1,721,001 research outputs found
Are we doing enough for our patients with terminal cancer?: A moral imperative to step up palliative care practice in Sub-Saharan Africa
No full textMandatory pre-abortion counseling is a barrier to accessing safe abortion services
No full textEmpirical research showcases that pre-abortion counseling scarcely reverses the woman’s decision either to terminate a pregnancy or not. Growing evidence regarding the high levels of decisional certainty among women seeking abortions renders a careful rethink of the place of mandatory pre-abortion counseling packages. Mandatory counseling packages, when inscribed in the laws, at times contain false information that can deter women from going in for safe abortions. Mandatory waiting times indirectly label opting for an abortion as not being the right thing to do. In areas where abortion stigma from health care providers and communities remains highly prevalent, women are forced to incur extra expenses by travelling to other countries. I argue that pre-abortion counseling on opting-in grounds is ethically sound (enhances the woman’s reproductive autonomy), since most clients in need of abortions are certain on their decisions before the abortion care provider and do not regret these decisions after the process. Regrets are prone to be more prevalent in areas with high unsafe abortion practices, generally due to complications from excessive bleeding, pain, and post abortion infections. Allowing systematic mandatory pre-abortion counseling practice as the rule in a competent adult is unjustified ethically and empirically, is time consuming and presents the legality of abortions in most settings an oxymoron.</p
Improving upon provider-initiated opt-out prenatal HIV-screening approaches in Sub-Saharan Africa
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Ethics approval: Responsibilities of journal editors, authors and research ethics committees
No full textMeaningful progress of medicine depends on research that must ultimately involve human subjects. Obtaining ethical approval therefore, especially in medical sciences, should be a moral reflex for researchers. This unfortunately is not the case, with numerous researchers bypassing the ethics approval procedure, or simply unaware of its importance. Good research involves risks taken by research participants and uses tax payers’ money in the process. These mandates the research endeavor to aim at attaining the highest degree of respect for the sacrifices made by others for science. Most researchers mistake scientific clearance or approval, for ethics approval. For a study to be ethical sound, it must be scientifically sound. This is only one of the activities carried out during protocol review. It is not uncommon for sensitive ethical concerns, especially in the social sciences to be overlooked and considered not to be accompanied by any serious risks for the research participants. The researcher has the responsibility of systematically consulting the competent ethics committee for advice and consequent approvals or ethical waivers. Journal editors and reviewers have the duty to systematically evaluate the ethical soundness of manuscripts submitted for review. Capacity building in research ethics and institutional support for Research Ethics Committees to speed up protocol review could reduce the incentive of carrying out research in human subjects without ethics approvals. It is hypocritical and idle to continue to expect optimal reviews on time and of good quality, from ethics committees functioning purely on altruistic grounds. Capacity building for researchers in research ethics, and institutional reforms and support for Research Ethics Committees appear not to have received the attention they truly deserve
Legal and ethical considerations during maternal death surveillance and response
Get PDFMaternal death surveillance and response (MDSR) is a promising strategy, to identify record and track key drivers of maternal deaths. Despite its potential in reducing maternal mortality, ethical and legal challenges need to be properly ascertained and acted upon, to guarantee its acceptability, sustainability, and effectiveness. This paper proposes a legal and ethical framework to guide practitioners and researchers through the MDSR process. Three (03) categories of both legal and ethical issues are discussed: namely the issues related to data, people and use of findings. Most challenges of the MDSR strategy have ethical and legal underappraisal origins, the most outstanding being the low maternal death notification rates. Efforts should be made for respondents to properly understand the rationale for the process, and how the data obtained will be put into use. Dispelling fears of possible litigation remains fundamental in obtaining quality data. Health care providers involved in the process need to understand their ethical and legal responsibilities, as well as privileges (legal protection). It is hoped that this framework will offer a structure to guide professionals in improving MDSR implementation and research
Revisiting the need for virtue in medical practice: A reflection upon the teaching of Edmund Pellegrino
No full textEdmund Pellegrino considered medicine as a skill, art, and perhaps most importantly, a moral enterprise. In this essay, I attempt to exemplify how the legacy and contributions of Edmund Pellegrino, as a teacher and a physician, could allow for a renaissance of medical practice in which physicians engage intellectual and moral virtue to both effect sound care, and do so in a humanitarian way, rather than in simple accordance with a business model of medicine. The virtues are viewed in a renewed light as being key characteristics of physicians, and important to patient centered care
When little can do more: the case for investing in mental healthcare in Ghana.
Get PDFLetter to the editors of the Pan African Medical Journal: About 21% of adults in Ghana suffer from moderate-severe psychological distress, leading to unemployment and productivity losses to 7% of Ghana´s gross domestic product (GDP) [1]. In two recently published reports on mental healthcare in Ghana, the World Health Organization- Assessment Instrument for Mental Health Systems (WHO-AIMS) 2020 and the World Health Organization Special Initiative for Mental Health Situational Assessment 2021 [2,3], key mental health considerations of public health and policy relevance draw our attention. Despite the significant strides Ghana has achieved over the years, the goal of creating an effective and comprehensive mental health service delivery infrastructure and workforce is far from complete. For instance, the current mental health service delivery architecture is skewed, with the Southern part advantaged. All three psychiatric hospitals in Ghana are in the South, with only three out of about sixty psychiatrists working in small psychiatric departments in the North. As a result, some indigenes have to travel over 700 km by road to seek care. This calls for attention to the equality and equity dimensions of health planning. The three psychiatric hospitals in Ghana have a combined capacity of 3.8 beds per 100,000 [3]. Additionally, whilst some low- and middle-income countries (LMICs) are investing about 4.0% of health expenditure in mental health, Ghana is investing 3% [4]. Another major challenge is low treatment coverage for mood disorders, with only 0.61% of persons with major depressive disorder receiving treatment. This rate is lower than the average of 16.8%-21.4% for some low-middle-income countries [5]. Furthermore, there are numerous challenges with the availability of psychotropic medications. This is a massive setback because Ghana has an overreliance on medical treatments due to a shortage of human resources to provide psychosocial services. In addition, most medications are paid out-of-pocket because Ghana´s national health insurance scheme does not cover them. Additionally, only 7% of health research in Ghana is specific to mental health. Furthermore, the data submitted to the government from health facilities are of low quality [2] and thus unreliable for research purposes, posing significant challenges to the quality and generalizability of the research output
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