Displaying publications 1 - 20 of 55 in total

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  1. Brouwer E, Frambach J, Somodi K, Nadarajah VD, Driessen E
    Med Educ, 2020 05;54(5):427-435.
    PMID: 31912525 DOI: 10.1111/medu.14054
    CONTEXT: Internationalisation in medical education raises ethical concerns over, for instance, its for-profit orientation, the potential erosion of cultural diversity and the possibility that standardised education may not meet the needs of patients everywhere. These concerns fit into a broader debate on social responsibility in higher education. This study aims to explore how academic staff in international medical education experience and act upon the ethical concerns that pertain to their programmes. By adding their perspectives to the debate, this study helps us understand how theory-based ethical concerns are reflected in practice.

    METHODS: We conducted a multicentre instrumental case study across three international medical programmes, all of which were characterised by an international student intake, an internationalised curriculum and international partnerships, and all of which used English as the medium of instruction. We conducted 24 semi-structured interviews with purposively sampled curriculum directors and teaching staff. Participants shared their personal experiences and responded to ethical concerns expressed in the literature. Our multidisciplinary team performed a template analysis of the data based on theoretical frameworks of ethics and social responsibility.

    RESULTS: Participants primarily experienced the internationalisation of their institutions and programmes as having a positive impact on students, the university and the future global society. However, they did face several ethical dilemmas. The first of these involved the possibility that marketisation through international recruitment and the application of substantial tuition fees might widen access to medical education, but might allow weaker students to enter medical schools. The second concern referred to the homogenisation of education methods and content, which offers opportunities to expose students to best practices, but may also pose a risk to education quality. The third issue referred to the experience that although student diversity helped to promote intercultural learning, it also jeopardised student well-being.

    CONCLUSIONS: In the eyes of teaching staff in international medical education, internationalisation can benefit education quality and society, but poses ethical dilemmas through the forces of marketisation, homogenisation and diversification. The findings reflect a tension between the views of scholars and those of practitioners. The critical perspective found in academic debates is largely missing in practice, and theoretical frameworks on ethics possibly overlook the benefits of international education. To facilitate ethical decision making, we propose that scholars and practitioners globally try to learn from each other.

