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Student Guide for
Medical Ethics Course
(METH 421)
Credit Hours: 2(1+3+0)
1433 H (2012 G)
Version 3.5
Last updated: 11/02/2012
Course Planner:
Dr. Abdulaziz AlKabba, Associate Dean, FOM-KFMC
Course Coordinator:
Dr. Ghaiath Hussein
2012
Department of Medical Ethics
Faculty of Medicine – King Fahad Medical City
King Saud Bin Abdulaziz University for Health Sciences
(KSAU-HS)
‫الطة‬ ‫تكلٍة‬ ‫الصذٍة‬ ‫األخالقٍات‬ ‫هقزر‬
-
‫الطثٍة‬ ‫فهذ‬ ‫الولك‬ ‫هذٌٌة‬
‫آٌات‬ ‫على‬ ‫ٌذحىي‬ ‫الكحاب‬ ‫هذا‬
‫وٌجة‬ ،‫شزٌفة‬ ‫وأدادٌث‬
‫تادحزام‬ ‫هعاهلحه‬
This book contains
verses from the Holy
Quran and Hadith of
Prophet Mohammed
(PBUH). Please treat
respectfully.
"
َ
‫ى‬ِ
‫إ‬
ْ‫ي‬ِ
‫ه‬
ْ‫ن‬ُ
‫ك‬ِ
‫ر‬‫َا‬
ٍِ
‫خ‬
ْ‫ن‬ُ
‫ك‬َ
ٌَ
‫س‬‫ْا‬‫د‬َ‫أ‬
‫ًا‬
‫ق‬‫َا‬
‫ل‬ْ‫خ‬َ
‫أ‬
"
‫يسهى‬ ِ‫سٔا‬
"
‫َا‬
‫و‬َ
ًِ
‫إ‬
ُ
‫ث‬ْ‫ث‬ِ
‫ع‬ُ
‫ت‬
َ
‫ن‬ِ
‫و‬َ
‫ج‬ُ
‫أ‬ِ
‫ل‬
َ
‫خ‬ِ
‫ل‬‫َا‬‫ص‬
ِ
‫ق‬‫َا‬
‫ل‬ْ‫خ‬َ‫أ‬ْ‫ل‬‫ا‬
"
‫أحًذ‬ ّ‫أخشخ‬
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 2 of 21
© 2012 Department of Medical Ethics, Faculty of Medicine, King Fahad Medical City
This document is not issued to the general public, and all rights are reserved by
the Faculty of Medicine, King Fahad Medical City (FOM-KFMC). The document may
not be reviewed, abstracted, quoted, reproduced or translated, in part or in whole,
without the prior written permission of FOM-KFMC. No part of this document may
be stored in a retrieval system or transmitted in any form or by any means –
electronic, mechanical or other – without the prior written permission of FOM-
KFMC.
Requests for permission should be directed to Faculty of Medicine, King Fahad
Medical City, address: King Fahad Medical City, Faculty of Medicine, Suleimaniya,
Riyadh 12231, Saudi Arabia, email: ethics@kfmc.med.sa. The views expressed
in documents by named author are solely the responsibility of this author.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 3 of 21
Contents
‫نظرة‬
‫عامت‬
‫على‬
‫المقرر‬
:
................................
................................
................................
................................
....
4
1.1
‫ما‬
‫المقصود‬
‫ثبألخاللٍبد‬
‫الطبيت؟‬
................................
................................
................................
...........
4
‫أهميت‬
‫تدريس‬
‫األخالقياث‬
‫الطبيت‬
‫للطبيب‬
‫المسلم‬
................................
................................
...................
4
OVERVIEW ON THE CURRICULUM:............................................................................................................................ 5
MEMBERS OF THE CURRICULUM COMMITTEE: ..............................................................................5
2 COURSE DESCRIPTION AND BASIC DEFINITIONS:.....................................................................5
2.1 COURSE DESCRIPTION: 5
2.2 ETHICS IN HEALTHCARE (BIOETHICS) 6
2.3 ETHICS IN ISLAM 7
3 IMPORTANCE OF TEACHING PROFESSIONALISM AND MEDICAL ETHICS: .....................................8
4 OBJECTIVES OF THE CURRICULUM: .......................................................................................8
4.1 MAIN OBJECTIVE: 8
4.2 SPECIFIC LEARNING OBJECTIVES: 9
5 STRUCTURE OF THE CURRICULUM ........................................................................................9
5.1 SECTION I: INTRODUCTION AND BASICS OF ISLAMIC MEDICAL ETHICS 9
5.2 SECTION II: PRACTICAL ASPECTS OF MEDICAL ETHICS 9
5.3 SECTION III: RESEARCH ETHICS 9
6 TEACHING METHODOLOGY: .............................................................................................. 10
7 STUDENT AND COURSE EVALUATION.................................................................................. 10
7.1 ATTENDANCE AND ACTIVE PARTICIPATION 10
7.2 ASSIGNMENTS 11
7.3 MID-TERM EXAM 11
7.4 RESEARCH REPORT & RESEARCH PRESENTATION 11
7.5 PRACTICUM (CLINICAL & RESEARCH ETHICS PRACTICAL ACTIVITIES LOGBOOK) 14
7.6 FINAL EXAM 15
7.7 COURSE EVALUATION 15
7.8 DEADLINES AND DUE DATES 15
8 IMPORTANT DATES.......................................................................................................... 15
9 COMMUNICATIONS AND COMPLAINTS ............................................................................... 15
9.1 WEBSITE: 15
9.2 EMAILS:....................................................................................................................................... 16
9.3 OFFICE APPOINTMENTS: 16
9.4 COMPLAINTS AND APPEALS: 16
10 LECTURES, GROUP-WORK AND RESEARCH PRESENTATIONS TIMETABLE................................... 17
11 NEED HELP? OR STILL HAVE QUESTIONS OR QUERIES?........................................................... 19
12 READINGS AND REFERENCES: ............................................................................................ 19
12.1 TEXTBOOKS: 19
11.1 WEBSITES 19
12.3 ARTICLES & REPORTS: 20
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 4 of 21
‫المقرر‬ ‫على‬ ‫عامت‬ ‫نظرة‬
:
،ّ‫ٔيُٓز‬ ،ّ‫َفس‬ ٕ‫َح‬ ّ‫سهٕك‬ ّ‫رٕخ‬ ‫الَٓب‬ ً
‫ا‬‫َظش‬ ،‫انؽت‬ ‫ؼبنت‬ ‫ٌذسسٓب‬ ً‫انز‬ ‫انًمشساد‬ ‫اْى‬ ٍ‫ي‬ ‫انؽجٍخ‬ ‫االخاللٍبد‬ ‫يمشس‬ ‫ٌؼزجش‬
‫ككم‬ ّ‫ٔيدزًؼ‬ ،ِ‫ٔيشظب‬ ،ِ‫ٔصيالء‬
.
،‫انؽجٍت‬ ‫لجم‬ ٍ‫ي‬ ‫انًمذيخ‬ ‫انصحٍخ‬ ‫نهخذيخ‬ ‫األخاللٍخ‬ ‫انًًبسسخ‬ ‫أسس‬ ‫انًمشس‬ ‫ْزا‬ ‫ٌزُبٔل‬
‫ا‬ ‫األخاللٍبد‬ ‫ٔأسس‬
‫ٔيُظًخ‬ ‫حبكًخ‬ ‫ٔلٍى‬ ‫أخاللٍبد‬ ٍ‫ي‬ ‫انؽجٍت‬ ٍّ‫ػه‬ ٌٕ‫ٌك‬ ٌ‫أ‬ ‫ٌدت‬ ‫ٔيب‬ ‫انؽجٍخ‬ ‫انًُٓخ‬ ‫ٔأصٕل‬ ‫ٔآداة‬ ‫نصحٍخ‬
‫األسس‬ ‫إنى‬ ‫إظبفخ‬ ،‫انششٌفخ‬ ‫انُجٌٕخ‬ ‫انسُخ‬ ً‫ف‬ ‫خبء‬ ‫ٔيب‬ ًَ‫انمشآ‬ ‫انٓذي‬ ً‫ف‬ ‫األخاللٍخ‬ ‫انمٍى‬ ‫ثًُظٕيخ‬ ٌٍ‫يسزششذ‬ ،‫انؽت‬ ‫نًُٓخ‬
‫انؽجٍخ‬ ‫األخالق‬ ً‫ف‬ ‫ػهٍٓب‬ ‫انًزؼبسف‬ ‫انؼبنًٍخ‬
.
‫ٌزُبٔل‬ ‫كًب‬
‫انمعبٌب‬ ٍ‫ي‬ ‫ٔنؼذد‬ ‫انؽجٍخ‬ ‫نهًسزدذاد‬ ‫ٔانفمٍٓخ‬ ‫انمبٍََٕخ‬ ‫األثؼبد‬ ‫انًمشس‬
‫ثٓب‬ ‫ٌؼًم‬ ً‫انز‬ ‫انصحٍخ‬ ‫ٔانًؤسسخ‬ ِ‫ٔيشظب‬ ّ‫ثضيالئ‬ ّ‫ٔػاللز‬ ،‫انؽجٍت‬ ‫ثؼًم‬ ‫انًزصهخ‬
.
1.1
‫المقصود‬ ‫ما‬
‫تاألخالقٍات‬
‫الطبيت؟‬
‫أث‬ ‫انخذيخ‬ ‫يٕفش‬ ً‫ف‬ ‫رٕفشْب‬ ‫ٌزٕخت‬ ً‫انز‬ ‫ًٍَخ‬
ٍِ
‫م‬‫ان‬ ‫انعٕاثػ‬ ‫يدًٕػخ‬ ًْ ‫انؽجٍخ‬ ‫األخاللٍبد‬
‫ٔرشخغ‬ ،‫انصحٍخ‬ ‫انخذيخ‬ ِ‫رٕفٍش‬ ‫ُبء‬
ً‫حبيٕساث‬ ٌَٕ‫لب‬ ‫يثم‬ ،‫انمذو‬ ً‫ف‬ ‫ظبسثخ‬ ‫ربسٌخٍخ‬ ‫حمت‬ ‫إنى‬ ‫انؽجٍت‬ ‫ػًم‬ ‫ٔظجػ‬ ‫رُظٍى‬ ‫يحبٔالد‬
(
1222
‫ق‬
.
‫و‬
).
‫ثمسى‬ ً
‫ا‬‫يشٔس‬
‫أثٕلشاغ‬
(
422
‫ق‬
.
‫و‬
).
‫ػذد‬ ‫إسٓبيبد‬ ‫إنى‬ ‫إظبفخ‬ ،‫انًدزًؼبد‬ ٍ‫ي‬ ‫انكثٍش‬ ً‫ف‬ ‫ْزا‬ ‫ٌٕيُب‬ ‫حزى‬ ‫انًؼزجشح‬ ‫انًٕاثٍك‬ ٍ‫ي‬ ‫ٌؼذ‬ ‫ٔانزي‬ ،
‫األؼج‬ ٍ‫ي‬
‫ػبو‬ ‫نهؽت‬ ً
‫ب‬ً‫يُظ‬ ً
‫ب‬‫يٍثبل‬ ‫ٔظغ‬ ‫انزي‬ ‫انؽجشي‬ ‫يثم‬ ًٍٍ‫انًسه‬ ‫بء‬
072
‫ٔظغ‬ ٍ‫ي‬ ‫أٔل‬ ‫ٌؼذ‬ ‫انزي‬ ‫انشْٕي‬ ٍ‫ث‬ ‫ٔاسحك‬ ،‫و‬
‫انذٌبَبد‬ ‫يخزهف‬ ٍ‫ي‬ ‫ٔاألؼجبء‬ ‫انفالسفخ‬ ٍ‫ي‬ ‫ٔغٍشْى‬ ،‫انشاصي‬ ‫صكشٌب‬ ٍ‫ث‬ ‫ٔيحًذ‬ ،‫انؽت‬ ‫يًبسسخ‬ ‫آداة‬ ٍ‫ػ‬ ً
‫ب‬‫كزبث‬
.
‫المسلم‬ ‫للطبيب‬ ‫الطبيت‬ ‫األخالقياث‬ ‫تدريس‬ ‫أهميت‬
‫رذسٌس‬ ‫أًٍْخ‬ ًٍ‫رك‬
‫أًْٓب‬ ‫أيٕس‬ ‫ػذح‬ ً‫ف‬ ً
‫ب‬‫خصٕص‬ ‫اإلساليٍخ‬ ‫انؽجٍخ‬ ‫ٔاألخاللٍبد‬ ،ً
‫ب‬‫ػًٕي‬ ‫انؽجٍخ‬ ‫األخاللٍبد‬
:
-
‫األخاللٍخ‬ ‫اندٕاَت‬ ً‫ف‬ ‫انزفكٍش‬ ‫ػهى‬ ‫انزذسٌت‬ ٌ‫إ‬
(
‫انؼهًٍخ‬ ‫انؽجٍخ‬ ‫انحمبئك‬ ‫فمػ‬ ‫ٔنٍس‬
)
‫يغ‬ ‫ٌزؼبيم‬ ‫انؽجٍت‬ ٍ‫ي‬ ‫ردؼم‬
‫ثبندٕاَت‬ ‫االْزًبو‬ ٌٔ‫د‬ ّ‫ٔػالخ‬ ‫اندسذ‬ ‫يغ‬ ‫انزؼبيم‬ ‫فمػ‬ ‫ٔنٍس‬ ‫يزكبيم‬ ‫ككم‬ ِ‫يشظب‬
‫نهًشظى‬ ‫ٔانُفسٍخ‬ ‫انشٔحٍخ‬
-
ٔ ،‫انًشكالد‬ ‫ٔرحهٍم‬ ‫األسئهخ‬ ‫ؼشذ‬ ‫يثم‬ ‫ػًهٍخ‬ ‫يُٓدٍبد‬ ‫ٔرؼهى‬ ‫انُمذي‬ ً‫انزحهٍه‬ ‫انزفكٍش‬ ‫ػهى‬ ‫انؽجٍت‬ ‫لذسح‬ ٍ‫ي‬ ‫رضٌذ‬
‫انزحهٍم‬ ً‫ف‬ ً
‫ب‬‫أٌع‬ ‫ثم‬ ً‫األخالل‬ ‫انزحهٍم‬ ً‫ف‬ ‫فمػ‬ ‫نٍس‬ ِ‫رفٍذ‬ ً‫انز‬ ً‫انزحهٍه‬ ‫انزفكٍش‬ ‫يٓبساد‬ ٍ‫ي‬ ‫ٔغٍشْب‬ ‫انًُبصػبد‬ ‫إداسح‬
‫انًًبسسخ‬ ً‫ف‬ ً‫انًُؽم‬
ً
‫ب‬‫ػًٕي‬ ‫انؽجٍخ‬
.
