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Review paper: Organ transplants: ethical, social, and religious issues in a multicultural society

Robson NZ, Razack AH, Dublin N

Asia Pac J Public Health, 2010 Jul;22(3):271-8.
PMID: 20460294 DOI: 10.1177/1010539509357446

Recent advances in the fields of organ donation and organ transplant have introduced new hope for the treatment of serious diseases. However, this promise has been accompanied by several issues. The most common issue raised is ethical implications, but in a multicultural society like Malaysia, additional concerns arise pertaining to social and religious issues. These concerns needs to be addressed as attitudes toward and acceptability of organ donation varies according to social, culture, and religion. The diverse cultural, religious, and traditional concepts pertaining to organ donation may hamper its acceptability and cause a lack of willingness to donate organs. The purpose of this article is to briefly explore the ethical issues involved in organ transplant and the various religious opinions on organ donation. It is hoped that this knowledge and understanding may benefit both health care providers and patients in a multicultural society like Malaysia.

Matched MeSH terms: Tissue and Organ Procurement/ethics*; Organ Transplantation/ethics*
Fulltext Review article : lawful and unlawful foods in Islamic law focus on Islamic medical and ethical aspects

Nurdeng D

International Food Research Journal, 2009;16(4):469-478.
MyJurnal

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).

Matched MeSH terms: Ethics, Medical
Fulltext Response: Scientific misconduct encountered by APAME journals: insight?

Looi LM, Wong LX, Koh CC

Malays J Pathol, 2016 Apr;38(1):73.
PMID: 27126670
Matched MeSH terms: Periodicals as Topic/ethics*
Response to 'Position statement on ethics, equipoise and research on charged particle therapy'

Jones B, Howick J, Hopewell J, Liew SM

J Med Ethics, 2014 Aug;40(8):576-7.
PMID: 24812333 DOI: 10.1136/medethics-2014-102105

In August 2011, a group of medical doctors, ethicists, academic and medical physicists were asked to debate and reach consensus on the potential need for randomised control trials to test charged particle radiation therapy (CPRT) for treating tumours. The outcome of the meeting was a paper recently published in the Journal of Medical Ethics entitled "Position statement on ethics, equipoise and research on charged particle therapy" by Sheehan et al. However 6 of the 30 meeting participants withdrew from authorship of the 'position statement' because their views were not adequately represented. The 'position statement' did not state our reasons for withdrawing from the statement, which is a considerable omission. We had two principal objections: (1) the case for the benefits to patients and society of randomized trials to test CPRT was not adequately represented, and (2) the complexities and potential harms of CPRT were not clearly stated. In this response we explain and justify our objections. Patients, doctors and policymakers seeking to make independent judgments about whether equipoise exists for the relative benefits of CPRT should therefore read this document alongside the 'position' statement.

Matched MeSH terms: Radiotherapy, High-Energy/ethics*
Researchers experience of misconduct in research in Malaysian higher education institutions

Olesen AP, Amin L, Mahadi Z

Account Res, 2018;25(3):125-141.
PMID: 29394103 DOI: 10.1080/08989621.2018.1429925

This article offers a qualitative analysis of research misconduct witnessed by researchers during their careers, either by research students or fellow researchers, when conducting or supervising research in their respective departments. Interviews were conducted with 21 participants from various research backgrounds and with a range of research experience, from selected universities in Malaysia. Our study found that misbehavior such as manipulating research data, misrepresentation of research outcomes, plagiarism, authorship disputes, breaching of research protocols, and unethical research management was witnessed by participants among junior and senior researchers, albeit for different reasons. This indicates that despite the steps taken by the institutions to monitor research misconduct, it still occurs in the research community in Malaysian institution of higher education. Therefore, it is important to admit that misconduct still occurs and to create awareness and knowledge of it, particularly among the younger generation of researchers. The study concludes that it is better for researchers to be aware of the behaviors that are considered misconduct as well as the factors that contribute to misconduct to solve this problem.

