Byersskov9366
In addition, there are references to a number of Medical Council of New Zealand statements about what good medical practice means in an environment of resource limitation. The paper concludes with a few measures that doctors and patients could take to reduce overtreatment but acknowledges that health care is extremely complex so it would be unrealistic to eliminate overtreatment entirely.Health research has increased during the last decade, which has enhanced the importance of research ethics. However, little is known regarding the knowledge, awareness, attitudes, and practices of investigators in Myanmar. To assess awareness, knowledge, and attitudes of post-graduates regarding research ethics and research ethics committees (RECs) and their informed consent practices and to determine the association between their responses and certain independent factors. We conducted a cross-sectional study using a questionnaire that was distributed to a convenience sample of post-graduates at the Defence Services Medical Academy in Myanmar. We used descriptive, t test, and chi-square statistics to analyze the data. Significance was set at p less then 0.05. We obtained surveys from 204 participants, which included 177 MSc and 27 PhDs of whom 63.6% had performed research and 86.5% had prior ethics training. Regarding awareness, 92.2% were aware of an REC at their academy, but only 47.1% were "fully aware" recommend that post-graduates receive further training in research ethics to ensure the ethical conduct of research. Further studies should be performed to determine the generalizability of our findings to other institutions in Myanmar.This study examines the representations of human gene patents in Chinese newspapers. We conducted a qualitative content analysis of news articles published between 2006 and 2017 to identify the major themes in media coverage, ethical considerations, perceptions of risks and benefits, and attitudes towards the patentability of human genes. The results show that two key ethical concerns were expressed by journalists (1) that it is morally wrong to own or patent human genes and (2) that gene patents could potentially impede patients' access to healthcare services. Nonetheless, the press coverage has tended to be largely favorable (57.8%), rather than opposed (17.8%) to human gene patenting. There were no normative claims that human genes should not be patentable in China, which indicates a generally positive attitude towards patentability in media discourse. Most articles that expressed criticism toward gene patenting discussed challenges in other countries, with significant attention given to the United States Supreme Court's ruling in the Myriad case that invalidated Myriad Genetics' patents on the BRCA1 and BRCA2 genes. Overall, the newspapers were uncritical of the Chinese gene patenting regime. News reporting on the issue was highly suggestive of a strong pro-commercialization stance, although some discussions emphasized potential risks over benefits. Our analysis highlights the need for balanced media reporting on human gene patents in China and a top-down approach to engage the public in substantive discussions on the ethical and societal implications of the existing patent regime.Although advance care planning (ACP) can lead to more patient-centered care, the communication around it can be challenging in acute care hospitals, where saving a life or shortening hospitalization is important priorities. Our qualitative study in an acute care hospital in Japan revealed when specifically physicians and nurses start communication to facilitate ACP. Seven physicians and 19 nurses responded to an interview request, explaining when ACP communication was initiated with 32 patients aged 65 or older. Our qualitative approach employed descriptive analysis to identify major themes, which included "initiation by patients" and "initiation by healthcare professionals." In the latter case, seven specific triggers were identified (1) when the patients' medical condition changed in terms of symptom relief, (2) when the patients' medical condition changed in terms of prognostic prediction, (3) when serious events occurred, (4) when a choice of treatment was presented, (5) when the location for end-of-life care was chosen, (6) when the patients' cognitive function deteriorated, and (7) when serious events settled down. Within this group of healthcare professionals, physicians were more focused on changes in their patients' medical condition, whereas nurses focused more on their patients' desire for a long-term perspective. Nurses encouraged patients to consider ACP themselves, which developed into an approach to respect patients' autonomy. In acute care hospitals, it appeared to be desirable to have an early discussion where patients could understand the significance ACP, which would matter even after their discharge from the hospital.Post-mortem reproduction is a complex and contested matter attracting attention from a diverse group of scholars and resulting in various responses from a range of countries. Vietnam has been reluctant to deal directly with this matter and has, accordingly, permitted post-mortem reproduction implicitly. First, by analysing Vietnam's post-mortem reproduction cases, this paper reflects on the manner in which Vietnamese authorities have handled each case in the context of the contemporary legal framework, and it reveals the moral questions arising therefrom. The