-
ٍّ‫ػه‬ ‫اهلل‬ ‫صهى‬ ٍّ‫َج‬ ‫ٔسُخ‬ ‫اهلل‬ ‫كزبة‬ ً‫ف‬ ‫انحٍُف‬ ‫انششع‬ ‫ٔٔظحٓب‬ ‫َظًٓب‬ ً‫انز‬ ‫انمًٍٍخ‬ ّ‫ثًُظٕيز‬ ‫انًسهى‬ ‫انؽجٍت‬ ‫اسرجبغ‬
‫اخم‬ ٍ‫ي‬ ّ‫ٔػًه‬ ‫نهؼهى‬ ّ‫ؼهج‬ ٌٕ‫فٍك‬ ،ّ‫ن‬ ‫ٔخبنصخ‬ ‫رؼبنى‬ ‫هلل‬ ‫لبصذح‬ ‫انؽجٍت‬ ‫ٍَخ‬ ٌٕ‫رك‬ ‫ثحٍث‬ ،‫انسهف‬ ‫َٓح‬ ً‫ٔف‬ ،‫ٔسهى‬
‫ٔن‬ ‫اهلل‬ ‫يشظبح‬ ‫ثٓب‬ ً‫ٌجزغ‬ ‫ػجبدح‬ ِ‫يشظب‬
ً
‫ب‬ٌٍَٕ‫د‬ ً
‫ا‬‫أخش‬ ‫ػهٍٓب‬ ‫نٍزمبظى‬ ‫ًٌبسسٓب‬ ‫يُٓخ‬ ‫يدشد‬ ‫فمػ‬ ‫ٍسذ‬
.
-
ً‫ف‬ ‫ثًب‬ ،ّ‫ثؼًه‬ ‫نهمٍبو‬ ‫ثٓب‬ ‫اندٓم‬ ّ‫ٌسؼ‬ ‫ال‬ ‫ثم‬ ‫ٌحزبخٓب‬ ً‫انز‬ ‫انفمٍٓخ‬ ‫انعٕاثػ‬ ‫ثأسبسٍبد‬ ‫انًسهى‬ ‫انؽجٍت‬ ‫إنًبو‬ ‫ظشٔسح‬
ٍ‫ي‬ ‫انًشٌط‬ ‫ػُٓب‬ ّ‫ٌسأن‬ ‫لذ‬ ً‫انز‬ ‫ثبنًشض‬ ‫انًشرجؽخ‬ ‫انفمٍٓخ‬ ‫ٔاألحكبو‬ ،ِ‫يشظب‬ ‫ػهى‬ ‫ثبنكشف‬ ّ‫لٍبي‬ ‫ظٕاثػ‬ ‫رنك‬
‫لجٍم‬
‫األحكبو‬ ٍ‫ي‬ ‫غٍشْب‬ ٔ‫أ‬ ّ‫صالر‬ ٔ‫أ‬ ‫انًشٌط‬ ‫صٕو‬
.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 5 of 21
Overview on the curriculum:
Ethics of Medical Practice (METH 421)
Duration
Course code
Semester
Year
Phase
16 weeks
METH421
Second
Four
Three
Course Code Course Title
Contact Hours
Credit
Hours
Prerequisite
Theoretical Tutorial Practical
METH 421 Ethics of Medical Practice 1 3 4 2 NONE
Curriculum Committee:
Supervisor of the 3rd
phase: Associate Dean for Clinical Phase
Module Supervisor: Dr. Abdulaziz AlKabba
Module Coordinator: Dr. Ghaiath M.A. Hussein
Members of the curriculum committee:
1. Prof. Omar H. Kasule Sr.
2. Prof. Jamal Aljarallah
3. Prof. Abdulrahman Al-Mazrou
4. Dr. Khalid Alshaye
5. Dr. Mohamed Alrukban
2 Course Description and Basic Definitions:
2.1 Course Description:
This course presents you to the basics of the ethical practice of healthcare provision by the
physician, and the professional standards that you should meet in any of your roles as a
doctor. These roles include your duties as team-member, practitioner/clinician, researcher,
manager/planner, educator, and patient advocate.
This is done provided the guidance given by our Islamic moral heritage, as well the national
and international guidelines and codes of ethics. It also approaches the Fiqhi-Legal aspects
related to the practice of medicine and the conduct of research.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 6 of 21
It also introduces you also to the professional and ethical standards to your relationships with
your colleagues, patients (and their families), the health institutions in which you work, and to
the whole community.
2.2 Ethics in healthcare (bioethics)
Ethics has been defined as a system of moral principles or standards governing conduct; a
system of principles by which human actions and proposals may be judged good or bad, right
or wrong; a set of rules or a standard governing the conduct of a particular class of human
action or profession; any set of moral principles or values recognized by a particular religion,
belief or philosophy; and the principles of right conduct of an individual. (UNESCO/IUBS/Eubios
Living Bioethics Dictionary version 1.4)
Bioethics is a branch of ethics. It is derived from Greek bio- (means life) and ethicos (means
moral). More precisely, it is the science/art that aims at identification, analysis, and resolution
of the ethical issues in the fields related to human life and health.
Medical/clinical ethics aims, by definition, to help the healthcare providers to identify, analyze
and resolve ethical issues they encounter during their practice.
Ethical issues arise when there are conflicting values, beliefs, commitments and priorities
either between the healthcare team and the patients (or their families), or among the
healthcare members themselves. These issues increase in their scope and complexity in
proportion to the complexity of the provided service. For instance, it is easy to observe that
the primary care ethical issues are quite few and trivial if compared to the ethical issues in
secondary or tertiary care institutions.
This is partially explained by the fact that patients (and maybe doctors as well) have higher
expectations to have a higher level of service. For example, no family would expect to have
aggressive heroic measures to be taken to save their patient's life in a rural primary care center
of clinic. Contrarily, they would not take it as easy in a tertiary specialized big hospital in the
middle of a big city.
The gap between the patients' and family expectations, on one side, and the doctors' ability to
utilize the available facilities that are overcrowded or not sufficient on the other side is the
main source of ethical issues. This is quite natural that the family sees their patient as the
patient that should be given the ultimate and priority care, while doctors have moral
commitments towards other patients who are in dare need for that time and facilities.
Indeed, there are many other sources for ethical issues related to the doctors' poor attitude,
miscommunication, poor leadership, lack of competence, and ignorance to name some.
Historically, medical ethics may be traced to guidelines on the duty of physicians in antiquity,
such as the The Code of Hammurabi dating to ca. 1780 BC, and the Hippocratic Oath ca. 400
BC.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 7 of 21
In the medieval and early modern period, the field is indebted to Muslim medicine such
as Ishaq bin Ali Rahawi (who wrote the Conduct of a Physician, the first book dedicated to
medical ethics), Muhammad ibn Zakariya ar-Razi (known as Rhazes in the West) and Ali ibn
Sahl Rabban al-Tabari who produced one of the first encyclopedia of medicine and medical
code of ethics in 970 G.
Contemporarily, the American Medical Association adopted its first code of ethics, in 1847.
However, this field has grown as an academic specialty in the western hemisphere, especially
North America only in the last few decades. Nevertheless, ethics has been discussed and
taught for centuries in the old world. Ethical principles are also deeply rooted in the Islamic
and other religious teachings.
Currently, there are growing factors that are shifting the field of bioethics to be internationally
spreading beyond the dominant trend of North American and European dominance, especially
our region including the Saudi Arabia. These could be summarized as follows:
1 - The complexity and expansion of the healthcare service are accompanied by more
complex and diverse ethical issues that need to be resolved.
2 - The increased awareness of the people about their rights, accompanied by aggressive
media coverage of healthcare, especially medical errors.
3 - The increasing interest in teaching medical ethics to medical students in more Saudi
medical colleges.
4 - The ongoing trend among governmental and private hospitals to obtain international
accreditation, which necessitates that they provide "ethics service" to their patients.
2.3 Ethics in Islam
Morality is an integral part of Islam. Moreover, it is considered the purpose for which the
Prophet Mohammed (PBUH) was sent. He (PBUH) said, "I was sent to perfect good character."
(Malik's Muwatta: 047/8)
He (PBUH) has also stated that, "The best amongst you are those who are best in morals"
(Sahih Muslim; 30/4750); "Righteousness is good morality, and wrongdoing is that which
wavers in your soul and which you dislike people finding out about." (An-Nawawi, 26); "The
faithful reaches, by his good character, the rank of the fasting (from food and water) and the
standing up (praying to God at night)" among many other advices by the prophet (PBUH) that
emphasize the role of morals in the Muslim's life.
Islam itself is unique in terms of how it unifies what is moral with what is legal. In other words,
what is moral is legal/permissible (Halal) and what is immoral is consequently illegal (Haram).
This spares the Muslim from the moral-legal discrepancies in other parts of the world, where
what is ethical is not necessarily legal, and vice versa. This also what makes us discuss the
ethical issues in medical practice within the Islamic context as "Ethical-Fiqhi-Legal" triad.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 8 of 21
The discussion and resolution of ethical issues from Islamic prospective will largely adopt the
Fiqhi methodology, as we will elaborate in the relevant sections of this manual.
3 Importance of Teaching Professionalism and Medical Ethics:
Though we are not expecting this course to make a virtuous person, or rebuild your character;
we aim at providing you the guidance on what constitutes an ethical attitude and explain to
you how to adopt it, and what is not ethical and how to avoid it. The bottom-line is that we
aim at making our graduates better doctors who adhere, to their best, to the professional
standards to provide the optimum healthcare to their patients.
The following summarizes the importance of teaching ethics and professionalism, including
Islamic ethics, to undergraduate medical students.
1- Training on moral reasoning about ethical issues (and not only the medical facts) makes
the physician more competences to deal with his patients as a whole, and not merely
dealing with their sick bodies.
2- It improves the analytical thinking abilities, and the learning of important skills like
asking questions, prominent solving and conflict resolution skills, which are beneficial
not only in the ethical analysis but also in the logical analysis needed for medical
practice in general.
3- Empower the attachment of the Muslim doctor to the set of moral framework that was
clarified by the Koran, Sunna and the guidance of our ancestors, so that the intentions
become purified for Allah in what we do, and not merely a materialistic approach to
medicine as a source of income.
4- Acquaint the Muslim doctor to the set of Fiqhi standards that s/he should know, like the
conditions of examining a patient of different sex, or the Fiqhi issues related to diseases,
like fasting, and prayers.
5- Moreover, the Muslim doctor may be consulted from a Scholar about a certain medical
issue that he wants to issue a Fatwa about. Therefore, you should know the basics of
Fiqhi approaches to medical practice to be able to help.
6- In addition, it was found that teaching ethics and professionalism to clinicians during
their undergraduate medical education will help in improving the outcome of the
healthcare.
4 Objectives of the Curriculum:
4.1 Main objective:
This curriculum aims at developing a standardized teaching program for ethics and professionalism for
medical students in clinical specialties that meets both the international standards and the Islamic and
cultural guidance of the community.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 9 of 21
4.2 Specific learning objectives:
1 - Demonstrate awareness of the main professional obligations of doctors
2 - Critically analyze ethical issues commonly encountered in medical practice and utilize given
frameworks and tools to resolve them
3 - Demonstrate the ability to resolve ethical issues faced during common clinical scenarios
4 - Practice according to Islamic bioethical guidance and Saudi codes of conduct for medical
practice
5 - Identify the ethical issues in research and apply ethical principles in conducting research
5 Structure of the curriculum
5.1 Section I: Introduction and Basics of Islamic Medical Ethics
This section will introduce the student to the basic philosophical and religious basis of bioethics, and
clarify the main ethical concepts and values that will be studied in more details in the following
sections.
The topics covered in this section include:
1- Orientation to the course
2- Introduction to the concepts of ethics, bioethics, and medical ethics
3- Comparison between the western and Islamic approaches to medical ethics
4- Professional duties of the doctor towards self, colleagues, patients, and community.
5- Professionalism in being a medical student and a doctor
6- Basic ethical principles and guidelines (national and international)
7- Overview on patients' rights
5.2 Section II: Practical Aspects of Medical Ethics
This section will include the practical aspects related to your practice as a future clinician. These topics
include:
1- Informed consent to treatment
2- Privacy and confidentiality
3- Medical Malpractice, Misconduct & Medical Errors
4- Patient's Autonomy and Consent to treatment
5- Privacy & Confidentiality
6- Terminally Incurable Diseases and the End of Life (EOL) Decisions
7- Financial Aspects in Practice and Conflict of Interests (COI)
8- How to manage ethical issues in clinical practice?
9- Resource allocation in the health-care system
10- Ethics of public health and health promotion
11- Islamic Fiqhi Rulings in Major Medical Specialties
5.3 Section III: Research Ethics
This section includes the ethical issues that are encountered before, during and after the
conduct of research.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 10 of 21
The main topics include:
1- Basic concepts in research ethics
2- The ethical standards of research
3- The concepts of benefit and harm in research
4- Informed consent in research
5- Research on vulnerable groups
6- Privacy and confidentiality in research
7- Conflict of interests in research
6 Teaching Methodology:
The teaching method will be based on the following:
1- Interactive sessions
2- Problem solving and case discussion
3- Assignments done by students
4- Student seminars
5- Case studies and case presentation
7 Student and Course Evaluation
Student evaluation methods were meant to be variable and continuous. They aim at evaluating the
student's ability to reflect what s/he learnt in hypothetical or simulated situations. Some tools are
individual, like assignments, while others depend on group work, like course research.
The following table summarizes the evaluation methods and their respective percentage of the total
mark.
Method Mark/100
Attendance (5) and Active class participation (5) 10
Assignments 5
Mid-term exam 20
Practicum (Clinical & Research Ethics practical activities) 5
Research report and presentation (the report (15) & presentation (5)) 20
Final exam 40
Total 100
7.1 Attendance and active participation
Physical attendance for at least 75% in the lectures is a perquisite by the faculty's regulations to attend
the exam. Any absence of more than 25% will decline you from sitting for the exam. It is the sole
responsibility of the student to make sure that s/he signed the attendance sheet in the allowed time.
However, attendance is not just about signing the attendance sheet!
You should participate and contribute to the session by asking questions, positive contributions in
group discussions, and answering questions.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 11 of 21
7.2 Assignments
Along the course, you will be asked to submit few assignments. These assignments are usually about
cases with ethical problems. You will be guided in each assignment by a set of questions that you may
need to follow in order to attain the best mark.
They are intended to be a self-reflection on what the student has learnt so far along the course. You
should feel free to express your understanding, than to focus on reaching a correct answer. Many
themes in ethics do not have agreed on clear cut right answers.
It is also expected that you should abide to the professional academic conduct, especially the proper
citation without the abuse of internet. We use software to detect plagiarism; thus it is very unadvisable
to just 'copy and paste' from the internet. Plagiarism similarity score of 20% or more means that your
work will be rejected and you will have to resubmit your work.
We take academic misconduct seriously. So should you.
7.2.1 Assessment of assignments:
Your assignments will be assessed based on the following criteria:
1- Originality of content. This means you need to reflect yourself in what you sib it
2- Novelty of content. This may be difficult to achieve in the topics of ethics, where there are
many articles already in the literature. However, you still need to add a new flavor to the
already discussed topic, or even better to choose a less discussed topic.
3- Strength of arguments. You need to defend what you present. This means that you need to
present a supported argument to what submit. A well-supported argument also means that you
need to present the possible counter-arguments to yours and how you would respond to them.
4- Uniform editing. The great content should be presented in a professional neat outlook and
layout. It is advisable to keep yourself to 1-2 fonts, to make sure that the sizes of the
subheadings are uniform, and to avoid using pictures and colors extensively unless justifiable.
5- Proper citation. You have to show that you have read well about the topic you’re writing on.
This is best reflected by the professional use of the suggested readings AND proper citation in a
uniform citation style. To make your life easy, there will a session on how to do that. Check the
timetable and bring your laptop on the given day.