Matched MeSH terms: Research Personnel/ethics*; Scientific Misconduct/ethics*
Research and Publishing Ethics among Iranian Researchers: The Realities

Talebi Bezmin Abadi A, Lee JY

Arch Iran Med, 2019 04 01;22(4):211-212.
PMID: 31126180
Matched MeSH terms: Research Personnel/ethics*; Biomedical Research/ethics*
Research Ethics: Researchers Consider How Best to Prevent Misconduct in Research in Malaysian Higher Learning Institutions Through Ethics Education

Olesen AP, Amin L, Mahadi Z

Sci Eng Ethics, 2019 08;25(4):1111-1124.
PMID: 29717467 DOI: 10.1007/s11948-018-0054-0

The purpose of this study is to encourage and highlight discussion on how to improve the teaching of research ethics in institutions of higher education in Malaysia. Drawing on semi-structured interviews with 21 academics in a research-intensive university in Malaysia, interviewees agreed on the importance of emphasizing the subject of research ethics among students, as well as academics or researchers. This study reveals that participants felt that there is an urgent need to improve the current awareness and knowledge of issues related to misconduct in research among students and academics. The results of this study indicate a need for better teaching on the subject of research ethics in order to prevent misconduct in research. Finally, it concludes with suggestions that there should be a clear definition of research misconduct, to include consequences when engaging in misconduct; a separate research ethics syllabus for pure and social sciences should be conducted; research ethics should be implemented as a core subject, and there should be an early intervention and continuous learning of research ethics, with an emphasis on ethics training.

Matched MeSH terms: Research Personnel/ethics*; Universities/ethics*; Scientific Misconduct/ethics*; Ethics, Research/education*
Religious, Ethical and Legal Considerations in End-of-Life Issues: Fundamental Requisites for Medical Decision Making

Jahn Kassim PN, Alias F

J Relig Health, 2016 Feb;55(1):119-34.
PMID: 25576401 DOI: 10.1007/s10943-014-9995-z

Religion and spirituality have always played a major and intervening role in a person's life and health matters. With the influential development of patient autonomy and the right to self-determination, a patient's religious affiliation constitutes a key component in medical decision making. This is particularly pertinent in issues involving end-of-life decisions such as withdrawing and withholding treatment, medical futility, nutritional feeding and do-not-resuscitate orders. These issues affect not only the patient's values and beliefs, but also the family unit and members of the medical profession. The law also plays an intervening role in resolving conflicts between the sanctity of life and quality of life that are very much pronounced in this aspect of healthcare. Thus, the medical profession in dealing with the inherent ethical and legal dilemmas needs to be sensitive not only to patients' varying religious beliefs and cultural values, but also to the developing legal and ethical standards as well. There is a need for the medical profession to be guided on the ethical obligations, legal demands and religious expectations prior to handling difficult end-of-life decisions. The development of comprehensive ethical codes in congruence with developing legal standards may offer clear guidance to the medical profession in making sound medical decisions.

Matched MeSH terms: Clinical Decision-Making/ethics*; Terminal Care/ethics*; Withholding Treatment/ethics*
Religious scholars' attitudes and views on ethical issues pertaining to pre-implantation genetic diagnosis (PGD) in Malaysia

Olesen A, Nor SN, Amin L

J Bioeth Inq, 2016 Sep;13(3):419-29.
PMID: 27365102 DOI: 10.1007/s11673-016-9724-2

Pre-Implantation Genetic Diagnosis (PGD) represents the first fusion of genomics and assisted reproduction and the first reproductive technology that allows prospective parents to screen and select the genetic characteristics of their potential offspring. However, for some, the idea that we can intervene in the mechanisms of human existence at such a fundamental level can be, at a minimum, worrying and, at most, repugnant. Religious doctrines particularly are likely to collide with the rapidly advancing capability for science to make such interventions. This paper focuses on opinions and arguments of selected religious scholars regarding ethical issues pertaining to PGD. In-depth interviews were conducted with religious scholars from three different religious organizations in the Klang Valley, Malaysia. Findings showed that Christian scholars are very sceptical of the long-term use of PGD because of its possible effect on the value of humanity and the parent-children relationship. This differs from Islamic scholars, who view PGD as God-given knowledge in medical science to further help humans understand medical genetics. For Buddhist scholars, PGD is considered to be new medical technology that can be used to save lives, avoid suffering, and bring happiness to those who need it. Our results suggest that it is important to include the opinions and views of religious scholars when it comes to new medical technologies such as PGD, as their opinions will have a significant impact on people from various faiths, particularly in a multi-religious country like Malaysia where society places high value on marital relationships and on the traditional concepts of family.

