The Major Medical Ethics Challenging Facing the Public and Health Care Providers in K.S.A

The Major Medical Ethics The Major Medical Ethics Challenging Facing the Public Challenging Facing the Public and Health Care Providers in and Health Care Providers in

K.S.AK.S.A(http://www.jfcmonline.com/article.asp?issn=2230-

8229;year=2012;volume=19;issue=1;spage=1;epage=6;aulast=Alkabba)

ByDr. Abdulaziz Fahad Al Kabbaa

Faculty of MedicineKing Fahad Medical City

KSAU-HS

Table of Contents

Medical Services are one of the Medical Services are one of the priorities and highly needed in priorities and highly needed in

developed country like K.S.A. However, developed country like K.S.A. However, common problems occurred in our common problems occurred in our

kingdom are ethical issues.kingdom are ethical issues.

Good medical ethics provide good medical services.

Major ethical issues in KSA

In this research, In this research, ranking the top ranking the top ethical challenges can be an ethical challenges can be an effective and valuableeffective and valuable way way bringing them to the publicbringing them to the public

This research focuses on major ethical issues

By the end of itBy the end of it, we should be aware of , we should be aware of the most important major ethical issues the most important major ethical issues

facing the health care providers and public in facing the health care providers and public in K.S.A. K.S.A.

Review Literature

Medical ethical challenges have been Medical ethical challenges have been discussed widely in the literature as isolated discussed widely in the literature as isolated ethical issues in health care.ethical issues in health care.

A modified Delphi Study A modified Delphi Study was was conducted with twelve clinical bio-ethicist conducted with twelve clinical bio-ethicist members of the Clinical Ethics Group of the members of the Clinical Ethics Group of the University of Toronto Joint Centre for University of Toronto Joint Centre for BioethicsBioethics....

One question was asked One question was asked

what do you think are the top ten ethical what do you think are the top ten ethical challenges that Canadians may face in challenges that Canadians may face in health care?health care? The panel was asked The panel was asked to rank the top ten to rank the top ten ethical challengesethical challenges throughout the Delphi throughout the Delphi process & consensus was reached after process & consensus was reached after three roundsthree rounds

The research also The research also seek perceptionsseek perceptions and and ethical problemsethical problems generated within generated within medical staff on medical industries. medical staff on medical industries.

Many of the challenges listed by the panel Many of the challenges listed by the panel have have received significant public attentionreceived significant public attention..

In this research, In this research, different results may different results may be achievedbe achieved according to the difference according to the difference in both culture and system.in both culture and system.

Cont…

It aim of this study is to:It aim of this study is to:

Explore the Major Medical Explore the Major Medical Ethical Issues that challenges Ethical Issues that challenges

and facing the public and health and facing the public and health care providers in K.S.A.care providers in K.S.A.

Aims of this Study

Specific ObjectivesThe specific objectives of this study are toThe specific objectives of this study are to::

1.1. To explore the major medical ethical To explore the major medical ethical challenges and facing Saudi public & health challenges and facing Saudi public & health care providers in K.S.Acare providers in K.S.A

2.2. To know and rank the major ethical issues in To know and rank the major ethical issues in K.S.A.K.S.A.

Study DesignThis is a cross-section study. This is a cross-section study. (Qualitative (Qualitative

Study)Study)

Study Area This study is conducted on three majors This study is conducted on three majors

cities of K.S.A that considered abundant cities of K.S.A that considered abundant numbers of medical and academic numbers of medical and academic

institutions, namelyinstitutions, namely : : Riyadh, Riyadh, JeddahJeddah and and DammamDammam ( Tiaf,Tabuk, )( Tiaf,Tabuk, )

Methodology

Study Population

The study population consists of The study population consists of members members of Ethics committee in the majors’ health of Ethics committee in the majors’ health institutions (hospitals) and/ or having experience institutions (hospitals) and/ or having experience in medical ethics field and medical administration in medical ethics field and medical administration (CEO) in KSA(CEO) in KSA. .

