The 1st International Conference on Medical Humanities in the Middle East invites proposals for oral presentations and posters on the topics of narrative medicine, medical sociology, philosophy of medicine, medical ethics and narrative ethics, literature and medicine, history of medicine and other humanistic initiatives in medicine occurring in the Middle East and North Africa region.
Introduction and Background: Ethics, as a standard, is focused on the way people behave when they are faced with conflicts between two or more principles to which they subscribe. The Four Traditional Pillars of Medical Ethics namely autonomy, non-maleficence, beneficence and justice are frequently challenged in occupational medicine day to day practice. Aim: This paper focuses on ethical dilemmas in the practice of Occupational Medicine. Challenges and Resolutions: The Occupational Health Physician (OHP) is responsible for Case management, for most of the challenges and conflicts there is no single correct solution and the doctor has to decide the best possible solution.
1- Medical confidentiality: If the employee has initiated consultation, the information should be kept in strict confidence. If the management has requested Functional Capacity Assessment to assess the employee's Fitness capabilities or to retire on a disability pension, the result is be passed on to the management. The importance of taking informed consentfrom the employee before the information is shared with the Management.
2- Business ethics: The Occupational Health physician should abide by a code of ethics followed by their employers. They comply with rules of the Supreme Council of Health.
3- Teamwork: The Occupational Health physician will work closely with Health and safety professionals such as Occupational hygienists and safety professionals. Exchange of information is important but scrupulous care must be taken to safeguard Medical Confidentiality.
4- Salient Features:
1. OHPs are called for advice on the nature or extent of work-related health risks to employees, to the workforce, to the environment or to the public.
2. OHPs may provide Primary Medical care, in addition to their Occupational Medical advice –This may risk a conflict of interest. Put the interest of the employee first and make a decision and seek alternative advice from The Medical Panel (MOPH).
3. Ethically, OHPs should disclose records and reports to the employees and maintain openness.
4. The discussion with the Management should focus on Functional Capacity Assessment rather than the diagnosis of the Medical condition.
Objectives: AIDS is a spectrum of conditions caused by infection with Human Immunodeficiency Virus (HIV). The virus induces the weakening of human immunity, and, if untreated, eventually, results in the clinical manifestation of AIDS leading to the fatal breakdown of the entire immune system and death. HIV/AIDS represent a major social and ethical issue because of the means of its transmission and social mindsets. It is observed that people with HIV/AIDS can sometimes encounter serious problems and violations in accessing healthcare due to the improper conduct of health professionals. This fact impacts negatively the physical and psychological integrity of people living with HIV.
Method: This research has been planned as a qualitative field study. The population consists of a sufficient number of patients living with HIV/AIDS in Istanbul (August 2017 to March 2018). The snowball sampling technique is chosen, as it is used when there is insufficient information to create a sample and when it is difficult to reach people to create the research frame. After obtaining informed consent of the volunteers, the interviews have been recorded on voice tape. The voice recordings have been transcribed, and the contents of the participants' opinions have been systematically analyzed.
Results: Interviews were held with twenty people living with HIV / AIDS. Data indicate that there is a need to reconsider the ethical conduct towards the people living with HIV during healthcare provision with respect to: breaking bad news, confidentiality, and non-discrimination. Healthcare policies should be reconstructed to secure patients’ privacy and non-stigmatization. Partner notification should be inherent in healthcare system for patient and partner beneficence as well as for the support of healthcare professionals.
Conclusion: Evidence shows that HIV cases have recently been on the rise in Turkey. It seems that some people might have not visited health institutions in apprehension of being stigmatized, or from fear of discrimination or breach of confidentiality and privacy. This fact exacerbates the public health issue, as well as human rights and right to health concerns. A substantial partner notification system should be incorporated into the health system by thorough policies based on ethical values.
There are no cross-cultural systematic literature reviews on factors associated with spirit possession. This cross-cultural systematic review included ten primary studies from different countries. The aim is to assess their methodological qualities and summarize the association between spirit possession and certain demographic (gender, age, marital status and educational level) and clinical (hysteria/hysterical traits and anxiety/neuroticism) factors.
Methodology: An electronic search in relevant databases using suitable search terms was carried out in order to identify studies pertinent to the aims of the review. A large number of studies (710) were identified. Applying inclusion and exclusion criteria, this was reduced to only 10 eligible studies. These were included in the review.
Results: Out of the ten primary studies included in the review only four (40%) were controlled. The remaining six (60%) were uncontrolled. For this reason, the latter studies were not considered as sources of reliable evidence in the review. According to the controlled studies, the two clinical factors (hysteria/hysterical traits and anxiety/neuroticism) and one of the demographic factors (educational level) were found to be significantly associated with spirit possession.