Matched MeSH terms: Choice Behavior/ethics; Ethics*; Genetic Testing/ethics*; Prenatal Diagnosis/ethics*; Technology/ethics*; Reproductive Techniques, Assisted/ethics*
Religion and waste

Fatimah Mohamad Z, Idris N, Baharuddin A

Waste Manag, 2011 Sep-Oct;31(9-10):1905-6.
PMID: 21763121 DOI: 10.1016/j.wasman.2011.06.013
Matched MeSH terms: Recycling/ethics*
Reasons on the similarity of objections with regards to gambling and speculation in Islamic finance and conventional finance

Kunhibava S

J Gambl Stud, 2011 Mar;27(1):1-13.
PMID: 20514512 DOI: 10.1007/s10899-010-9201-5

Gambling and speculation which leads to zero-sum outcomes are prohibited in Islamic finance and condemned in conventional finance. This article explores the reasons for the similarity of objections towards gambling and speculation. Three probable reasons are explored namely the concept of stewardship in conventional thought and the concept of khalifa in Islam, Christianity and morality's influence on conventional law and finance and the concept of ethics of sacrifice and ethics of tolerance.

Matched MeSH terms: Financial Management/ethics*
Rather than responding to the past, shape the future instead

Kaur S

Am J Bioeth, 2015;15(6):61-3.
PMID: 26030504 DOI: 10.1080/15265161.2015.1028668
Matched MeSH terms: Ethics, Research/history*
Fulltext Protocol for a cross-sectional study measuring person-centredness among healthcare providers in Malaysian primary care clinics: the adaptation and validation of the Person-Centred Practice Inventory-Staff (PCPI-S) Questionnaire

Balqis-Ali NZ, Saw PS, Jailani AS, Yeoh TW, Fun WH, Mohd-Salleh N, et al.

BMJ Open, 2020 03 26;10(3):e034128.
PMID: 32220914 DOI: 10.1136/bmjopen-2019-034128

INTRODUCTION: Person-centred care (PCC) has become a global movement in healthcare. Despite this, the level of PCC is not routinely assessed in clinical practice. This protocol describes the adaptation and validation of the Person-Centred Practice Inventory-Staff (PCPI-S) tool that will be used to assess person-centred practices of primary healthcare providers in Malaysia.
METHODS AND ANALYSIS: To ensure conceptual and item equivalence, the original version of the PCPI-S will be reviewed and adapted for cultural context by an expert committee. The instrument will subsequently be translated into Malay language using the forward-backward translation method by two independent bilingual speaking individuals. This will be pretested in four primary care clinics and refined accordingly. The instrument will be assessed for its psychometric properties, such as test-retest reliability, construct and internal validity, using exploratory and confirmatory factor analysis.
ETHICS AND DISSEMINATION: Study findings will be disseminated to healthcare professionals and academicians in the field through publication in peer-reviewed journals and conference presentations, as well as at managerial clinic sites for practice improvement. The study was approved by the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia (KKM/NIHSEC/ P18-766 (14) and Monash University Human Research Ethics Committee (2018-14363-19627).

Matched MeSH terms: Ethics Committees, Research
Fulltext Promoting physical activity in sedentary elderly Malays with type 2 diabetes: a protocol for randomised controlled trial

Sazlina SG, Browning CJ, Yasin S

BMJ Open, 2012;2(6).
PMID: 23161092 DOI: 10.1136/bmjopen-2012-002119

INTRODUCTION: Like many countries Malaysia is facing an increase in the number of people with type 2 diabetes mellitus diabetes (T2DM) and modifiable lifestyle factors such as sedentary behaviour are important drivers of this increase. The level of physical activity is low among elderly Malay people. In Malaysia, strategies to promote physical activity in elderly Malay people with T2DM are not well documented in the research literature. This paper discusses an intervention to increase physical activity in elderly Malay people with T2DM. The aim of our study was to evaluate the effectiveness of personalised feedback alone and in combination with peer support in promoting and maintaining physical activity in comparison with usual care.
METHODS AND ANALYSIS: A three-arm randomised controlled trial will be conducted among sedentary Malay adults aged 60 years and above with T2DM attending an urban primary healthcare clinic in Malaysia. The participants will be randomised into three groups for a 12-week intervention with a follow-up at 24 and 36 weeks to assess adherence. The primary outcome of this study is pedometer-determined physical activity. Glycaemic and blood pressure control, body composition, cardiorespiratory fitness, balance, lipid profile, health-related quality of life, psychological well-being, social support and self-efficacy for exercise are the secondary measures. Linear mixed models will be used to determine the effect of the intervention over time and between groups. ETHICAL AND DISSEMINATION: The Monash University Human Research Ethics Committee and the Malaysian Ministry of Health's Medical Research Ethics Committee approved this protocol. The findings of this study will be presented at international conferences and published in peer-reviewed journals.
TRIAL REGISTRATION: This study protocol has been registered with the Malaysian National Medical Research Registry and with the Current Controlled Trial Ltd (http://www.controlled-trials.com/ISRCTN71447000/).

