Daughters and daughters-in-law providing elderly care: a qualitative study from Karachi, Pakistan.

Background And Context: Providing care to the elderly is an emerging area of interest due to the increase in elderly population not only in the developed world but also in low and middle income countries. In Pakistan a country with an overall population of over 200 million, the elderly population amounts to 11.3 million.

The current status and challenges of bioethics education in undergraduate medical education in Karachi, Pakistan.

Background: The importance of including bioethics in the medical curricula has been recognized globally. Certain countries including Pakistan continue to lag behind although some developments have occurred recently.

Objectives: The research aimed to provide a snapshot of bioethics education in undergraduate medical colleges in Karachi, Pakistan.

Amid Explosions in Gaza, The Silence from the Bioethics Community is Deafening.

Bioethicists, through their writings, have been known to represent the conscience of the times. Speaking up against injustices, they have acted as moral compasses in the past. The events of October 7, 2023 and the resulting armed onslaught of Israeli forces on Gaza has created a huge humanitarian crisis.

COVID-19 vaccine hesitancy among health service providers: A single centre experience from Karachi, Pakistan.

Objective: To assess the views of health service providers towards coronavirus disease 2019 vaccination with Cansino, Sinovac and Sinopharm vaccines.

Methods: The analytical cross-sectional study was conducted at the Sindh Institute of Urology and Transplantation, Karachi, in May and June 2021, and comprised doctors, nurses, technical staff, and medical social officers. Data was collected using a questionnaire, in Urdu and English languages, assessing determinants of hesitancy.

Indirect costs associated with "free" paediatric haemodialysis: Experience from Karachi, Pakistan.

Treatment of children with end-stage kidney disease (ESKD), requiring maintenance dialysis, poses unique challenges. In low- and middle-income countries, lifelong treatment leads to significant stress on the overall family unit. Families face serious financial, social and psychological consequences despite free treatment.

Primary hyperoxaluria and genetic linkages: an insight into the disease burden from Pakistan.

Autosomal recessive disorders are prevalent in Pakistan, a developing South Asian country where consanguineous marriages are common. This study seeks to determine the prevalence of monogenic causes in children presenting with nephrocalcinosis and nephrolithiasis at a dialysis and transplant center in Karachi, Pakistan. A retrospective analysis was conducted in children aged 1-18 years presenting with nephrocalcinosis, between 2010 and 2019.

Adapting the ethical review process for COVID-19 research: reviewers' perspectives from Pakistan.

Background: Research ethics committees (RECs) globally have adapted their responses to provide timely reviews of research proposals in the wake of the COVID-19 pandemic. The REC of the National Bioethics Committee (NBC) of Pakistan has followed suit.

Aims: To explore perceptions of NBC-REC reviewers who reviewed COVID-19 research proposals while describing the newly instituted Rapid Turnaround Review (RTR) system.

Patient's expectations of privacy and confidentiality in Pakistan: A mixed-methods study.

Privacy and confidentiality are considered a cornerstone in the practice of medical ethics. However, these notions may play out differently in the cultural context of Pakistan. In order to understand the perceptions and expectations of privacy and confidentiality, a cross-sectional mixed method study was undertaken in a tertiary care hospital in Karachi, Pakistan.

Ethical dilemmas in clinical care during COVID-19 pandemic.

In a short span of a few weeks, the COVID-19 pandemic has affected the entire world like no other event in modern history. Healthcare institutions and providers have been at the forefront of containing the ravages of this disease, and are experiencing unprecedented challenges. Medical decision making has become all the more complex because of the moral weight of difficult decisions that need to be made.

The meaninglessness of doing bioethics: Reality check from a conflict zone.

Running bioethics workshops one after the other can become a mundane affair, primarily because of the similarity of their content and discourse. However, conducting a workshop for participants from conflict zones such as Palestine provided an entirely new perspective for this author. While the bioethics discourse may translate into useful and actionable guidelines in the free world to help uphold human dignity, to those living in occupied territories and conflict zones, in the face of their lived lives, it appears little more than a self-serving academic exercise by "parachute bioethicists".

Social Media and Ethos of Medical Practice.

Social media is an undeniable reality in our lives. The professional use of social media is increasing with every passing day. It has provided new avenues of service delivery in individual and hospital practices.

Demystifying the practice of khafd in the Dawoodi Bohra community: A commentary on the WeSpeakOut report from India.

In this commentary, we critique a recent report on female genital cutting (FGC) in the Indian Dawoodi Bohra community titled "The Clitoral hood a contested site: Khafd or female genital mutilation/cutting (FGM/C) in India." Published against the backdrop of possible legislation against FGC in India, the report makes good recommendations and is a useful addition to global literature on FGC. We critique specific sections of the document using relevant literature and informal conversations with the Bohra community in Pakistan, thereby highlighting both its strengths and weaknesses.

Why women go to medical college but fail to practise medicine: perspectives from the Islamic Republic of Pakistan.

Context: 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.

Biobanking in the subcontinent: exploring concerns.

Biobanking is an important tool for biomedical research. However, it raises a variety of ethical issues, which are compounded in the developing world. This paper is based on data from three sources on the ethical issues associated with biobanking, including a mixed method pilot study conducted with students in Karachi, Pakistan, a workshop in Karachi, and another workshop held in Bengaluru, India.

Protection of Human Beings Trafficked for the Purpose of Organ Removal: Recommendations.

This report presents a comprehensive set of recommendations for protection of human beings who are trafficked for the purpose of organ removal or are targeted for such trafficking. Developed by an interdisciplinary group of international experts under the auspices of the project Trafficking in Human Beings for the Purpose of Organ Removal (also known as the HOTT project), these recommendations are grounded in the view that an individual who parts with an organ for money within an illegal scheme is ipso facto a victim and that the crime of trafficking in human beings for the purpose of organ removal (THBOR) intersects with the crime of trafficking in organs. Consequently, the protection of victims should be a priority for all actors involved in antitrafficking activities: those combating organ-related crimes, such as health organizations and survivor support services, and those combating trafficking in human beings, such as the criminal justice sectors.

Pakistan's experience with kidney transplantation and trade: a call for international solidarity.

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.

A degree in bioethics: an "introspective" analysis from Pakistan.

The success of degree-level bioethics programmes, a recent development across the world, is generally evaluated on the basis of their quantifiable impact; for instance, the number of publications graduates produce. The author conducted a study of Pakistani graduates who had pursued a higher qualification in bioethics, and on the basis of the respondents' written and verbal narratives, this paper presents an analysis of their perceptions of the internal impact of bioethics degree programmes. Using these narratives, the paper also analyses the reactions of their colleagues to their new qualification.

Ethical review in Pakistan: the credibility gap.

The concept of mandatory ethical review of research involving human participants is gradually taking root in Pakistani institutions. Based on the opinions of Institutional Review Board (IRB) members from institutions across the country, the process faces several challenges which threaten its integrity. The lack of registration or accreditation for IRBs has resulted in a wide variation in the calibre and working of such Boards.

Informed consent: views from Karachi.

Little is known about the public's perceptions about the process of obtaining informed consent for participation in medical research. A study was made of the views of patients, their attendants, parents, schoolteachers and office workers living in Karachi, Pakistan. Participants felt that informed consent was an important step in recruiting research participants but many felt that it was a trust-based process not requiring proper documentation.