Internal Medicine — Ethics, Deontology and Clinical Communication Skills

Internal Medicine · Clinical Specialties

How it begins

The technical competence of the internist is a necessary but not sufficient condition for excellent medical practice. Decision making in scenarios of uncertainty, conflict of values and human vulnerability requires a rigorous mastery of clinical ethics, compliance with deontological duties and a sophisticated set of communication skills. This document integrates the philosophical foundation of…

What it covers

1. Ethics, Morals, Deontology and Bioethics: Conceptual Delimitation
2. · Hierarchical relationships and overlaps
3. · Ethics of minimums and maximums
4. Historical Genesis of Modern Bioethics
5. The Four Principles of Bioethics (Principlism)
6. · Hierarchization of Diego Gracia: the proposal of the two levels
7. · Alternative and complementary currents to principlism
8. Medical Ethics: Codes, Oaths and Professional Duties
9. · Deontological reference documents
10. · Essential deontological duties of the internist
11. Informed Consent
12. · Constitutive elements (validity of the IC)
13. · Form: verbal vs. written
14. · Representation and consent by substitution
15. · Anatomy of information: the disclosure standard
16. · Special situations of consent
17. Confidentiality, Medical Secrecy and Data Protection
18. · Limits and legitimate exceptions to secrecy
19. · The duty to warn: the Tarasoff doctrine
20. Capacity, Competence and Evaluation of Decision Making
21. · Appelbaum and Grisso criteria (the four standards)
22. Ethics of the End of Life
23. · Advance directives and prior instructions
24. · Fine differentiation: killing vs. let die, action vs. omission
25. · Organ donation and diagnosis of death
26. Justice, Resource Allocation and Equity
27. · Assignment criteria (triage and scarce resources)
28. Ethics and Deliberation Methodology Committees
29. · Deliberative method of Diego Gracia (case analysis procedure)
30. Clinical Communication: Interview Models
31. · From the biomedical model to the biopsychosocial and patient-centered model
32. · Essential communication skills
33. Bad News Communication: SPIKES Protocol
34. · Emotion management: the NURSE acronym in detail
35. · Communication of prognosis and uncertainty
36. Difficult Communicative Situations and Care of the Professional
37. · The difficult patient (or the difficult encounter)
38. · The aggressive patient
39. · Communication of medical error (disclosure)
40. · Intercultural communication and barriers
41. Integrative Synthesis
42. · Glossary of acronyms and key terms