Values-Based Medicine Is an Ethical Concept for Implementing the Ethical Principles in Daily Practice.

Values-based medicine (VsBM) is an ethical concept, and bioethical framework has been developed to ensure that medical ethics and values are implemented, pervasive, and powerful parameters influencing decisions about health, clinical practice, teaching, medical industry, career development, malpractice, and research. Neurosurgeons tend to adopt ethics according to their own values and to what they see and learn from teachers. Neurosurgeons, in general, are aware about ethical codes and the patient's rights. However, the philosophy, concept, and principles of medical ethics are rarely included in the training programs or in training courses. The impact of implementing, observing the medical ethics and the patients' value and culture on the course, and outcome of patients' management should not underestimate. The main principles of medical ethics are autonomy, beneficence, nonmaleficence, justice, dignity, and honesty, which should be strictly observed in every step of medical practice, research, teaching, and publication. Evidence-based medicine has been popularized in the last 40-50 years in order to raise up the standard of medical practice. Medical ethics and values have been associated with the medical practice for thousands of years since patients felt a need for treatment. There is no conflict between evidence-based medicine and values-based medicine, as a medical practice should always be performed within a frame of ethics and respect for patients' values. Observing the principles of values-based medicine became very relevant as multicultural societies are dominant in some countries and hospitals in different corners of the world.

Code of Ethics and Professional Standards of Conduct for Emergency Management Professionals.

The Code of Ethics and Professional Standards of Conduct for Emergency Management Professionals (2022) was recently created to further delineate the ethical boundaries and conduct expectations for professional emergency management practice. Significantly, the code of ethics provides an essential foundation toward recognition as a profession with hallmarks of monopoly, autonomy, and authority. The code and standards of conduct establish a clear definition of the role emergency management has in overseeing a complex, diverse risk portfolio that protects lives, livelihoods, and quality of life. The document captures the intent, challenges, dimensions, and significance of emergency management practice in a rapidly changing world and brings ethics to the forefront of decisions. This article speaks to the discursive dialogue toward, methodological development of, and future tools for integrating into practice the Code of Ethics and Professional Standards of Conduct for Emergency Management Professionals.

The revised International Code of Medical Ethics: an exercise in international professional ethical self-regulation.

The World Medical Association (WMA), the global representation of the medical profession, first adopted the International Code of Medical Ethics (ICoME) in 1949 to outline the professional duties of physicians to patients, other physicians and health professionals, themselves and society as a whole. The ICoME recently underwent a major 4-year revision process, culminating in its unanimous adoption by the WMA General Assembly in October 2022 in Berlin. This article describes and discusses the ICoME, its revision process, the controversial and uncontroversial issues, and the broad consensus achieved among WMA constituent members, representing over 10 million physicians worldwide. The authors analyse the ICoME, including its response to contemporary changes and challenges like ethical plurality and globalisation, in light of ethical theories and approaches, reaching the conclusion that the document is a good example of international ethical professional self-regulation.

Development and validation of the code of ethics for midwives in Iran.

BACKGROUND: Considering ethical issues in midwifery care is essential for improving the quality of health services and the client's satisfaction. This study aimed to develop and validate the code of ethics for Midwives in Iran (ICEM). MATERIALS AND METHODS: This was a mixed sequential study that was performed in three phases including a qualitative study, a review, and the content validity assessment. The first phase was a qualitative study with a content analysis approach. The data were collected by conducting in-depth semi-structured individual interviews with 14 midwifery and ethics experts. The purposive sampling method was used to recruit the participants and sampling continued until data saturation. The data were analyzed using the conventional content analysis described by Graneheim and Lundman. Lincoln and Guba's criteria were used to confirm the trustworthiness of the data. Then, a narrative review of the selected national and international codes of ethics for Midwives was performed to complete the items of the ICEM. For validity assessment, the face and content validity of the items of ICEM was assessed by 15 experts to calculate the content validity ratio (CVR) and index (CVI). RESULTS: Fourteen experts were interviewed in the qualitative phase, and 207 codes were extracted from a content analysis which were categorized into 23 sub-categories and 6 main categories. The extracted codes were considered as the items for ICEM that were completed by a review of the selected national and international code of ethics for Midwives. The content validity and ratio assessment of the items demonstrated an average CVI = 0.92 and CVR = 0.85. Then, the final version of ICEM was developed with 92 items in 6 domains about; 1) "professional Commitments" with 30 items; 2) "providing midwifery services to the client and her companions" with 26 items; 3) "relationship with colleagues" with 11 items; 4) "herself" with 6 items; 5) "education and research" with 8 items; and, 6) "management" with 11 items. CONCLUSION: ICEM was prepared with 92 items in six sections that facilitate its use for midwives who are working in the different fields of care, counseling, education, research, and management. In this new version of the ICEM, the items related to recent social-, scientific, and technical improvements were considered for providing ethical midwifery care.

An ethical code for collecting, using and transferring sensitive health data: outcomes of a modified Policy Delphi process in Singapore.

One of the core goals of Digital Health Technologies (DHT) is to transform healthcare services and delivery by shifting primary care from hospitals into the community. However, achieving this goal will rely on the collection, use and storage of large datasets. Some of these datasets will be linked to multiple sources, and may include highly sensitive health information that needs to be transferred across institutional and jurisdictional boundaries. The growth of DHT has outpaced the establishment of clear legal pathways to facilitate the collection, use and transfer of potentially sensitive health data. Our study aimed to address this gap with an ethical code to guide researchers developing DHT with international collaborative partners in Singapore. We generated this code using a modified Policy Delphi process designed to engage stakeholders in the deliberation of health data ethics and governance. This paper reports the outcomes of this process along with the key components of the code and identifies areas for future research.