7.3 Mid-Term Exam
The mid-term exam will be composed of (about 20) MCQs, with one best answer, and 2-4 short essay
questions. These may include short cases with questions to answer, or you are asked to "discuss" or
"list". The weight of each MCQ and short essay will be mentioned in the questions sheet.
Answering in either Arabic or English is allowed; however, each question should be answered in only
one language.
7.4 Research report & Research presentation
As a part of the course evaluation, every student has to submit a written work that reflects his/her
understanding of what s/he got in the course. This work should reflect his/her abilities to search the
literature, organize ideas, develop objectives, develop a research plan, and implement it to discuss the
relevant ethical aspects.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 12 of 21
We expect you (with your team) to find an ethical problem related to the objectives of the course,
study it guided by your research objectives, and present and discuss your results and conclusions from
what you found. Finally, you should have practical recommendations that you come up with at the end
of the research.
Your research is expected to contribute new knowledge to the scientific community and not a
repetition of what is already known about the subject.
7.4.1 Structure of the research
Typically, the research should contain the following sections:
I. Title page: (Header of the FOM; Title of the project; Names and IDs of the research
team; Name of the supervisor; and Date of submission
II. Table of contents: you are strongly recommended to use the [Add Table of contents
from your Word software]
III. Acknowledgment: This section is to acknowledge the efforts of those who helped you in
your research.
IV. Introduction: This is a key section. You need to tell the reader of your research what
you are studying, and why do you need to study it ( i.e. the rationale)
V. Review of literature: in this section you should show your reader that you really know
what you are studying and that what you're studying is not a repetition of work that is
already there. Remember: we expect new knowledge from your research.
VI. Objectives (general and specific): use action verbs, and make them SMART (Specific,
Measurable, Attainable/Acceptable/Achievable. Relevant/Reliable, and Time-bound)
VII. Methodology: in this section, you tell the reader how did you do your research. Make
sure this sections tells in details about the following: study area, study population, data
collections techniques and tools, and data analysis
VIII. Results: this section contains the findings of your data collection, preferably as tables
and figures.
IX. Discussion: In this section you discuss the results in comparison to what other found on
the same issue. You are expected to provide justifications for what you found in the
results.
X. Conclusion & Recommendations: You are expected to provide some practical steps to
be taken by relevant stakeholders to improve the situation regarding the topic of your
research.
XI. References: This section contains the references that you used in your work, especially
in the introduction and the review of literature. You are strongly recommended to use
reference management software (like Reference Manager, End Note, or RefWorks).
Discuss this option with your supervisor.
Don't Plagiarize! This simply means that your work will get ZERO.
7.4.2 The case study
Along this course, we aim that you know how to define, analyze and be able to use the relevant tools
to resolve ethical issues. This is best demonstrated by a case study. In a case study you are asked to
find a case with one or more ethical issues around it. You are strongly recommended to find a true
case, though you have to make sure you completely de-identify it. Discuss how to do that with your
supervisor.
A case study will be typically composed of these sections:
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 13 of 21
I. The presentation of the case, very similar to the way you do in clinical rounds with the exception that
you describe the aspects related to the ethical issue you will discuss, and not only the medical and clinical
facts.
II. What are the ethical issues in the case? In this section, you are supposed to list the ethical issues that
you found in the case
III. What are the ethical and Fiqhi principles at stake? In this section, you are supposed to list the ethical
principles followed by the Fiqhi and Islamic issues related to the case.
IV.Ethical case analysis: This section reflects the way you analyze the case, using any of the analysis
frameworks and tools (e.g. 4-boxes model) that you have gone through in this course.
V. Fiqhi Case analysis: In this section, you should present the Fiqhi approach to your case, for example
what are the Goals of Shariya (
‫انششٌؼخ‬ ‫يمبصذ‬
) involved, which Fiqhi Maxims (
‫انفمٍٓخ‬ ‫انمٕاػذ‬
) are applicable and
if there are previous Fatwas on the issue.
VI.Case resolution: although you may not be always able to resolve the issue, or suggest definitive steps
to be taken; you should present your approach to resolve the case.
7.4.3 A Fiqhi study
A Fiqhi study is a different format that can reflect your ability to search and analyze. As you know,
many of the practices and medical interventions have been studied by the Scholars (Ulama). Many
issues have been discussed in many conferences and had resolutions from Fatwa and Fiqhi
complexes. However, it is quite impossible for us as teachers to present to you along this course
each and every fatwa or religious approach to medical practice in different specialties. Therefore,
we encourage that few groups of you present a Fiqhi study to present the Islamic approach to a
given issue related to illness, diseases, or medical practice.
You are strongly recommended to approach NEW topics. For example a study on cleanliness or
fasting for patients (taharat al-maridh) is not acceptable, as there are already tens of books on the
issues. May be you can consider Islamic approach to ethical issues in specialties, like Emergency
Medicine, Oncology, Anesthesia, etc.
7.4.4 Ethical approval for your research
Usually the research at your level are classified as "Low-Risk, Low Vulnerability" studies, so they
rarely need a full ethical review. However, NO data collection should take place without a written
permission from the faculty, preferable from the dean's office. Please consult with your supervisor
and the course coordinator on whether your research needs one and how to obtain it.
7.4.5 Format and styling in writing and citation
Your work should follow the following instructions:
i. Make a separate page for title
ii. All sections of the proposed format for each kind of research work you want to
submit should be there.
iii. Preferably, make each section in a separate page
iv. Any omission of any section should be justified
v. All your work should be in Arial Font, double spaced, size of font should be as
follows:
Main headers/titles (size 18);
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 14 of 21
Subtitles (size 16);
Sub-subtitles (size 14); and
The rest of the text (size 12).
vi. Using Photos should be justified, with proper acknowledgment of the source and
copyright
vii. Don’t' use colors other than black unless justifiable and needed. In total, not
more than two colors allowed.
viii. Citation should be either in AMA, Vancouver, or Harvard Styles. Arabic references
and Fiqhi studies need to be agreed on with an expert relevant scholar.
7.4.6 The presentation associated with the research
The presentation is the way you tell others in summary about your research or case study. It
should summarize the whole work in 15 minutes presentation. Although there is no objection to
PowerPoint presentations; innovation in presenting your works will be highly appreciated and
will receive extra marks for that. Innovative ideas and ways of presentation may include making a
short movie, a role play, use of posters, or models, etc.
Each student will be individually evaluated, so make sure you know the research thoroughly. This
means that the work among the group members should be organized fairly with all group
involved.
You need to make sure with your supervisor that your presentation is relevant to the objectives.
You should make sure that a copy of your presentation is ready on the PC of the hall at least one
day before the presentation.
7.5 Practicum (Clinical & Research Ethics practical activities logbook)
As a part of your training in bioethics, you need to actively participate in activities related to
ethics. You need to attend a total of at least 4 hours in bioethics-related activities, within or
outside the KFMC.
These activities include (for example and not exhaustive):
- Attending at least ONE clinical ethics consultation;
- Attending at least ONE research ethical review committee;
- Attending at least one M&M (Morbidity and Mortality) report;
- Help in training of clinical staff (or medical students) on selected topics in bioethics;
- Prepare educational or advocacy material; and
- Participate in an ethics-awareness campaign for patients and staff
It is the student's responsibility to:
1- Register for the intended activity individually (don’t expect that your leader or friend
will do it for you)
2- Make sure that all the activities you attended are recorded and signed by your
supervisor
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 15 of 21
3- Attach any published works and printed material with the logbook.
7.6 Final Exam
As for the mid-term exam, the final exam will be composed of (about 40) MCQs, with one best
answer, and 2-4 short essay questions. These may include short cases with questions to
answer, or you are asked to "discuss" or "list". The weight of each MCQ and short essay will be
mentioned in the questions sheet.
Answering in either Arabic or English is allowed; however, each question should be answered
in only one language.
7.7 Course evaluation
The course will be evaluated through your feedback after each lecture and each test, or exam.
Your feedback is crucial to help improving the course for you and for the batches to come.
7.8 Deadlines and due dates
It is the student’s responsibility to meet the deadlines for submission of the assignments,
reports, and other academic tasks. Any delay will have sequences including reduced marks,
penalty reduction per/each day of delay, and refusal to receive the report or the assignment by
the supervisor or the course coordinator. Respecting your due dates reflects your ability to
manage your time and proper prioritization of your academic tasks, which this course helps on
learning.
8 Important dates
Start of the course Monday, 13/02/2012
Mid-term exam Monday, 19/03/2012
Mid-term vacation Saturday 22/3- Thursday 30/3/2012
Due date for research submission Monday 21/05/2012 (males)
Monday 28/05/2012 (females)
Due date for logbook submission Wednesday 30/05/2012
Research presentations Mon. 21/05/2012 (Males)
Mon. 28/05/2012 (Females)
Final exam Monday 04/06/2012
9 Communications and complaints
9.1 Website:
The website (https://sites.google.com/site/medicalethicscourse) is the main means of
communication and announcements for this course. Make sure you access it at least twice a
week. However, paper announcements will still be posted in relevant ad boards in the faculty.
Though your leaders are assigned to help making sure all students are aware of any possible
changes or important announcements, the main and foremost responsibility lies on each of the
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 16 of 21
individual students to know and keep themselves updated. Other means to facilitate that
include the students’ forum and BlackBerry groups that are not under the department.
9.2 Emails:
You should have an active email, whether a KFMC mail or otherwise. You need to make sure
you check your email at least twice a week. To reduce the usage of paper, we encourage email
submission of an e-copy even you should submit a hardcopy. Emails are searchable and
retrievable so you can have better proof that you have submitted what you should submit.
In the beginning of the course you need to make sure that the email you submitted to the
course coordinator is correct. You should receive a confirmation of receipt email. In case you
didn't please contact the course secretary, or coordinator.
9.3 Office appointments:
You may request to meet the course coordinator by requesting an office appointment. There
will be given days and times for male students and female students. Regular meetings with the
groups’ leaders will be held to reflect you concerns. Please contact the course coordinator for
further details.
9.4 Complaints and Appeals:
In case you have a complaint against one of the staff in the department, paramagnet or
visiting, or you want to appeal a decision that concerns you (your mark in an assignment or a
report), you have the right to contact the course coordinator. Should you are still unsatisfied
you can contact the course planner, who is also the dean of the faculty and the head of
department. The process to do so will be explained to you by the dean’s secretary office.
If your appeal is against results of the mid-term or the final exam, you’ll still contact the course
coordinator; however you need to contact the Examination Center to explain to you the
process you should follow to have your paper re-marked.
We assure you that the department and the faculty as a whole have zero-tolerance against
discrimination and sexism against students for any reason, whether verbal of physical. We will
take your complaints seriously, and we expect you to be serious in your commitment and
compliance with the academic guidelines that guide your attitude as medical students.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 17 of 21
10 Lectures, group-work and research presentations timetable
Unless otherwise stated, ALL lectures will be jointly given for male and female in the FOM main auditorium on Monday from 8.30-10.00 am AND
the group-work will be in the designated classrooms from 1-3.30 p.m. Dr. Ghaiath and Prof. Kasule will be the standby/backup speakers for all
sessions. This timetable may be changed in its order, content, or speakers. You will be notified if any changes are made.
All lectures are planned to be broadcasted live in the internet through the website: http://www.livestream.com/medicalethicscourse
Date
Title Speaker Format Time Location
Section I: Introduction to medical ethics
Main
auditorium
(FOM-Male
section)
Mon.
13.02.2012
1. Distribution of previous batch students’ awards Dr. AlKabba 8.00 – 8.30
2. Introduction to the course Dr. AlKabba Presentation 8.30-8.45
3. ‫انًسهى‬ ‫انؽجٍت‬ ‫اخاللٍبد‬ ‫انى‬ ‫يمذيخ‬ Dr. AlKabba Presentation 8.45-9.15
4. Introduction to medical ethics Dr. Ghaiath Interactive session 9.15-10.00
Mon.
20.02.2012
Review, attendance and debate Students Interactive session 8.00-8.15
Main
Auditorium
5
.
‫انًُظ‬
،ّ‫انفم‬ ‫ٔأصٕل‬ ‫انششٌؼخ‬ ‫يمبصذ‬ ‫خالل‬ ٍ‫ي‬ ‫ٔانًٕد‬ ،‫ٔانًشض‬ ،‫نهصحخ‬ ً‫انششػ‬ ‫ٕس‬
ً‫انؽج‬ ‫انًدبل‬ ً‫ف‬ ‫ٔرؽجٍمبرٓب‬ ‫انششػٍخ‬ ‫ٔانمٕاػذ‬
Dr. Khalid Alshaye Lecture 8.15-9.30
6. Islamic Approach to Medical Ethics Prof. Kasule Lecture 9.30-10.00
7. Academic Misconduct & Plagiarism Dr. AlKabba Interactive session 1.00 – 1.30
8. Proper citation (Reference Manager Software) BRING YOUR LAPTOP Dr. Ghaiath practical training 1.30-3.00
Mon.
27.02.2012
Review, debate and question Students Interactive session 8.00-8.15
9. Overview of the Doctor's professional relationships & duties Dr. Ghaiath Interactive session 8.15-9.00
Main
Auditorium
10.Doctor's duties towards self and colleagues Prof. Kasule Interactive session 9.00-10.00
11.ّ‫ٔيدزًؼ‬ ِ‫يشظب‬ ‫يغ‬ ‫انؽجٍت‬ ‫نؼاللبد‬ ً‫االسالي‬ ‫انًُظٕس‬ Dr. Khaled Alshaye Lecture 1.00-2.00
Cases for discussion Dr. Khaled Alshaye Group work 2.00-2.30
Mon.
05.03.2012
12.Professionalism
Dr. Mohamed Alrukban Interactive session
8.30 – 9.20 Main
Auditorium
13. ‫انُجٕي‬ ‫انؽت‬ ٍ‫ػ‬ ‫َجزح‬
(
‫انحذٌث‬ ‫ثبنؽت‬ ّ‫ٔػاللز‬ ّ‫يفٕٓي‬
) 9.20-10.00
Practical session Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 2.30 Classrooms
Mon.
12.03.2012
Review, attendance and debate Students Interactive session 8.00-8.15
Main
Auditorium
14.Overview of Patients Rights Dr. AlKabba Lecture 8.15-9.15
15.Islamic approach to ethics and patients’ rights Prof. Kasule Interactive session 9.15-10.00
16.Practical session (cases on patients rights) Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 2.30 Classrooms
Mon.
19.03.2012
Midterm Exam Exam 1.00-3.00 Classrooms
22/3-30/3/2012 Mid semester vacation
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 18 of 21
Date Title Speaker Format Time Location
Mon.
02.04.2012
Section II: Practical Aspects of ethics in medical care and end-of-life decisions
Review, attendance and debate Students Interactive session 8.00-8.15 Main
Auditorium
17.Overview of Informed consent to treatment Dr. Ghaiath Interactive session 8.15-9.00
18.Practical and Islamic approach to Informed consent to treatment Prof. Kasule Interactive session 9.00-10.00
Practical session Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms
Mon.
09.04.2012
Review, attendance and debate Students Interactive session 8.00-8.15 Main
Auditorium
19.Privacy & Confidentiality in healthcare Dr. Ghaiath Interactive session 8.15-9.00
20.Truth telling and breaking bad news Prof. Jamal Jarallah Interactive session 9.00-10.00
Practical session Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms
Mon.
