The doctrine of informed consent has the effect of allowing the mentally competent adult patient to exercise individual choice in any proposed medical treatment. The ethical principles primarily inherent in this doctrine would be the principles of autonomy and beneficence. However, it is argued in this essay that the concept and meaning of autonomy might be vastly different between western and eastern communities. Consequently the doctrine of informed consent will lead to a different meaning in these different societies. The essay also raises the implication of transplanting legal doctrines into societies which might not be fully prepared to implement the ideal contained in the doctrine of informed consent.
In this paper, attempts will be made to study and understand the lawful and unlawful foods in the light of Islamic Medical law focus on ethical aspect that has been practiced during Islamic civilization. We will realize that lawful and unlawful foods are not, as some imagine, mere pretense, but rather constitute the divine command which protects against many diseases. In order to present such a law, the jurists of Islam needed great acuteness and power of reflection to make them understand the matters relating to lawful and unlawful foods in Islam. To attempt to follow these jurists, in their treatment, of the different school of thoughts (madhahib) would take us far beyond the limits of this research. Thus, we will rather confine ourselves to those laws which are clearly stated in the Qur’an and tradition (hadith), as well as a few of the most important issues dealt with in the different school of thoughts (madhahib).
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.
Background: The approach to the teaching of ethics and professionalism in the Faculty of Medicine (FM) of International Islamic University Malaysia (IIUM) is unique. A specifically designed package is incorporated designated as the Islamic Input into the Medical Programme (IIMP). The IIMP spans over the entire 5 years of the medical programme. In the Faculty of Allied Health Sciences (FAHS) students do not go through a similar Islamic Input module but exposed to ethical issues specific to health sciences. Method: The aim of this study is to assess the impact of the teaching of ethics through the IIMP. A cross-sectional study was conducted in medical and allied health sciences faculties of IIUM. In total 259 students volunteered and were allocated to 4 groups, Years 2 and 5 students of FM and Years 2 and 4 of FAHS. A set of questionnaire consisting of 20 vignettes related to medical ethics was distributed to all students. An independent t-test was used to compare the mean total scores between the groups. Results: A significant difference (p < 0.05) was seen between the mean total scores for the Year 2 and Year 5 students of FM; Year 2 students of FM and Year 2 students of FAHS; and between the Year 5 students of FM and Year 4 students of FAHS. Also there was significant difference between the two medical and allied health sciences groups as a whole. Discussion: This study suggests that the IIMP of the IIUM has a positive impact on the medical students when dealing with ethical issues. The Year 5 medical students were expected to have obtained a higher mean total score. The probable reason for the lower mean total score include the teaching-learning approach utilized which is mainly lecture with minimal small group approach. Also the allocation of marks for medical ethics in summative assessment in the IIUM medical curriculum is minimal compared to the core medical subjects which would have some influence on the weight given by students. Conclusion: The Medical Faculty of IIUM believes that the approach to the teaching of medical ethics by incorporating the Islamic Input module is effective, practical and relevant. However the teaching-learning method and the assessment will have to be re-addressed to achieve greater impact.
Introduction : It is no doubt that the success of any health organization depends so closely on its managerial functions. To achieve this, the leader or manager as the core strategist of its organization must in all time be updated with the latest evidence-based information so that he or she can be easily operationalized his or her management function in more effective and sustainable manners. It depends largely on scientific literatures that published relevant articles within this scope. Unfortunately, management topics related to health care system is scattered published and this has indirectly affect manager to access the latest scientific documents.
Methods : We examined the practice of well known international journal in health care namely New England Medical Journal (NEMJ) on its role in propagating latest health management topics to its prospective clients.
Results : The result showed that a total of 31% health management topics were published throughout 2007 out of 1140 articles appeared. Of these, about 33% were confined to general health administration. The remaining articles were related to healthcare delivery practices (24%), medical ethics and legal matters (17% each), and manpower issues and training (9%).
Conclusion : Focus on managerial related articles relatively low as compared to clinical and other evidence-based medicine that clearly dominated health management issues.
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.
Members of the medical profession are expected to be well aware and abide by the revised code of ethics adopted by the Malaysian Medical Council on 9th December 1986. Under the Act Council may, in the exercise of its disciplinary jurisdiction, impose punishments related to misconduct or malpractices. When a complaint or information is made against any practitioner, the President shall forward such complaint to the Chairman of the Preliminary Investigation Committee. The procedure of the disciplinary inquiry is not exactly like those in the court of law but the same principle of justice is adhered to and all evidence used to make a decision must only be those that are admissible in accordance with the rule of evidence.
Concerns about professionalism in medicine have made necessary the explicit teaching and learning of ethics, professionalism and personal development. The noble profession of medicine, taken up as a "calling" by those who are expected to put the needs of the patient above their own, appears to have become a fees-for-service business model and trade. Parental expectations, the diminishing sense of responsibility in teachers, lack of role models, technological advancements, sub-specialisation and third-party involvement in the healthcare delivery system have been identified as reasons for these concerns. The General Medical Council in the United Kingdom, and other professional bodies in both Europe and the Americas, have emphasised the need to enhance the teaching and learning of professionalism in medical schools, particularly the development of good attitudes, appropriate and competent skills, and the inculcation of a value system that reflects the tenets of professionalism in medicine. The medical curriculum will need to be scrutinised so as to introduce the subject of professionalism at all levels of training and education. Barriers to learning professionalism have been identified and students need to be equipped to resolve conflicts and to put the needs of others above their own.
Telemedicine is fast becoming popular in many countries in the world. It has several advantages such as being cost saving and providing better access to health care in the remote areas in many parts of the world. However, it has some disadvantages as well. One of the major problems is the problem of patients' rights and confidentiality in the use of telemedicine. There are no standard guidelines and procedures in the practice of telemedicine as yet. Both the patient and the physician are unsure of the standard of practice and how to maintain confidentiality. The patient is uncertain as to how to protect her/his rights in the use of telemedicine. The issue of litigation is also unclear as to where the physician is practicing when he/she uses telemedicine. Is she/he practicing in the country where the patient is or is the physician practicing in the country of her/his origin? These issues need to be addressed urgently so that telemedicine will have standards of ethical practice and the patient's rights and confidentiality will be protected.
To answer the question posed the terms of reference of local ethical committees as well as a few from overseas were reviewed. It was noted that these committees were established by various professional bodies and functioned independently. Guidelines for ethical practice and conduct were made available to the profession with compliance left to the individual doctor. Amongst the many ethical issues of concern both to the public and the profession was that of self regulation. It is being suggested that these concerns be addressed rather then set up a national body.