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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
Human Embryonic Stem Cell Research: Ethical Views of Buddhist, Hindu and Catholic Leaders in Malaysia

Sivaraman MA, Noor SN

Sci Eng Ethics, 2016 Apr;22(2):467-85.
PMID: 26049934 DOI: 10.1007/s11948-015-9666-9

Embryonic Stem Cell Research (ESCR) raises ethical issues. In the process of research, embryos may be destroyed and, to some, such an act entails the 'killing of human life'. Past studies have sought the views of scientists and the general public on the ethics of ESCR. This study, however, explores multi-faith ethical viewpoints, in particular, those of Buddhists, Hindus and Catholics in Malaysia, on ESCR. Responses were gathered via semi-structured, face-to-face interviews. Three main ethical quandaries emerged from the data: (1) sanctity of life, (2) do no harm, and (3) 'intention' of the research. Concerns regarding the sanctity of life are directed at particular research protocols which interfere with religious notions of human ensoulment and early consciousness. The principle of 'do no harm' which is closely related to ahimsa prohibits all acts of violence. Responses obtained indicate that respondents either discourage research that inflicts harm on living entities or allow ESCR with reservations. 'Intention' of the research seems to be an interesting and viable rationale that would permit ESCR for the Buddhists and Hindus. Research that is intended for the purpose of alleviating human suffering is seen as being ethical. This study also notes that Catholics oppose ESCR on the basis of the inviolability of human life.

Matched MeSH terms: Ethics, Research; Stem Cell Research/ethics*
Perspectives in tackling medico-legal controversies. Proceedings of the Commonwealth Medico-Legal Conference. January, 17-19, 2003

Med J Malaysia, 2003 Mar;58 Suppl A:1-150.
PMID: 14692413
Matched MeSH terms: Abortion, Induced/ethics; Delivery of Health Care/ethics
Addressing procedural challenges of ethical review system: Towards a better ethical quality of clinical trials review in Malaysia

See HY, Mohamed MS, Mohd Noor SN, Low WY

Account Res, 2019 01;26(1):49-64.
PMID: 30526066 DOI: 10.1080/08989621.2018.1556646

The review of clinical trials with human participants in Malaysia is governed by a decentralized control system. The clinical trial protocols are reviewed by 13 registered research ethics committees (RECs) in Malaysia. A governmental body, the National Pharmaceutical Control Bureau, is responsible for the inspection and oversight of these registered RECs to ensure that they comply with the regulatory requirements. However, this study highlights that each REC in Malaysia has a different standard operating procedure and ethical review process. Other procedural challenges identified include inadequate membership, poor mechanism for research monitoring after ethical approval, and insufficient resources. Establishments of a national standard of REC and a central ethics committee are suggested to ensure procedural compliance in the oversight of clinical trials in Malaysia. While there is a growing concern that procedural compliance may not have a direct impact on the protection of human subjects, our key point is that an ethical review system compliant with the national standards could serve as a strong framework to support and enhance the ethical quality of decision-making and judgement. We believe that being aware of how influential procedural compliance can be would help committees improve the ethical quality of their research review.

Matched MeSH terms: Clinical Trials as Topic/ethics*; Ethics Committees
The role of motivational interview in the request for termination of pregnancy: A case report

Seed HF, Thong KS

Med J Malaysia, 2019 08;74(4):326-327.
PMID: 31424041

In Malaysia, induced termination of pregnancy is legal, if a registered medical practitioner is the one who terminates the pregnancy, and is acting in good faith without the risk to the life or injury to the mental health of the pregnant woman; in the event that continuation of the pregnancy is greater than the risk if the pregnancy is terminated. This case report highlights the approach of motivational interviewing in evoking a change of the behaviour of a patient wishing termination of pregnancy for psychosocial reasons.