article then offers an account of Vietnamese social norms as an explanation for the tendency to conduct post-mortem reproduction. In arguing that a deeper and more thorough examination of the moral and ethical reasoning is required, the paper advocates in favour of supportive post-mortem reproduction regulation. In doing so, the paper seeks to reconcile the Vietnamese legal framework and post-mortem reproduction experiences of other countries. The article concludes that Vietnam and countries sharing the similar cultural traits should permit post-mortem reproduction explicitly. This would require full engagement with the ethical and legal issues arising, and careful promulgation of regulations and guidelines based on comparative experiences of a range of countries in handling this matter.This paper analyses the ethical considerations using the stakeholder theory on two specific domains of the newly implemented 'Ayushman Bharat-Pradhan Mantri Jan Arogya Yojna (PM-JAY)' scheme by the Government of India. The paper recommends a solidarity-based approach over an entitlement based one that focuses on out-of-pocket expenses for the most vulnerable and a stewardship role from the private sector to ensure equity, accountability, and sustainability of PM-JAY scheme.Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as 'what makes a case or example truly local, and why?', 'what topics have we found to be best explained through local cases or examples?', and 'how does one identify a relevant local case?' Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles.In India, there has been a shift from using unclaimed bodies to voluntary body donation for anatomy dissections in medical colleges. This study used in-depth qualitative interviews to explore the deeper intent, values and attitudes towards body donation, the body and death, and expectations of the body donor (N = 12), as well as their next of kin (N = 7) and representative religious scholars (N = 12). All donors had enrolled in a body bequest programme in a medical school in South India. This study concludes that body donors are philanthropists with deep-rooted values of altruism and service, who are often willing to forgo traditional religious and cultural death rituals. The next of kin are often uncomfortable with the donor's decision, and this suggests that it is important that dialogue/counselling occurs at the time of the bequest, if the donor's wishes are to be respected. Religious injunctions are often misinterpreted; this implies that religious leaders/scholars can play a significant role in addressing these misconceptions which are barriers to body donation. Body bequest programmes in India may be enhanced by positioning body donation as 'daana'-giving without any expectation of return for a higher purpose, including ceremonies of respect in medical colleges. Furthermore, increased public engagement and awareness about body bequest programmes are also important to enhance participation. When medical students internalise what body donors expect of them, i.e. altruism, empathy with patients and becoming 'good doctors', it will help to ensure that the donation was not in vain and that the dead truly teach the living.In this paper, the ethical, legal, and social implications of Thailand's surrogacy regulations from both domestic and global perspectives are explored. Surrogacy tourism in Thailand has expanded since India strengthened its visa regulations in 2012. In 2015, in the wake of a major scandal surrounding the abandonment of a surrogate child by its foreign intended parents, a law prohibiting the practice of surrogacy for commercial purposes was enacted. Consequently, a complete ban on surrogacy tourism was imposed. However, some Thai physicians and surrogate mothers cross into neighboring countries to provide foreign clients with the commercial surrogacy services that are forbidden in Thailand. Tiplaxtinin Under this legislation, the needs of Thai couples who are unable to conceive are accommodated by legally accessible, non-commercial surrogacy services; however, there is currently no provision in place aimed at protecting the rights and interests of surrogate mothers and children. It is widely believed that the abolition of surrogacy tourism, an industry that give rise to several major scandals, and legal access to surrogacy by Thai couples were the Thai government's primary goal in implementing this legislation.The unique mix of modern Western and traditional Confucian values in Singapore presents young people with contradictory views on duties to aging parents. It remains to be seen whether the changing demands of modern life will result in new generations giving up Confucian family ethics or whether the Confucian dynamic will find a way to adapt to the new pressures. It is the opinion of this author that the Confucian family structure has mixed potential for the growing crisis of elder care. Alone, both Confucian traditions and typical Western institutional approaches toward elder care fall short of what is necessary for intergenerational social justice, yet a hybrid of the two has great potential for the growing aging crisis. To demonstrate this, I first give a brief account of the history of filial piety in Confucianism as well as the social environment from which it originated. Then I turn my attention to the present issues of an aging population and elder care that face much of the developed world in the twenty-first century.