UNIVERSITY OF ALYARMOK

FACULTY OF MEDICINE
DEPARTMENT OF COMMUNITY MEDICINE

Assessment of Medical students knowledge

and attitude towards patient rights as well as
medical ethics in university of Al Yarmouk
2017-2018

By Moaz musa abdelgadir

SUPERVISOR : DR. Hamza
 Introduction

Background :-
Health as a fundamental human rights was
recognized in the world Health Organization's
constitution stating that the enjoyment of the
highest attainable standard of health is one of the
fundamental rights of every human being without
distinction of race , religion , and political belief ,
economic or social condition .
Medical ethics is defined as a structured
system which aims to present appropriate
strategies for solving the ethics problems in
medical sciences and dentistry .
Patient's rights are a fundamental human right
, a quality assurance measure that protects
patients against abuse and discrimination and
promotes ethical practices .
Since the introduction of the human rights by
the united Nations in 1948 , the world Health
Organization ( WHO ) generated Patient's Bill of
Rights as part of the human rights and
legislations . Patient's Bill of Rights have been
passed all over the world (1) .
 In all countries , laws are endorsed for
adjusting the performance of health specialists . In
fact these laws have been enacted in order to
supported the members of the society against the
inefficient specialists and , at the same time
accurately describe the performance of the
qualified ones . Emphasis on the human rights in
the healthcare , particularly respecting the
patient's dignity , is of utmost importance(2).
Nowadays , improvements in knowledge and
Technology in prevention , diagnosis , and
treatment have provided by physicians with a large
number of decisions which has , consequently ,
resulted in creation of new issues . Therefore ,
teaching the imperious and unfriendly ethical
principles is not sufficient and the students must
be trained regarding new ethical strategies for
solving the problems(3).
Patient's rights vary in different countries
often depending upon prevailing cultural and social
norms but there is growing international
consensus that they include privacy, confidentiality
of medical information, treatment refusal, proper
information on health care service.
Consultation on medical emergencies and
knowledgment of relevant risk of medical
procedures(5).
Problem statement :-
Despite the fact that patient rights are
considered a fundamental human right by
WHO and the Sudanese government
nationally, there is a huge lack of its practical
application in Sudanese hospitals especially
by newly graduated junior doctors , whose
medical school education in the field of
medical ethics is generally regarded as
deficient nation wide and the training of which
is virtually non existent leading to a poor
patient doctor relationship and low patient
satifaction

JUSTIFICATION :-
Patients in 3rd world countries like Sudan
are becoming more aware of their legal
rights as patients and the legal
obligations of healthcare providers
towards them. This is evidenced by rising
legal complaints against medical
professionals and health care institutions.
This raised awareness should prompt a
higher more professional standard of
health care from doctors especially
newly graduated junior doctors. How
doctors are trained, is regarded as a key element in
determining the ethical and legal conduct within
the healthcare sector (3). It is therefore important
to find out from medical students their
knowledge and attitudes about medical ethics and
law and relate it to the knowledge and attitudes of
the people they work with. Various
methodologies have been tried to stimulate
better ethical conduct in healthcare settings
but there are few studies designed to
measure what is known and practised, so
that educational efforts may be better
targeted (4).

OBJECTIVES :-
GENERAL OBJECTIVES :-
To assess knowledge and
attitude of medical students towards
patient rights
SPECIFIC OBJECTIVES :-
1. To assess the degree of
knowledge of medical students
about patients right
2. To assess the degree of
medical students basic
knowledge about medical
ethics
3. To assess medical students
attitude towards patient rights

LITERATURE REVIEW
patients' rights
The legal interests of persons who
submit to medical treatment.

For many years, common medical

practice meant that physicians made
decisions for their patients. This
paternalistic view has gradually been
supplanted by one promoting patient
autonomy, whereby patients and
doctors share the decision-making
responsibility. Consequently doctor-
patient relationships are very
different now than they were just a
few decades ago. However, conflicts
still abound as the medical community
and those it serves struggle to define
their respective roles(6).
- patients' rights
Those culturally and legally specified
rights, claims, powers, privileges, and
remedies due to a person receiving
health care services. They include, but
are not limited to, the following:
1/ The patient has the right, within
the law, to personal privacy and
information privacy, as manifested by
the right to:
Refuse to talk with or see anyone not
officially connected with the hospital,
including visitors, persons officially
connected with the hospital but who
are not directly involved in his care
2/ The patient has the right to expect
reasonable safety in so far as the
hospital practices and environment
are concerned. To address the needs
of patient, visitor and staff regarding
safety and security
3/The patient has the right to know
the identity and professional status of
individuals providing service and
which physician or other practitioner
is primarily responsible for his care
4/Information
The patient has the right to obtain
from the practitioner responsible for
coordinating his care, complete and
current information concerning his
diagnosis (to the degree known),
treatment, pain management, and any
known prognosis
5/The patient has the right to formally
access his medical records
6/The patient may access, request an
amendment to, and/or receive an
accounting of disclosures of their own
protected health information as
permitted under applicable law.
7/Communication
The patient has the right of access to
people outside the hospital by means
of visitors, and by oral and written
communication
 8/When the patient does not speak or
understand the predominant language
of the community, or is hearing
impaired, he/she shall have access to
an interpreter if at all possible. This is
particularly true where language
barriers are a continuing problem
9/H. Consent
The patient has the right to
reasonably informed participation in
decisions involving his/her health care
10/ The patient has the right to know
who is responsible for authorizing and
performing the procedures or
treatment(7)

