The Italian Code of Medical Deontology. Historical, ethical and legal issues

Ethics and humanization of care: Reflections in the teaching of French institutional psychotherapy experience

French institutional psychotherapy, developed by Jean Oury and his team at the Clinic de la Borde, has played a significant role in the evolution of psychotherapeutic practice, highlighting the importance of considering the institutional context as a determining factor in understanding and treating mental disorders. This innovative approach, based on recognition of asylums' pathogenic effects, has placed particular emphasis on the humanisation of treatment and the application of bioethical principles within psychiatric institutions. This article aims to investigate the key elements of French institutional psychotherapy, analysing its relationship with bioethics and its contribution to the humanisation of care.

Information obligation in surgery

The following article aims to clarify the guidelines needed for the gaining of informed consent in surgery treatments.  Legal dispositions in the provisions of law n. 219/2017, written according to the regulatory mechanism uphold by the Italian Supreme Court and medical code of practice have been properly analyzed in order answer the questions unanswered by the law. Who is supposed to inform the patient? About which risks?  Does the patient's characteristics affect information obligation? Is necessary to add more information than those required by the law? How do emergency and urgency affect information obligation? Can the patient give consent in advance to an additional operation during the undergoing surgery, if needed? The answers provided by the law and by the Italian Supreme Court picture a state of obligation, where the single physician risks to encounter several responsibilities. It's important to face this problem inside sanitary facilities, creating a suitable informed consent form and planning surgeries to allow the usage of personal data according to the patient's need.

Same-sex parenting according to the Italian Constitutional Court: the need for legislative solutions

The authors have set out to analyze the most recent Italian Constitutional Court jurisprudence (rulings n. 32 and 33/2021) on the issue of surrogacy, by contextualizing the underlying factors and possible implications. The judges argue that their decisions are grounded in the best interest of the minor, whether born from surrogate motherhood or from heterologous fertilization, and believe that a legislative intervention to regulate the issue can no longer be postponed. According to that rationale, the legislator should take into account the difference between surrogacy and heterologous fertilization, and therefore the recognition of intentional parenthood cannot be unconditional, but must be differentiated, depending on the fertilization technique used.

Physicians' perception of the importance of ethical and deontological issues in a major Italian Province: pilot questionnaire and its validation

BACKGROUND AND AIM

This study aims at validating a questionnaire on physicians' knowledge and perception of deontological and ethical rules that guide the medical profession, in a major Italian Province.

METHODS

We designed an on-line survey questionnaire. Participants (N=200) were asked to fill in information regarding their demographic features and knowledge of the deontological code.

RESULTS

Concerning the preliminary data, the median total score on knowledge of the deontological code was 0.50. A significant difference in the total score was observed among education groups. Specifically, the median total score among subjects with a specialist qualification was significantly lower than among those with only a medical degree.

CONCLUSIONS

The tested instrument and methodology appear to be efficacious and reliable. Our preliminary data indicate that knowledge of the rules concerning medical deontology and the related principles of medical ethics seems to be very limited. Therefore, the authors plan to implement a second phase of the study, which will consist of the questionnaire' distribution to a broader and more representative sample.

Thomas Percival. Discussing the foundation of Medical Ethics

BACKGROUND AND AIM OF THE WORK

In 1803, the English physician Thomas Percival published Medical Ethics, a work destined to become a milestone in the development of modern codes of medical ethics, starting from the first edition of the American Medical Association's ethical code. Notwithstanding the undeniable influence that this book has exerted upon the codification of the principles of medical ethics, researchers and experts foster different and opposing points of views on its real nature. They question whether Medical Ethics truly belongs to the literary genre of codes of medical ethics or, better yet, to that of medical etiquettes.

METHODS

This debate is crucial in the field both of medical history and of medical ethics, with regard not only to Percival's work, but also to the ethical value of the current codes of medical ethics and deontology.

RESULTS

The lack of a rigorous philosophical-moral analysis of the current medical codification is reflected in its mere loyalty to the legal regulation, in substantial continuity with the past. However, the constant challenges proposed by the biomedical development, require the need to rethink the traditional conceptual tools of the current codes of medical ethics, with the purpose to achieve new schemes and innovative solutions.

CONCLUSIONS

On this perspective, when the codes of medical ethics are worked out by physicians, they could be considered as wrongly titled medical etiquettes. This consideration could regard current codes of medical ethics, that remain faithful to tradition and that would more probably be codes of medical etiquette with a wrong title.