Matched MeSH terms: Abortion, Legal/ethics; Motivational Interviewing/ethics
Using Surplus Embryos and Research Embryos in Stem Cell Research: Ethical Viewpoints of Buddhist, Hindu and Catholic Leaders in Malaysia on the Permissibility of Research

Sivaraman MAF

Sci Eng Ethics, 2018 02;24(1):129-149.
PMID: 28281154 DOI: 10.1007/s11948-017-9893-3

The sources of embryos for Embryonic Stem Cell Research (ESCR) include surplus embryos from infertility treatments, and research embryos which are created solely for an ESCR purpose. The latter raises more ethical concerns. In a multi-religious country like Malaysia, ethical discussions on the permissibility of ESCR with regard to the use surplus and research embryos are diversified. Malaysia has formulated guidelines influenced by the national fatwa ruling which allows the use of surplus embryos in ESCR. Input from other main religions is yet to be documented. In light of this, this study addresses (i) the ethical viewpoints of Buddhist, Hindu and Catholic leaders on the permissibility of using surplus and research embryos; and (ii) the moral standpoints of religious leaders towards attaining a consensus on the practice of ESCR in Malaysia. Responses from the religious leaders were obtained via semi-structured, face-to-face interviews. The findings show that generally the Buddhist and Hindu leaders approve the use of surplus embryos. Their responses on the creation of research embryos for ESCR are varied. Meanwhile, the Catholic leaders distinctively objected to ESCR regardless of the embryo sources, referring to it as the destruction of life. Taking into account the diverse views, this study explores the response of the religious leaders for a general consensus wherever possible. The ethical discourse surrounding ESCR in a multi-religious setting offers new perspective, which needs to be explored in a broader global community.

Matched MeSH terms: Embryo Research/ethics*; Stem Cell Research/ethics*
Maqasid al-Shariah Based Islamic Bioethics: A Comprehensive Approach

Ibrahim AH, Rahman NNA, Saifuddeen SM, Baharuddin M

J Bioeth Inq, 2019 Sep;16(3):333-345.
PMID: 30715660 DOI: 10.1007/s11673-019-09902-8

Maqasid al-Shariah based Islamic bioethics is an Islamic bioethics concept which uses the objectives of the Shariah (maqasid al-Shariah) as its approach in analysing and assessing bioethical issues. Analysis based on maqasid al-Shariah based Islamic bioethics will examine any bioethical issues from three main aspects namely intention, method, and output or final goal of the studied issues. Then, the evaluation will be analysed from human interest hierarchy, inclusivity, and degree of certainty. The Islamic bioethics concept is a manifestation of dynamic Islamic jurisprudence which can overcome new complex and complicated bioethical issues such as tri-parent baby technology issues. Therefore, this article will introduce and explain the concept of maqasid al-Shariah based Islamic bioethics and outline a general guidance of maqasid al-Shariah based Islamic bioethics to determine a maqṣad (objective) based on standards of human good or well-being (maslahah) and harm (mafsadah).

Matched MeSH terms: Bioethics*; Technology Assessment, Biomedical/ethics*; Reproductive Techniques, Assisted/ethics
Fulltext Nurse managers' experience with ethical issues in six government hospitals in Malaysia: a cross-sectional study

Musa Mb, Harun-Or-Rashid MD, Sakamoto J

BMC Med Ethics, 2011;12:23.
PMID: 22085735 DOI: 10.1186/1472-6939-12-23

Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues.

