse or

choose treatment• A practitioner should act in the best

interest of the patient• First, do no harm to the patient• Fairness and equality concerns the

distribution of health resources, and the decision of who gets what treatment

• The patient's dignity and right to privacy should be respected at all times in medical care and teaching

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100 Dermatologists

58%

25-35 Y

24%

36-45 Y

18%

>60 Y

23%

77%

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Four categories of questions

• Financial aspects

• Behavior during examination

• Diagnostic aspects

• Therapeutic approaches

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1-Financial aspects

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Do you exempt poor patients from paying your fees?

• Yes:91%

• No:9%

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What would you request necessary or total Investigations?

• Only necessary: 88%

• Total:12%

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Would you guide the patient to a specific laboratory ?

• No:56%

• Yes:44%

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Would you prescribe an expensive drug just for psychological satisfaction of patient despite the presence of a good and cheap alternative?

• Yes:56 %

• No 44%

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Would you exempt a colleague from the rule “first come first

served?”

• Yes:82%

• No:18%

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What do you think about repaying the fees to him/her?

• Agree:95%

• Disagree:5%

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What do you think about writing medical certificate just for the

payment of fees?

• Disagree:78%

• Agree:22%

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2-Diagnostic aspects

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Would you tell the patients that you don't know the diagnosis?

• No:60%

• Yes:40%

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Would you ask a more experienced colleagues if you

don’t know the diagnosis?

• Yes:100%

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Would you tell the patient the complete truth about his

disease?

• Yes:92%

• No: 8%

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Would you inform the patient that his ex- doctor is a cheater?

• No: 83%

• Yes:17%

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3-Examination aspects

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What do you think about discrimination in clinical

examination between simple & rich patients?

• Wrong:97%

• Right:3%

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If the disease is in the genitalia and the patient refuses to disclose it?

• I will refuse to continue examination and repay the fees:50%

• Persuade the patient:25%

• Prescribe a treatment without seeing the lesion:25%

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What do you think about examining a patient in front of his or her

friend?• Wrong:87%

• Yes:13%

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If the patient asked to prescribe a drug for a person, who is not present at your office, What will

you do? • Refuse:68%

• Ask to see the patient and let the patient pays the fees:20%

• Agree:12%

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Have you ever been harassed by a patient during examination?

• No:71%

• Yes: 29%

34% mostly verbal

27% mostly by asking for unnecessary examination of genitalia

Would you like to go back

to intensive care?

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Should we ask the patient’s permission of the for examination

in front of medical student?

• Yes:94%

• No:6%

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What do you think about the discrimination in clinical

examination between Muslim and non Muslim patients?

• Disagree:98%

• Agree:2%

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4-Therapeutic aspects

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Would you prescribe a specific medicine in agreement with a

drug company?

• No:97%

• Yes:3%

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Is cosmetic dermatology beneficial for the patient?

• Yes:66%

• No:34%

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What do you think about using laser removal of pubic hair?

• Agree:57%

• Disagree:43%

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