    Matched MeSH terms: Ethics, Medical
  2. Puthucheary SD
    Med J Malaysia, 1980 Sep;35(1):86-95.
    PMID: 7254006
    The code of ethics derived from the Hippocratic Oath needs to be supplemented by a formal curriculum in Medical Ethics and Medical Humanities in our Medical schools. The need and justification for it, a review of the medical ethics curricula in American. European. British and Australian Universities, together with an outline of the proposed curriculum is described.
    Matched MeSH terms: Ethics, Medical*
  3. Miyasaka M, Akabayashi A, Kai I, Ohi G
    J Med Ethics, 1999 Dec;25(6):514-21.
    PMID: 10635508
    SETTING: Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries.
    OBJECTIVE: To characterise the medical ethics curricula at Asian medical schools.
    DESIGN: Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand.
    PARTICIPANTS: A total of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country.
    MAIN OUTCOME MEASURES: The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties.
    RESULTS: A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics.
    CONCLUSION: Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse.
    Matched MeSH terms: Ethics, Medical*
  4. Mazlina M, Julia PE
    Singapore Med J, 2011 Jun;52(6):421-7.
    PMID: 21731994
    Medical ethics issues encountered in rehabilitation medicine differ from those in an acute care setting due to the complex relationships among the parties involved in rehabilitative care. The study examined the attitudes of Malaysian rehabilitation doctors toward medical ethics issues commonly encountered during patient care.
    Matched MeSH terms: Ethics, Medical*
  5. Ravindran J
    Med J Malaysia, 1998 Dec;53(4):321-4.
    PMID: 10971972
    Matched MeSH terms: Ethics, Medical*
  6. van Rostenberghe H, Yong A, Mohd Zin F, Fuad MDF, Idris B, Tahir NA, et al.
    MyJurnal
    Autonomy is widely accepted to be the third pillar of medical ethics. However, if it comes to refusal of life saving treatments, some extra considerations are necessary, especially if decisions are made by surrogate decision makers. Four cases of problematic decision making are presented here, followed by a discussion about the cultural and religious misconceptions about the rights of surrogate decision makers.
    Matched MeSH terms: Ethics, Medical
  7. Victor Lim
    MyJurnal
    Consent is defined as the “voluntary agreement to or acquiescence in what another person proposes or desires”. In the context of medical practice it is now universally accepted that every human being of adult years and of sound mind has the right to determine what shall be done with his or her own body. Informed consent is now a central part of medical ethics and medical law. There has been a change in the public’s expectations of their role in medical decision making. The paternalistic approach by doctors is no longer acceptable. Today the patient has the right to receive and the doctor the obligation to give sufficient and appropriate information so that the patient can make an informed decision to accept or refuse a treatment option. This has led to higher standards of practice in the process of informed consent taking. Consent taking is both a legal and moral requirement. Failure to comply with standards of practice can result in criminal prosecution, civil litigation or disciplinary action by the relevant professional authority. Consent taking is a process and not merely a one-off affixation of the patient’s signature on consent form. It involves a continuous discussion to reflect the evolving nature of treatment from before the treatment is given to the post-operative or discharge period. The regulatory authorities in many countries have established standards for consent taking which would include the capacity of the patient, the person who should seek consent, the information to be provided and the necessary documentation.
    Matched MeSH terms: Ethics, Medical
  8. Ong BB, Kaur S
    Malays J Pathol, 1997 Dec;19(2):111-4.
    PMID: 10879250
    The duty of confidentiality in the normal doctor-patient relationship is well recognized. However, the duty of confidentiality between the pathologist who performs the autopsy and the requesting authorities and the next-of-kin is not as clearly spelt out. This article discusses the problems faced by the pathologist with regards to hospital and medico-legal autopsies in Malaysia. A proposed ethical guideline is included on how to deal with peculiar issues regarding confidentiality and the pathologist.
    Matched MeSH terms: Ethics, Medical
  9. Ngan OMY, Bergstresser SM, Sanip S, Emdadul Haque ATM, Chan HYL, Au DKS
    Dev World Bioeth, 2020 06;20(2):105-114.
    PMID: 31241234 DOI: 10.1111/dewb.12239
    Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient-centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision-making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end-of-life care.
    Matched MeSH terms: Ethics, Medical*
  10. Isa NM
    Sci Eng Ethics, 2016 10;22(5):1319-1332.
    PMID: 26358749 DOI: 10.1007/s11948-015-9698-1
    The discovery and invention of new medical applications may be considered blessings to humankind. However, some applications which might be the only remedy for certain diseases may contain ingredients or involve methods that are not in harmony with certain cultural and religious perspectives. These situations have raised important questions in medical ethics; are these applications completely prohibited according to these perspectives, and is there any room for mitigation? This paper explores the concept of darurah (necessity) and its deliberation in the formulation of fatwas on medicine issued by the National Fatwa Council of Malaysia. Darurah has explicitly been taken into consideration in the formulation of 14 out of 45 fatwas on medicine thus far, including one of the latest fatwas regarding uterine donation and transplantation. These fatwas are not only limited to the issues regarding the use of unlawful things as remedies. They include issues pertaining to organ transplantation, management of the corpse and treatment of brain dead patients. While deliberation of darurah in medicine may vary from issue to issue, darurah applies in a dire situation in which there are no lawful means to prevent harm that may be inflicted upon human life. Nevertheless, other aspects must also be taken into the deliberation. For example, consent must be obtained from the donor or his next of kin (after his death) to conduct a cadaveric organ transplantation.
    Matched MeSH terms: Ethics, Medical*