16.04.2012
Review, attendance and debate Students Interactive session 8.00-8.15 Main
Auditorium
21.Medical Malpractice, Medical Errors Dr. AlKabba Lecture 8.15 – 9.15
22.Legal & Fiqhi aspects of medical error Prof. Kasule Interactive session 9.15-10.00
Practical session Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms
Mon.
23.04.2012
Review, attendance and debate Students Interactive session 8.00-8.15
Main
Auditorium
23.Terminally Incurable Diseases and the End of Life (EOL) & Do-Not Resuscitate (DNR) Prof. Kasule Lecture 8.15 – 9.15
24.Resource allocation in the health-care system Dr. AlKabba Lecture 9.15-10.00
25.‫نهحٍبح‬ ‫انًُمزح‬ ‫ٔانزذخالد‬ ‫ثبالحزعبس‬ ‫انًزؼهمخ‬ ‫انفمٍٓخ‬ ‫االحكبو‬ Dr. Khaled Alshaye Lecture& discussion 1.00-3.00
Section III: Practical Aspects of ethics in medical research and public health practice and research
Mon. 30.04.12
Review, attendance and debate Students Interactive session 8.00-8.15 Main
Auditorium
26.Financial Aspects in clinical Practice and Conflict of Interests (COI) Dr. AlKabba Lecture 8.15 – 9.30
27.Ethical Issues in Research – Part 1 (History, harm, vulnerability) Dr. Ghaiath Interactive session 9.30-10.00
Practical session on COI Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms
Mon. 07.05. 12
Review, attendance and debate Students Interactive session 8.00-8.15 Main
Auditorium
28.Ethical Issues in Research – Part 2 (COI, Privacy & Confidentiality) Dr. Ghaiath Interactive session 8.15 – 9.30
29.Ethical Issues in Research – Part 3 (consent to research) Prof. Kasule Interactive session 9.30-10.00
Practical session on research ethics Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms
Mon. 14.05.12
Review, attendance and debate Students Interactive session 8.00-8.15 Main
Auditorium
30.Ethics of public health and health promotion Prof. Kasule Interactive session 8.15-9.15
31.How to resolve ethical issues in clinical practice? Dr. Ghaiath Interactive session 9.15-10.00
practical session and Course revision Dr. Ghaiath/ Prof. Kasule Group work 1.00-3.00
Mon. 21.05.12
Male Student Research presentations
8.00-10.00 (Gr.s 1-8) 1.00-3.00 (groups 9-16) Main
Auditorium
Mon. 28.05. 12 Female Student Research presentations 8.00-10.00 (Gr.s 1-8)
Mon.
04.06.202
Final Exam 9.00-11.00 Classrooms
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 19 of 21
11 Need help? Or still have questions or queries?
If you have questions or queries, fell free to contact us.
- For technical assistance and issues related to location, schedule, or
attendance sheet, contact
o Mr. Abdulbasir Pula
o Phone: 01-2889999 extension 6301
o Email: apula@kfmc.med.sa
o Office in 1st
floor, Medical Ethics Department Office
- For academic issues related to the course, contact
o Dr. Ghaiath Hussein, the course coordinator
o Email: ghussein@kfmc.med.sa; ghaiathme@gmail.com,
o Phone: 01-2889999 extension 7588
o Office by appointment, 7th
floor
12 Readings and references:
12.1Textbooks:
 Singer PA, Viens AM: The Cambridge textbook of bioethics. Cambridge University
Press; 2008
 Saudi Council for Health Specialties 2003, Ethics of the Medical Profession, A manual
guide for medical practitioners Saudi Council for Health Specialties, Riyadh, Saudi Arabia.
(URL: http://english.scfhs.org.sa/Book/EN-scfhs_2007_p1.pdf)

9111
http://www.archive.org/download/waq43949/43949.pdf

http://www.archive.org/download/waq99210/99210.pdf

http://www.archive.org/download/waq91111/91111.pdf

‫نهًشٌط‬ ٍّٓ‫انفم‬ ‫االحكبو‬
-
‫ػجذانخبنك‬ ٍ‫ث‬ ًٍ‫ػجذانشح‬

ً‫اإلسالي‬ ّ‫انفم‬ ً‫ف‬ ‫نهًزٕفى‬ ‫ٔانؽجٍخ‬ ‫انششػٍخ‬ ‫األحكبو‬
،
‫د‬
.
ً‫انؼشث‬ ‫ثهحبج‬
‫أحًذ‬ ٍ‫ث‬

‫الطثٍة‬ ‫الجزادة‬ ‫أدكام‬
:
‫د‬
.
ً‫الشٌقٍط‬ ‫هخحار‬ ‫تي‬ ‫هذوذ‬
‫الطثٍة‬ ‫فقه‬ ‫جقزٌة‬
:
ً‫الذاسه‬ ‫اهلل‬ ‫عثذ‬ ‫تي‬ ‫فهذ‬
ً‫اإلساله‬ ‫الوٌظىر‬ ً‫ف‬ ‫وأدته‬ ‫الطثٍة‬ ‫فقه‬
:
‫د‬
.
‫الجثىري‬ ‫اهلل‬ ‫عثذ‬
‫هقارى‬ ً‫فقه‬ ‫تذث‬ ً‫إساله‬ ‫هٌظىر‬ ‫هي‬ ‫طثٍة‬ ‫قضاٌا‬
:
‫د‬
.
‫إدرٌس‬ ‫هذوذ‬ ‫الفحاح‬ ‫عثذ‬
‫ا‬ ‫وأدكام‬ ‫أداب‬ ً‫ف‬ ‫الطٍة‬ ‫ًفخ‬
‫لطثٍة‬
:
‫أتىدذٌفة‬ ‫وأعذاد‬ ‫جوع‬
‫الطثٍة‬ ‫لألعوال‬ ‫الشزعٍة‬ ‫األدكام‬
:
‫د‬
.
‫الذٌي‬ ‫شزف‬ ‫أدوذ‬
12.2 Websites

d.net/Doat/hani/12.htm
http://www.saai
 Medical Ethics Course: https://sites.google.com/site/medicalethicscourse/
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 20 of 21
 Prof. Omar Kasule’s ISLAMIC MEDICAL EDUCATION RESOURCES:
http://omarkasule-03.tripod.com/
12.3Articles & Reports:
1. A Guide to Understanding Informed Consent. National Cancer Institute US National Institute of Health
(NIH) . 3-4-2006. National Cancer Institute US National Institute of Health (NIH). URL: http://www.cancer.gov.
2. Al Aqeel, A. I. 2007, "Islamic ethical framework for research into and prevention of genetic diseases",
Nat Genet, vol. 39, no. 11, pp. 1293-1298.
3. Albar, M. A. 1996, "Islamic ethics of organ transplantation and brain death", Saudi J Kidney Dis Transpl,
vol. 7, no. 2, pp. 109-114.
4. Al-Gaai, E. A. & Hammami, M. M. 2009, "Medical chaperoning at a tertiary care hospital in Saudi
Arabia: survey of physicians", J Med Ethics, vol. 3 5
, no. 12, pp. 729-732.
5. Alkaabba, A. & Hussein, G. M. 2011, "Democratization of medical education is needed to effective
teaching of bioethics", J Med Liban, vol. 59, no. 1, pp. 33-36.
6. Al-Umran, K. U., Al-Shaikh, B. A., Al-Awary, B. H., Al-Rubaish, A. M., & Al-Muhanna, F. A. 2006,
"Medical ethics and tomorrow's physicians: an aspect of coverage in the formal curriculum", Medical Teacher,
vol. 28, no. 2, pp. 182-1 48
.
7. Bernard M.Dickens. Legal Aspects of the Beginning of Human Life. In: F.K.Beller, R.Weir ,editors. The
Beginning of Human Life. Kluwer; 1994. p. 35-48.
8. Bernard M.Dickens. Legal Evolution of the Concept of Brain Death. Transplantation Today 2, 60-64. 1985.
9. Chong, S. A., Capps, B. J., Subramaniam, M., Voo, T. C., & Campbell, A. V. 2010, "Clinical Research in
Times of Pandemics", Public Health Ethics.
10. Cooper A, Joglekar A, Gibson J, Swota A, Martin D. Communication of bed allocation decisions in a
critical care unit and accountability for reasonableness. BMC Health Services Research 2005;5(1):67.
11. Culver, C. M., Clouser, K. D., Gert, B., Brody, H., Fletcher, J., Jonsen, A., Kopelman, L., Lynn, J., Siegler,
M., & Wikler, D. 1985, "Basic curricular goals in medical ethics", New England Journal of Medicine, vol. 312, no.
4, pp. 253-256.
12. Cummings, C. L. & Mercurio, M. R. 2010, "Ethics for the Pediatrician: Autonomy, Beneficence, and
Rights", Pediatrics in Review, vol. 31, no. 6, pp. 252-255.
13. Derick T Wade 2001, "Ethical issues in diagnosis and management of patients in the permanent
vegetative state", BMJ no. 322, pp. 352-354.
14. Dickens BM, Cook RJ. Challenges of ethical research in resource-poor settings. International Journal of
Gynaecology and Obstetrics 2003;80:79-86.
15. Dickens, B. M. & Cook, R. J. 2003, "Challenges of ethical research in resource-poor settings",
International Journal of Gynaecology and Obstetrics, vol. 80, pp. 79-86.
16. Ebrahim AF. Organ transplantation: contemporary Sunni Muslim legal and ethical perspectives.
Bioethics 1995 Jul;9(3-4):291-302.
17. Faiz Khan. AN ISLAMIC APPRAISAL OF MINDING THE GAP. Psycho-Spiritual Dynamics in the
Doctor-Patient Relationship. Journal of Religious Ethics 36[1], 77-96. 2008.
18. Farzaneh Zahedi, Bagher Larijani, & Javad Tavakoly Bazzaz. End of Life Ethical Issues and Islamic Views.
Iran J Allergy Asthma Immunol 6[Suppl. 5], 5-15. 2007.
19. Gallagher A, Tschudin V. Educating for ethical leadership. Nurse Educ Today 2010 Apr;30(3):224-7.
20. Giordano, J. & Boswell, M. V. 2005, "Pain, placebo, and nocebo: epistemic, ethical, and practical issues",
Pain Physician no. 4 ,p. -3.
21. Greco, D. & Petrini, C. 2004, "Ethical issues in public health", Ann Ist Super Sanita no. 3, p. -71.
22. HARDEN, R. M., SOWDEN, S., & DUNN, W. R. 1984, "Educational strategies in curriculum
development: the SPICES model", Medical Education, vol. 18, no. 4, pp. 284-297.
23. Hebert, P. C., Meslin, E. M., & Dunn, E. V. 1992, "Measuring the ethical sensitivity of medical students: a
study at the University of Toronto", Journal of Medical Ethics, vol. v18, no. n3, p. 142.
Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 21 of 21
24. Hyder, A. A., Wali, S. A., Khan, A. N .
, Teoh, N. B., Kass, N. E., & Dawson, L. 2004, "Ethical review of
health research: a perspective from developing country researchers", Journal of Medical Ethics, vol. 30, no. 1,
pp. 68-72.
25. Ibia, E., Binkowitz, B., Saillot, J. L., Talerico, S., Koerner, C .
, Ferreira, I., Agarwal, A., Metz, C., & Maman,
M. 2010, "Ethical considerations in industry-sponsored multiregional clinical trials", Pharm Stat, vol. 9, no. 3,
pp. 230-241.
26. Illes, J. & Bird, S. J. 2006, "Neuroethics: a modern context for ethics in neuroscience", Trends Neurosci
no. 9, p. -7.
27. John R.Williams 2009, Medical Ethics Manual, 2nd edition 2009 edn, The World Medical Association, Inc..
28. Kelly, E. & Nisker, J. 2009, "Increasing Bioethics Education in Preclinical Medical Curricula: What
Ethical Dilemmas Do Clinical Clerks Experience?", Academic Medicine, vol. 84, no. 4.
29. Knoppers BM & Laberge C 1989, "DNA sampling and informed consent.", CMAJ, vol. 140, no. 1023.
30. La Puma, J. & Schiedermayer, D. L. 1991, "Ethics Consultation: Skills, Roles, and Training", Annals of
Internal Medicine, vol. 114, no. 2, pp. 155-160.
31. Martin F.McKneally & Peter A.Singer. Bioethics for clinicians: 25. Teaching bioethics in the clinical
setting. CMAJ . 2001.
32. Martin H N Tattersall & Ian H Kerridge .Doctors behaving badly? MJA 185[6], 299-300. 2006.
33. Memish, Z. A., McNabb, S. J., Mahoney, F., Alrabiah, F., Marano, N., Ahmed, Q. A., Mahjour, J., Hajjeh, R.
A., Formenty, P., Harmanci, F. H., El Bushra, H., Uyeki, T. M., Nunn, M .
, Isla, N., Barbeschi, M., & Jeddah Hajj
Consultancy Group 2009, "Establishment of public health security in Saudi Arabia for the 2009 Hajj in
response to pandemic influenza A H1N1", Lancet, vol. 374, no. 9703, pp. 1786-1791.
34. Miles SH, Lane LW, Bickel J ,Walker RM, & Cassel CK. Medical ethics education: coming of age. Acad
Med. 64[12], 705-714. 1989.
35. Nancy Kass. An Ethics Framework for Public Health. Am J Public Health 91[11], 1776-1782. 2001.
36. Norman Daniels. Accountability for reasonableness: Establishing a fair process for priority setting is
easier than agreeing on principles. BMJ 321[7272], 1300-1301. 2000. 2-10-2008.
37. Omar Hasan Kasule Sr. "Medical Ethico-Legal-Fiqhi Basis of Medical Practice: An Islamic Perspective",
in Scientific and Islamic Medicine Seminar, The Students' Executive Board Faculty of Medicine Deponegoro
University, Timur Indonesia.
38. Omar Hasan Kasule Sr. 2008b, "Medical Ethico-Legal-Fiqhi Issues: An Islamic Perspective", in Training
workshop on the Islamic Input in the Medical Curriculum held at the Faculty of Medicine UNISSULA.
39. Paul S.Appelbaum, Thomas Grisso, Ellen Frank, Sandra O'Donnell, & J.Kupfer. Competence of Depressed
Patients for Consent to Research. Am J Psychiatry [156], 1380-1384. 1999.
40. Robert I.Field & Arthur L.Caplan. A Proposed Ethical Framework for Vaccine Mandates: Competing
Values and the Case of HPV. Kennedy Institute of Ethics Journal 18[2], 111-124. 6-1-2008.
Siegler, M., Pellegrino, E. D., & Singer, P. A. 1990, "Clinical medical ethics", J Clinical Ethics, vol. 1, pp. 5-9.
41. Siegler M, Pellegrino ED, Singer PA. Clinical medical ethics. J Clinical Ethics 1990;1:5-9.
42. Silver-Isenstadt, A. & Ubel, P. 1999, "Erosion in medical students attitudes about telling patients they are
students", Journal of General Internal Medicine, vol. 14, no. 8, pp. 481-487.
43. Slowther, A., Johnston, C .
, Goodall, J., & Hope, T. 2004, "Development of clinical ethics committees",
BMJ, vol. 328, no. 7445, pp. 950-952.
44. Soleymani Lehmann, L., Kasoff, W. S., Koch, P., & Federman, D. D. 2004, "A Survey of Medical Ethics
Education at U.S. and Canadian Medical Schools", Academic Medicine, vol. 79, no. 7.