Matched MeSH terms: Ethics Committees, Research
Promoting Ethics and Integrity in Management Academic Research: Retraction Initiative

Ayodele FO, Yao L, Haron H

Sci Eng Ethics, 2019 04;25(2):357-382.
PMID: 29441445 DOI: 10.1007/s11948-017-9941-z

In the management academic research, academic advancement, job security, and the securing of research funds at one's university are judged mainly by one's output of publications in high impact journals. With bogus resumes filled with published journal articles, universities and other allied institutions are keen to recruit or sustain the appointment of such academics. This often places undue pressure on aspiring academics and on those already recruited to engage in research misconduct which often leads to research integrity. This structured review focuses on the ethics and integrity of management research through an analysis of retracted articles published from 2005 to 2016. The study employs a structured literature review methodology whereby retracted articles published between 2005 and 2016 in the field of management science were found using Crossref and Google Scholar. The searched articles were then streamlined by selecting articles based on their relevance and content in accordance with the inclusion criteria. Based on the analysed retracted articles, the study shows evidence of ethical misconduct among researchers of management science. Such misconduct includes data falsification, the duplication of submitted articles, plagiarism, data irregularity and incomplete citation practices. Interestingly, the analysed results indicate that the field of knowledge management includes the highest number of retracted articles, with plagiarism constituting the most significant ethical issue. Furthermore, the findings of this study show that ethical misconduct is not restricted to a particular geographic location; it occurs in numerous countries. In turn, avenues of further study on research misconduct in management research are proposed.

Matched MeSH terms: Research Personnel/ethics*; Ethics, Research*
Fulltext Professional conduct of clinical teachers: perspectives of medical students

Harlina H. Siraj, Salam, A., Juriza, I., Zaleha A. Mahdy, Nabishah, M.

Education in Medicine Journal, 2014;6(3):13-19.
MyJurnal

Introduction: Appropriate professional conduct of clinical teacher is vital in their medicine practice. In UKM medical centre Malaysia, personal and professional development (PPD) of future medical professionals is greatly emphasized. The objective of this study was to determine the medical students' perception about the professional conduct of their clinical teachers at UKM medical centre. Methods: It was an online questionnaire survey conducted among the clinical students enquiring about the professional conduct of their clinical teachers. There were five statements and one open ended question which described students' preference about PPD teaching- learning method, expectation on PPD session, need of teachers training and experience about the excellent and inappropriate professional conduct of clinical teachers. The open ended question described what students had observed regarding the 'doctor-patient relationship' medical ethics and 'student-teacher relationship. A total of 77 questionnaires were returned after complete evaluation. The data were compiled and analysed using SPSS version 20 and the answers to the open ended questions were transcribed. Result: Role modelling was the preferred teaching-learning method for PPD as stated by 38% respondents; subsequent preferred methods were small group (30%), role play (24%), large group (7%) and reflective writing (1%). Majority (67.5%) respondents indicated that professional conduct of their clinical teachers was frequent enough as they had expected while 29.9% claimed that professional conduct was infrequently emphasized. Excellent professional conduct of clinical teachers was witnessed by 73% respondents while 27% indicated that they had never seen excellent conduct. When asked about inappropriate professional behaviours by clinical teachers, 53% indicated to have witnessed. Qualitative data also revealed both positive and negative experiences as reflected in open comments. According to 70% respondents clinical teachers required training to apply PPD in their daily practices. Conclusion: Professional conduct of clinical teachers as perceived by the students was excellent and frequents enough with experience of inappropriate behaviour too. Role modeling was the preferred teaching method while attention needed on reflective assignment. Educators must emphasize on role modelling in their daily practices and curriculum planners should give due importance on training needs of clinical teachers to apply PPD in their daily practices.

Matched MeSH terms: Ethics, Medical
Proceedings in a disciplinary action at the Malaysian Medical Council

Mahmud MN

Med J Malaysia, 2005 Aug;60 Suppl D:32-4.
PMID: 16315621

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.

