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Current covid-19 pandemic challenges health-care ethics. Ones of the most important challenges are medical resources allocation and a duty to treat, often addressed to medical personnel. This paper suggests that there are good reasons to rethink our health-care ethics for future global catastrophic risks. Current pandemic shows how challenging can be an issue of resources allocation even in a relatively small kind of catastrophic event such as covid-19 pandemic. In this paper, the authors show that any future existential bigger catastrophe may require new guidelines for the allocation of medical resources. The idea of assisted dying is considered as a hypothetical scenario.

This is a conceptual work based on conceptual analysis at the intersection of risk studies, health-care ethics and future studies. This study builds the argument on the assumption that the covid-19 pandemic should be treated as a sort of global catastrophic risk. Findings show that there are no such attempts in currently published peer-reviewed academic literature. This is crucial concept for the meta-analysis. This study shows why and how current pandemic can be interpreted in terms of global catastrophic risk even if, literally, covid-19 does not meet all criteria required in the risk studies to be called a global catastrophe.

We can expect an emergence of discriminatory selection policy which will require some actions taken by future patients like, for example, genetic engineering. But even then it is inevitable that there will still be a large number of survivors who require medical assistance, which they have no chance of receiving. This is why this study has considered the concept of assisted dying understood as an official protocol for health-care ethics and resources allocation policy in the case of emergency situations. Possibly more controversial idea discussed in this paper is an idea of assisted dying for those who cannot receive required medical help. Such procedure could be applied in a mass-scale during a global catastrophic event.

Philosophers and ethicists should identify and study all possible pros and cons of this discrimination rule. As this study’s findings suggested above, a reliable point of reference is the concept of substantial human enhancement. Human enhancement as such, widely debated, should be studied in that specific context of discrimination of patients in an access to limited medical resources. Last but not least, scientific community should study the concept of assisted dying which could be applied for those survivors who have no chance of obtaining medical care. Such criteria and concepts as cost-benefit analysis, the ethics of quality of life, autonomy of patients and duty of medical personnel should be considered.

Politicians and policymakers should prepare protocols for global catastrophes where these discrimination criteria would have to be applied. The same applies to the development of medical robotics aimed at replacing human health-care personnel. We assume that this is important implication for practical policy in healthcare. Our prediction, however plausible, is not a good scenario for humanity. But given this realistic development trajectory, we should do everything possible to prevent the need for the discriminatory rules in medical care described above.

This study offers the idea of assisted dying as a health-care policy in emergency situations. The authors expect that next future global catastrophes – looking at the current pandemic only as a mild prelude – will force a radical change in moral values and medical standards. New criteria of selection and discrimination will be perceived as much more exclusivist and unfair than criteria applied today.

Based on the developmental process of pharmacy in medical relationships, it is essential to pay attention to ethical issues in this field and develop a good pharmacist–patient relationship. The present study aimed to mention the frequency of ethical challenges of pharmacy in Iran as a fundamental step towards designing a practical ethical guideline for professionals.

In this observational study, data were collected using a two-part questionnaire with 64 items developed after examining relevant texts and conducting unstructured interviews with pharmacy specialists. The first part determined the frequency of ethical challenges that the pharmacist confronts, using 43 short scenarios, whereas the second part comprised 21 questions with short answers. For validation, the questionnaire was sent to 20 medical ethics specialists who were familiar with issues in pharmacy ethics.

Data were collected from 48 members of the Iranian Association of Pharmacists (Working Group of Hospital Pharmacists). and the frequency of ethical challenges was determined. The most frequent issues were patient's request for over-the-counter drugs, asking about their lab results, asking drug for another person and returning the drug.

One of the limitation of our study is its population, there were hospital pharmacist, other pharmacist such as community pharmacist may face different challenges.

The finding of this study could lead the policymakers to develop ethical guidelines for pharmacy practices.

The pharmacist–patient relationship is one of the important aspects of health system, and therefore regulating this relationship based on the professional ethics guidelines could have a positive impact on therapeutic relationships.