45. Stuart F.Quan. Doctor, Do You Have A Minute? The Dilemma Posed by Physician Interaction with the
Pharmaceutical Industry. Clin Sleep Med. 3[4], 345-346. 15-6-2007.
46. Tangwa GB. Ethical principles in health research and review process .Acta Trop 2009;112(Suppl 1):2-7.
47. Torda, A. 2006, "Ethical issues in pandemic planning", Med J Aust no. 10, p. -6
World Health Organization ( 2000, "Operational Guidelines for Ethics Committees That
Review Biomedical Research
."

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Medical Ethics Curriculum Student guide 2012

  • 1. Student Guide for Medical Ethics Course (METH 421) Credit Hours: 2(1+3+0) 1433 H (2012 G) Version 3.5 Last updated: 11/02/2012 Course Planner: Dr. Abdulaziz AlKabba, Associate Dean, FOM-KFMC Course Coordinator: Dr. Ghaiath Hussein 2012 Department of Medical Ethics Faculty of Medicine – King Fahad Medical City King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) ‫الطة‬ ‫تكلٍة‬ ‫الصذٍة‬ ‫األخالقٍات‬ ‫هقزر‬ - ‫الطثٍة‬ ‫فهذ‬ ‫الولك‬ ‫هذٌٌة‬ ‫آٌات‬ ‫على‬ ‫ٌذحىي‬ ‫الكحاب‬ ‫هذا‬ ‫وٌجة‬ ،‫شزٌفة‬ ‫وأدادٌث‬ ‫تادحزام‬ ‫هعاهلحه‬ This book contains verses from the Holy Quran and Hadith of Prophet Mohammed (PBUH). Please treat respectfully. " َ ‫ى‬ِ ‫إ‬ ْ‫ي‬ِ ‫ه‬ ْ‫ن‬ُ ‫ك‬ِ ‫ر‬‫َا‬ ٍِ ‫خ‬ ْ‫ن‬ُ ‫ك‬َ ٌَ ‫س‬‫ْا‬‫د‬َ‫أ‬ ‫ًا‬ ‫ق‬‫َا‬ ‫ل‬ْ‫خ‬َ ‫أ‬ " ‫يسهى‬ ِ‫سٔا‬ " ‫َا‬ ‫و‬َ ًِ ‫إ‬ ُ ‫ث‬ْ‫ث‬ِ ‫ع‬ُ ‫ت‬ َ ‫ن‬ِ ‫و‬َ ‫ج‬ُ ‫أ‬ِ ‫ل‬ َ ‫خ‬ِ ‫ل‬‫َا‬‫ص‬ ِ ‫ق‬‫َا‬ ‫ل‬ْ‫خ‬َ‫أ‬ْ‫ل‬‫ا‬ " ‫أحًذ‬ ّ‫أخشخ‬
  • 2. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 2 of 21 © 2012 Department of Medical Ethics, Faculty of Medicine, King Fahad Medical City This document is not issued to the general public, and all rights are reserved by the Faculty of Medicine, King Fahad Medical City (FOM-KFMC). The document may not be reviewed, abstracted, quoted, reproduced or translated, in part or in whole, without the prior written permission of FOM-KFMC. No part of this document may be stored in a retrieval system or transmitted in any form or by any means – electronic, mechanical or other – without the prior written permission of FOM- KFMC. Requests for permission should be directed to Faculty of Medicine, King Fahad Medical City, address: King Fahad Medical City, Faculty of Medicine, Suleimaniya, Riyadh 12231, Saudi Arabia, email: ethics@kfmc.med.sa. The views expressed in documents by named author are solely the responsibility of this author.
  • 3. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 3 of 21 Contents ‫نظرة‬ ‫عامت‬ ‫على‬ ‫المقرر‬ : ................................ ................................ ................................ ................................ .... 4 1.1 ‫ما‬ ‫المقصود‬ ‫ثبألخاللٍبد‬ ‫الطبيت؟‬ ................................ ................................ ................................ ........... 4 ‫أهميت‬ ‫تدريس‬ ‫األخالقياث‬ ‫الطبيت‬ ‫للطبيب‬ ‫المسلم‬ ................................ ................................ ................... 4 OVERVIEW ON THE CURRICULUM:............................................................................................................................ 5 MEMBERS OF THE CURRICULUM COMMITTEE: ..............................................................................5 2 COURSE DESCRIPTION AND BASIC DEFINITIONS:.....................................................................5 2.1 COURSE DESCRIPTION: 5 2.2 ETHICS IN HEALTHCARE (BIOETHICS) 6 2.3 ETHICS IN ISLAM 7 3 IMPORTANCE OF TEACHING PROFESSIONALISM AND MEDICAL ETHICS: .....................................8 4 OBJECTIVES OF THE CURRICULUM: .......................................................................................8 4.1 MAIN OBJECTIVE: 8 4.2 SPECIFIC LEARNING OBJECTIVES: 9 5 STRUCTURE OF THE CURRICULUM ........................................................................................9 5.1 SECTION I: INTRODUCTION AND BASICS OF ISLAMIC MEDICAL ETHICS 9 5.2 SECTION II: PRACTICAL ASPECTS OF MEDICAL ETHICS 9 5.3 SECTION III: RESEARCH ETHICS 9 6 TEACHING METHODOLOGY: .............................................................................................. 10 7 STUDENT AND COURSE EVALUATION.................................................................................. 10 7.1 ATTENDANCE AND ACTIVE PARTICIPATION 10 7.2 ASSIGNMENTS 11 7.3 MID-TERM EXAM 11 7.4 RESEARCH REPORT & RESEARCH PRESENTATION 11 7.5 PRACTICUM (CLINICAL & RESEARCH ETHICS PRACTICAL ACTIVITIES LOGBOOK) 14 7.6 FINAL EXAM 15 7.7 COURSE EVALUATION 15 7.8 DEADLINES AND DUE DATES 15 8 IMPORTANT DATES.......................................................................................................... 15 9 COMMUNICATIONS AND COMPLAINTS ............................................................................... 15 9.1 WEBSITE: 15 9.2 EMAILS:....................................................................................................................................... 16 9.3 OFFICE APPOINTMENTS: 16 9.4 COMPLAINTS AND APPEALS: 16 10 LECTURES, GROUP-WORK AND RESEARCH PRESENTATIONS TIMETABLE................................... 17 11 NEED HELP? OR STILL HAVE QUESTIONS OR QUERIES?........................................................... 19 12 READINGS AND REFERENCES: ............................................................................................ 19 12.1 TEXTBOOKS: 19 11.1 WEBSITES 19 12.3 ARTICLES & REPORTS: 20
  • 4. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 4 of 21 ‫المقرر‬ ‫على‬ ‫عامت‬ ‫نظرة‬ : ،ّ‫ٔيُٓز‬ ،ّ‫َفس‬ ٕ‫َح‬ ّ‫سهٕك‬ ّ‫رٕخ‬ ‫الَٓب‬ ً ‫ا‬‫َظش‬ ،‫انؽت‬ ‫ؼبنت‬ ‫ٌذسسٓب‬ ً‫انز‬ ‫انًمشساد‬ ‫اْى‬ ٍ‫ي‬ ‫انؽجٍخ‬ ‫االخاللٍبد‬ ‫يمشس‬ ‫ٌؼزجش‬ ‫ككم‬ ّ‫ٔيدزًؼ‬ ،ِ‫ٔيشظب‬ ،ِ‫ٔصيالء‬ . ،‫انؽجٍت‬ ‫لجم‬ ٍ‫ي‬ ‫انًمذيخ‬ ‫انصحٍخ‬ ‫نهخذيخ‬ ‫األخاللٍخ‬ ‫انًًبسسخ‬ ‫أسس‬ ‫انًمشس‬ ‫ْزا‬ ‫ٌزُبٔل‬ ‫ا‬ ‫األخاللٍبد‬ ‫ٔأسس‬ ‫ٔيُظًخ‬ ‫حبكًخ‬ ‫ٔلٍى‬ ‫أخاللٍبد‬ ٍ‫ي‬ ‫انؽجٍت‬ ٍّ‫ػه‬ ٌٕ‫ٌك‬ ٌ‫أ‬ ‫ٌدت‬ ‫ٔيب‬ ‫انؽجٍخ‬ ‫انًُٓخ‬ ‫ٔأصٕل‬ ‫ٔآداة‬ ‫نصحٍخ‬ ‫األسس‬ ‫إنى‬ ‫إظبفخ‬ ،‫انششٌفخ‬ ‫انُجٌٕخ‬ ‫انسُخ‬ ً‫ف‬ ‫خبء‬ ‫ٔيب‬ ًَ‫انمشآ‬ ‫انٓذي‬ ً‫ف‬ ‫األخاللٍخ‬ ‫انمٍى‬ ‫ثًُظٕيخ‬ ٌٍ‫يسزششذ‬ ،‫انؽت‬ ‫نًُٓخ‬ ‫انؽجٍخ‬ ‫األخالق‬ ً‫ف‬ ‫ػهٍٓب‬ ‫انًزؼبسف‬ ‫انؼبنًٍخ‬ . ‫ٌزُبٔل‬ ‫كًب‬ ‫انمعبٌب‬ ٍ‫ي‬ ‫ٔنؼذد‬ ‫انؽجٍخ‬ ‫نهًسزدذاد‬ ‫ٔانفمٍٓخ‬ ‫انمبٍََٕخ‬ ‫األثؼبد‬ ‫انًمشس‬ ‫ثٓب‬ ‫ٌؼًم‬ ً‫انز‬ ‫انصحٍخ‬ ‫ٔانًؤسسخ‬ ِ‫ٔيشظب‬ ّ‫ثضيالئ‬ ّ‫ٔػاللز‬ ،‫انؽجٍت‬ ‫ثؼًم‬ ‫انًزصهخ‬ . 1.1 ‫المقصود‬ ‫ما‬ ‫تاألخالقٍات‬ ‫الطبيت؟‬ ‫أث‬ ‫انخذيخ‬ ‫يٕفش‬ ً‫ف‬ ‫رٕفشْب‬ ‫ٌزٕخت‬ ً‫انز‬ ‫ًٍَخ‬ ٍِ ‫م‬‫ان‬ ‫انعٕاثػ‬ ‫يدًٕػخ‬ ًْ ‫انؽجٍخ‬ ‫األخاللٍبد‬ ‫ٔرشخغ‬ ،‫انصحٍخ‬ ‫انخذيخ‬ ِ‫رٕفٍش‬ ‫ُبء‬ ً‫حبيٕساث‬ ٌَٕ‫لب‬ ‫يثم‬ ،‫انمذو‬ ً‫ف‬ ‫ظبسثخ‬ ‫ربسٌخٍخ‬ ‫حمت‬ ‫إنى‬ ‫انؽجٍت‬ ‫ػًم‬ ‫ٔظجػ‬ ‫رُظٍى‬ ‫يحبٔالد‬ ( 1222 ‫ق‬ . ‫و‬ ). ‫ثمسى‬ ً ‫ا‬‫يشٔس‬ ‫أثٕلشاغ‬ ( 422 ‫ق‬ . ‫و‬ ). ‫ػذد‬ ‫إسٓبيبد‬ ‫إنى‬ ‫إظبفخ‬ ،‫انًدزًؼبد‬ ٍ‫ي‬ ‫انكثٍش‬ ً‫ف‬ ‫ْزا‬ ‫ٌٕيُب‬ ‫حزى‬ ‫انًؼزجشح‬ ‫انًٕاثٍك‬ ٍ‫ي‬ ‫ٌؼذ‬ ‫ٔانزي‬ ، ‫األؼج‬ ٍ‫ي‬ ‫ػبو‬ ‫نهؽت‬ ً ‫ب‬ً‫يُظ‬ ً ‫ب‬‫يٍثبل‬ ‫ٔظغ‬ ‫انزي‬ ‫انؽجشي‬ ‫يثم‬ ًٍٍ‫انًسه‬ ‫بء‬ 072 ‫ٔظغ‬ ٍ‫ي‬ ‫أٔل‬ ‫ٌؼذ‬ ‫انزي‬ ‫انشْٕي‬ ٍ‫ث‬ ‫ٔاسحك‬ ،‫و‬ ‫انذٌبَبد‬ ‫يخزهف‬ ٍ‫ي‬ ‫ٔاألؼجبء‬ ‫انفالسفخ‬ ٍ‫ي‬ ‫ٔغٍشْى‬ ،‫انشاصي‬ ‫صكشٌب‬ ٍ‫ث‬ ‫ٔيحًذ‬ ،‫انؽت‬ ‫يًبسسخ‬ ‫آداة‬ ٍ‫ػ‬ ً ‫ب‬‫كزبث‬ . ‫المسلم‬ ‫للطبيب‬ ‫الطبيت‬ ‫األخالقياث‬ ‫تدريس‬ ‫أهميت‬ ‫رذسٌس‬ ‫أًٍْخ‬ ًٍ‫رك‬ ‫أًْٓب‬ ‫أيٕس‬ ‫ػذح‬ ً‫ف‬ ً ‫ب‬‫خصٕص‬ ‫اإلساليٍخ‬ ‫انؽجٍخ‬ ‫ٔاألخاللٍبد‬ ،ً ‫ب‬‫ػًٕي‬ ‫انؽجٍخ‬ ‫األخاللٍبد‬ : - ‫األخاللٍخ‬ ‫اندٕاَت‬ ً‫ف‬ ‫انزفكٍش‬ ‫ػهى‬ ‫انزذسٌت‬ ٌ‫إ‬ ( ‫انؼهًٍخ‬ ‫انؽجٍخ‬ ‫انحمبئك‬ ‫فمػ‬ ‫ٔنٍس‬ ) ‫يغ‬ ‫ٌزؼبيم‬ ‫انؽجٍت‬ ٍ‫ي‬ ‫ردؼم‬ ‫ثبندٕاَت‬ ‫االْزًبو‬ ٌٔ‫د‬ ّ‫ٔػالخ‬ ‫اندسذ‬ ‫يغ‬ ‫انزؼبيم‬ ‫فمػ‬ ‫ٔنٍس‬ ‫يزكبيم‬ ‫ككم‬ ِ‫يشظب‬ ‫نهًشظى‬ ‫ٔانُفسٍخ‬ ‫انشٔحٍخ‬ - ٔ ،‫انًشكالد‬ ‫ٔرحهٍم‬ ‫األسئهخ‬ ‫ؼشذ‬ ‫يثم‬ ‫ػًهٍخ‬ ‫يُٓدٍبد‬ ‫ٔرؼهى‬ ‫انُمذي‬ ً‫انزحهٍه‬ ‫انزفكٍش‬ ‫ػهى‬ ‫انؽجٍت‬ ‫لذسح‬ ٍ‫ي‬ ‫رضٌذ‬ ‫انزحهٍم‬ ً‫ف‬ ً ‫ب‬‫أٌع‬ ‫ثم‬ ً‫األخالل‬ ‫انزحهٍم‬ ً‫ف‬ ‫فمػ‬ ‫نٍس‬ ِ‫رفٍذ‬ ً‫انز‬ ً‫انزحهٍه‬ ‫انزفكٍش‬ ‫يٓبساد‬ ٍ‫ي‬ ‫ٔغٍشْب‬ ‫انًُبصػبد‬ ‫إداسح‬ ‫انًًبسسخ‬ ً‫ف‬ ً‫انًُؽم‬ ً ‫ب‬‫ػًٕي‬ ‫انؽجٍخ‬ . - ٍّ‫ػه‬ ‫اهلل‬ ‫صهى‬ ٍّ‫َج‬ ‫ٔسُخ‬ ‫اهلل‬ ‫كزبة‬ ً‫ف‬ ‫انحٍُف‬ ‫انششع‬ ‫ٔٔظحٓب‬ ‫َظًٓب‬ ً‫انز‬ ‫انمًٍٍخ‬ ّ‫ثًُظٕيز‬ ‫انًسهى‬ ‫انؽجٍت‬ ‫اسرجبغ‬ ‫اخم‬ ٍ‫ي‬ ّ‫ٔػًه‬ ‫نهؼهى‬ ّ‫ؼهج‬ ٌٕ‫فٍك‬ ،ّ‫ن‬ ‫ٔخبنصخ‬ ‫رؼبنى‬ ‫هلل‬ ‫لبصذح‬ ‫انؽجٍت‬ ‫ٍَخ‬ ٌٕ‫رك‬ ‫ثحٍث‬ ،‫انسهف‬ ‫َٓح‬ ً‫ٔف‬ ،‫ٔسهى‬ ‫ٔن‬ ‫اهلل‬ ‫يشظبح‬ ‫ثٓب‬ ً‫ٌجزغ‬ ‫ػجبدح‬ ِ‫يشظب‬ ً ‫ب‬ٌٍَٕ‫د‬ ً ‫ا‬‫أخش‬ ‫ػهٍٓب‬ ‫نٍزمبظى‬ ‫ًٌبسسٓب‬ ‫يُٓخ‬ ‫يدشد‬ ‫فمػ‬ ‫ٍسذ‬ . - ً‫ف‬ ‫ثًب‬ ،ّ‫ثؼًه‬ ‫نهمٍبو‬ ‫ثٓب‬ ‫اندٓم‬ ّ‫ٌسؼ‬ ‫ال‬ ‫ثم‬ ‫ٌحزبخٓب‬ ً‫انز‬ ‫انفمٍٓخ‬ ‫انعٕاثػ‬ ‫ثأسبسٍبد‬ ‫انًسهى‬ ‫انؽجٍت‬ ‫إنًبو‬ ‫ظشٔسح‬ ٍ‫ي‬ ‫انًشٌط‬ ‫ػُٓب‬ ّ‫ٌسأن‬ ‫لذ‬ ً‫انز‬ ‫ثبنًشض‬ ‫انًشرجؽخ‬ ‫انفمٍٓخ‬ ‫ٔاألحكبو‬ ،ِ‫يشظب‬ ‫ػهى‬ ‫ثبنكشف‬ ّ‫لٍبي‬ ‫ظٕاثػ‬ ‫رنك‬ ‫لجٍم‬ ‫األحكبو‬ ٍ‫ي‬ ‫غٍشْب‬ ٔ‫أ‬ ّ‫صالر‬ ٔ‫أ‬ ‫انًشٌط‬ ‫صٕو‬ .
