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Indian Journal of Medical Ethics

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https://www.readbyqxmd.com/read/28433962/ten-minute-snapshots-a-team-approach-to-teaching-postgraduates-about-professional-dilemmas
#1
Prabha S Chandra, G Ragesh, Santosh K Chaturvedi
As medical professionals, most of us face professional dilemmas that catch us unawares and are not discussed in medical training. One often learns about these dilemmas on one's own and deals with them with a common sense approach, rather than reflection. The professional dilemmas may concern receiving gifts from patients, handling issues of confidentiality or dealing with personal questions. There is seldom any formal instruction in competencies related to professionalism, especially in India. We adopted a team approach to provide training in these issues to postgraduate trainees in mental health and to engage them in discussion, using team feedback on snapshots of real-life professional situations, which were simulated through role play...
April 12, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28433965/national-health-policy-2017-a-cautious-welcome
#2
T Sundararaman
On March 15, 2017 the union cabinet approved the new National Health Policy. The next day a 28-page policy text and an accompanying 13-page situational analysis were placed in Parliament and in the public domain. To have, at all times, a health policy in place that shows a road map on how a nation would show "progressive realization" of health as a basic human right is an obligation under the International Covenant on Economic, Social and Cultural Rights. This is an international treaty adopted in 1976, to which India became a signatory in 1979, and this was one of the catalysts for the adoption of the first National Health Policy in 1 983...
April 4, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28433964/ethical-management-of-substance-use-disorders-the-indian-scenario
#3
Arpit Parmar, Vaibhav Patil, Siddharth Sarkar
Substance use disorders are among the most prevalent and emergent public health problems in India. The treatment of individuals with these disorders is associated with many ethical dilemmas. Due to the pervasiveness of substance use disorders, the majority of mental health professionals working in the area of addiction medicine face several ethical dilemmas. When discussing substance use disorders, it must be borne in mind that there are important differences between India and the western countries in terms of the social and cultural aspects, as well as the legislative framework and healthcare delivery system...
April 4, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28433963/schuklenk-s-critique-of-the-cioms-guidelines-all-procedure-no-substance
#4
Ruth Macklin
In his article on the 2016 revision of the CIOMS International Ethical Guidelines (​1), Udo Schuklenk criticises the guidelines but adds a few words of faint praise. His criticisms are primarily procedural, and comprise the following main points: the guidelines aren't really ethical guidelines; the process used by the work group that wrote the guidelines involves "appeals to authority"; the work group used a method of consensus to reach conclusions on controversial points; the work group consisted of twice the number of participants from the global North as from the global South, yet the guidelines are largely directed at low-resource countries...
March 29, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28433961/harnessing-the-medical-humanities-for-experiential-learning
#5
Satendra Singh, Purnima Barua, Upreet Dhaliwal, Navjeevan Singh
A month-long workshop on medical humanities was held in the Jorhat Medical College, Assam in September 2015. It employed experiential learning (both online and onsite) using humanities tools, such as the theatre of the oppressed, art, literature, reflective narratives, movies, the history of medicine, graphic medicine, poetry and diversity studies. As a result of the interactions, 28 volunteer participants, comprising students and faculty members, wrote reflective narratives on doctor​-patient relationships, produced a newsletter and a logo for their medical humanities group, and staged cultural performances and forum theatre...
March 29, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28428154/bias-in-medicine-in-the-context-of-the-film-aligarh
#6
Aiswarya Sasi
In today's world, I feel another sin needs to be added to the list of the seven deadly sins, viz the sin of intolerance. We hear this term on the news every other day and see society display this attitude more often than not. While the movie Aligarh raised myriad social issues, as a medical student, I would like to speak of one in particular - the influence of stigma on healthcare.