Results showed that designing codes of ethics and practical guidelines based on the frequency of the noted challenges enhances the quality of treatment, improves the pharmacist–patient relationship, increases the level of cooperation and decreases patient complaints.

Education systems throughout the world seek to take the advantage of every presenting opportunity for achieving a standard level of ethical accountability and capability. The purpose of this paper is to explain the challenges of professional ethics training from the perspective of faculty members at the Ardabil University of Medical Sciences (ARUMS).

The present qualitative framework analysis held interviews with 21 key faculty members were selected using the purposeful and snowball method to interview from ARUMS in 2016. The duration of each interview varied between 45 and 120 min. The data obtained were analyzed in MAXQDA-10. Codes were extracted using inductive methods.

Three main themes were extracted from the interviews, namely, educational efficacy, professional interaction and equity in education along with 12 subthemes, namely, teacher’s personal capability, work in the area of expertise, regular class attendance, quality class attendance, inclusion of theoretical bases, the teacher as an ethical role model, respect for the student, encouragement of ethical behaviors, respect for the patient’s rights, fair assessment, attention to differences and positive discrimination.

This study results could help to improve the quality of training and ethical standards in medical education.

To comply with the codes of ethics in research, permission was obtained from the Ethics Committee and the participants were ensured about the confidentiality of their data and their right to withdraw from the study at any stage. Given that this project was a qualitative study, the authors did not have a moral or practical problem in the study. This study was approved with number “IR.ARUMS.FEC.1394.25” at the Ardabil University of Medical Sciences Research Ethics Council. The cooperation of participants in the study was completely voluntary; moreover, the authors obtained written consent from participants for the study.

Health care practitioners in prison face the challenge of providing high standards of health care within the unique peculiarities and restraints of the prison environment. The strict adherence to principles of medical ethics by the prison health care staff and the knowledge and acceptance of these principles by the whole prison community not only results in ethical conduct but also yields practical professional advantages such as guidance in situations of conflict, promotion of confidence and avoidance of misunderstandings. The internationally consented conventions, declarations and recommendations relevant on medical ethics in prison are presented and their basic principles ‐ the primary task of the prison doctor, access to a doctor, equivalence of care, patient’s consent and confidentiality, preventive health care, humanitarian assistance, professional independence, professional competence ‐ are discussed. In addition, the personal obligation of the prison doctor for ethical reflection and decision making in individual ethical issues not covered by the quoted documents and in ethically controversial issues is emphasized. A training course and published guidelines for ethical conduct in prison health care are recommended.

The purpose of this study is to explore the presence of ethical standards in the content of international hospitals codes of ethics disclosed in their websites.

Firstly, the focus is on developing an integrated framework of universal values and hospital responsibilities for the content of hospitals’ codes of ethics documents. A list of key ethical issues was determined through an examination of the American Medical Association Code of Medical Ethics (2016), the WAMA (2017), International Code of Medical Ethics and relevant peer-reviewed journal articles (Finseschi, 1997; Vergallo, 2016; Suhonen et al., 2011; Reader et al., 2014). Based on the detailed literature review, 48 concepts, which were evenly, classified under two groups; professional conduct issues and patients’ rights. In the second stage, the issues were ranked related to professional conduct and patients’ rights from most to least frequent for the proposed conceptual framework, using World Global Hospitals codes of ethics.

It was found that only 62% of the top 100 hospitals have an ethics code report in their websites. The findings of the study have significant theoretical and practical implications. First, most of the hospitals’ ethical codes extensively emphasize professional conduct and patients’ rights, whereas they differ in what they include or exclude from their codes and the wording used. The number and frequency of the professional conduct issues is higher than patients’ rights. Emerging ethical issues, such as physicians’ and patients’ freedom of choice, sperm donation and artificial reproduction, were not widely mentioned, whereas abortion, euthanasia, human rights and transplantation issues were disregarded entirely.

This study provides a benchmark for hospitals to assess their codes against other hospitals’ codes in terms of the specific items they address.

