Democratization of medical education is needed to effective teaching of bioethics
The major medical ethical challenges facing the public and healthcare providers in Saudi Arabia
In this section of the website, you will find my articles that were published in peer-reviewed journals and the abstracts that were accepted for presentation in conferences. As you might expect, most of them are on bioethics.
My areas of interest are the relation between politics and ethics, Islamic ethics, ethics in the developing countries, public helath ethics and teaching of ethics.
Authors: Ghaiath Hussein, Abdulaziz AlKabba, Ahmed Bahnasy, Adnan Albar
Background: Despite the relatively high expenditure on healthcare in Saudi Arabia, its health system remains highly centralized in the main cities with its primary focus on secondary and tertiary care rather than primary care. This has led to numerous ethical challenges for the healthcare providers. This article reports the results of a study conducted with a panel of practitioners, and non-clinicians, in Saudi Arabia, in order to identify the top ten ethical challenges for healthcare providers, patients, and their families.
Materials and Methods: The study design was a cross-sectional, descriptive, and qualitative one. The participants were asked the question: “What top ten ethical challenges are Saudis likely to face in health care?” The participants were asked to rank the top ten ethical challenges throughout a modified Delphi process, using a ranking Scale. A consensus was reached after three rounds of questions and an experts’ meeting.
Results:The major 10 ethical issues, as perceived by the participants in order of their importance, were: (1) Patients’ Rights, (2) Equity of resources, (3) Confidentiality of the patients, (4) Patient Safety, (5) Conflict of Interests, (6) Ethics of privatization, (7) Informed Consent, (8) Dealing with the opposite sex, (9) Beginning and end of life, and (10) Healthcare team ethics.
Conclusion: Although many of the challenges listed by the participants have received significant public and specialized attention worldwide, scant attention has been paid to these top challenges in Saudi Arabia. We propose several possible steps to help address these key challenges.Keywords: Bioethics, ethical issues, ethics priorities, medical ethics
J Med Liban. January 2011
Authors: Ghaiath Hussein, Abdulaziz AlKabba
Abstract: Despite a history in medical education spanning 2500 years, it has only been in the last 30 years that medical ethics has come of age by being formally included in medical curricula [1].
By 1990, medical ethics had become an integral part of the core curriculum in most American medical schools. At present, most medical schools in the UK include medical ethics as part of theirformal curriculum.This progress in the field in the North American and European contexts was attributed to a set of factors related to the development of the health system, moral development, and political development that took place at a more accelerated pace than in developing countries.However, teaching of medical ethics has additional factors that affected its development and progress in both the developed and developing countries.
This article discusses the spectrum of factors that affect the teaching of medical ethics in developing counties, with emphasis on the kingdom of Saudi Arabia (KSA), in which the authors work. In particular, the authors introduce cation as a needed factor for effective teaching of medicalethics.
Abstract
Background: Bioethics as a field related to the health system and health service delivery hasgrown in the second half of the 20thcentury, mainly in North America. This is attributed, the authorargues, to mainly three kinds of development that took place in the developed countries at a pacedifferent than the developing countries. They are namely: development of the health system; moraldevelopment; and political development.
Discussion:This article discusses the factors that impede the development of the field of bioethicsfrom an academic activity to a living field that is known and practiced by the people in thedeveloping countries. They are quite many; however, the emphasis here is on role of the politicalstructure in the developing countries and how it negatively affects the development of bioethics. Itpresents an argument that if bioethics is to grow within the system of health service, it should beaccompanied by a parallel changes in the political mindsets in these countries.
Summary: For bioethics to flourish in developing countries, it needs an atmosphere of freedomwhere people can practice free moral reasoning and have full potential to take their life decisionsby themselves. Moreover, bioethics could be a tool for political change through the empowermentof people, especially the vulnerable.To achieve that, the article is proposing a practical framework for facilitating the development of the field of bioethics in the developing countries.
Abstract:
Background: Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in theemphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching andevaluation of medical ethics have been changing as more Saudi academics receivedspecialized training and qualifications in bioethics from western universities.
Methods: This study aims at studying the current teaching methods and evaluation tools used by theSaudi public medical schools. It is done using a self-administered online questionnaire.
Results: Out of the 14 medical schools that responded, the majority of the responding schools (6;42.8%), had no ethics departments; but all schools had a curriculum dedicated to medicalethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The mostpopular teaching method was lecturing (13; 92.8%). The most popular form of studentassessment was a paper-based final examination (6; 42.8%) at the end of the course that wasallocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated15-30% of the total grade to research.
Conclusion: Although there is a growing interest and commitment in teaching ethics to medical studentsin Saudi schools; there is lack of standardization in teaching and evaluation methods. There isa need for a national body to provide guidance for the medical schools to harmonize theteaching methods, particularly introducing more interactive and students-engaging methodson the account of passive lecturing.
Democracy: the forgotten challenge for bioethics in the developing countries
List of articles published in peer-reviewed journals
Abstract:
The provision of health care service in resource-poor settings is associated with a broad set of ethical issues. Devakumar's case discusses the ethical issues related to the inability to treat in a cholera clinic patients who do not have cholera. This paper gives a closer look on the context in which Devakumar's case took place. It also analyses the potential local and organizational factors that gives rise to ethical dilemmas and aggravate them. It also proposes a framework to help in the proactive handling of the factors that leads to ethical dilemmas and resolving the ethical issues as they appear. It adopts the four principles of autonomy, beneficence, non-maleficence and justice as universal and prima facie principles, but with the inclusion of a local understanding of what of each of these principles means. It is based on a collaborative approach that involves the beneficiaries and other partners in the field to help share information and resources, as well as adopting the provision of a wider service to the whole community. This is done by asking three basic questions: (a) who are the relevant stakeholders? (b) what ought to be the ethical principles in place? and (c) how should we take, implement and follow the decision about service provision?
Journal of Academic Ethics/SpringerJanuary 1, 2008
Abstract
This article featuring Sudan constitutes one of five articles in a collection of essays on local capacity-building in research ethics by graduates from the University of Toronto’s Joint Centre for Bioethics MHSc in Bioethics, International Stream programmefunded by the Fogarty International Center for Advanced Study in the Health Sciences(FIC).
Research ethics is a relatively new area of practice in Sudan. In 2008, the NationalHealth Research Council (NHRC) and health research ethics were clearly stated in the Public Health Act, marking the first legislation rendering research misconduct as a legaloffense. It also clearly stated that the NHRC is the focal body of health research in Sudan.Despite the difficulty in following the pace of newly-formed institutions and academies inSudan, the NHRC’s Research Directorate assisted in the establishment of eight ResearchEthics Committees (RECs) in two state ministries of health, two federal hospitals, theSudan Medical Specialization Board (SMSB), and three universities.