Learning outcomes

1. Recognize the humanitarian aspect of activity in the service of health based on the doctor-patient relationship, both in care and in teaching and research.
2. Distinguish between the paternalistic conception of the doctor–patient relationship, deriving from the Hippocratic tradition, and the modern, more egalitarian approach which gives all protagonism to the patient.
3. Acknowledge the importance of medical confidentiality and identify exceptional cases in which it should be waived to the benefit of society or patients themselves.
4. Protect patients' right to health.
5. Understand and bear in mind the consequences of breaching trust and taking advantage of the vulnerability of a sick person.
6. Identify the major social and professional repercussions that a breach of professional confidentiality could have on a patient.
7. Show caution regarding the disclosure of confidential information and never do this without the patient's explicit consent.
8. Interpret medical confidentiality as a contract between society and the doctor rather than a personal contract (doctor–patient).
9. Describe justice as one of the basic principles of bioethics.
10. Distinguish between the different senses of the concept of justice (commutative, distributive, legal, social), bearing in mind that bioethics use one of these almost exclusively: that of social justice.
11. Describe the healthcare services that should be equally available to all citizens.
12. Describe the concept of ethics of minimums based on the protection of physical, mental and spiritual integrity of individuals (principle of non-maleficence) and protection of interpersonal and social integrity, avoiding discrimination, marginalisation or segregation of some individuals by others at the level of basic coexistence (principle of justice).
13. Describe the concept of ethics of maximums based on the notion that every human being aspires to perfection and happiness, and therefore to the maximum, in accordance with their religious, moral, cultural, political and economic and other values.
14. Appreciate the growing importance of patient autonomy as described in all modern codes of conduct.
15. Avoid giving misleading information for charitable reasons, which does not mean that information should be given brusquely and without empathy.
16. Interiorise the commitment to defend patients' autonomy: respect the right of those who are able to make the decisions that affect their lives in accordance with their values, desires and preferences, free of coercion, manipulation or interference.
17. Understand that information, however negative it may be, should contain an element of encouragement, which is achieved when doctors effectively show that at no time will they abandon the patient.
18. Recognize one's own limitations and welcome help from colleagues in taking decisions on patient care.
19. Accept the ethics of the second opinion.
20. Develop teamwork skills.
21. Commit to the use of scientific methods in professional activity, which, in the case of healthcare is often called evidence-based medicine.
22. Inform patients when using non-conventional or symptomatic treatments for their condition and of the importance of not abandoning any necessary treatment, warning them in a clear and understandable manner that the treatment is not conventional or a substitute.
23. Coordinate with the doctor responsible for basic treatment.
24. Recognise that doctors' first loyalty must be to their patients and that the latter's health must be prioritised over any other advantage.
25. Respect patients' religious, ideological and cultural convictions, unless these conflict with the Universal Declaration of Human Rights, and prevent one's own convictions from impinging on patients' decision-making capacity.
26. Acknowledge that the right to health protection exists in all developed countries, notwithstanding any difficulties in obtaining the corresponding resources.
27. Report all professional activities with scrupulous accuracy in individual patient records, both to serve as a reminder of the actions taken and to facilitate follow-up work by colleagues.
28. Define the basic principles of medical records and the information they contain, as the absence of principles is the source of many conflicts and discrepancies that occur in the legal treatment of medical records, and therefore a common source of insecurity in the healthcare sector.
29. Maintain data confidentiality.
30. Ensure proper, justified use of patient records that are required for use in legal proceedings.
31. Understand that the patient record is the shared intellectual property of the patient, the doctor and the institution in which it was made.
32. Understand that medicine is not an exact science and that, accordingly, doctors can commit errors.
33. Differentiate between error and negligence.
34. Describe how health is not merely the absence of disease but also all physical, psychological and social conditions that allow maximum plenitude and autonomy of the person.
35. Become aware of the duty to relieve pain and suffering caused by disease and to care for those who cannot be cured.
36. Give information in an understandable and prudent, also including preventive measures to prevent infection and spread of the disease.
37. Give this information to family-members or carers of dependent patients.
38. Define informed consent as a gradual process within the doctor–patient relationship, under which competent patients receive sufficient, comprehensible information from doctors, which enables them to participate voluntarily, consciously and actively in decision making with respect to the illness.
39. Explain that consent is generally given verbally, but that it occasionally needs to be in writing.
40. Maintain and sharpen one's professional competence, in particular by independently learning new material and techniques and by focusing on quality.
41. Communicate clearly, orally and in writing, with other professionals and the media.