The results of this study provide a benchmark for evaluating and developing ethical codes for hospitals in light of the international health standards and norms.

To the best of the knowledge, no previous study has theoretically or practically analyzed hospitals’ codes of ethics.

Is there a sound philosophical foundation in the nature of professional activity for resolving the tension between altruism and self‐interest in favor of virtue and character? I believe there is, and I ground my proposal in six characteristics of the relationship of professionals to those who seek their help. Considered individually, none of these phenomena is unique in kind or degree. They may exist individually in other human relationships and occupations. But as a moral cluster they are, in fact, unique; they generate a kind of “internal morality”—a grounding for the ethics of the professions that is in some way impervious to vacillations in philosophical fashions, as well as social, economic, or political change. This internal morality explains why the ethics of medicine, for example, remained until two decades ago firmly rooted in the ethics of character and virtue, as were the ethics of the Hippocratic and Stoic schools. It is found in the seminal texts of Moslem, Jewish, and Christian medical moralists. It persisted in the eighteenth century in the writings of John Gregory, Thomas Percival, and Samuel Bard, who, although cognizant of the philosophies of Hobbes, Adam Smith, and Hume, nonetheless maintained the traditional dedication of the profession to the welfare of the patient and to a certain set of values. Only in the last two decades has there been—to use Hume's terms—a “sentiment of approbation” regarding self‐interest.

This paper aims to avail a soft approach to embracing the process of creating a business code of conduct and ethics and make it work for a pharmaceutical company [player] which wants to remain relevant before stakeholders and society, amidst escalating inducements to go against the acceptable pharmaceutical behaviour.

Data collection was guided by qualitative methodologies. A four stepwise process was followed: data collection at the case company – Kampala Pharmaceutical Industries (KPI), Uganda; validation of data collected at KPI; data collection from external stakeholders of KPI; and re-validation of KPI data based on data collected from external stakeholders. In all this, combination of semi-structured and informal interviews with CEOs, senior staff managers, non-participant observation of ethical related activities plus organizing a stakeholder engagement workshop on business code of conduct and ethics was achieved. This workshop helped document what ought to be an ideal design process to secure stakeholder buy-in of the code of business ethics. A local pharmaceutical company in Uganda, KPI was used, which, for continuous five years since its adoption of the business code of conduct and ethics, registered commercial viability without any record of unethical practices. Triangulation was used to ensure credibility and validity of the results. For data analysis, a three-stepwise process was followed, which helped develop a framework within which the collected data revealed themes which were later analyzed. For generalization of the findings, the “adaptive theory approach” was used.

When poorly introduced in an organization, the business code of conduct and ethics can work against the company simply because it will be received with “intentional rebellion” from stakeholders, notably staff. However, when a soft stakeholder engagement and consultative approach is used and followed during the business code of ethics and conduct’s design process, multiple stakeholders feel proud and are much willing to live by the promise spelt out in it. Cited notable benefits of living by the code include reputational enhancement, strategic competitiveness and increased possibilities of wining cross-border cooperation among like-minded pharmaceutical players. In the efforts to reap from the code of ethics, communication was observed as an indispensable activity. Refresher trainings to remind the stakeholders about the promises in the code are also needed as time passes by, otherwise they forget. Needless to say, rewarding those who live an exemplary life in embracing and living by the code was cited as key in sustaining the ethical agenda. Lastly, managing multiple stakeholders influences is a curvilinear fashion and involves back and forth consultations.

The lessons learnt from KPI can be borrowed and used by both global pharmaceutical players and national/local players, especially those that face challenges living by the promise of their existing codes or those without business code of conduct and ethics. That is, both players can use the suggested process to help participants in their medicine supply chain to come up with working business codes of conduct, as well as guide the stakeholder consultative process which results in stakeholder buy-in.