Matched MeSH terms: Nurse Administrators/ethics; Nursing Staff, Hospital/ethics
A grim contradiction: the practice and consequences of corporate social responsibility by British American Tobacco in Malaysia

Barraclough S, Morrow M

Soc Sci Med, 2008 Apr;66(8):1784-96.
PMID: 18304713 DOI: 10.1016/j.socscimed.2008.01.001

In the wake of the World Health Organization Framework Convention on Tobacco Control, corporate social responsibility (CSR) is among the few remaining mechanisms for tobacco corporations publicly to promote their interests. Health advocates may be unaware of the scale, nature and implications of tobacco industry CSR. This investigation aimed to construct a typology of tobacco industry CSR through a case study of the evolution and impact of CSR activities of a particular tobacco corporation in one country - British American Tobacco, Malaysia (BATM), the Malaysian market leader. Methods included searching, compiling and critically appraising publicly available materials from British American Tobacco, BATM, published literature and other sources. The study examined BATM's CSR strategy, the issues which it raises, consequences for tobacco control and potential responses by health advocates. The investigation found that BATM's CSR activities included assistance to tobacco growers, charitable donations, scholarships, involvement in anti-smuggling measures, 'youth smoking prevention' programs and annual Social Reports. BATM has stated that its model is predominantly motivated by social and stakeholder obligations. Its CSR activities have, however, had the additional benefits of contributing to a favourable image, deflecting criticism and establishing a modus vivendi with regulators that assists BATM's continued operations and profitability. It is imperative that health advocates highlight the potential conflicts inherent in such arrangements and develop strategies to address the concerns raised.

Matched MeSH terms: Tobacco Industry/ethics*; Marketing/ethics
Fulltext An international survey of medical ethics curricula in Asia

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*; Ethics, Clinical
Fulltext Analysis of the reliability of patient COVID-19 screening data compared against their actual test data

Albargi AM, Assiry AA, Bahammam HA, Alassiri MY, Marya A, Karobari MI

Sci Prog, 2021;104(3):368504211042980.
PMID: 34541957 DOI: 10.1177/00368504211042980

OBJECTIVES: This study aimed to evaluate the truthfulness of patients about their pre-appointment COVID-19 screening tests at a dental clinic.
METHODS: A total of 613 patients were recruited for the study from the dental clinic at the Faculty of Dentistry, Najran University, Saudi Arabia. The data collection was done in three parts from the patients who visited the hospital to receive dental treatment. The first part included the socio-demographic characteristics of the patients and the COVID-19 swab tests performed within the past 14 days. The second part was the clinical examination, and the third part was a confirmation of the swab test taken by the patient by checking the Hesen website using the patient ID. After data collection, statistical analysis was carried out using SPSS 26.0. Descriptive analysis was done and expressed as mean, standard deviation, frequency, and percentage (%). A cross-tabulation, also described as a contingency table, was used to identify trends and patterns across data and explain the correlation between different variables.
RESULTS: It was seen from the status of the swab test within 14 days of the patient's arrival at the hospital for the dental treatment that 18 (2.9%) patients lied about the pre-treatment swab test within 14 days, and 595 (97.1%) were truthful. The observed and expected counts showed across genders and diagnosis a statistically significant difference (p

Matched MeSH terms: Dental Offices/ethics; Truth Disclosure/ethics*
Teaching and learning of professionalism in medical schools

Sivalingam N

Ann Acad Med Singap, 2004 Nov;33(6):706-10.
PMID: 15608822

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.

Matched MeSH terms: Ethics, Medical
Ethical and legal aspects of assisted reproduction practice in Asia

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
Snapshot of academic dishonesty among Malaysian nursing students: A single university experience

Abusafia AH, Roslan NS, Mohd Yusoff D, Mat Nor MZ

J Taibah Univ Med Sci, 2018 Aug;13(4):370-376.
PMID: 31435349 DOI: 10.1016/j.jtumed.2018.04.003

Objective: The aim of this study was to evaluate academic dishonesty among nursing students at a public university in Malaysia.
Methods: This study utilized a descriptive and cross-sectional design to evaluate academic dishonesty among nursing students using a purposive sampling method. The participants of this study consisted of 201 students from diploma (Year 2 and 3) and degree (Year 2 to Year 4) nursing programmes. A self-administered, validated questionnaire was used for data collection. Institutional ethics committee clearance was obtained prior to commencement of the study.
Results: The results of this study showed that 82.1% and 74.6% of nursing students had engaged at least once in an act of academic dishonesty in an academic or clinical setting, respectively. The most frequent form of academic dishonesty in an academic setting was plagiarism (77.1%). There was a significant association between gender and academic dishonesty in a clinical setting (p