  • 5. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 5 of 21 Overview on the curriculum: Ethics of Medical Practice (METH 421) Duration Course code Semester Year Phase 16 weeks METH421 Second Four Three Course Code Course Title Contact Hours Credit Hours Prerequisite Theoretical Tutorial Practical METH 421 Ethics of Medical Practice 1 3 4 2 NONE Curriculum Committee: Supervisor of the 3rd phase: Associate Dean for Clinical Phase Module Supervisor: Dr. Abdulaziz AlKabba Module Coordinator: Dr. Ghaiath M.A. Hussein Members of the curriculum committee: 1. Prof. Omar H. Kasule Sr. 2. Prof. Jamal Aljarallah 3. Prof. Abdulrahman Al-Mazrou 4. Dr. Khalid Alshaye 5. Dr. Mohamed Alrukban 2 Course Description and Basic Definitions: 2.1 Course Description: This course presents you to the basics of the ethical practice of healthcare provision by the physician, and the professional standards that you should meet in any of your roles as a doctor. These roles include your duties as team-member, practitioner/clinician, researcher, manager/planner, educator, and patient advocate. This is done provided the guidance given by our Islamic moral heritage, as well the national and international guidelines and codes of ethics. It also approaches the Fiqhi-Legal aspects related to the practice of medicine and the conduct of research.
  • 6. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 6 of 21 It also introduces you also to the professional and ethical standards to your relationships with your colleagues, patients (and their families), the health institutions in which you work, and to the whole community. 2.2 Ethics in healthcare (bioethics) Ethics has been defined as a system of moral principles or standards governing conduct; a system of principles by which human actions and proposals may be judged good or bad, right or wrong; a set of rules or a standard governing the conduct of a particular class of human action or profession; any set of moral principles or values recognized by a particular religion, belief or philosophy; and the principles of right conduct of an individual. (UNESCO/IUBS/Eubios Living Bioethics Dictionary version 1.4) Bioethics is a branch of ethics. It is derived from Greek bio- (means life) and ethicos (means moral). More precisely, it is the science/art that aims at identification, analysis, and resolution of the ethical issues in the fields related to human life and health. Medical/clinical ethics aims, by definition, to help the healthcare providers to identify, analyze and resolve ethical issues they encounter during their practice. Ethical issues arise when there are conflicting values, beliefs, commitments and priorities either between the healthcare team and the patients (or their families), or among the healthcare members themselves. These issues increase in their scope and complexity in proportion to the complexity of the provided service. For instance, it is easy to observe that the primary care ethical issues are quite few and trivial if compared to the ethical issues in secondary or tertiary care institutions. This is partially explained by the fact that patients (and maybe doctors as well) have higher expectations to have a higher level of service. For example, no family would expect to have aggressive heroic measures to be taken to save their patient's life in a rural primary care center of clinic. Contrarily, they would not take it as easy in a tertiary specialized big hospital in the middle of a big city. The gap between the patients' and family expectations, on one side, and the doctors' ability to utilize the available facilities that are overcrowded or not sufficient on the other side is the main source of ethical issues. This is quite natural that the family sees their patient as the patient that should be given the ultimate and priority care, while doctors have moral commitments towards other patients who are in dare need for that time and facilities. Indeed, there are many other sources for ethical issues related to the doctors' poor attitude, miscommunication, poor leadership, lack of competence, and ignorance to name some. Historically, medical ethics may be traced to guidelines on the duty of physicians in antiquity, such as the The Code of Hammurabi dating to ca. 1780 BC, and the Hippocratic Oath ca. 400 BC.
  • 7. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 7 of 21 In the medieval and early modern period, the field is indebted to Muslim medicine such as Ishaq bin Ali Rahawi (who wrote the Conduct of a Physician, the first book dedicated to medical ethics), Muhammad ibn Zakariya ar-Razi (known as Rhazes in the West) and Ali ibn Sahl Rabban al-Tabari who produced one of the first encyclopedia of medicine and medical code of ethics in 970 G. Contemporarily, the American Medical Association adopted its first code of ethics, in 1847. However, this field has grown as an academic specialty in the western hemisphere, especially North America only in the last few decades. Nevertheless, ethics has been discussed and taught for centuries in the old world. Ethical principles are also deeply rooted in the Islamic and other religious teachings. Currently, there are growing factors that are shifting the field of bioethics to be internationally spreading beyond the dominant trend of North American and European dominance, especially our region including the Saudi Arabia. These could be summarized as follows: 1 - The complexity and expansion of the healthcare service are accompanied by more complex and diverse ethical issues that need to be resolved. 2 - The increased awareness of the people about their rights, accompanied by aggressive media coverage of healthcare, especially medical errors. 3 - The increasing interest in teaching medical ethics to medical students in more Saudi medical colleges. 4 - The ongoing trend among governmental and private hospitals to obtain international accreditation, which necessitates that they provide "ethics service" to their patients. 2.3 Ethics in Islam Morality is an integral part of Islam. Moreover, it is considered the purpose for which the Prophet Mohammed (PBUH) was sent. He (PBUH) said, "I was sent to perfect good character." (Malik's Muwatta: 047/8) He (PBUH) has also stated that, "The best amongst you are those who are best in morals" (Sahih Muslim; 30/4750); "Righteousness is good morality, and wrongdoing is that which wavers in your soul and which you dislike people finding out about." (An-Nawawi, 26); "The faithful reaches, by his good character, the rank of the fasting (from food and water) and the standing up (praying to God at night)" among many other advices by the prophet (PBUH) that emphasize the role of morals in the Muslim's life. Islam itself is unique in terms of how it unifies what is moral with what is legal. In other words, what is moral is legal/permissible (Halal) and what is immoral is consequently illegal (Haram). This spares the Muslim from the moral-legal discrepancies in other parts of the world, where what is ethical is not necessarily legal, and vice versa. This also what makes us discuss the ethical issues in medical practice within the Islamic context as "Ethical-Fiqhi-Legal" triad.
  • 8. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 8 of 21 The discussion and resolution of ethical issues from Islamic prospective will largely adopt the Fiqhi methodology, as we will elaborate in the relevant sections of this manual. 3 Importance of Teaching Professionalism and Medical Ethics: Though we are not expecting this course to make a virtuous person, or rebuild your character; we aim at providing you the guidance on what constitutes an ethical attitude and explain to you how to adopt it, and what is not ethical and how to avoid it. The bottom-line is that we aim at making our graduates better doctors who adhere, to their best, to the professional standards to provide the optimum healthcare to their patients. The following summarizes the importance of teaching ethics and professionalism, including Islamic ethics, to undergraduate medical students. 1- Training on moral reasoning about ethical issues (and not only the medical facts) makes the physician more competences to deal with his patients as a whole, and not merely dealing with their sick bodies. 2- It improves the analytical thinking abilities, and the learning of important skills like asking questions, prominent solving and conflict resolution skills, which are beneficial not only in the ethical analysis but also in the logical analysis needed for medical practice in general. 3- Empower the attachment of the Muslim doctor to the set of moral framework that was clarified by the Koran, Sunna and the guidance of our ancestors, so that the intentions become purified for Allah in what we do, and not merely a materialistic approach to medicine as a source of income. 4- Acquaint the Muslim doctor to the set of Fiqhi standards that s/he should know, like the conditions of examining a patient of different sex, or the Fiqhi issues related to diseases, like fasting, and prayers. 5- Moreover, the Muslim doctor may be consulted from a Scholar about a certain medical issue that he wants to issue a Fatwa about. Therefore, you should know the basics of Fiqhi approaches to medical practice to be able to help. 6- In addition, it was found that teaching ethics and professionalism to clinicians during their undergraduate medical education will help in improving the outcome of the healthcare. 4 Objectives of the Curriculum: 4.1 Main objective: This curriculum aims at developing a standardized teaching program for ethics and professionalism for medical students in clinical specialties that meets both the international standards and the Islamic and cultural guidance of the community.
  • 9. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 9 of 21 4.2 Specific learning objectives: 1 - Demonstrate awareness of the main professional obligations of doctors 2 - Critically analyze ethical issues commonly encountered in medical practice and utilize given frameworks and tools to resolve them 3 - Demonstrate the ability to resolve ethical issues faced during common clinical scenarios 4 - Practice according to Islamic bioethical guidance and Saudi codes of conduct for medical practice 5 - Identify the ethical issues in research and apply ethical principles in conducting research 5 Structure of the curriculum 5.1 Section I: Introduction and Basics of Islamic Medical Ethics This section will introduce the student to the basic philosophical and religious basis of bioethics, and clarify the main ethical concepts and values that will be studied in more details in the following sections. The topics covered in this section include: 1- Orientation to the course 2- Introduction to the concepts of ethics, bioethics, and medical ethics 3- Comparison between the western and Islamic approaches to medical ethics 4- Professional duties of the doctor towards self, colleagues, patients, and community. 5- Professionalism in being a medical student and a doctor 6- Basic ethical principles and guidelines (national and international) 7- Overview on patients' rights 5.2 Section II: Practical Aspects of Medical Ethics This section will include the practical aspects related to your practice as a future clinician. These topics include: 1- Informed consent to treatment 2- Privacy and confidentiality 3- Medical Malpractice, Misconduct & Medical Errors 4- Patient's Autonomy and Consent to treatment 5- Privacy & Confidentiality 6- Terminally Incurable Diseases and the End of Life (EOL) Decisions 7- Financial Aspects in Practice and Conflict of Interests (COI) 8- How to manage ethical issues in clinical practice? 9- Resource allocation in the health-care system 10- Ethics of public health and health promotion 11- Islamic Fiqhi Rulings in Major Medical Specialties 5.3 Section III: Research Ethics This section includes the ethical issues that are encountered before, during and after the conduct of research.
  • 10. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 10 of 21 The main topics include: 1- Basic concepts in research ethics 2- The ethical standards of research 3- The concepts of benefit and harm in research 4- Informed consent in research 5- Research on vulnerable groups 6- Privacy and confidentiality in research 7- Conflict of interests in research 6 Teaching Methodology: The teaching method will be based on the following: 1- Interactive sessions 2- Problem solving and case discussion 3- Assignments done by students 4- Student seminars 5- Case studies and case presentation 7 Student and Course Evaluation Student evaluation methods were meant to be variable and continuous. They aim at evaluating the student's ability to reflect what s/he learnt in hypothetical or simulated situations. Some tools are individual, like assignments, while others depend on group work, like course research. The following table summarizes the evaluation methods and their respective percentage of the total mark. Method Mark/100 Attendance (5) and Active class participation (5) 10 Assignments 5 Mid-term exam 20 Practicum (Clinical & Research Ethics practical activities) 5 Research report and presentation (the report (15) & presentation (5)) 20 Final exam 40 Total 100 7.1 Attendance and active participation Physical attendance for at least 75% in the lectures is a perquisite by the faculty's regulations to attend the exam. Any absence of more than 25% will decline you from sitting for the exam. It is the sole responsibility of the student to make sure that s/he signed the attendance sheet in the allowed time. However, attendance is not just about signing the attendance sheet! You should participate and contribute to the session by asking questions, positive contributions in group discussions, and answering questions.
  • 11. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 11 of 21 7.2 Assignments Along the course, you will be asked to submit few assignments. These assignments are usually about cases with ethical problems. You will be guided in each assignment by a set of questions that you may need to follow in order to attain the best mark. They are intended to be a self-reflection on what the student has learnt so far along the course. You should feel free to express your understanding, than to focus on reaching a correct answer. Many themes in ethics do not have agreed on clear cut right answers. It is also expected that you should abide to the professional academic conduct, especially the proper citation without the abuse of internet. We use software to detect plagiarism; thus it is very unadvisable to just 'copy and paste' from the internet. Plagiarism similarity score of 20% or more means that your work will be rejected and you will have to resubmit your work. We take academic misconduct seriously. So should you. 7.2.1 Assessment of assignments: Your assignments will be assessed based on the following criteria: 1- Originality of content. This means you need to reflect yourself in what you sib it 2- Novelty of content. This may be difficult to achieve in the topics of ethics, where there are many articles already in the literature. However, you still need to add a new flavor to the already discussed topic, or even better to choose a less discussed topic. 3- Strength of arguments. You need to defend what you present. This means that you need to present a supported argument to what submit. A well-supported argument also means that you need to present the possible counter-arguments to yours and how you would respond to them. 4- Uniform editing. The great content should be presented in a professional neat outlook and layout. It is advisable to keep yourself to 1-2 fonts, to make sure that the sizes of the subheadings are uniform, and to avoid using pictures and colors extensively unless justifiable. 5- Proper citation. You have to show that you have read well about the topic you’re writing on. This is best reflected by the professional use of the suggested readings AND proper citation in a uniform citation style. To make your life easy, there will a session on how to do that. Check the timetable and bring your laptop on the given day. 7.3 Mid-Term Exam The mid-term exam will be composed of (about 20) MCQs, with one best answer, and 2-4 short essay questions. These may include short cases with questions to answer, or you are asked to "discuss" or "list". The weight of each MCQ and short essay will be mentioned in the questions sheet. Answering in either Arabic or English is allowed; however, each question should be answered in only one language. 7.4 Research report & Research presentation As a part of the course evaluation, every student has to submit a written work that reflects his/her understanding of what s/he got in the course. This work should reflect his/her abilities to search the literature, organize ideas, develop objectives, develop a research plan, and implement it to discuss the relevant ethical aspects.