For many years, issues surrounding bioethics have dominated priorities of World Health Organization (WHO), UNESCO and many international and national development allies. However, there is an escalating violation of medical codes of conduct and ethics. Hence, this publication is a step toward the implementation of the principles and objectives of the UNESCO Universal Declaration on Bioethics and Human Rights which is currently challenged with a difficult question posed by life sciences – How far can we go given the dented medical relationship between ethics, medical science and freedom?

The prime objective of this article is related to dignified human beings as patients in clinical interventions. The main attention of such a perception focuses on observance of humaneness in relationships among physicians, patients, family members, and community at large. This paper aims to address these issues.

The paper examines in depth, analytical deliberations concerning traditional and modern values of medical care and healthcare knowledge and practices.

Therefore, we need to attest that we live in a global village in which multicultural people must live side‐by‐side, if they desire to peacefully coexist. We must assume that human values are based upon general agreements about ethical issues. Such agreements rely on a framework of equitable treatments of all mankind. Medical ethics is about committed codes and oaths of professional medical authorities to protect natural rights, human rights, and civil rights of patients in clinical interventions. It strives to achieve professional objectives to facilitate patients to be recovered from pain and suffering and regain their health in order to live the good life.

This paper is devoted to define the notions relevant to the philosophies of quality of life, ethical, and moral problems concerning clinical medicine, and preventive care systems. It analyzes certain ethical and moral distinctions between medical care and healthcare services, and indicates that cautions should be observed in discussing these notions within the context of preventive care and clinical care systems.

This paper explores the following questions: What is the meaning of a psychosomatic normal life? How life should be respected? What are the meta‐medical practices? What should be the logical and philosophical foundations for medical care and healthcare ethics? How should clinicians and practitioners respect not only cost‐benefit analysis but also consider cost‐effectiveness analysis in providing and promoting medical care and healthcare services for patients?

The aim of this paper is to call for an increased focus on the ethics of direct-to-consumer (DTC) prescription drug advertising. This is important, not only to improve DTC prescription drug advertising, but also to inform DTC advertising of future medical advances.

This conceptual paper discusses two examples of medical advances – personal genetic testing services and surgically implanted medical devices – to explain how investigating the research of DTC prescription drug advertising can set the stage for more ethical advertising of future medical advances.

Specific issues related to health literacy, at-risk populations impacted by health disparities, and medicalization of issues common to aging relate to the DTC advertising of prescription drugs and other medical advances. Creative approaches to investigating these issues in the context of prescription drug advertising can enrich the debate about drug advertising, but also prepare researchers, policymakers, and consumers for future advertising of new medical developments.

The value of this paper is its call for increased focus on the ethics of DTC prescription drug advertising, to improve the current marketing environment but also lay the foundation for other healthcare marketing in the future.

Migration is increasing worldwide. health care practitioners must provide care to migrants in a culturally competent manner that is sensitive to cultural, political and economic contexts shaping health and illness. Many studies have provided strong evidence that health providers benefit from training in cross-cultural care. Cultural competence education of medical students during their early learning can begin to address attitudes and responsiveness toward refugees. At Memorial University in Canada, the authors designed “Morning in Refugee Health”, an innovative program in cultural competency training for first year medical students in the Clinical Skills and Ethics course. The purpose of this paper is to discuss these issues.

Here the authors introduce the curriculum and provide the rationale for the specific pedagogical techniques employed, emphasizing the consideration of culture in its relation to political and economic contexts. The authors describe the innovation of training standardized patients (SPs) who are themselves immigrants or refugees. The authors explain how and why the collaboration of community agencies and medical school administration is key to the successful implementation of such a curriculum.

Medical students benefit from early pre-clinical education in refugee health. Specific attention to community context, SP training, small group format, linkages between clinical skills and medical ethics, medical school administrative and community agency support are essential to development and delivery of this curriculum. As a result of the Morning in Refugee Health, students initiated a community medical outreach project for newly arriving refugees.

The approach is unique in three ways: integration of training in clinical skills and ethics; training of SPs who are themselves immigrants or refugees; and reflection on the political, economic and cultural contexts shaping health and health care.