Matched MeSH terms: Ethics Committees
Fulltext The use of simulation technique among undergraduate nursing student

Mohd Said Nurumal, Mohammad Syafiq Mohamad Azizi, Muhammad Kamil Che Hasan

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):10-0.
MyJurnal

Introduction: Simulation is widely practiced as learning strategies in many disciplines including nursing. It is con- sidered an updated technological approach towards providing safe and sound patients care. Thus, this study was conducted to assess the level of knowledge among nursing students using a simulated mannequin for cardiovascular assessment. Methods: This is a cross-sectional study design focusing Year 4 nursing students at Kulliyyah of Nurs- ing, International Islamic University Malaysia (IIUM). A simulation mannequin was used for students performing a cardiovascular assessment. Level of knowledge was tested using an adapted questionnaire. The study was approved by the Kulliyyah of Nursing Postgraduate Research Committee (Ref: IIUM/313/DDAA/20/4/10) and IIUM Research Ethics Committee (Ref: IREC 2018-024). Results: A total of 57 nursing students involved in this study revealing good cardiovascular assessment knowledge. Majority of them reported that simulation exercise is one of the good learning strategies to enhance their capabilities and increase their confidence level. Conclusions: The results from this study could indicate that using technological simulation approach could provide a similar effect in performing cardiovas- cular assessment among nursing student IIUM. Future larger scale is needed including for any other disciplines in nursing to facilitate students’ preparation towards the real clinical setting.

Matched MeSH terms: Ethics Committees, Research
Fulltext Medical ethics: what you should know

Mohd Rizal Abdul Manaf

Int J Public Health Res, 2012;2(1):129-136.
MyJurnal

Introduction Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. A physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. This paper presents some information regarding medical ethics, including the values and principles of ethical conduct. Later the requirements of consent form is presented to guide the researchers before conducting a study.

Matched MeSH terms: Ethics, Medical
Fulltext Changing trends in informed consent

Victor Lim

International e-Journal of Science, Medicine & Education, 2014;8(1):3-7.
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
Fulltext The traditional practice in the hospital setting: what are the ethical implications?

Rosnani Zakaria, Muzaimi Mustapha, Tengku Alina Tengku Ismail, Bella Puvok, Kamarul Aryffin Baharuddin, Mohd Suhaimi Ab Wahab, et al.

Education in Medicine Journal, 2015;7(4):68-72.
MyJurnal

Myth, believe in powerful ‘being’ commonly known as jinn and usage of ‘bomoh’ as the medium is still widespread in our community in Kelantan especially among the Malay community. This believe and practice of usin ‘bomoh’ to cure and help with known and unknown disease believe to be caused by the jinn, occasionally poses a significant complication and threat to the management of patient in the hospital. Our case is just one of many cases that happen in our local hospital, and we hope by sharing this case will illustrate how ethical discussion occasionally surpassed the four common ethical pillars.

Matched MeSH terms: Ethics
Fulltext The Impact of the Teaching of Ethics in a Medical and Allied Health Sciences Curriculum in International Islamic University Malaysia

Naznin, M, Abdul Rahman, S., Ariff, O., Ahmad Mansur, M, Kasule, O.H.

International Medical Journal Malaysia, 2008;7(1):0-0.
MyJurnal

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.

Matched MeSH terms: Ethics, Medical
Fulltext What health management topic frequently appeared in the New England Medical Journal (NEMI)? : a systemic review

Khalib, A.L., Nirmalini, R.

Malaysian Journal of Community Health, 2008;14(2):31-35.
MyJurnal

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.

Matched MeSH terms: Ethics, Medical

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