Communication with the seriously ill: physicians' attitudes in Saudi Arabia.

Abstract:

OBJECTIVES:To study some ethical problems created by accession of a previously nomadic and traditional society to modern invasive medicine, by assessment of physicians' attitudes towards sharing information and decision-making with patients in the setting of a serious illness. DESIGN:Self-completion questionnaire administered in 1993. SETTING:Riyadh, Jeddah, and Buraidah, three of the largest cities in Saudi Arabia. SURVEY SAMPLE:Senior and junior physicians from departments of internal medicine and critical care in six hospitals in the above cities. RESULTS:A total of 249 physicians participated in the study. Less than half (47%) indicated they provided information on diagnosis and prognosis of serious illnesses all the time. Physicians who were more senior and those who spoke Arabic fared better than other groups. The majority (75%) preferred to discuss information with close relatives rather than patients, even when the patients were mentally competent. Most of the physicians (72%) felt patients had the right to refuse a specific treatment modality, and 68% denied patients the right to demand such a treatment if considered futile. Further analysis showed that physicians' attitudes varied along a spectrum from passive (25%) to paternalistic (21%) with the largest group (47%) in a balanced position. CONCLUSIONS:In traditional societies where physicians are regarded as figures of authority and family ties are important, there is a considerable shift of access to information and decision-making from patients to their physicians and relatives in a manner that threatens patients' autonomy. Ethical principles, wider availability of invasive medical technology and a rise in public awareness dictate an attitude change.

journal_name

J Med Ethics

authors

Mobeireek AF,al-Kassimi FA,al-Majid SA,al-Shimemry A

doi

10.1136/jme.22.5.282

subject

Has Abstract

pub_date

1996-10-01 00:00:00

pages

282-5

issue

5

eissn

0306-6800

issn

1473-4257

journal_volume

22

pub_type

杂志文章
  • Veterinary surgeons' attitudes towards physician-assisted suicide: an empirical study of Swedish experts on euthanasia.

    abstract:AIM:To examine the hypothesis that knowledge about physician-assisted suicide (PAS) and euthanasia is associated with a more restrictive attitude towards PAS. DESIGN:A questionnaire about attitudes towards PAS, including prioritization of arguments pro and contra, was sent to Swedish veterinary surgeons. The results w...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2010.038901

    authors: Lerner H,Lindblad A,Algers B,Lynöe N

    更新日期:2011-05-01 00:00:00

  • Family presence during cardiopulmonary resuscitation: who should decide?

    abstract::Whether to allow the presence of family members during cardiopulmonary resuscitation (CPR) has been a highly contentious topic in recent years. Even though a great deal of evidence and professional guidelines support the option of family presence during resuscitation (FPDR), many healthcare professionals still oppose ...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2012-100715

    authors: Lederman Z,Garasic M,Piperberg M

    更新日期:2014-05-01 00:00:00

  • Acupuncture trials and informed consent.

    abstract::Participants are often not informed by investigators who conduct randomised, placebo-controlled acupuncture trials that they may receive a sham acupuncture intervention. Instead, they are told that one or more forms of acupuncture are being compared in the study. This deceptive disclosure practice lacks a compelling m...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2006.016535

    authors: Miller FG,Kaptchuk TJ

    更新日期:2007-01-01 00:00:00

  • The justificatory power of moral experience.

    abstract::A recurrent issue in the vast amount of literature on reasoning models in ethics is the role and nature of moral intuitions. In this paper, we start from the view that people who work and live in a certain moral practice usually possess specific moral wisdom. If we manage to incorporate their moral intuitions in ethic...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2008.026559

    authors: van Thiel GJ,van Delden JJ

    更新日期:2009-04-01 00:00:00

  • Clinically assisted hydration and the Liverpool Care Pathway: Catholic ethics and clinical evidence.

    abstract::The Liverpool Care Pathway for the Dying Patient (LCP), a framework introduced for providing comfortable care at the last stage of life, has recently become highly contentious. Among the most serious allegations levelled against it, has been that the LCP may be used as a covert form of euthanasia by withdrawal of clin...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章,评审

    doi:10.1136/medethics-2013-101533

    authors: Nowarska A

    更新日期:2015-08-01 00:00:00

  • What (or sometimes who) are organoids? And whose are they?

    abstract::In terms of ethical implications, Boers, van Delden and Bredenoord (2018) have made an interesting step forward with their model of organoids as hybrids, which seeks to find a balance between subject-like value and object-like value. Their framework aims to introduce effective procedures not to exploit donors and to i...

    journal_title:Journal of medical ethics

    pub_type: 评论,杂志文章

    doi:10.1136/medethics-2018-105268

    authors: Lavazza A

    更新日期:2019-02-01 00:00:00

  • What do medical students experience as moral problems during their obstetric and gynaecology clerkship?

    abstract::This article reports on moral problems that were raised by medical students as the basis for an ethical case-conference in an obstetrics and gynaecology clerkship. After introducing the issue of teaching clinical ethics, the method of our case-conference is explained. Next, the variety of topics and related moral prob...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2007.023457

    authors: Olthuis G,Dukel L

    更新日期:2008-09-01 00:00:00

  • AIDS legislation--turning up the heat?

    abstract::This paper is not about the medical condition of AIDS. Nor is it about the history of the condition since it was first reported in Atlanta, Georgia in 1981. It looks rather, at the catalogue of legislative and other legal responses to the spread of AIDS. The paper analyses the AIDS condition in its historical context....

