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Developing World Bioethics

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https://www.readbyqxmd.com/read/28922586/rebuilding-patient-physician-trust-in-china-developing-a-trust-oriented-bioethics
#1
EDITORIAL
Jing-Bao Nie, Joseph D Tucker, Wei Zhu, Yu Cheng, Bonnie Wong, Arthur Kleinman
No abstract text is available yet for this article.
September 18, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28922581/the-crisis-of-patient-physician-trust-and-bioethics-lessons-and-inspirations-from-china
#2
Jing-Bao Nie, Lun Li, Grant Gillett, Joseph D Tucker, Arthur Kleinman
Trust is indispensable not only for interpersonal relationships and social life, but for good quality healthcare. As manifested in the increasing violence and tension in patient-physician relationships, China has been experiencing a widespread and profound crisis of patient-physician trust. And globally, the crisis of trust is an issue that every society, either developing or developed, has to face in one way or another. Yet, in spite of some pioneering works, the subject of patient-physician trust and mistrust - a crucial matter in healthcare especially because there are numerous ethical implications - has largely been marginalized in bioethics as a global discourse...
September 18, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28922561/reconciling-female-genital-circumcision-with-universal-human-rights
#3
John-Stewart Gordon
One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision (FGC), which is prevalent in many African countries and the Middle East as well as in some Asian and Western countries. It is commonly assumed that FGC, in all its versions, constitutes a gross violation of the universal human rights of health, physical integrity, and individual autonomy and hence should be abolished. This article, however, suggests a mediating approach according to which one form of FGC, the removal of the clitoris foreskin, can be made compatible with the high demands of universal human rights...
September 18, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28922559/quarantine-isolation-and-the-duty-of-easy-rescue-in-public
#4
Alberto Giubilini, Thomas Douglas, Hannah Maslen, Julian Savulescu
We address the issue of whether, why and under what conditions, quarantine and isolation are morally justified, with a particular focus on measures implemented in the developing world. We argue that the benefits of quarantine and isolation justify some level of coercion or compulsion by the state, but that the state should be able to provide the strongest justification possible for implementing such measures. While a constrained form of consequentialism might provide a justification for such public health interventions, we argue that a stronger justification is provided by a principle of State Enforced Easy Rescue: a state may permissibly compel individuals to engage in activities that entail a small cost to them but a large benefit to others, because individuals have a moral duty of easy rescue to engage in those activities...
September 18, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28922547/the-vicious-circle-of-patient-physician-mistrust-in-china-health-professionals-perspectives-institutional-conflict-of-interest-and-building-trust-through-medical-professionalism
#5
Jing-Bao Nie, Yu Cheng, Xiang Zou, Ni Gong, Joseph D Tucker, Bonnie Wong, Arthur Kleinman
To investigate the phenomenon of patient-physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust (particularly physicians' distrust of patients and their relatives) leads to increased levels of fear and self-protection by doctors which exacerbate difficulties in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization...
September 18, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28886233/mistrust-of-physicians-in-china-society-institution-and-interaction-as-root-causes
#6
Cheris Shun-Ching Chan
Based on two years' ethnographic research on doctor-patient relations in urban China, this paper examines the causes of patients' mistrust of physicians. I identify the major factors at the societal, institutional, and interpersonal levels that lead to patients' mistrust of physicians. First, I set the context by describing the extent of mistrust at the societal level. Then, I investigate the institutional sources of mistrust. I argue that the financing mechanism of public hospitals and physicians' income structures are the most crucial factors in inducing patients' mistrust...
September 8, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28872755/african-communal-basis-for-autonomy-and-life-choices
#7
Polycarp Ikuenobe
I argue that the metaphysical capacity of autonomy is not intrinsically valuable; it is valuable only when used in relation to a community's values and instrumentally for making the proper choices that will promote one's own and the community's well-being. I use the example of the choice to take one's life by suicide to illuminate this view. I articulate a plausible African conception of personhood as a basis for the idea of relational autonomy. I argue that this conception is better understood as a social-moral thesis, and not a metaphysical thesis...
