Ethical and deontological dominants in ophthalmology

Abstract

In the article the ethical and deontological dominants as scientific and practical strategy that prevents the medical errors, and humanization doctor-patient relationship through a formation of culture of communication are presented. Ophthalmology as a branch of practical and scientific medicine requires special relationship between doctor and patient, and because of this it also requires particular ethical and deontological interpretation. Formal signs of ethics laws concerning ophthalmic practice aren’t worth anything in case of unskilled diagnosis and treatment. Possibility of errors on the part of the doctor-ophthalmologist while aiding a patient is of a special importance. In planed and in urgent cases irreparable flaws are not excluded. Consideration should be given, in particular, to the errors in the initial examination, insufficient amount of additional methods of examination, overdiagnosis, errors in determining the treatment strategy (conservative or surgical) and others. Identification and analysis of the errors in order to prevent them is the ethical imperative in medical practice and effective way to improve clinical medicine. The author of the article describes the causes of errors, indicating that they are objective and subjective. The first are related to the change of views on the treatment of a certain disease. The complex of therapeutic measures, that was considered the most rational until recently, can be proven as wrong from the perspective of the latest achievements of science. Mistakes made by doctors in their communication with patients as a result of not following the basic deontological principles are also included here. In addition, the classification of medical errors on deontological, diagnostic, therapeutic is made and their essence is analyzed in the article. The violation of the principles of appropriate behavior of the doctor in treating the patient, that is not following the ethics of medical practice by the doctor, is the base of deontological errors. The main reasons for diagnostic errors are: ignorance or inept use of medical history, incomplete examination of the patient, a false interpretation of clinical data, erroneous assessment of radiological and laboratory tests; carelessness and haste in the examination, the wrong formulation of diagnosis. Medical errors are related to the incorrect clinical diagnosis. As a result of such diagnoses, patients are assigned the treatment that does not correspond to the true nature of the disease, and at the same time the required therapy is not applied. Private practice in medicine promotes the development of many positive human qualities, which include displays of personal responsibility, activity and initiative, self-reliance and independence. But a direct financial interest of the doctor contains the danger of degradation of their internal spiritual and moral qualities. Gradual loss of spiritual qualities of a doctor leads to the loss of professional skills, confidence of patients and eventually - to cease of medical practice as such. The negative effects of private medical practice are analyzed in the article. Continuous efforts to implement in medical practice such qualities as honesty, openness, honesty, kindness, humanity, selflessness and others promotes the strength of the relationship between the doctor and the patient, increases the credibility of doctors in dealing with governmental establishments, the public and patients personally. Timely implementation of new technologies and materials promotes the development of doctor’s creative approach to the process of medical treatment. Also, the author focuses on the problem of doctor-patient communication as a social, psychological phenomenon that encompasses a wide variety of spiritual and material forms of human activity and is its urgent need. The moral value of communication is that it is a direct source of understanding of good and evil through the exchange of activities, their evaluation and judgment. The most difficult problem of humanizing of the relationship between doctor and patient is methodological work of the formation of ethical and pedagogical skills in communication. In medicine ethical guidelines become social direction. Therefore, these aspects of medical ethics and deontology occupy in our article prominent place among professional considerations and advice.