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.12.4.187

    authors: Kirby MD

    更新日期:1986-12-01 00:00:00

  • Coercion and choice in parent-child live kidney donation.

    abstract::This paper explores whether donor-parents felt coerced to donate a kidney to their child. There is a paucity of UK literature on parental live kidney donors and the voluntariness of their decision-making. Data were gathered as part of a study exploring parental experiences of consenting for live donation at a UK speci...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2013-101988

    authors: Burnell P,Hulton SA,Draper H

    更新日期:2015-04-01 00:00:00

  • Join the Lone Kidney Club: incentivising live organ donation.

    abstract::Given the dramatic shortage of transplantable organs, demand cannot be met by established and envisioned organ procurement policies targeting postmortem donation. Live organ donation (LOD) is a medically attractive option, and ethically permissible if informed consent is given and donor beneficence balances recipient ...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2019-105999

    authors: Glas A

    更新日期:2020-02-14 00:00:00

  • Research guidelines for embryoids.

    abstract::Human embryo models formed from stem cells-known as embryoids-allow scientists to study the elusive first stages of human development without having to experiment on actual human embryos. But clear ethical guidelines for research involving embryoids are still lacking. Previously, a handful of researchers put forward n...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2020-106493

    authors: Piotrowska M

    更新日期:2021-01-05 00:00:00

  • "Idiots, infants, and the insane": mental illness and legal incompetence.

    abstract::Prior to the second world war, most persons confined in insane asylums were regarded as legally incompetent and had guardians appointed for them. Today, most persons confined in mental hospitals (or treated involuntarily, committed to outpatient treatment) are, in law, competent; nevertheless, in fact, they are treate...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章,评审

    doi:10.1136/jme.2004.008748

    authors: Szasz T

    更新日期:2005-02-01 00:00:00

  • Why the Kantian ideal survives medical learning curves, and why it matters.

    abstract::The "Kantian ideal" is often misunderstood as invoking individual autonomy rather than rational self legislation. Le Morvan and Stock's otherwise insightful discussion of "Medical learning curves and the Kantian ideal"--for example--draws the mistaken inference that that ideal is inconsistent with the realities of med...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2005.014704

    authors: Brecher B

    更新日期:2006-09-01 00:00:00

  • Will international human rights subsume medical ethics? Intersections in the UNESCO Universal Bioethics Declaration.

    abstract::The International Bioethics Committee (IBC) of the United Nations Educational, Scientific and Cultural Organisation (UNESCO) is currently drafting a Universal Bioethics Declaration ("the declaration"). The content and even the name of the declaration has yet to be finalized, but it is expected to range widely over hum...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2004.006502

    authors: Faunce TA

    更新日期:2005-03-01 00:00:00

  • Coercive offers and research participation: a comment on Wertheimer and Miller.

    abstract::Concepts such as 'coercion' and 'inducement' are often used within bioethics without much reflection upon what they mean. This is particularly so in research ethics where they are assumed to imply that payment for research participation is unethical. Wertheimer and Miller advance our thinking about these concepts and ...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2010.035931

    authors: McMillan J

    更新日期:2010-07-01 00:00:00

  • Issues of consent and the primary-school medical.

    abstract::This article discusses what level of consent is needed from a child or parent before a primary-school medical can take place (i.e. where children are aged under 12). It also considers whether there are occasions when a doctor can see a child if the parents have failed to give consent or have explicitly refused consent...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.26.6.469

    authors: Bradley P

    更新日期:2000-12-01 00:00:00

  • Towards a specific approach to education in dental ethics: a proposal for organising the topics of biomedical ethics for dental education.

    abstract::Understanding dental ethics as a field separate from its much better known counterpart, medical ethics, is a relatively new, but necessary approach in bioethics. This need is particularly felt in dental education and establishing a curriculum specifically for dental ethics is a challenging task. Although certain topic...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2011-100067

    authors: Gorkey S,Guven T,Sert G

    更新日期:2012-01-01 00:00:00

  • Resuscitation and senility: a study of patients' opinions.

    abstract::In the context of 'Do-not-resuscitate' (DNR) decisions, there is a lack of information in the UK on the opinions of patients and prospective patients. Written anonymous responses to questionnaires issued to 322 out-patient subjects showed that 97 per cent would opt for cardiopulmonary resuscitation (CPR) in their curr...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.19.2.104

    authors: Robertson GS

    更新日期:1993-06-01 00:00:00

  • Moral intuition, good deaths and ordinary medical practitioners.

    abstract::Debate continues over the acts/omissions doctrine, and over the concepts of duty and charity. Such issues inform the debate over the moral permissibility of euthanasia. Recent papers have emphasised moral sensitivity, medical intuitions, and sub-standard palliative care as some of the factors which should persuade us ...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.16.1.28

    authors: Parker M

    更新日期:1990-03-01 00:00:00

  • British community pharmacists' views of physician-assisted suicide (PAS).

