Medical Ethics: Real-World Application
By Afshin Nasseri

You may have acquired this book as a result of conflicts with peers, administrators, patients, or State Medical Boards, where the outcomes of those interactions have left you wondering, “…what if I had done things differently?"

Medical Ethics: Real-World Application By Afshin Nasseri

You may have acquired this book as a result of conflicts with peers, administrators, patients, or State Medical Boards, where the outcomes of those interactions have left you wondering, “…what if I had done things differently?”

In that case, I hope that this book answers some of your questions and guides you with regards to any future quandaries you may encounter.

If you are a healthcare worker seeking to understand the subject of medical ethics, then I hope this book helps you acquire the clarity you seek.
If you are an individual simply curious about medical ethics, then I raise my hat to you for your pursuit of knowledge.

Meet Afshin Nasseri

Dr. Nasseri has dedicated most of his adult life to Internal Medicine. He spent 20 years as the sole physician in his large primary care practice, focusing on a variety of patient issues such as hypertension, hypercholesterolemia, thyroid disorders, men’s health, diabetes, arthritis, and mental health issues encompassing anxiety, depression, and stress management. He also created primary care facilities at two different hospitals lacking primary care infrastructure and was responsible for establishing standards of management and practice for the facilities. Dr. Nasseri also assisted in ICU and CCU infrastructure development for one of these facilities, by establishing protocols for care in a high-growth environment.

Over his extensive professional career and experience, he came to the realization that there must be a better way to improve patient compliance, lifestyle, and behaviors, and became a certified Health Coach and Life Coach in order to improve the lives of his patients.

Early in his medical career, he was recognized as an accredited teacher to Brown and Boston University medical students and interns. Dr. Nasseri is an active leader at GRACECares, Inc. a nonprofit organization aimed at community development through mindful empowerment and works with the Lucknow Project and a variety of local organizations to provide free healthcare and medicines to rural villages in Uttar Pradesh, India.

He is an accomplished member of the American College of Physicians, the Harvard Institute of Coaching, the American Society of Laser Medicine, the Obesity Medicine Association (OMA), the Mindfulness-Based Stress Reduction Program (MBSR) at Brown University, and is certified by both the Fowler Institute of Coaching and the Beck Institute in Cognitive Behavioral Therapy.

He is fluent in English, Spanish, French, and Farsi (Persian). He has lived and worked professionally in a variety of countries and has rich cultural background and understanding which allows him to connect with clients and patients from across the world.

Genetic Testing, Precision Medicine, Research

Genomic testing may predict diseases and susceptibility without the ability to improve therapeutic measures for prevention or cure. Patients should be educated about the benefits, risks, limitations, and outcomes of genomic testing. A referral of the patient to a clinical geneticist or genetic counselor is the most prudent path given that physicians are not all regularly trained and educated on this subject matter.

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Mental Health

A patient with the clear capacity to understand, or one who clearly does not have capacity, does not need a psychiatric evaluation. However, a mental health evaluation can help in questionable cases to further assess capacity. For example, suicidal patients lack the capacity to understand as active suicidal ideation is a sign of impaired judgment. Or, a patient may have a history of bipolar disorder making it impossible for him/her to manage his financial decisions.

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Medical Etiquette, Doctor to Doctor

There are certain standards of professional behavior, that physician’s practice in their relationship and conduct other physicians. These behaviors are not considered to be medical ethics issues. A physician expects his/her phone calls to a fellow physician be taken promptly and be seen equally promptly when visiting a physician’s office. This extension of courtesy exists since physicians are often consulting about patients with other physicians.

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Physician Patient Relationship

The physician-patient relationship is the core of practice of medicine and is a relationship of confidentiality and trust. The physician must honor this sacred relationship by acting in the patient’s best interests. Acceptance of all patients without discrimination, including age, disability, gender identity, language, marital and family status, medical condition, ethnic origin or political affiliations, religions, sex, sexual orientation and socioeconomic status, is necessary.

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Medical Records, Error & Correction

In the case of a chart error, the doctor should draw a line through the error, and initial next to the correction. Hence, anyone reading the chart would see the original content, and this ensures that medical errors are not being concealed.

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The term ‘confidentiality’ refers to the protection of sensitive information. Health care providers respect confidentiality by protecting personal health information to others who have no right to the information and by safeguarding patient information from those without authorization. Providers can violate this duty both intentionally and unintentionally. An unethical physician might intentionally breach confidentiality by selling information about a celebrity patient to a journalist. A nurse might inadvertently violate confidentiality by discussing a patient’s condition with a co-worker in a public area where it may be overheard by other patients or visitors.

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Informed Consent

Medical decision-making is ideal in a setting where patients are empowered to make informed decisions regarding their health by being provided with adequate information regarding their health with respect and acceptance.

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Decision Making & Competence

Competency is a legal term and determination of competency ultimately lies with the judicial system. All adult patients are considered competent unless specifically proven otherwise in a court of law. Physicians, however, can determine whether a patient has the capacity to properly comprehend his/her medical condition through neurological examinations including testing memory, comprehension, reasoning, and judgment. Furthermore, laboratory studies can be used to determine any organic abnormalities to determine any underlying pathology which may affect a patient’s capacity.

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Code of Ethics and Professionalism

Ethics have been one of the building blocks of medicine since the time of Hippocrates, where the medical profession was first conceptualized, and the first public promise was made for physicians to place the interests of the patients above their own.

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