Ethics can be defined as the study of what is right or wrong in human behaviour. It sets guidelines for human behaviours, norms and actions as people interact together in the environment. It is also the aspect that enables one to attain certain standard of performance in any relationship therefore; ethics is the study of the ideal human conduct and put one in touch with ones daily activities.
There are two broad graps.
(1). Descriptive Ethics (2). Normative Ethics.
Descriptive ethics describes the norms in the society. It give the best way that one can interact with other people.
Normative Ethics it deals mainly with one profession. It gives one the objective of achieving certain high level of performance in your profession.
Subareas of normative ethics- medical ethics, business ethics, legal ethics etc.
Medical ethics is a branch or normative ethics that gives the guidelines, code of conduct, dos and donts to be observe in order to achieve a high level of performance in our medical profession as we relate with the society.
Scope: Medical ethics that relates to health care called Health care ethics one that relates to HC Institution ethics and biomedical research ethics.
Health care ethics.
(1). Community needs Vs individual rights.
Individual may be distracted thought against its human right, if he constitute nuisana to the society. E.g Isolating a TB pt or guarantine of a deseased pt for the least incubation period.
(2). Ethics of privacy:
1. Says that a pt has a right to his/her privacy, so examination of pt should be in private. It also says that when you examine the opposite sex, it must be in the presence of a chaperone. Who is of the same sex as the pt.
2. Keep the secrets of the pt. only those directly involved with the management of the pt should have access to the secret. Those secrets kept on computers to pass word, so the secret of the pt must remain a secret.
“Data of pt should be kept secrete, other persons except medical practitioner involved in the blatant should not have access to it”.
3. Ethics of screening for dx. Says that results of screening for dx should not be carelessly communicated.
4. Ethics of assisted reproduction: says that couples going for in-vitro fertilization should be helped only after informed consented. They must be told abt all the possibilities.
5. Ethics of De-institutionalization (for eg, institutionalizing a psychiatric pt) says that if you have been treating a pt, before you can discharge the pt, you must certify them fit to go into the society.
Health care institution Ethics.
1. Ethics of the declaration of Geneva: this is common to both Health care ethics & health care institution ethic says that all newly graduated doctor must swear to Hippocratic oath otherwise known as the physical oath. And they must use the statement therein as a guide to their daily practice.
Respect for teachers & senior colleague.
Respect for human life right from conception until death.
No consideration for race, sex, religion in your practise.
Keep secrete of pt.
2. Ethics of medical training: This gives authority to training of med personnel by accredited med such. It gives guidelines for qualification for admitting students, the minimum knowledge they must acquire during their training and the code of conduct for them to achieve the max. Standard of training include post graduate training and research methodology.
Biomedical Research Ethics.
1. Nuremberg code of 1947-1st international code of ethics in research involving human subjects. The code emphasizes the subjects voluntary consents and it sets a stage that animal expt should proceed human expt.
It also state that human subject must be qualified, protected from injuries, disabilities and even death and that the human subject has a right to opt out of the research at any point.
2. Declaration of Geneva in 1948 has amended in 1968, also called the physician’s oath.
3. Declaration of Helsinki of 1964: This emphasize the right of the human subject to enter into the research and their right to discontinue at any point in time.
4. Declaration of Sydney 1968: This is related to assisted or willful termination of life called Euthanasia.
5. Oslo’s declaration 1970.: This related to therapeutic abortion. It states that abortion should only be performed as a therapeutic method by a competent doctor. However, places where abortion is legalized, a doctor who will not perform abortion should refer the pt to a competent doctor who is willing to do it.
6. Tokyo’s Declaration: This says that a doctor should not take part in any form of human degradation nor provide instruments for such practices.
WATER
QUALITY OF WATER.
H20 must be free from pathogens:- Biological characteristics of good H20. it must not contain dx carrying organism.
Physical characteristcs:- clear in appearance, odourless, tasteless. It must not be turbid.
Chemical characteristics:- must be free from toxic chemicals and there are minimal acceptable cone of chemicals.
SOURCE OF WATER.
Surface water and Deep water.