September 5, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28872746/-we-are-the-eyes-and-ears-of-researchers-and-community-understanding-the-role-of-community-advisory-groups-in-representing-researchers-and-communities-in-malawi
#8
Deborah Nyirenda, Salla Sariola, Kate Gooding, Mackwellings Phiri, Rodrick Sambakunsi, Elvis Moyo, Chiwoza Bandawe, Bertie Squire, Nicola Desmond
Community engagement to protect and empower participating individuals and communities is an ethical requirement in research. There is however limited evidence on effectiveness or relevance of some of the approaches used to improve ethical practice. We conducted a study to understand the rationale, relevance and benefits of community engagement in health research. This paper draws from this wider study and focuses on factors that shaped Community Advisory Group (CAG) members' selection processes and functions in Malawi...
September 5, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28816023/community-sensitization-and-decision-making-for-trial-participation-a-mixed-methods-study-from-the-gambia
#9
Susan Dierickx, Sarah O'Neill, Charlotte Gryseels, Edna Immaculate Anyango, Melanie Bannister-Tyrrell, Joseph Okebe, Julia Mwesigwa, Fatou Jaiteh, René Gerrets, Raffaella Ravinetto, Umberto D'Alessandro, Koen Peeters Grietens
BACKGROUND: Ensuring individual free and informed decision-making for research participation is challenging. It is thought that preliminarily informing communities through 'community sensitization' procedures may improve individual decision-making. This study set out to assess the relevance of community sensitization for individual decision-making in research participation in rural Gambia. METHODS: This anthropological mixed-methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia...
August 16, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28752949/haitian-people-s-expectations-regarding-post-disaster-humanitarian-aid-teams-actions
#10
Lonzozou Kpanake, Ronald Jean-Jacques, Paul Clay Sorum, Etienne Mullet
The way people at the receiving end of humanitarian assistance perceive this intervention may provide invaluable bottom-up feedback to improve the quality of the intervention. We analyzed and mapped Haitians' views regarding international humanitarian aid in cases of natural disaster. Two hundred fifty participants-137 women and 113 men aged 18-67-who had suffered from the consequences of the earthquake in 2010 were presented with a series of vignettes depicting a humanitarian team's action and were asked to what extent these actions corresponded to what ought to be expected from an international aid mission...
July 28, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28752914/research-in-epidemic-and-emergency-situations-a-model-for-collaboration-and-expediting-ethics-review-in-two-caribbean-countries
#11
Derrick Aarons
Various forms of research are essential in emergency, disaster and disease outbreak situations, but challenges exist including the long length of time it takes to get research proposals approved. Consequently, it would be very advantageous to have an acceptable model for efficient coordination and communication between and among research ethics committees/IRBs and ministries of health, and templates for expediting (done with speed and efficiency) ethical review of research proposals in emergency and epidemic situations to be used across the Caribbean and in other low and middle income countries...
July 28, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28745008/-you-cannot-collect-data-using-your-own-resources-and-put-it-on-open-access-perspectives-from-africa-about-public-health-data-sharing
#12
Evelyn Anane-Sarpong, Tenzin Wangmo, Claire Leonie Ward, Osman Sankoh, Marcel Tanner, Bernice Simone Elger
Data-sharing is a desired default in the field of public health and a source of much ethical deliberation. Sharing data potentially contributes the largest, most efficient source of scientific data, but is fraught with contextual challenges which make stakeholders, particularly those in under-resourced contexts hesitant or slow to share. Relatively little empirical research has engaged stakeholders in discussing the issue. This study sought to explore relevant experiences, contextual, and subjective explanations around the topic to provide a rich and detailed presentation of what it means to different stakeholders and contexts to share data and how that can guide practice and ethical guidance...
July 25, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28714281/the-ethics-and-politics-of-patient-physician-mistrust-in-contemporary-china
#13
Yunxiang Yan
Focusing on the shared sense of victimization and disadvantage-ness by both patients and doctors/medical workers in cases of medical conflicts, this paper aims to examine the current patient-doctor tensions in the larger context of moral transformation in Chinese society since the 1980s. Although the decline of public trust in certain aspects is closely associated with the impact of commodification and commercialization of medical sector during the past two decades, other factors play important role as well...
