Medical ethics are important both in medical practice, which involves the medical relationship of the patient, and in medical research. The basic principle of medical ethics is autonomy.[42] Autonomy is the freedom of patients and clients to make decisions about their conditions without interference, pressure, and coercion. This means respectfully giving the patient appropriate information and disclosing information about a patient after obtaining informed consent [4, 43, 44]. Trust is always key in any doctor-patient relationship, because the patient rusts the doctor for the best of himself, so the patient is entitled to autonomy. It is the duty of physicians to counsel the patient and explain the diagnosis, proposed treatment and treatment options. The physician is not expected to impose a decision on the patient. Hence the freedom of thought, intention and decision, especially in the new era of codecision. For this to be complete, the patient must be counselled in plain language so that they understand the risks and benefits of the procedures. This is also the principle in order not to do evil or evil. Autonomy allows the patient freedom of choice and action.

The principle of autonomy requires that the physician provide the client with all available treatment options [21]. It also shows that even after the entire consultation, the patient has the right to refuse and refuse treatment [10]. Ethical principles are influenced by cultural and traditional beliefs and practices. Some cultures disapprove when told that the clinical condition is bad, worse when death is expected. Physicians have always been confronted with the idea of how much, measuring, and how much clinical information to share with a patient, especially when it comes to bad news [45]. This is contrary to the ethical principle of autonomy, according to which people are allowed or should be forced to make their decisions without influence. The other medico-ethical principles of truth-seeking and confidentiality, including informed consent, are all based on autonomy [4]. Autonomy allows the patient to choose from all available treatment options based on their goals and values [41, 44, 46]. Although physicians are sometimes able to convince their patients to accept what they think is best for the patient [41]. Autonomy therefore makes the patient responsible for his or her health needs and desires [11].

(1) Informed consent and refusal of treatment – Why respect for autonomy is so important; adequate information; processing without consent; Competence; Assault and negligence. Medical ethics can be traced back to the Greek physician Hippocrates, father of medicine, to whom the Hippocratic oath is attributed not to harm (circa 400 BC). Modern ethics, set out in the Principles of Biomedical Ethics (1985), has given us the four principles of health care: autonomy, justice, non-malevolence, and charity. Every profession has policies, rules and regulations that guide its practice, that`s what ethics are. It is the professional conduct of medical practice, including research to advance medicine and make new discoveries. One of the necessary aspects of human life is health [1] and it is the duty of clinicians to take care of the health needs of the population [2]. Medical ethics have been immemorial since ancient times. In medical education, medical ethics is taught at undergraduate and postgraduate levels to equip a new graduate in the dental and medical profession. Clinicians face a variety of challenges in their work, some of which may have ethical issues, worst of all when there is poor clinical condition and death is expected [3]. Decision-making about patient care is a core responsibility of any physician practicing medicine [4].

Physicians who make a mistake in their practice can be sued by the Medical Association. Every national medical board has guidelines for wandering doctors who go off the rails in their medical practice. Medical associations have a body of investigation and disciplinary committees for physicians who do not practice medicine without the application of medical ethics. Various disciplinary measures include an apology to the patient, suspension of practice for a period of time, or the extreme, which is permanent forfeiture of the license to practice medicine, and removal of physicians` names from the medical register. Because of the importance of ethics, the World Health Organization created an ethics team in 2002 known as the Global Health Ethics Unit, an entity dedicated to ethics [5]. Through this ethics team, the World Health Organization works closely with the United Nations Inter-Agency Committee, non-governmental organizations and other international organizations [5]. Medical ethics helps promote quality medical care by identifying, analyzing, and attempting to resolve ethical issues that arise in medical practice [10, 17, 24]. Ethical dilemmas can be found in telemedicine, artificial intelligence, COVID-19 testing, end-of-life care management, medical errors, priority testing, biotechnology, medical ethics education, e-health, and bioethics [10].

Some of the factors and barriers to ethical dilemmas are related to medical facts, individual characteristics, and unclassified factors [31]. (4) Medical research – Ethical and legal tensions in medical research involving patients, human volunteers and animals; the need for effective regulation. Certain factors that are not related to individual characteristics and medical effects influence the decision-making process. These include logistics location, competing interests, and cross-industry opportunities [31]. In some countries, there have been interprofessional rivalries between different categories of health workers, and it is clients and patients who suffer. The consensus statement views the teaching of medical ethics and law as a contribution to the overall goal of medical education – “the creation of good physicians who improve and promote the health and medical well-being of the people they serve in a manner that fairly and justly respects their dignity, autonomy, and rights.” To achieve these goals, medical students must be able to understand the ethical principles and values that underpin good medical practice. be able to think critically about ethics, reflect on their own beliefs, and understand and appreciate alternative, perhaps competing, approaches; and “be able to argue and advocate to contribute to informed discussion and debate”. Students should be aware of the main professional and legal obligations of physicians in the UK, particularly those established by the General Medical Council, and be able to participate constructively in the ethical and legal considerations required in day-to-day practice. The ethical conduct of medical research, particularly in the field of clinical emergencies, is crucial. Many factors pose challenges to the proper conduct of medical research in clinical emergencies.

These factors range from government regulation to decision-making or intervention [72]. First, in many countries there are no specific regulations for emergency clinical research [72]; This is a fundamental problem that needs to be solved. The issue of informed consent is also central to the ethical conduct of research in clinical emergencies, particularly in clinical trials. For example, in unconscious patients, the decision on which a clinical intervention (a study intervention or an approved intervention) should be performed on such a patient should be made within minutes; Unfortunately, these patients cannot give consent [74]. In addition, the authorized legal representative (ARL) of these patients is often unreachable or in a state of emotional imbalance [74, 75]. In such a situation, some authorities have recommended the use of the LAR`s “deferred consent” (p. e.g., next of kin) of such a patient, while others recommended that medical researchers involved in this type of clinical research (e.g., trials) be able to continue the study and be able to prove that: being on the wrong side of a medical dispute, can lead to financial hardship, loss of time, A tarnished professional reputation, a revoked license and even prison. Staying up to date on the latest legal regulations and ethical standards ensures quality care for your patients and protects your practice. We surveyed our doctors to see which legal and ethical concerns are paramount in health care. Ethical considerations in the study of vulnerable populations: vulnerable populations constitute the disadvantaged sub-segment of the Community; These include minors (persons under 18 years of age), the mentally handicapped, children, prisoners, pregnant women, foetuses, the elderly, displaced persons and other disadvantaged categories [65, 78, 79, 80].

Because of the inherent characteristics of this population, they are unable to safeguard their own interests [80, 81]. Among all types of medical research, studies are one of the most important types because of their complexity and the inclusion of an intervention in their scope. A study by Welch et al. detailed the particularities and limitations of each subgroup of the vulnerable population with respect to ethical issues surrounding their participation in a clinical trial [80]. Based on these specificities and limitations, it was concluded that: In collaborative medical research, whether international or local, medical researchers should work together as a team to jointly prioritize the challenges of the epidemic, determine the most appropriate research project that will provide answers to these challenges, conduct and ensure research, that the research ultimately benefits the communities concerned.