1. Domestic crises-for cooking, washing, bathing, gardening, flushing of toilets.
2. Public uses – swimming pools, ornamental pumps, recreational centres.
3. Industrial uses – cooling & processing of materials.
4. Agricultural uses – irrigation & farming.
5. Power uses – Hydropower and steel power.
6. Carrying away of waste i.e. for sanitation purposes.
SOURCES OF WATER
1. Rain purest in nature provided collection points are neat but it dissolves the minerals in the atmosphere. Where it passes. It’s always clear. It tends to become impure as it passes atmosphere
2. Surface waters come under rivers, lakes, tank, ponds, and seas. They use contain a lot of impurities and heavily contaminated by people and animals.
3. Deep sources of water called the ground water: The cheapest and the most practical means of providing water to many comm...
Advantages.
1. Very likely to be free from pathogens.
2. Usu. requires no treatment.
3. Likely going to be assure of supply all year round.
4. Not subject to contamination by human activities Eg. Wells.
Two types: shallow & deep wells.
Shallow well. Deep well.
Def: taps water from above 1st impervious layer Taps water below
the list impervious layer
Chem. Qity Moderately hard Much harder.
Bacteriology Often grossly contaminated Taps a purer
source of water
yield Often go dry industry produce a more
month of the year constant supply of H20
Shallow Deep
SANITARY WELL
This is one that is properly located, well constructed, well protected from contamination.
Location – a good well should be located not less than fifty from a likely source of contamination. The well should be located at a higher elevation from the source of contamination. If a well is too far away, people will not use it.
Lining of the well- set in stones or cements. From top to bottom leaving only about into the surface depth of the well. There is parapet above the surface of the well,
Platform- should beslant to the grand.
Cover- from covering the well.
Drawer or powered pump or hand pump- for collecting water from the well.
CONTAMINATION OF WATER
Water related dx can be classified into 5 groups.
(1). Water borne dx eg cholera, dysenteries, thpholh, hepatitis A, poliomyelitis, Typhoid x paratyphoid fever.
Preventive strategy is (i) improve the quality of drinking water,(ii) prevent casual use of unprotected sources of water e.g surface water.(iii) public health education.
(2). Water based dx – transmitted that human contact. Infective agents for these dx spend some times in the aquatic environs e.g schistosomiasis, flukes, guinea worm, and paragonimiasis.
Prevention
- Water supply.
- Reduce the need for contact with infected water.
- Avoid water contamination.
(3) water washed dx- these are all water borne dx that affects skin and eye (infections) e.g Trachoma, conjunctivitis ;scabies.
Prevention
– Water quantity.
– Improve access to reliable water supply.
(4) Water related insec vecror- Malaria, onchoruasic, fuariasis, yellow feller, toypanesmiasis etc.
Prevention
- Improve surface of water managent i.e destroy br ending sites of insects use mosquito nettings e t c.
(5) After chemical dx- shortage of chemical like in iodine causing endemic goities.
Prevention
- Provide iodine supplementation.
(6) To excess of the chemical as in fluorine causing. flourorsis and dental caries.
Prevention:
Deglutination
WATER PURIFICATION
(1). protection of the water source. Be aware that industrial chemicals pose a great hazard to the water.
Agricultural x industrial contaminants should be avoided.
The catchmt area should be properly protected. Protection from human contamination on the source of the water.
(2). Store the water – stored to meet the comm. Needs for all year round. Storage of the water will remove microform esp. when strong for about two weeks, org die naturally. Storing for more than two weeks, algae will grow. Storage helps to sediment solids in the water.
(3). Make for sedimentation or coagulation- Addition of aluminum sulphate.It causes sedimentation or flocculation/percolates the final materials in the water.
(4) Filtration- This removes pathogenic bacteria, protozoasis and large virus. Smaller viruses will pass through the filter, they are called filterable viruses. For commercial filteration, there are the sand filtre, water passes through a fine sand graded bed in acts to filter it.
(5) Disinfection of water- Aims at complete destruction on the micro organism that has heat, ultraviolent rays, boiling, and chemicals. The commonest method is used of chlorine (chlorination). Gaseous chlorine is used to disinfect commercial scale water solid chlorine in form of bleaching powder. Liquid – Jik.
Other chemicals that are used are iodine, ozone, potassium permanganate e.t.c.
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