July 17, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28691185/regulating-clinical-trials-in-india-the-economics-of-ethics
#14
Gerard Porter
The relationship between the ethical standards for the governance of clinical trials and market forces can be complex and problematic. This article uses India as a case study to explore this nexus. From the mid-2000s, India became a popular destination for foreign-sponsored clinical trials. The Indian government had sought to both attract clinical trials and ensure these would be run in line with internationally accepted ethical norms. Reports of controversial medical research, however, triggered debate about the robustness and suitability of India's regulatory system...
July 9, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28707453/dignity-is-a-useful-concept-for-bioethics
#15
EDITORIAL
Debora Diniz
No abstract text is available yet for this article.
August 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/27990743/punishment-of-minor-female-genital-ritual-procedures-is-the-perfect-the-enemy-of-the-good
#16
Allan J Jacobs, Kavita Shah Arora
Female genital alteration (FGA) is any cutting, removal or destruction of any part of the external female genitalia. Various FGA practices are common throughout the world. While most frequent in Africa and Asia, transglobal migration has brought ritual FGA to Western nations. All forms of FGA are generally considered undesirable for medical and ethical reasons when performed on minors. One ritual FGA procedure is the vulvar nick (VN). This is a small laceration to the vulva that does not cause morphological changes...
August 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/27762091/reexamining-the-prohibition-of-gestational-surrogacy-in-sunni-islam
#17
Ruaim A Muaygil
Advances in reproductive medicine have provided new, and much needed, hope for millions of people struggling with infertility. Gestational surrogacy is one such development that has been gaining popularity with infertile couples, especially those unable to benefit from other reproductive procedures such as In Vitro Fertilization. For many Muslim couples, however, surrogacy remains a nonviable option. Islamic scholars have deemed the procedure incompatible with Islam and have prohibited its use. This paper examines the arguments presented for proscribing surrogacy arrangements in Sunni Islam in particular...
August 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/27699996/evaluating-the-usefulness-of-compulsory-licensing-in-developing-countries-a-comparative-study-of-thai-and-brazilian-experiences-regarding-access-to-aids-treatments
#18
Samira Guennif
While compulsory licensing (CL) is described in the TRIPS agreement as flexibility to protect public health by improving access to medicines in developing countries, a recent literature contends adversely that CL may harm public health. Therefore, this article intends to evaluate the usefulness of CL in the South through the prism of obligations and goals entrusted to patent holders (the effective and non-abusive exploitation of patents in order to achieve industrial and health developments) and in light of experiences in Thailand and Brazil regarding access to antiretroviral drugs...
August 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/27699957/the-vulnerability-of-study-participants-in-the-context-of-transnational-biomedical-research-from-conceptual-considerations-to-practical-implications
#19
Helen Grete Orth, Silke Schicktanz
Outsourcing clinical trials sponsored by pharmaceutical companies from industrialized countries to low- (middle)-income countries - summarized as transnational biomedical research (TBR) - has lead to many concerns about ethical standards. Whether study participants are particularly vulnerable is one of those concerns. However, the concept of vulnerability is still vague and varies in its definition. Despite the fact that important international ethical guidelines such as the Declaration of Helsinki by the World Medical Association or the Ethical Guidelines for Biomedical Research Involving Human Subjects by the Council of International Organizations of Medical Sciences refer to vulnerability as ethical principle, each of their approaches are different...
August 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/27527727/the-enemy-as-a-patient-what-can-be-learned-from-the-emotional-experience-of-physicians-and-why-does-it-matter-ethically
#20
Gil Rubinstein, Miriam Ethel Bentwich
This qualitative research examines the influence of animosity on physicians during clinical encounters and its ethical implications. Semi-structured interviews were conducted with ten Israeli-Jewish physicians: four treated Syrians and six treated Palestinian terrorists/Hezbollah militants or Palestinian civilians. An interpretive phenomenological analysis was used to uncover main themes in these interviews. Whereas the majority of physicians stated they are obligated to treat any patient, physicians who treated Syrians exhibited stronger emotional expression and implicit empathy, while less referring to the presence of the Israeli-Arab conflict...
August 2017: Developing World Bioethics
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