  • 12. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 12 of 21 We expect you (with your team) to find an ethical problem related to the objectives of the course, study it guided by your research objectives, and present and discuss your results and conclusions from what you found. Finally, you should have practical recommendations that you come up with at the end of the research. Your research is expected to contribute new knowledge to the scientific community and not a repetition of what is already known about the subject. 7.4.1 Structure of the research Typically, the research should contain the following sections: I. Title page: (Header of the FOM; Title of the project; Names and IDs of the research team; Name of the supervisor; and Date of submission II. Table of contents: you are strongly recommended to use the [Add Table of contents from your Word software] III. Acknowledgment: This section is to acknowledge the efforts of those who helped you in your research. IV. Introduction: This is a key section. You need to tell the reader of your research what you are studying, and why do you need to study it ( i.e. the rationale) V. Review of literature: in this section you should show your reader that you really know what you are studying and that what you're studying is not a repetition of work that is already there. Remember: we expect new knowledge from your research. VI. Objectives (general and specific): use action verbs, and make them SMART (Specific, Measurable, Attainable/Acceptable/Achievable. Relevant/Reliable, and Time-bound) VII. Methodology: in this section, you tell the reader how did you do your research. Make sure this sections tells in details about the following: study area, study population, data collections techniques and tools, and data analysis VIII. Results: this section contains the findings of your data collection, preferably as tables and figures. IX. Discussion: In this section you discuss the results in comparison to what other found on the same issue. You are expected to provide justifications for what you found in the results. X. Conclusion & Recommendations: You are expected to provide some practical steps to be taken by relevant stakeholders to improve the situation regarding the topic of your research. XI. References: This section contains the references that you used in your work, especially in the introduction and the review of literature. You are strongly recommended to use reference management software (like Reference Manager, End Note, or RefWorks). Discuss this option with your supervisor. Don't Plagiarize! This simply means that your work will get ZERO. 7.4.2 The case study Along this course, we aim that you know how to define, analyze and be able to use the relevant tools to resolve ethical issues. This is best demonstrated by a case study. In a case study you are asked to find a case with one or more ethical issues around it. You are strongly recommended to find a true case, though you have to make sure you completely de-identify it. Discuss how to do that with your supervisor. A case study will be typically composed of these sections:
  • 13. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 13 of 21 I. The presentation of the case, very similar to the way you do in clinical rounds with the exception that you describe the aspects related to the ethical issue you will discuss, and not only the medical and clinical facts. II. What are the ethical issues in the case? In this section, you are supposed to list the ethical issues that you found in the case III. What are the ethical and Fiqhi principles at stake? In this section, you are supposed to list the ethical principles followed by the Fiqhi and Islamic issues related to the case. IV.Ethical case analysis: This section reflects the way you analyze the case, using any of the analysis frameworks and tools (e.g. 4-boxes model) that you have gone through in this course. V. Fiqhi Case analysis: In this section, you should present the Fiqhi approach to your case, for example what are the Goals of Shariya ( ‫انششٌؼخ‬ ‫يمبصذ‬ ) involved, which Fiqhi Maxims ( ‫انفمٍٓخ‬ ‫انمٕاػذ‬ ) are applicable and if there are previous Fatwas on the issue. VI.Case resolution: although you may not be always able to resolve the issue, or suggest definitive steps to be taken; you should present your approach to resolve the case. 7.4.3 A Fiqhi study A Fiqhi study is a different format that can reflect your ability to search and analyze. As you know, many of the practices and medical interventions have been studied by the Scholars (Ulama). Many issues have been discussed in many conferences and had resolutions from Fatwa and Fiqhi complexes. However, it is quite impossible for us as teachers to present to you along this course each and every fatwa or religious approach to medical practice in different specialties. Therefore, we encourage that few groups of you present a Fiqhi study to present the Islamic approach to a given issue related to illness, diseases, or medical practice. You are strongly recommended to approach NEW topics. For example a study on cleanliness or fasting for patients (taharat al-maridh) is not acceptable, as there are already tens of books on the issues. May be you can consider Islamic approach to ethical issues in specialties, like Emergency Medicine, Oncology, Anesthesia, etc. 7.4.4 Ethical approval for your research Usually the research at your level are classified as "Low-Risk, Low Vulnerability" studies, so they rarely need a full ethical review. However, NO data collection should take place without a written permission from the faculty, preferable from the dean's office. Please consult with your supervisor and the course coordinator on whether your research needs one and how to obtain it. 7.4.5 Format and styling in writing and citation Your work should follow the following instructions: i. Make a separate page for title ii. All sections of the proposed format for each kind of research work you want to submit should be there. iii. Preferably, make each section in a separate page iv. Any omission of any section should be justified v. All your work should be in Arial Font, double spaced, size of font should be as follows: Main headers/titles (size 18);
  • 14. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 14 of 21 Subtitles (size 16); Sub-subtitles (size 14); and The rest of the text (size 12). vi. Using Photos should be justified, with proper acknowledgment of the source and copyright vii. Don’t' use colors other than black unless justifiable and needed. In total, not more than two colors allowed. viii. Citation should be either in AMA, Vancouver, or Harvard Styles. Arabic references and Fiqhi studies need to be agreed on with an expert relevant scholar. 7.4.6 The presentation associated with the research The presentation is the way you tell others in summary about your research or case study. It should summarize the whole work in 15 minutes presentation. Although there is no objection to PowerPoint presentations; innovation in presenting your works will be highly appreciated and will receive extra marks for that. Innovative ideas and ways of presentation may include making a short movie, a role play, use of posters, or models, etc. Each student will be individually evaluated, so make sure you know the research thoroughly. This means that the work among the group members should be organized fairly with all group involved. You need to make sure with your supervisor that your presentation is relevant to the objectives. You should make sure that a copy of your presentation is ready on the PC of the hall at least one day before the presentation. 7.5 Practicum (Clinical & Research Ethics practical activities logbook) As a part of your training in bioethics, you need to actively participate in activities related to ethics. You need to attend a total of at least 4 hours in bioethics-related activities, within or outside the KFMC. These activities include (for example and not exhaustive): - Attending at least ONE clinical ethics consultation; - Attending at least ONE research ethical review committee; - Attending at least one M&M (Morbidity and Mortality) report; - Help in training of clinical staff (or medical students) on selected topics in bioethics; - Prepare educational or advocacy material; and - Participate in an ethics-awareness campaign for patients and staff It is the student's responsibility to: 1- Register for the intended activity individually (don’t expect that your leader or friend will do it for you) 2- Make sure that all the activities you attended are recorded and signed by your supervisor
  • 15. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 15 of 21 3- Attach any published works and printed material with the logbook. 7.6 Final Exam As for the mid-term exam, the final exam will be composed of (about 40) MCQs, with one best answer, and 2-4 short essay questions. These may include short cases with questions to answer, or you are asked to "discuss" or "list". The weight of each MCQ and short essay will be mentioned in the questions sheet. Answering in either Arabic or English is allowed; however, each question should be answered in only one language. 7.7 Course evaluation The course will be evaluated through your feedback after each lecture and each test, or exam. Your feedback is crucial to help improving the course for you and for the batches to come. 7.8 Deadlines and due dates It is the student’s responsibility to meet the deadlines for submission of the assignments, reports, and other academic tasks. Any delay will have sequences including reduced marks, penalty reduction per/each day of delay, and refusal to receive the report or the assignment by the supervisor or the course coordinator. Respecting your due dates reflects your ability to manage your time and proper prioritization of your academic tasks, which this course helps on learning. 8 Important dates Start of the course Monday, 13/02/2012 Mid-term exam Monday, 19/03/2012 Mid-term vacation Saturday 22/3- Thursday 30/3/2012 Due date for research submission Monday 21/05/2012 (males) Monday 28/05/2012 (females) Due date for logbook submission Wednesday 30/05/2012 Research presentations Mon. 21/05/2012 (Males) Mon. 28/05/2012 (Females) Final exam Monday 04/06/2012 9 Communications and complaints 9.1 Website: The website (https://sites.google.com/site/medicalethicscourse) is the main means of communication and announcements for this course. Make sure you access it at least twice a week. However, paper announcements will still be posted in relevant ad boards in the faculty. Though your leaders are assigned to help making sure all students are aware of any possible changes or important announcements, the main and foremost responsibility lies on each of the
  • 16. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 16 of 21 individual students to know and keep themselves updated. Other means to facilitate that include the students’ forum and BlackBerry groups that are not under the department. 9.2 Emails: You should have an active email, whether a KFMC mail or otherwise. You need to make sure you check your email at least twice a week. To reduce the usage of paper, we encourage email submission of an e-copy even you should submit a hardcopy. Emails are searchable and retrievable so you can have better proof that you have submitted what you should submit. In the beginning of the course you need to make sure that the email you submitted to the course coordinator is correct. You should receive a confirmation of receipt email. In case you didn't please contact the course secretary, or coordinator. 9.3 Office appointments: You may request to meet the course coordinator by requesting an office appointment. There will be given days and times for male students and female students. Regular meetings with the groups’ leaders will be held to reflect you concerns. Please contact the course coordinator for further details. 9.4 Complaints and Appeals: In case you have a complaint against one of the staff in the department, paramagnet or visiting, or you want to appeal a decision that concerns you (your mark in an assignment or a report), you have the right to contact the course coordinator. Should you are still unsatisfied you can contact the course planner, who is also the dean of the faculty and the head of department. The process to do so will be explained to you by the dean’s secretary office. If your appeal is against results of the mid-term or the final exam, you’ll still contact the course coordinator; however you need to contact the Examination Center to explain to you the process you should follow to have your paper re-marked. We assure you that the department and the faculty as a whole have zero-tolerance against discrimination and sexism against students for any reason, whether verbal of physical. We will take your complaints seriously, and we expect you to be serious in your commitment and compliance with the academic guidelines that guide your attitude as medical students.
  • 17. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 17 of 21 10 Lectures, group-work and research presentations timetable Unless otherwise stated, ALL lectures will be jointly given for male and female in the FOM main auditorium on Monday from 8.30-10.00 am AND the group-work will be in the designated classrooms from 1-3.30 p.m. Dr. Ghaiath and Prof. Kasule will be the standby/backup speakers for all sessions. This timetable may be changed in its order, content, or speakers. You will be notified if any changes are made. All lectures are planned to be broadcasted live in the internet through the website: http://www.livestream.com/medicalethicscourse Date Title Speaker Format Time Location Section I: Introduction to medical ethics Main auditorium (FOM-Male section) Mon. 13.02.2012 1. Distribution of previous batch students’ awards Dr. AlKabba 8.00 – 8.30 2. Introduction to the course Dr. AlKabba Presentation 8.30-8.45 3. ‫انًسهى‬ ‫انؽجٍت‬ ‫اخاللٍبد‬ ‫انى‬ ‫يمذيخ‬ Dr. AlKabba Presentation 8.45-9.15 4. Introduction to medical ethics Dr. Ghaiath Interactive session 9.15-10.00 Mon. 20.02.2012 Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 5 . ‫انًُظ‬ ،ّ‫انفم‬ ‫ٔأصٕل‬ ‫انششٌؼخ‬ ‫يمبصذ‬ ‫خالل‬ ٍ‫ي‬ ‫ٔانًٕد‬ ،‫ٔانًشض‬ ،‫نهصحخ‬ ً‫انششػ‬ ‫ٕس‬ ً‫انؽج‬ ‫انًدبل‬ ً‫ف‬ ‫ٔرؽجٍمبرٓب‬ ‫انششػٍخ‬ ‫ٔانمٕاػذ‬ Dr. Khalid Alshaye Lecture 8.15-9.30 6. Islamic Approach to Medical Ethics Prof. Kasule Lecture 9.30-10.00 7. Academic Misconduct & Plagiarism Dr. AlKabba Interactive session 1.00 – 1.30 8. Proper citation (Reference Manager Software) BRING YOUR LAPTOP Dr. Ghaiath practical training 1.30-3.00 Mon. 27.02.2012 Review, debate and question Students Interactive session 8.00-8.15 9. Overview of the Doctor's professional relationships & duties Dr. Ghaiath Interactive session 8.15-9.00 Main Auditorium 10.Doctor's duties towards self and colleagues Prof. Kasule Interactive session 9.00-10.00 11.ّ‫ٔيدزًؼ‬ ِ‫يشظب‬ ‫يغ‬ ‫انؽجٍت‬ ‫نؼاللبد‬ ً‫االسالي‬ ‫انًُظٕس‬ Dr. Khaled Alshaye Lecture 1.00-2.00 Cases for discussion Dr. Khaled Alshaye Group work 2.00-2.30 Mon. 05.03.2012 12.Professionalism Dr. Mohamed Alrukban Interactive session 8.30 – 9.20 Main Auditorium 13. ‫انُجٕي‬ ‫انؽت‬ ٍ‫ػ‬ ‫َجزح‬ ( ‫انحذٌث‬ ‫ثبنؽت‬ ّ‫ٔػاللز‬ ّ‫يفٕٓي‬ ) 9.20-10.00 Practical session Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 2.30 Classrooms Mon. 12.03.2012 Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 14.Overview of Patients Rights Dr. AlKabba Lecture 8.15-9.15 15.Islamic approach to ethics and patients’ rights Prof. Kasule Interactive session 9.15-10.00 16.Practical session (cases on patients rights) Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 2.30 Classrooms Mon. 19.03.2012 Midterm Exam Exam 1.00-3.00 Classrooms 22/3-30/3/2012 Mid semester vacation