METHODOLOGY:-
1. Study design :-
Institutional based, descriptive
study
2. Study area :-
University of alyarmouk
 Yarmouk College was established by
a decision of the organizing
committee of the foundation of
private and international education
at its meeting No. (6) dated
23/12/2009 and got the final
approval under the letter of the
Ministry of Higher Education and
Scientific Research / Private Higher
Education Institutions administration
on 24/12/2009, includes the
following programs:
- Human Medicine Program
- Dental program
- Pharmacy program
- Medical Laboratory Program
- Dental industry technology diploma
Locate in Khartoum , al-steen street
and have 2 building.
3. Study population:

Medical student at University of alyarmok

 Female Males No. of student Year
90 60 150 FIRST
55 45 100 SECON
D
55 40 95 THIED
40 40 80 FORTH
50 35 85 FIFTH
30 30 60 SIXTH

Inclusion criteria :
Medical student in clinical years at
alyarmouk university

Exclusion Criteria :
- Students of other programmes except
medicine
- Students below clinical/clerkship
years
- Medical students in other university.

Questionnaire
Age__ gender___ program______
The Patient has right for the following Agree Disagree Don't Know
 To receive compassionate and respectful
care
To ask for opinion of physician
To referred to another health service
provider
Making decisions about treatment and
investigation
Privacy protection and ensure
confidentiality of information
Patients to be informed about their
treatment plans and complication
The right to sue the authorities upon
their ignorance

5-Data collection :
Data will be collected using self administered
questionnaires consisting of 3 parts each aimed at
collecting information for different parts the
researches objective.the first part aims to collect
data on knowledge about patients rights the
second aims at assessing the students attitude the
third assesses basic knowledge on medical ethics
of the students.the first 2 parts use a likerts scale
the last uses a true and false mode. 60 samples
will be handed out.
6-Data analysis : using frequency tables by
SPSS statistical software system version (20).(8)

7-Ethical concern :-
verbal constant will be taken from Participant .

References :
1. Patient rights University of Colorado Boulder.
2. Patient rights University of California.
3. Patient rights and Responsibilities University
of student Health services / Virginia
commonwealth University.
4. BMC International Health and human Rights
Research article Awareness and practice of
patient's rights law in Lithuania.
5. Awareness of responsiveness to and practice
of patient's rights at Uganda's national referral
hospital.
6. Investigation of the Awareness of the students
Shiraz Dental school concerning the patients '
Rights and the principles of Ethics in Dentistry.
7. Knowledge and attitude of Saudi health
professions 'students regarding patient's bill
of rights.
8. wikipedia.
9. (3) (justification) Aarons de. Issues bioethics
teaching medical ethics to health professionls
west Indian med journal 2002 51:59 -63
(4)hickey lk lin y,Robertson, understanding the
clinical dilemmas that shape medical students
ethical development questionaere bmj
2001,322 709
Questions Strong disagr neutr agre Stron
ly ee al e gly
disagr agree
ee
ethical conduct is only
important to avoid legal action
The patients wishes must
ALWAYS be adhered to
The patient should always
be told if something goes
wrong
Confidentiality in general
can not be maintained due
to overwhelming
circumstances
The docter should do what is
best for the patient
regardless of the patients
wishes
Patients consent should only
be taken for operations and
surgical procedures but NOT
tests
Doctors and nurses
should refuse to treat
patients who are
aggressive or whose co-
patients are
uncooperative
The law allows certain
procedures to be done,
If the patients requests
it for unethical
purpose should the
doctor refuse the patients
request
Please answer true or false
1- Regarding compassion
Is important in medical
practice of ethics
There is no relationship
between compassion
and medical ethics
2-Regarding competence
Means scientific knowledge &
technical skill
Scientific knowledge only
Scientific knowledge, ethics &
technical skills
 3-Autonomy
Is a principle of medical ethics
Means freedom
Does not conflict with
paternalism
Is needed to fulfil
professionalism
4-the following names are related to
medical ethics
Helsinki
Nuremberg
Belmont
Almaata
5- non-malificience means
Malpractice
Non malpractice
Do no harm
Is a principle of medical ethics
6- you can breach a patients
confidentiality when
Ordered by courts, always
 When you have to conduct an
important research
When public interest is involved
His/her relatives ask you to do
so
7-social justice means
Fairness
Allocating resources justly
Compassionating with ill people
Sharing resources