• Views on Bioethics Statements among Medical Students from Three Different Saudi Universities

      Yateem, Thamer, BSc; Ashour, Tareef, BSc; Binsalih, Salih, MD, FACP; Al-Sayyari, Abdulla A., MBA, MD, FACP (The Aquila Digital Community, 2011-11-08)
      Objective To investigate the level of agreement with ethics statements amongst medical students from different Saudi Universities that use traditional or problem based learning (PBL) methods. Methods The respondents enrolled were medical students from Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) which utilizes PBL methods, King Saud University in Riyadh (KSU), and King Abdulaziz University in Jeddah (KAU), both of which utilize traditional methods. As all KSAU-HS medical students are applied medical science graduates, a fourth group consisting of applied medical science graduates from KSU and KAU were included as controls. The respondents were asked to grade their degree of agreement with 19 statements on different bioethical issues by using a Likert type scale from 1 to 5 (1= I completely disagree, 5= I completely agree). The 19 statements were further divided into 5 summative ethical domains: –(a) goals of medicine (3 questions), (b) autonomy and informed consent (9 questions), (c) quality of life (1 question), (d)resource allocation (4 questions), and (e)withdrawal and withholding of treatment (2 questions). To avoid gender bias, only male students were sampled as KSAU-HS has only male students. Overall mean scores and mean scores for each statement and for each domain by each university were compared using unpaired two-tailed t test and Wilcoxon rank sum test. Results There were 43 students from KSAU-HS, 36 from KSU, 47 from KAU and 43 applied medical science graduates. There were significant differences between the overall mean scores by KSAU-HS on one hand (4.03 +/-0.69) and those by the other three groups on the other, being 3.75 +/- 0.66 (p=0.001) for KSU students, 3.76+/- 0.7 (p=0.015) for KAU students and 3,63 +/- 0.51 (p=0.0001) for the applied medical science graduates. The main differences between KSAU-HS students and the students from KSU and KAU were seen in the areas of objectives of medical care (p=0.05), autonomy (p=0.0001), patient centeredness (p=0.02), and informed consent (p=0.05). These differences could not be explained by the older age of KSAU-HS students or their being postgraduates as revealed by the different results seen with the applied medical science graduates. Conclusion The most paternalistic attitudes were held by the applied medical science graduates followed by KSU and KAU students. The least paternalistic were the students of KSAU-HS. We speculate that these differences are related to the different bioethics teaching and training methods used in the 3 universities.
    • Vignettes of the Bhopal Disaster

      Dhara, V. Ramana, MD, ScD, MPH (The Aquila Digital Community, 2013-01-04)
      Dr. Dhara is a former member of the International Medical Commission on Bhopal. This poem is about his experiences interacting with victims of the disaster.
    • Violence from Within: Doctors vs. Nurses

      Out, Noel N., Ph.D. (The Aquila Digital Community, 2011-04-20)
      This paper is part of an effort to understand the direct cause or causes of the nursing crisis in the United States. The study examines this issue using official and self-report data from the NURSE WEEK/American Organization of Nurse Executives Survey and numerous literature reviews. The analysis addresses the magnitude of the relationship between physicians’ violence against nurses and nurse turnover rates. While the general image of physicians is almost always one of gentleness and helpfulness, it is ironic that the results of this study suggest that physicians’ violence against nurses is directly related to the high rate of nurse turnover. The study indicates that physicians are receiving training only in patient management, but not enough training in collegial management in environments where there are nurse professionals in the healthcare organization.
    • Welcome and Kudos

      Davis, Sheila P., Ph.D., RN (The Aquila Digital Community, 2005-01-01)
    • What's the flap about coronavirus?

      Dhara, V. Ramana (The Aquila Digital Community, 2020-01-01)
      This is a haiku about the vectors, modes of transmission and spread of SARS, MERS, and SARS-CoV-2
    • Winners and Losers in the American Political Debates of the Nation’s Health: An Ethical and Moral Dilemma

      Davis, Dr. Sheila P. (The Aquila Digital Community, 2020-10-19)
      The third and final issue of the Online Journal of Health Ethics for 2020 presents two poignant articles that are rankled with current health ethics and moral issues as the world races to a resolve for the COVID pandemic. There appears to be no easy, quick-fix solutions to the pandemic that has claimed over 1.11 million lives worldwide in this first wave. The Gellert article addresses his view of the U.S. government’s political response and the Gunn article presents an ethical perspective of the emerging promised vaccine to halt the virus.
    • Withholding and Withdrawing Life Support: Moral Dilemmas, Moral Distress, and Moral Residue

      Stewart, Robert Scott, Ph.D. (The Aquila Digital Community, 2007-01-01)
      This paper argues for the following points. (1) Despite the recent public controversy surrounding the Terri Schiavo case, withholding and withdrawal of life support rarely presents any moral dilemmas. (2) Given this, we ought to turn our attention to how end of life care is done rather than whether it ought to be done. (3) A ‘caring perspective’ is an essential ingredient in end of life care. Unfortunately, as nurses undergo their ‘professionalisation process’, they often lose this caring perspective. Hence, ways must be found to avoid this loss. (4) Assuming success in this enterprise, it is necessary that nurses be integrally engaged in both end of life care and decision making.
    • Wittgenstein’s Theory of Conceptual Competence and Virtue Analyses of Ethical Dilemmas in Nursing Practice

      Nordby, Halvor (The Aquila Digital Community, 2008-04-30)
      The article discusses Ludwig Wittgenstein’s theory of conceptual competence within the area of nursing ethics. Wittgenstein’s analysis shares fundamental assumptions with virtue approaches to ethical dilemmas in caring practice but is at the same time crucially different. The main difference is that while virtue theories have focused on psychological attitudes like compassion and empathy, Wittgenstein focuses on a person’s understanding of concepts like good and wrong. According to Wittgenstein, an ethical competence in nursing is not equivalent to knowledge of moral principles that are understood independently of contexts of application. But Wittgenstein is also opposed to the view that it is contextual knowledge that provides the normative basis for caring. For Wittgenstein, an ethical competence is essentially a preconception awareness of how caring concepts apply. According to this analysis, nurses should address ethical dilemmas in patient interaction by focusing on their understanding of ethical concepts in the context of interaction. Case studies are used to clarify this and other practical implications of Wittgenstein’s position.
    • Worldwide Ethics 2017

      Dr. Sheila Davis (The Aquila Digital Community, 2017-01-01)
      Editor's introduction to Volume 13, Issue 1 of the Online Journal of Health Ethics.