Dev World Bioeth
September 2024
During the COVID-19 pandemic, healthcare professionals around the world were driven by universal values of solidarity and duty to provide care. However, local societal norms and existing healthcare systems influenced interactions among physicians, and with patients and their families. An exploratory qualitative study design using in-depth interviews was undertaken with physicians working at two public sector hospitals in Karachi, Pakistan.
View Article and Find Full Text PDFThe arrival of the Covid-19 pandemic in Pakistan necessitated that the Centre of Biomedical Ethics and Culture in Karachi realign its activities to changing realities in the country. As Pakistan's only bioethics center, and with no guidelines available for allocation of scarce medical resources, CBEC developed "Guidelines for Ethical Healthcare Decision-Making in Pakistan" with input from medical and civil society stakeholders. The CBEC blog connected to the center's bioethics programs for students from Pakistan and Kenya shifted to Covid-related issues specific to the context of existing social and political realities within these countries.
View Article and Find Full Text PDFContext: Female medical students outnumber men in countries such as Saudi Arabia, India and Pakistan, yet many fail to practise medicine following graduation. In Pakistan, 70% of medical students are women, yet it is estimated that half of them will not pursue medicine following graduation. This is considered a major reason for physician shortages in the country.
View Article and Find Full Text PDFBioethics education and discussions about ethical dilemmas are being increasingly reduced to teaching students how to balance the four, easily memorised philosophical principles popularised by influential American philosophers Tom Beauchamp and Jim Childress. The reality is that human beings approach and comprehend moral issues in diverse ways shaped by shared histories, cultural norms and values, kinship systems, lived experiences and existing socio-political realities. Therefore, ethical discourse limited to a culturally myopic Principlism that disregards the indigenous landscape can be an abstract and meaningless venture.
View Article and Find Full Text PDFBackground: Many nations are able to prosecute transplant-related crimes committed in their territory, but transplant recipients, organ sellers and brokers, and transplant professionals may escape prosecution by engaging in these practices in foreign locations where they judge the risk of criminal investigation and prosecution to be remote.
Methods: The Declaration of Istanbul Custodian Group convened an international working group to evaluate the possible role of extraterritorial jurisdiction in strengthening the enforcement of existing laws governing transplant-related crimes across national boundaries. Potential practical and ethical concerns about the use of extraterritorial jurisdiction were examined, and possible responses were explored.
The Ethics Committee of The Transplantation Society convened a meeting on pediatric deceased donation of organs in Geneva, Switzerland, on March 21 to 22, 2014. Thirty-four participants from Africa, Asia, the Middle East, Oceania, Europe, and North and South America explored the practical and ethical issues pertaining to pediatric deceased donation and developed recommendations for policy and practice. Their expertise was inclusive of pediatric intensive care, internal medicine, and surgery, nursing, ethics, organ donation and procurement, psychology, law, and sociology.
View Article and Find Full Text PDFIndian J Med Ethics
December 2015
Pakistan has taken a long and tortuous road towards curbing the trade in organs within its borders. Yet, despite the phenomenal gains, several challenges remain in this area. For example, robust and sustainable deceased donor programmes must be established to meet the needs of a country which has a high prevalence of kidney disease and failure.
View Article and Find Full Text PDFDespite the majority opinion of Muslim jurists that organ donation is permitted in Sharia, surveys indicate continuing resistance by lay Muslims, especially to donating organs following death. Pakistan, a country with 165 million Muslims, currently reliant on live donors, is considering steps to establish deceased donor programs which will require public acceptance and support. This article analyzes the results of in-depth interviews with 105 members of the public focusing on opinions and knowledge about juristic rulings regarding kidney donations, donor-family dynamics in deceased donation decisions, and attitudes towards buying kidneys.
View Article and Find Full Text PDFThis essay provides a brief overview of the rise of organ trade in Pakistan towards the end of the last century and the concerted, collective struggle--of physicians and medical associations aided by the media, journalists, members of civil society, and senior judiciary--in pressuring the government to bring about and implement a national law criminalizing such practices opposed by an influential pro-organ trade lobby. It argues that among the most effective measures to prevent re-emergence of organ trafficking in the country is increasing ethical live donations and above all, establishing sustainable, public supported deceased donor programs. To do this, the transplant community must recognize that organ transplantation is not merely a donor-recipient-physician transaction but a complex issue in which decisions to donate an organ are influenced by indigenous values and belief systems about human illness, life and death.
View Article and Find Full Text PDFCamb Q Healthc Ethics
July 2010
J Pak Med Assoc
April 2010
Objective: To assess knowledge and perceptions of plagiarism in medical students and faculty of private and public medical colleges in Karachi.
Methods: A questionnaire based study was conducted on groups of 4th year medical students and medical faculty members. Group A consisted of medical students while group B comprised faculty members.
The paper outlines the universal problem of ensuring ethical practices in human subject research, and focuses on specific difficulties faced in the developing world with particular reference to Pakistan. It discusses the influence of traditional and hierarchical social norms of physician-patient relationships in heightening these problems. Two emerging issues of specific concern in Pakistan are described: an exponential rise in multinational clinical drug trials, and commercial ventures offering unproven stem cell "therapy" for all kinds of diseases.
View Article and Find Full Text PDFAlthough a preference for sons is reportedly a universal phenomenon, in some Asian societies daughters are considered financial and cultural liabilities. Increasing availability of ultrasonography and amniocentesis has led to widespread gender screening and selective abortion of normal female foetuses in many countries, including India. Feminists have taken widely divergent positions on the morality of this practice.
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