March 21, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28343147/ethical-ramifications-of-the-paolo-macchiarini-case
#7
Jaime A Teixeira da Silva
The Paolo Macchiarini case has several ethical ramifications. Professor Macchiarini, formerly of the Karolinska Institutet (KI), became famous for the tracheal surgeries he conducted between 2008 and 2014. His rapid rise to fame was followed by an almost equally rapid fall from grace as official reports, articles in newspapers and television programmes revealed several aspects related to misconduct in his curriculum vitae, professional practices and publishing-related activity. Formal misconduct reports issued by four KI co-workers in late 2014, then again in 2016, coupled with social scandals, including the tricking of a famous US television newscaster into a false marriage, a previous arrest in Italy for apparent bribery, and acute narcissism, all tainted Macchiarini's legend...
March 15, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28285263/research-ethics-for-a-globalised-world-the-revised-cioms-international-guidelines
#8
Hans-Jöerg Ehni, Urban Wiesing
On December 6, 2016, the Council of International Organisations of Medical Sciences published a new version of its guidelines with the title "International Ethical Guidelines for Health-related Research Involving Humans." In this article we briefly describe the revision process and the structure and content of these guidelines. We outline some of its main guidelines such as the ones on social value, post-trial access, and risk-benefit ratio. In our overall evaluation we come to the conclusion that the CIOMS guidelines manage to strike a balance between the protection of human participants in health-related research and the promotion of such research activities in an exemplary way...
March 7, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28285262/revised-cioms-research-ethics-guidance-on-the-importance-of-process-for-credibility
#9
Udo Schuklenk
This paper reviews the 2016 CIOMS International Ethical Guidelines for Health-related Research Involving Humans. I argue that these new guidelines constitute a significant improvement over the guidelines they replace. However, the procedures put in place by CIOMS resulted in an authoring group consisting of a majority of authors and advisors hailing from the global North, while the guidelines squarely aim at influencing policies in the global South. I question CIOMS' strategy to produce a consensus based document, and raise concerns about frequent appeals to authority designed to establish the credibility of these guidelines and the processes that led to them...
March 7, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28279947/abortion-rights-judgment-a-ray-of-hope
#10
Veena Johari, Uma Jadhav
While granting a prisoner the right to abort her foetus, a recent Bombay High Court judgment recognised a woman's absolute right to abortion. This article discusses the judgment in detail and the bioethical debates over abortion rights. It deals with the restrictions imposed by the law not only on when the foetus can be aborted, but also who can get the abortion done and in what circumstances.
February 28, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28279946/the-safety-of-women-health-workers-at-the-frontlines
#11
Jashodhara Dasgupta, Jayashree Velankar, Pritisha Borah, Gangotri Hazarika Nath
This article, based on the report of the fact-finding team on the gang rape and death of an accredited social health activist (ASHA) in Muzaffarnagar in January 2016, attempts to analyse the issues of the safety and mobility of front-line women health workers. It argues that although the National Health Mission is often alluded to as a flagship programme of the government, it has failed in its basic responsibility as an ethical employer, since there is no support and back-up system that can be easily accessed by ASHAs in terms of dealing with the fallout of their social role as "change agents" in rural areas, and community reactions to their mobility and public exposure...
February 21, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28214791/a-need-to-stand-united-reply-to-the-wame-secretary
#12
John H Noble
I believe Dr Winker and I agree more than differ about the need for authors of medical journal reports of randomised controlled trial (RCT) findings to acknowledge when they make post hoc adjustments to the original content that they submit to obtain FDA marketing approval for a new drug or medical device.
February 13, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28214789/-truth-in-research-labelling-regarding-wame-s-quoted-comments
#13
Margaret Winker
We were surprised to read Dr Noble's article, "Truth in research labelling". Dr Noble quotes from an email exchange he and I had regarding a petition that he had asked the World Association of Medical Editors (WAME) to endorse (personal communication, Bernard Carroll and John Noble, September 27, 2016). Unfortunately, the article's description of WAME's comments, which were intended to provide constructive suggestions to improve the petition by ensuring that it was fully supported by facts, is incomplete and the comments have been taken out of context...