    abstract:OBJECTIVES:To explore British community pharmacists' views on PAS, including professional responsibility, personal beliefs, changes in law and ethical guidance. DESIGN:Postal questionnaire. SETTING:Great Britain. SUBJECTS:A random sample of 320 registered full-time community pharmacists. RESULTS:The survey yielded ...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.26.5.363

    authors: Hanlon TR,Weiss MC,Rees J

    更新日期:2000-10-01 00:00:00

  • Sham neurosurgery in patients with Parkinson's disease: is it morally acceptable?

    abstract::For a few decades, patients with Parkinson's disease (PD) have been treated with intracerebral transplantations of fetal mesencephalic tissue. The results of open trials have been variable. Double blind, placebo-controlled studies have recently been started in order to further investigate the efficacy of this new medi...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.27.3.151

    authors: Dekkers W,Boer G

    更新日期:2001-06-01 00:00:00

  • A plea for end-of-life discussions with patients suffering from Huntington's disease: the role of the physician.

    abstract::Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherit...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2011-100369

    authors: Booij SJ,Engberts DP,Rödig V,Tibben A,Roos RA

    更新日期:2013-10-01 00:00:00

  • The criminalisation of HIV transmission.

    abstract::Since Bennett, Draper, and Frith published a paper in this journal in 2000 considering the possible criminalisation of HIV transmission, an important legal development has taken place. February 2001 saw the first successful United Kingdom prosecution for the sexual transmission of disease for over a century, when Step...

    journal_title:Journal of medical ethics

    pub_type: 评论,杂志文章

    doi:10.1136/jme.28.3.160

    authors: Chalmers J

    更新日期:2002-06-01 00:00:00

  • Internal morality of medicine and physician autonomy.

    abstract::Robert Veatch and others have questioned whether there are internal moral rules of medicine. This paper examines the legal regulatory model for governing professions as the autonomous exercise of professional skills and asks whether there is a theoretical basis for this model. Taking John Rawls's distinction between t...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2018-105069

    authors: McAndrew S

    更新日期:2019-03-01 00:00:00

  • When enough is enough; terminating life-sustaining treatment at the patient's request: a survey of attitudes among Swedish physicians and the general public.

    abstract:OBJECTIVES:To explore attitudes and reasoning among Swedish physicians and the general public regarding the withdrawal of life-sustaining treatment at a competent patient's request. DESIGN:A vignette-based postal questionnaire including 1202 randomly selected individuals in the county of Stockholm and 1200 randomly se...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2009.034967

    authors: Lindblad A,Juth N,Fürst CJ,Lynöe N

    更新日期:2010-05-01 00:00:00

  • The justification of race in biological explanation.

    abstract::In medicine, racial differences are frequently presented as part of the best explanation of differences in the risk of diseases. The problem of using racial classification in biomedical research has become important because of its ethical consequences in society. However, the biological relevance of the concept of rac...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2011.043752

    authors: Lorusso L

    更新日期:2011-09-01 00:00:00

  • Medical murder in Belgium and the Netherlands.

    abstract::This article is a response to Raphael Cohen-Almagor's paper entitled 'First do no harm: intentionally shortening lives of patients without their explicit request in Belgium'. His paper deals with very important matters of life and death, however its concept usage is in part misleading. For instance, the fact that medi...

    journal_title:Journal of medical ethics

    pub_type: 评论,杂志文章

    doi:10.1136/medethics-2015-103128

    authors: Materstvedt LJ,Magelssen M

    更新日期:2016-09-01 00:00:00

  • The ethics of clinical trials.

    abstract::In summary, the discussion by Professors Helmchen and Müller-Oerlinghausen of the morality of clinical trials has emphasized a point that is frequently overlooked. It is an essential to consider those situations in which it might be unethical not to conduct a trial as it is to be concerned about the ways in which tria...

    journal_title:Journal of medical ethics

    pub_type: 临床试验,杂志文章

    doi:10.1136/jme.1.4.174

    authors: Wing JK

    更新日期:1975-12-01 00:00:00

  • The healthcare worker at risk during the COVID-19 pandemic: a Jewish ethical perspective.

    abstract::The current COVID-19 pandemic has raised many questions and dilemmas for modern day ethicists and healthcare providers. Are physicians, nurses and other healthcare workers morally obligated to put themselves in harm's way and treat patients during a pandemic, occurring a great risk to themselves, their families and po...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/medethics-2020-106294

    authors: Solnica A,Barski L,Jotkowitz A

    更新日期:2020-07-01 00:00:00

  • The potential impact of an opt-out system for organ donation in the UK.

    abstract::The recent report of the UK government's Organ Donation Taskforce is in favour of continuing with the current organ donation system rather than changing to an opt-out system where people are assumed to be willing to donate. How did it reach this decision and is it correct? ...

    journal_title:Journal of medical ethics

    pub_type: 杂志文章

    doi:10.1136/jme.2009.031757

    authors: Rieu R

    更新日期:2010-09-01 00:00:00