  • 18. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 18 of 21 Date Title Speaker Format Time Location Mon. 02.04.2012 Section II: Practical Aspects of ethics in medical care and end-of-life decisions Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 17.Overview of Informed consent to treatment Dr. Ghaiath Interactive session 8.15-9.00 18.Practical and Islamic approach to Informed consent to treatment Prof. Kasule Interactive session 9.00-10.00 Practical session Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms Mon. 09.04.2012 Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 19.Privacy & Confidentiality in healthcare Dr. Ghaiath Interactive session 8.15-9.00 20.Truth telling and breaking bad news Prof. Jamal Jarallah Interactive session 9.00-10.00 Practical session Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms Mon. 16.04.2012 Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 21.Medical Malpractice, Medical Errors Dr. AlKabba Lecture 8.15 – 9.15 22.Legal & Fiqhi aspects of medical error Prof. Kasule Interactive session 9.15-10.00 Practical session Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms Mon. 23.04.2012 Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 23.Terminally Incurable Diseases and the End of Life (EOL) & Do-Not Resuscitate (DNR) Prof. Kasule Lecture 8.15 – 9.15 24.Resource allocation in the health-care system Dr. AlKabba Lecture 9.15-10.00 25.‫نهحٍبح‬ ‫انًُمزح‬ ‫ٔانزذخالد‬ ‫ثبالحزعبس‬ ‫انًزؼهمخ‬ ‫انفمٍٓخ‬ ‫االحكبو‬ Dr. Khaled Alshaye Lecture& discussion 1.00-3.00 Section III: Practical Aspects of ethics in medical research and public health practice and research Mon. 30.04.12 Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 26.Financial Aspects in clinical Practice and Conflict of Interests (COI) Dr. AlKabba Lecture 8.15 – 9.30 27.Ethical Issues in Research – Part 1 (History, harm, vulnerability) Dr. Ghaiath Interactive session 9.30-10.00 Practical session on COI Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms Mon. 07.05. 12 Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 28.Ethical Issues in Research – Part 2 (COI, Privacy & Confidentiality) Dr. Ghaiath Interactive session 8.15 – 9.30 29.Ethical Issues in Research – Part 3 (consent to research) Prof. Kasule Interactive session 9.30-10.00 Practical session on research ethics Dr. Ghaiath/ Prof. Kasule Group work 1.00 – 3.00 Classrooms Mon. 14.05.12 Review, attendance and debate Students Interactive session 8.00-8.15 Main Auditorium 30.Ethics of public health and health promotion Prof. Kasule Interactive session 8.15-9.15 31.How to resolve ethical issues in clinical practice? Dr. Ghaiath Interactive session 9.15-10.00 practical session and Course revision Dr. Ghaiath/ Prof. Kasule Group work 1.00-3.00 Mon. 21.05.12 Male Student Research presentations 8.00-10.00 (Gr.s 1-8) 1.00-3.00 (groups 9-16) Main Auditorium Mon. 28.05. 12 Female Student Research presentations 8.00-10.00 (Gr.s 1-8) Mon. 04.06.202 Final Exam 9.00-11.00 Classrooms
  • 19. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 19 of 21 11 Need help? Or still have questions or queries? If you have questions or queries, fell free to contact us. - For technical assistance and issues related to location, schedule, or attendance sheet, contact o Mr. Abdulbasir Pula o Phone: 01-2889999 extension 6301 o Email: apula@kfmc.med.sa o Office in 1st floor, Medical Ethics Department Office - For academic issues related to the course, contact o Dr. Ghaiath Hussein, the course coordinator o Email: ghussein@kfmc.med.sa; ghaiathme@gmail.com, o Phone: 01-2889999 extension 7588 o Office by appointment, 7th floor 12 Readings and references: 12.1Textbooks:  Singer PA, Viens AM: The Cambridge textbook of bioethics. Cambridge University Press; 2008  Saudi Council for Health Specialties 2003, Ethics of the Medical Profession, A manual guide for medical practitioners Saudi Council for Health Specialties, Riyadh, Saudi Arabia. (URL: http://english.scfhs.org.sa/Book/EN-scfhs_2007_p1.pdf)  9111 http://www.archive.org/download/waq43949/43949.pdf  http://www.archive.org/download/waq99210/99210.pdf  http://www.archive.org/download/waq91111/91111.pdf  ‫نهًشٌط‬ ٍّٓ‫انفم‬ ‫االحكبو‬ - ‫ػجذانخبنك‬ ٍ‫ث‬ ًٍ‫ػجذانشح‬  ً‫اإلسالي‬ ّ‫انفم‬ ً‫ف‬ ‫نهًزٕفى‬ ‫ٔانؽجٍخ‬ ‫انششػٍخ‬ ‫األحكبو‬ ، ‫د‬ . ً‫انؼشث‬ ‫ثهحبج‬ ‫أحًذ‬ ٍ‫ث‬  ‫الطثٍة‬ ‫الجزادة‬ ‫أدكام‬ : ‫د‬ . ً‫الشٌقٍط‬ ‫هخحار‬ ‫تي‬ ‫هذوذ‬ ‫الطثٍة‬ ‫فقه‬ ‫جقزٌة‬ : ً‫الذاسه‬ ‫اهلل‬ ‫عثذ‬ ‫تي‬ ‫فهذ‬ ً‫اإلساله‬ ‫الوٌظىر‬ ً‫ف‬ ‫وأدته‬ ‫الطثٍة‬ ‫فقه‬ : ‫د‬ . ‫الجثىري‬ ‫اهلل‬ ‫عثذ‬ ‫هقارى‬ ً‫فقه‬ ‫تذث‬ ً‫إساله‬ ‫هٌظىر‬ ‫هي‬ ‫طثٍة‬ ‫قضاٌا‬ : ‫د‬ . ‫إدرٌس‬ ‫هذوذ‬ ‫الفحاح‬ ‫عثذ‬ ‫ا‬ ‫وأدكام‬ ‫أداب‬ ً‫ف‬ ‫الطٍة‬ ‫ًفخ‬ ‫لطثٍة‬ : ‫أتىدذٌفة‬ ‫وأعذاد‬ ‫جوع‬ ‫الطثٍة‬ ‫لألعوال‬ ‫الشزعٍة‬ ‫األدكام‬ : ‫د‬ . ‫الذٌي‬ ‫شزف‬ ‫أدوذ‬ 12.2 Websites  d.net/Doat/hani/12.htm http://www.saai  Medical Ethics Course: https://sites.google.com/site/medicalethicscourse/
  • 20. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 20 of 21  Prof. Omar Kasule’s ISLAMIC MEDICAL EDUCATION RESOURCES: http://omarkasule-03.tripod.com/ 12.3Articles & Reports: 1. A Guide to Understanding Informed Consent. National Cancer Institute US National Institute of Health (NIH) . 3-4-2006. National Cancer Institute US National Institute of Health (NIH). URL: http://www.cancer.gov. 2. Al Aqeel, A. I. 2007, "Islamic ethical framework for research into and prevention of genetic diseases", Nat Genet, vol. 39, no. 11, pp. 1293-1298. 3. Albar, M. A. 1996, "Islamic ethics of organ transplantation and brain death", Saudi J Kidney Dis Transpl, vol. 7, no. 2, pp. 109-114. 4. Al-Gaai, E. A. & Hammami, M. M. 2009, "Medical chaperoning at a tertiary care hospital in Saudi Arabia: survey of physicians", J Med Ethics, vol. 3 5 , no. 12, pp. 729-732. 5. Alkaabba, A. & Hussein, G. M. 2011, "Democratization of medical education is needed to effective teaching of bioethics", J Med Liban, vol. 59, no. 1, pp. 33-36. 6. Al-Umran, K. U., Al-Shaikh, B. A., Al-Awary, B. H., Al-Rubaish, A. M., & Al-Muhanna, F. A. 2006, "Medical ethics and tomorrow's physicians: an aspect of coverage in the formal curriculum", Medical Teacher, vol. 28, no. 2, pp. 182-1 48 . 7. Bernard M.Dickens. Legal Aspects of the Beginning of Human Life. In: F.K.Beller, R.Weir ,editors. The Beginning of Human Life. Kluwer; 1994. p. 35-48. 8. Bernard M.Dickens. Legal Evolution of the Concept of Brain Death. Transplantation Today 2, 60-64. 1985. 9. Chong, S. A., Capps, B. J., Subramaniam, M., Voo, T. C., & Campbell, A. V. 2010, "Clinical Research in Times of Pandemics", Public Health Ethics. 10. Cooper A, Joglekar A, Gibson J, Swota A, Martin D. Communication of bed allocation decisions in a critical care unit and accountability for reasonableness. BMC Health Services Research 2005;5(1):67. 11. Culver, C. M., Clouser, K. D., Gert, B., Brody, H., Fletcher, J., Jonsen, A., Kopelman, L., Lynn, J., Siegler, M., & Wikler, D. 1985, "Basic curricular goals in medical ethics", New England Journal of Medicine, vol. 312, no. 4, pp. 253-256. 12. Cummings, C. L. & Mercurio, M. R. 2010, "Ethics for the Pediatrician: Autonomy, Beneficence, and Rights", Pediatrics in Review, vol. 31, no. 6, pp. 252-255. 13. Derick T Wade 2001, "Ethical issues in diagnosis and management of patients in the permanent vegetative state", BMJ no. 322, pp. 352-354. 14. Dickens BM, Cook RJ. Challenges of ethical research in resource-poor settings. International Journal of Gynaecology and Obstetrics 2003;80:79-86. 15. Dickens, B. M. & Cook, R. J. 2003, "Challenges of ethical research in resource-poor settings", International Journal of Gynaecology and Obstetrics, vol. 80, pp. 79-86. 16. Ebrahim AF. Organ transplantation: contemporary Sunni Muslim legal and ethical perspectives. Bioethics 1995 Jul;9(3-4):291-302. 17. Faiz Khan. AN ISLAMIC APPRAISAL OF MINDING THE GAP. Psycho-Spiritual Dynamics in the Doctor-Patient Relationship. Journal of Religious Ethics 36[1], 77-96. 2008. 18. Farzaneh Zahedi, Bagher Larijani, & Javad Tavakoly Bazzaz. End of Life Ethical Issues and Islamic Views. Iran J Allergy Asthma Immunol 6[Suppl. 5], 5-15. 2007. 19. Gallagher A, Tschudin V. Educating for ethical leadership. Nurse Educ Today 2010 Apr;30(3):224-7. 20. Giordano, J. & Boswell, M. V. 2005, "Pain, placebo, and nocebo: epistemic, ethical, and practical issues", Pain Physician no. 4 ,p. -3. 21. Greco, D. & Petrini, C. 2004, "Ethical issues in public health", Ann Ist Super Sanita no. 3, p. -71. 22. HARDEN, R. M., SOWDEN, S., & DUNN, W. R. 1984, "Educational strategies in curriculum development: the SPICES model", Medical Education, vol. 18, no. 4, pp. 284-297. 23. Hebert, P. C., Meslin, E. M., & Dunn, E. V. 1992, "Measuring the ethical sensitivity of medical students: a study at the University of Toronto", Journal of Medical Ethics, vol. v18, no. n3, p. 142.
  • 21. Medical Ethics Student Guide , (METH421 V.3.5) © 2012 Dept. of Medical Ethics (KFMC-FOM) Page 21 of 21 24. Hyder, A. A., Wali, S. A., Khan, A. N . , Teoh, N. B., Kass, N. E., & Dawson, L. 2004, "Ethical review of health research: a perspective from developing country researchers", Journal of Medical Ethics, vol. 30, no. 1, pp. 68-72. 25. Ibia, E., Binkowitz, B., Saillot, J. L., Talerico, S., Koerner, C . , Ferreira, I., Agarwal, A., Metz, C., & Maman, M. 2010, "Ethical considerations in industry-sponsored multiregional clinical trials", Pharm Stat, vol. 9, no. 3, pp. 230-241. 26. Illes, J. & Bird, S. J. 2006, "Neuroethics: a modern context for ethics in neuroscience", Trends Neurosci no. 9, p. -7. 27. John R.Williams 2009, Medical Ethics Manual, 2nd edition 2009 edn, The World Medical Association, Inc.. 28. Kelly, E. & Nisker, J. 2009, "Increasing Bioethics Education in Preclinical Medical Curricula: What Ethical Dilemmas Do Clinical Clerks Experience?", Academic Medicine, vol. 84, no. 4. 29. Knoppers BM & Laberge C 1989, "DNA sampling and informed consent.", CMAJ, vol. 140, no. 1023. 30. La Puma, J. & Schiedermayer, D. L. 1991, "Ethics Consultation: Skills, Roles, and Training", Annals of Internal Medicine, vol. 114, no. 2, pp. 155-160. 31. Martin F.McKneally & Peter A.Singer. Bioethics for clinicians: 25. Teaching bioethics in the clinical setting. CMAJ . 2001. 32. Martin H N Tattersall & Ian H Kerridge .Doctors behaving badly? MJA 185[6], 299-300. 2006. 33. Memish, Z. A., McNabb, S. J., Mahoney, F., Alrabiah, F., Marano, N., Ahmed, Q. A., Mahjour, J., Hajjeh, R. A., Formenty, P., Harmanci, F. H., El Bushra, H., Uyeki, T. M., Nunn, M . , Isla, N., Barbeschi, M., & Jeddah Hajj Consultancy Group 2009, "Establishment of public health security in Saudi Arabia for the 2009 Hajj in response to pandemic influenza A H1N1", Lancet, vol. 374, no. 9703, pp. 1786-1791. 34. Miles SH, Lane LW, Bickel J ,Walker RM, & Cassel CK. Medical ethics education: coming of age. Acad Med. 64[12], 705-714. 1989. 35. Nancy Kass. An Ethics Framework for Public Health. Am J Public Health 91[11], 1776-1782. 2001. 36. Norman Daniels. Accountability for reasonableness: Establishing a fair process for priority setting is easier than agreeing on principles. BMJ 321[7272], 1300-1301. 2000. 2-10-2008. 37. Omar Hasan Kasule Sr. "Medical Ethico-Legal-Fiqhi Basis of Medical Practice: An Islamic Perspective", in Scientific and Islamic Medicine Seminar, The Students' Executive Board Faculty of Medicine Deponegoro University, Timur Indonesia. 38. Omar Hasan Kasule Sr. 2008b, "Medical Ethico-Legal-Fiqhi Issues: An Islamic Perspective", in Training workshop on the Islamic Input in the Medical Curriculum held at the Faculty of Medicine UNISSULA. 39. Paul S.Appelbaum, Thomas Grisso, Ellen Frank, Sandra O'Donnell, & J.Kupfer. Competence of Depressed Patients for Consent to Research. Am J Psychiatry [156], 1380-1384. 1999. 40. Robert I.Field & Arthur L.Caplan. A Proposed Ethical Framework for Vaccine Mandates: Competing Values and the Case of HPV. Kennedy Institute of Ethics Journal 18[2], 111-124. 6-1-2008. Siegler, M., Pellegrino, E. D., & Singer, P. A. 1990, "Clinical medical ethics", J Clinical Ethics, vol. 1, pp. 5-9. 41. Siegler M, Pellegrino ED, Singer PA. Clinical medical ethics. J Clinical Ethics 1990;1:5-9. 42. Silver-Isenstadt, A. & Ubel, P. 1999, "Erosion in medical students attitudes about telling patients they are students", Journal of General Internal Medicine, vol. 14, no. 8, pp. 481-487. 43. Slowther, A., Johnston, C . , Goodall, J., & Hope, T. 2004, "Development of clinical ethics committees", BMJ, vol. 328, no. 7445, pp. 950-952. 44. Soleymani Lehmann, L., Kasoff, W. S., Koch, P., & Federman, D. D. 2004, "A Survey of Medical Ethics Education at U.S. and Canadian Medical Schools", Academic Medicine, vol. 79, no. 7. 45. Stuart F.Quan. Doctor, Do You Have A Minute? The Dilemma Posed by Physician Interaction with the Pharmaceutical Industry. Clin Sleep Med. 3[4], 345-346. 15-6-2007. 46. Tangwa GB. Ethical principles in health research and review process .Acta Trop 2009;112(Suppl 1):2-7. 47. Torda, A. 2006, "Ethical issues in pandemic planning", Med J Aust no. 10, p. -6 World Health Organization ( 2000, "Operational Guidelines for Ethics Committees That Review Biomedical Research ."