February 13, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28214790/sensitising-intern-doctors-to-ethical-issues-in-a-doctor-patient-relationship
#14
Nilima D Shah, Ritambhara Y Mehta, Kamlesh R Dave
There is a felt need in India to influence the ethical behaviour of doctors by giving students formal education in ethics in medical colleges. Since internship is the interface between learning and independent practice, it is important to sensitise intern doctors to ethical issues in a doctor-patient relationship at this stage.
February 8, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28214788/authorship-criteria-and-reporting-of-ethical-compliance-in-indian-biomedical-journals
#15
Pravin Bolshete
The "instructions to authors" of a total of 55 PubMed/MEDLINE indexed Indian biomedical journals were evaluated to assess the authorship criteria and guidance on reporting of research ethics including incorporation of recent updates. Thirty-seven (67.3%) journals recommended the ICMJE guidelines for manuscript preparation. Thirty-two of 55 (58.2%) journals defined authorship; only two journals defined authorship as per the latest (2013) ICMJE criteria. The journals' recommendations which indicated ethical compliance in articles were - the conduct of a study in accordance with the Declaration of Helsinki(n=39); ethical approval (n=37); consent (n=26); assent (n=10); and consent for identifiable information (n=31)...
February 1, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28195538/a-question-of-ethics-not-nationalism-author-s-response
#16
Siddarth David
The aim of the comment "Use of pellet guns for crowd control in Kashmir: How lethal is 'non-lethal'?" was neither to disparage the armed forces, nor recommend counterinsurgency strategies, nor support any particular community or group. It sought to raise discussions around the question pointed out by the responder himself, namely, "the ethical point of view" on the use of pellet guns in controlling violent mobs. The author also feels that the question is not so much about "favouring" the protestors or the security forces, but whether an instrument that causes significant fatalities and morbidities among bystanders should continue to be used as a method of crowd control...
January 27, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28195534/should-a-medical-ethics-journal-discuss-the-actions-of-the-security-forces
#17
Ravindra B Ghooi
This refers to the comment "Use of pellet guns for crowd control in Kashmir: How lethal is 'non-lethal'?" by Siddarth David in the Indian Journal of Medical Ethics. My objection is not to the ethics of the use of pellet guns, but to the ethics of publishing such an article in a journal devoted to medical ethics.
January 27, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28195536/patient-autonomy-within-real-or-valid-consent-samira-kohli-s-case
#18
Supriya Subramani
In bioethics literature, the primary justification for the requirement of informed consent has been the protection of autonomous choices. To allow patients to be autonomous decision-makers, physicians are supposed to disclose and share information related to all treatment, procedures and risks. Advocates of the autonomy-based informed consent model argue that in informed consent cases, the disclosure of information should be according to the reasonable person standard or reasonable patient standard, rather than the average competent physician standard...
January 18, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28195537/-exit-exams-for-medical-graduates-a-guarantee-of-quality
#19
Ranjit Kumar Dehury, Janmejaya Samal
Despite a great deal of opposition from many segments of the medical community, the Medical Council of India (MCI) has proposed to the Ministry of Health and Family Welfare, Government of India that a pan-India exit examination be introduced for graduating MBBS doctors. Whether the proposal should be put forward was considered twice, once in 2010 and again in 2013, and finally the plan was ready to be taken forward seriously in 2015. The proposal has elicited appreciation and criticism from different segments of the medical community...
January 12, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28195535/the-unfair-trade-why-organ-sale-is-indefensible
#20
Siby K George
This paper argues against the proposal of a system of compensated living donation in the global south, especially India, without recourse to essentialist ethics. It relies on the anti-essentialist ethical-ontology of Levinas for the claim that it is the concrete vulnerability of the suffering other, rather than any absolute moral imperative, that makes a market for organs unethical.
January 4, 2017: Indian Journal of Medical Ethics
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