Cont…

Sampling Technique::Random Sample of four (4) hospitals in Random Sample of four (4) hospitals in Riyadh, two (2) in Jeddah & two (2) in Riyadh, two (2) in Jeddah & two (2) in Dammam. Besides, one in Taif and Dammam. Besides, one in Taif and another one in Tabukanother one in Tabuk

The hospitals are:The hospitals are:A.A. RiyadhRiyadh1.1.King Fahad Medical City (KFMC)King Fahad Medical City (KFMC)2.2.National Guard Hospital (KFNGH)National Guard Hospital (KFNGH)3.3.Military Hospital (RKH)Military Hospital (RKH)4.4.King Khalid University Hospital (KKUH)King Khalid University Hospital (KKUH)

B.B. JeddahJeddah5.5.King Faisal Specialized HospitalKing Faisal Specialized Hospital6.6.King Abdul-Aziz University Hospital (KAUH)King Abdul-Aziz University Hospital (KAUH)

Cont…

C. DammamC. Dammam7.7.Dammam Central HospitalDammam Central Hospital8.8.King Faisal Specialized HospitalKing Faisal Specialized Hospital

D.D. OthersOthers9.9. Taif – Military HospitalTaif – Military Hospital• Tabuk – Military HospitalTabuk – Military Hospital

Cont…

In this study In this study Delphi MethodDelphi Method which is which is validated & used in similar international study validated & used in similar international study in Canada has been applied in this study.in Canada has been applied in this study. It has three stepsIt has three steps::

Step 1Step 1the participants were asked to list the the participants were asked to list the top 10 medical ethics challenging health care top 10 medical ethics challenging health care provider in our culture (Saudi Arabia). provider in our culture (Saudi Arabia).

They were requested to email their responses They were requested to email their responses back to the investigators.back to the investigators.

Data Collection Tool & Analysis Method

Step 2:Step 2: These forms were collected and entered to These forms were collected and entered to SPSS file (Version 17)and frequencies of SPSS file (Version 17)and frequencies of the ranks were obtained. the ranks were obtained. These frequencies were ranked from the These frequencies were ranked from the highest values to the lowest.highest values to the lowest.

Ethical Issues in Saudi Arabia as described by Health Care Professionals

Items FrequencyRank

Patients Identification and Rights551

Confidentiality412

Medical Negligence (Medical Error(313

Consent FORM (as a patient or as a research person)304

Islamic Medicine & Ethics of Muslim Doctors295

Research Ethics276

Equity of Resource Distribution277

Dealing with Health Care Team258

Patients Require Resuscitation (DNR)229

Examining Opposite Sex1710

Physicians Rights and Duties1211

The Effect Health System on Decision Making1212

Conflict of Interest1013

Legitimate Necessity914

The resultsThe results of this ranks of this ranks were resentwere resent again again to the respondents and to the respondents and they were asked to they were asked to re-rank themre-rank them, If they don’t agree about the , If they don’t agree about the item s’ importance.item s’ importance.

They were requested to email the new list They were requested to email the new list back again to the researchersback again to the researchers..

Cont…

These forms were collected and These forms were collected and entered to SPSS file and entered to SPSS file and frequencies of them were frequencies of them were obtained. obtained.

It were re-ranked again from the It were re-ranked again from the highest frequencies to the lowest.highest frequencies to the lowest.

ItemsRank

Do you agree?

Your New Rank Yes No

Patients Identification and Rights1

Confidentiality2

Medical Negligence (Medical Error)3

Consent FORM (as a patient or as a research subject4

Islamic Medicine & Ethics of Muslim Doctors5

Research Ethics6

Equity of Resource Distribution7

Dealing with Health Care Team8

Patients Require Resuscitation (DNR)9

Examining Opposite Sex10

Physicians Rights and Duties11

The Effect Health System on Decision Making12

Conflict of Interest13

Legitimate Necessity14

Abortion (Legal)15

Step 3:Step 3:A panel consistsA panel consists of you - of you -as highly as highly professional expertise in the field-professional expertise in the field- are are invited to this meeting to decide the top invited to this meeting to decide the top 10 major ethical issues facing the Saudi 10 major ethical issues facing the Saudi community in this meeting. community in this meeting. The final list top 10 will be compared with The final list top 10 will be compared with the international result (Canadian Study)the international result (Canadian Study)..

The 10 medical ethics- which have been agreed upon by the expertise- are as follow:

1- Patients Rights1- Patients Rights2- Equity of resources2- Equity of resources3- Confidentiality of the patients3- Confidentiality of the patients4- Patient Safety4- Patient Safety5- Conflict of Interest 5- Conflict of Interest 6- Ethics of privatization6- Ethics of privatization7- Informed Consent 7- Informed Consent 8- Dealing with opposite sex 8- Dealing with opposite sex 9- Beginning and end of life9- Beginning and end of life10-Health Care Team Ethics10-Health Care Team Ethics

MEDICAL ETHICAL ISSUES CHALLENGING FACING THE PUBLIC AND HEALTH CARE Providers in K. S. A.

THANK YOUTHANK YOU