[Evolution of Spanish Deontology (1978-2022). What has changed in the last 40 years?] / Evolución de la deontología española (1978-2022) ¿qué ha cambiado en los últimos 40 años?

The article reviews the evolution of the deontology of the Spanish Medical Organization through how it has been reflected in the diverse codes of deontology approved by this institution. After an approximation to the spirit and contents of the first Code of ethics approved in 1978, born after the Spanish Constitution, passed that same year, which established the recognition and the need to regulate professional associations and the exercise of qualified professionals. The 1978 Code is compared with the one recently approved in December 2022, using the second 1990 Code as a bridge. In the comparison we find many bioethical issues on which, through the last decades, reflections have been made and answers have been introduced that respond to the many social and technological changes that have occurred. Special reference is made to the concept of respect, embodied in the relationship between the doctor and the patient. It is a relationship that is often not symmetrical because the sufferer may feel or endure extreme vulnerability. The article also reflects on the evolution of relevant issues or those that may raise more controversies, such as respect for initial and final life. The synthesis of the current 2022 Code of Medical Ethics can be done in three words: Respect and Human Rights.

[The new code of medical ethics (2022) and its general principles]. / El nuevo código de deontología (2022) y sus principios generales.

The article describes and analyses the General Principles of the 2022 Code of Medical Ethics that are included in the articles 4 to 6 of the second chapter. The General Principles make it possible to understand and interpret the set of precepts and recommendations of the code, for which reason the study of this second chapter is of special relevance. In addition, I contextualize General Principles by relating them to other current international ethical-deontological documents. We will also review how they are extended in the broad articles of the new code. We will observe that there is a clear relationship between the General Principles of the new code with respect to previous Spanish Medical Codes, which is logical since they gather permanent values of Medical Ethics. In the General Principles is proposed that each doctor is at the service of the human being and of society and has as primary duties, respect for human life, dignity of each person, as well as the health care of the individual and the society (Article 4.1).

[Quality in medicine as a deontological requirement]. / La calidad en medicina como obligación deontológica.

Medical practice has two main dimensions, one scientific and the other human, and in both, the commitment of the doctor is essential. Medical deontology, as a branch of ethics that deals with the duties and obligations of doctors, embodies in the codes of deontology the ethical principles and standards of mandatory compliance. From this point, medical practice should guarantee that patients receive an quality medical care, and to be treated with dignity and respect. In December 2022, the General Council of Official Medical Associations of Spain published a new version of the Spanish Code of Medical Ethics that aims, among other purposes, to standardize medical care of scientific and human quality. Medical practice supported by scientifically-based medicine, lex artis medica, patient safety, professional responsibility, honesty and integrity are some of the aspects that in this updated document of medical ethics frame and define the work of the doctor for a performance of medicine with quality.

Scientific consensus views are useful, but dangerous, without a code of ethics.

Using the Fukushima accident experience, this letter discusses recent efforts on measuring scientific consensus views-that is, quantifying the agreement among scientists. In the field of radiological protection, the efforts to measure scientific consensus views deserve attention, because hoaxes have been spreading even after the Fukushima nuclear accident. We discussed two points. First, the visualization of the diversity of scientific opinions shatters the diversity illusion caused by the mass media's irresponsible dissemination of pro and con arguments. Second, the use of scientific consensus views without an ethical code is dangerous. Measuring scientific consensus views should be accompanied with the development of ethical guidelines on using it.

The new Code of Ethics of the World Psychiatric Association: A fresh look at the ethical issues of the psychiatric profession.

This article develops the WPA's new Code of Ethics that was developed in 2020. It succeeds the Declaration of Hawaii of 1977 and the Declaration of Madrid of 1996. The Code is divided into four sections that cover the practice of psychiatry in clinical practice, education, research and publication as well as public mental health. We will discuss the new ethical issues that this Code raises in parallel with the development of psychiatry and psychiatrists' role in society in recent years.

The promises and limitations of codes of medical ethics as instruments of policy change.

Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to prompt calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and 'multivocal', that is, they usually underdetermine or provide more than one answer to the question, 'What should I do now?' Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation-collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine.

Spheres of Morality: The Ethical Codes of the Medical Profession.

The medical profession contains five "spheres of morality": clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients' well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between them frequently, creating the possibility of conflict between the ethical obligations of their various roles. This paper examines the entire moral landscape of medicine through the lens of role morality. It develops a novel framework that helps physicians recognize how their moral commitments depend on the nature and context of the situation, clarifies ethical conflicts that physicians face, and concludes with ideas for resolving these conflicts.

The Ethical Code of Conduct for Physiotherapists-An Axiological Analysis.

The goal of the article is an axiological analysis of the Ethical Code of Conduct for Physiotherapists. The basic ethical values constituting the axiological basis of physiotherapy are care, professionalism, responsibility, fairness, professional integrity, respect for a patient/client's dignity and autonomy. Those values have been selected from the theory and practice of physiotherapy, but also from socio-cultural conditions influencing the relations and interdependencies between physiotherapists and other professional groups or society as a whole. Those values can exist as qualities of a subject (a physiotherapist) or as functions realised by them (acting for the welfare of a patient/client, society, profession). Some of the analysed values have been directly enumerated in the Ethical Code of Conduct for Physiotherapists, while others must be deduced from the rules included in this document. The analysed values should be internalised by the physiotherapists during their training and professional practice.

In Defense of the Netherlands Code of Conduct for Research Integrity: Response to Radder.

We assess Radder's criticisms of the Netherlands Code of Conduct for Research Integrity and show that they either miss their mark or depend on controversial background assumptions about the purpose of the Code. Although Radder raises important questions about the broader roles and purposes of research in society, his conclusion that the Code should be revised in the ways he proposes is unjustified.