  11. Sandosham AA
    Med J Malaysia, 1974 Mar;28(3):133-4.
    PMID: 4278067
    Matched MeSH terms: Ethics, Medical*
  12. Osman A
    MyJurnal
    The developments in the technology of life support such as mechanical ventilators, dialysis machines and cardiovascular support techniques have provided the means of maintaining organ function for prolonged period of time. However, in many instances, such life-sustaining treatment in intensive care units did not result in desirable outcome where patients return to their normal state of health. Several ethical issues have surfaced from these medical advances mainly on the decision-making process, which physicians have to deal in their daily practice. Withholding and withdrawing life-prolonging treatments that allow patients to die naturally need to be differentiated from physician-assisted suicides and euthanasia that involves the active ending of life. The definition of life and death and the guiding ethical principles that one takes before embarking to a particular conclusion is a pre-requisite to good clinical practice. Islam, as a comprehensive religion provides clear definition of life and death and has guidelines that underlie its own ‘medical ethics’ that one could be guided by to assist in the decision-making process.
    Matched MeSH terms: Ethics, Medical
  13. Loh KY, Sivalingam N
    Med J Malaysia, 2008 Mar;63(1):85-7; quiz 88.
    PMID: 18935748 MyJurnal
    Doctor-patient relationship is a special kind of social. relationship where bonding is planned and carried out with the final objective of helping the patient to achieve the treatment goal. A positive therapeutic relationship encourages active participation of patient in the treatment plan, contributing to success of treatment goals and minimizing malpractice suits. The humanistic approach emphasizes the importance of love, belonging, self esteem, self expression and the final stage of self actualization-the drive to realize one's full potential. In person centered approach to therapeutic relationship, the three most fundamental elements are congruent (genuineness), unconditioned positive regards and empathy. In daily medical consultation, applying these elements can promote greater chance of success in the therapeutic process.
    Matched MeSH terms: Ethics, Medical
  14. Sivaraman MAF
    Asian Bioeth Rev, 2019 Dec;11(4):409-435.
    PMID: 33717326 DOI: 10.1007/s41649-019-00103-4
    One of the goals of medicine is to improve well-being, in line with the principle of beneficence (do no harm). Likewise, scientists claim that the goal of human embryonic stem cell (hESC) research is to find treatments for diseases. In hESC research, stem cells are harvested from a 5-day-old embryo. Surplus embryos from infertility treatments or embryos created for the sole purpose of harvesting stem cells are used in the research, and in the process the embryos get destroyed. The use of human embryos for research purpose raises ethical concern. In this context, the religious leaders play the role to be the moral compass and "reality check" to engage with the public. In Malaysia, the Ministry of Health has outlined the Guidelines for Stem Cell Research and Therapy, reflecting on Islamic principles. Since there has not been much focus on the viewpoints of other faiths in Malaysia, this study attempts to (i) explore the ethical guiding principles deliberated by religious leaders from the Buddhist, Hindu and Catholic traditions and (ii) identify if there is a common ground between the mainstream religious views and principles of medical ethics, in relation to hESC research. Eleven religious leaders representing the Buddhist, Hindu and Catholic traditions were interviewed. Interestingly, though reasoning of religious leaders came from different angles, their underlying concerns revolve around the values of "do no harm" and "intention to save lives". These values are also the key principles in medical ethics. The findings are applied to answer the question as to whether religious and medical guiding principles can co-exist and complement in ethical decision-making, without compromising the values.
    Matched MeSH terms: Ethics, Medical
  15. Citation:
    Ethical Professional Practice Guidelines. Kuala Lumpur: Academy of Medicine Malaysia; 2016
    Matched MeSH terms: Ethics, Medical
  16. Schenker JG, Shushan A
    Hum Reprod, 1996 Apr;11(4):908-11.
    PMID: 8671351
    This report describes the ethical and legal aspects of assisted reproduction technology (ART) that have been instituted in Asian countries. The data were collected by a questionnaire circulated to ART units in Asia. These are Taiwan, Singapore, Korea, Indonesia, Thailand, Japan, Iran, India, Jordan, Malaysia, China, Israel, Hong Kong, Pakistan, Lebanon, Saudi Arabia, and Persian Gulf countries. According to the survey, there are approximately 260 ART centers in Asia (half of which are in Japan). On a global basis each ART centre in Asia serves an average population of 13 million people. On the other hand, in those Asian countries where the standards of living are relatively high, the availability of ART services, including the more sophisticated and costly ART procedures like micromanipulation, is similar to that in the Western world. In most of the Asian countries practising ART, however, no state registry exists. Taiwan is the only country that has specific legislation, and in six other countries some kind of ministerial regulations are practised. We conclude that ART is now practised in 20 countries in Asia. The prevailing rules and cultural heritage in many of these Asian countries has a major influence on the implementation of ART in Asia. However, in view of the complicated and sensitive issues involved, and as no supervision on ART clinics exists in most of the Asian countries, we advocate that some kind of quality control should be urgently instituted in all centres practising ART. In this way, it is hoped that the highest standards be attained for all parties concerned.
    Matched MeSH terms: Ethics, Medical
  17. Ravindran J
    Med J Malaysia, 2000 Aug;55 Suppl B:43-50.
    PMID: 11125521
    Matched MeSH terms: Ethics, Medical*
  18. Choe TS
    Med J Malaysia, 2000 Aug;55 Suppl B:51.
    PMID: 11125523
    Matched MeSH terms: Ethics, Medical*
  19. Looi LM
    Med J Malaysia, 2000 Aug;55 Suppl B:9-13.
    PMID: 11125526
    Matched MeSH terms: Ethics, Medical*
  20. Shamsinar BA
    Med J Malaysia, 2000 Aug;55 Suppl B:62-4.
    PMID: 11125525
    Matched MeSH terms: Ethics, Medical*
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