Matched MeSH terms: Ethics, Medical*; Codes of Ethics
Fulltext Principlism and neonatology: utilising the principles of medical ethics in decision-making for neonates

Tan, Mark Kiak Min

Journal of Clinical and Health Sciences, 2018;3(2):5-12.
MyJurnal

Prematurity is the leading cause of infant mortality and one of the main reasons for newborn infants to be admitted to the Neonatal Intensive Care Unit (NICU). Advancements in medicine has made the NICU a maze of sophisticated modern technology and expensive to run. These advances in technology have also resulted in an added layer of complexity to many ethical dilemmas that are encountered in the NICU. In 1977, Beauchamp and Childress introduced the principles of biomedical ethics. These four principles of (1)respect for autonomy, (2)nonmaleficence, (3)beneficence and (4)justice, form a suitable starting point for the analysis of the moral challenges of medical innovation. This article explores how the four ethical principles relate to decision-making in the NICU, and how they can be applied to the treatment of sick newborn infants in clinical practice. It also highlights the reasons why healthcare personnel need to equip themselves with good communication skills and up to date knowledge of ethical considerations in the NICU in order to make quality decisions about care for their patients. This article also suggests that a Clinical Ethics Committee can play a vital role in ensuring that the best decisions are achieved for these patients.

Matched MeSH terms: Ethics Committees, Clinical
Fulltext Prevalence of burnout among Universiti Sains Malaysia medical students

Chin ARW, Chua YY, Chu MN, Mahadi NF, Yusof MSB, Wong MS, et al.

Education in Medicine Journal, 2016;8(3):61-74.
MyJurnal

Introduction: The academic life of medical students can be considered as psychological toxic. About half of United States medical students experience burnout and more than 25% experience depression. This study aimed to determine the prevalence of burnout among medical students in a Malaysian medical school and its associated factors.
Methods: This is a cross sectional study of 452 medical students from Universiti Sains Malaysia (USM). Copenhagen Burnout Inventory was distributed via Google Forms through Facebook Messenger. Ethical approval was obtained from the Human Research Ethics Committee USM. Data were collected via Google Sheets. Each respondent only submitted one Google Form as no resubmission link was provided once completed Google Form was submitted.
Result: The prevalence of burnout among USM medical students was 67.9%. Personal burnout was the highest (81.6%), followed by work-related burnout (73.7%) and client-related burnout (68.6%). The analysis showed that regardless of year of study, gender and ethnicity (all P > 0.05), USM medical students were vulnerable to burnout.
Conclusion: The prevalence of burnout among USM medical students was high and the most prevalent type of burnout was personal burnout. Therefore, burnout among medical students should be a concern and must be addressed to prevent subsequent unwanted consequences.

Matched MeSH terms: Ethics Committees, Research
Fulltext Prevalence and risk factors of postpartum depression, general depressive symptoms, anxiety and stress (PODSAS) among mothers during their 4-week postnatal follow-up in five public health clinics in Perak: A study protocol for a cross-sectional study

Mohammad Redzuan SA, Suntharalingam P, Palaniyappan T, Ganasan V, Megat Abu Bakar PN, Kaur P, et al.

BMJ Open, 2020 06 21;10(6):e034458.
PMID: 32565453 DOI: 10.1136/bmjopen-2019-034458

INTRODUCTION: Postpartum depression, general depressive symptoms, anxiety and stress (PODSAS) are often overlooked, and may cause morbidity to new mothers, their babies and families. This study aims to determine the point prevalence of depression (post partum and general), anxiety and stress among mothers in five public health clinics in Perak at 4 weeks postdelivery and identify their associated risk factors. Findings from this study will be used to identify the needs for early screening and detection, encourage development of interventions to reduce its occurrence and support mothers with PODSAS.
METHODS AND ANALYSIS: This cross-sectional study will recruit 459 postpartum mothers during their 4-week postnatal follow-up in five selected public health clinics in Perak from September 2019 to May 2020. Participants will be mothers aged 18 years and above at 4 weeks postdelivery who are able to understand the English and Malay languages. Non-Malaysians and mothers with known diagnosis of psychotic disorders will be excluded from the study. Sociodemographic information and possible risk factors of the participants will be captured via a set of validated questionnaires, postpartum depression (PPD) will be measured using the Edinburgh Postpartum Depression Scale questionnaire and general depressive symptoms, anxiety and stress will be measured using the 21-item Depression, Anxiety and Stress Scale. Data analysis will be conducted using SPSS V.25.0 (IBM). Besides descriptive statistics, multivariable regression analyses will be done to identify possible risk factors and their independent associations with depression (PPD and general depressive symptoms, combined and separately), anxiety and stress.
ETHICS AND DISSEMINATION: The study protocol was reviewed and approved by the Medical Research Ethics Committee, Ministry of Health Malaysia on 7 August 2019. Results of this study will be reported and shared with the local health stakeholders and disseminated through conference proceedings and journal publications.
REGISTRATION NUMBER: This study is registered in the Malaysian National Medical Research Register with the ID: NMRR-19-868-47647.

Matched MeSH terms: Ethics Committees, Research

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