Concise Minutes of the Karachi Bioethics Group (KBG) Meeting held in 2021
Minutes of the Karachi Bioethics Group (KBG) Meeting
Date: Monday, February 01, 2021
Time: 8.00 am – 09.32 am
- Ethakul app
The Aga Khan University has developed an app for Bioethics Just-in-Time learning. People facing ethical dilemmas during their work and studies can post on the App anonymously, and a pool of facilitators can respond, thus generating a discussion. The app also has a list of resources. It was initially restricted to AKU, but we are open to external users now. The app was used for a research project, and the contents had to be deleted for confidentiality reasons, but we intend to repopulate the discussion/contents part it soon, as posts come in.
KBG members are invited to download, use the app and give us suggestions, and recommend it to trainees. We maintain anonymity, and strict code of conduct is followed in the postings.
The links to download the app are:
For problems, please write to bioethics.group@aku.edu
- Presentation – Ethics of COVID vaccination
AKU had a grand round on the Ethics of COVID vaccination in October 2020, and some of the issues highlighted were: beneficence, informed consent, allocation of resources, therapeutic misconception, vulnerability, post-research responsibility, scientific validity, and social desirability.
*****
Date: Tuesday, June 1, 2021
Time: 8.30 am – 10.00 am
- Presentation by Dr. Mustafa Aslam: Ethical pros and cons of essential one-year service in district hospitals after MBBS and house job in KPK
A bill was passed in KPK which makes medical students serve in district hospitals. The initial bill was for three years, and now it requires two years long service. A protest was observed in the medical students and doctors’ community. The primary purpose of this bill was to increase the human resources in district hospitals.
- Violence & Microaggression in healthcare environment (KBG)
KBG should deliberate and draft recommendations to the concerned authorities and engage relevant bodies. But for that, our own stance and ideas should be clear in our own thought processes. A draft should be made, and revolved among the members before sending it to the authorities.
For this purpose, KBG should also have committed activists to take the cause further.
*****
Date: August 3, 2021
Time: 8.30 am – 10.00 am
- Case Presentation by Dr. Tashfeen Ahmad: Ethics of Reckless Behavior during COVID-19
Dr. Tashfeen presented cases comprising reckless behavior by COVID-19-positive people which jeopardized public safety. Though reckless behavior is unethical, sometimes laws, policies, and systems perpetuate reckless behavior.
- Case-Based Discussion (no case, just discussion)
*****
Date: Tuesday, December 07, 2021
Time: 8.30 am – 10.00 am
- Presentation on “ethics of handling a not-so-good surgeon” (Dr. Tashfeen Ahmed)
Dr. Tashfeen discussed the ethical discourse of health professionals’ incompetence. In his presentation, he mentioned a case where a surgeon working at a university hospital noticed a relatively high complication rate of procedures performed by her colleague. She discussed the concerned matter with the Head of the Department but no action was taken as there was no formal complaint against that surgeon.
Most recently a patient underwent surgery for the third time because the first two surgeries failed by the same surgeon. She was concerned that the patient was being harmed by the technical inadequacy of her colleague and she was having difficulty finding an avenue where the concern may be addressed and resolved.
Dr. Tashfeen termed the surgeon’s incompetency a very glaring issue and said that the medical practitioners are well aware of the fact as it happened everywhere. However, unfortunately, there is no literature with “surgeon’s incompetence” in the title, and he considered it a probable bias in publication.
Furthermore, he raised a number of ethical concerns in the presentation:
- Is the Head of the Department justified in refraining from action without any formal complaint?
- Does a doctor have a moral responsibility to inform such concerns to higher authorities?
- What institutional mechanisms are required to assure no harm to the patients in case of apparent technical inadequacies?
- Does anonymous reporting have a place in such scenarios?
- Are there any guidelines of PMC/ PMDC in this regard?
- The second presentation on “Shifting attitudes and practices of GPs – planning for research to improve ethical practice” (by Dr. Naveed Noor)
The presentation was focused on the study background & research questions along with the research findings, interventions and ideas.
The research was mainly focused on incentives offered by pharmaceutical companies to general practitioners in Pakistan. As a result, GPs are prescribing unnecessarily. 80% of the urban population relies on private GPs, therefore, this conflict of interest is highlighted as an important ethical concern.
The aim & objective of this study is to increase awareness among the GPs of such unprofessional practices.
Date: Monday, February 01, 2021
Time: 8.00 am – 09.32 am
- Ethakul app
The Aga Khan University has developed an app for Bioethics Just-in-Time learning. People facing ethical dilemmas during their work and studies can post on the App anonymously, and a pool of facilitators can respond, thus generating a discussion. The app also has a list of resources. It was initially restricted to AKU, but we are open to external users now. The app was used for a research project, and the contents had to be deleted for confidentiality reasons, but we intend to repopulate the discussion/contents part it soon, as posts come in.
KBG members are invited to download, use the app and give us suggestions, and recommend it to trainees. We maintain anonymity, and strict code of conduct is followed in the postings.
The links to download the app are:
https://play.google.com/store/apps/details?id=com.aku.bioethicsethakul&hl=en
https://apps.apple.com/az/app/ethakul/id1437160199
For problems, please write to bioethics.group@aku.edu
- Presentation – Ethics of COVID vaccination
AKU had a grand round on the Ethics of COVID vaccination in October 2020, and some of the issues highlighted were: beneficence, informed consent, allocation of resources, therapeutic misconception, vulnerability, post-research responsibility, scientific validity, and social desirability.
*****
Date: Tuesday, June 1, 2021
Time: 8.30 am – 10.00 am
- Presentation by Dr. Mustafa Aslam: Ethical pros and cons of essential one-year service in district hospitals after MBBS and house job in KPK
A bill was passed in KPK which makes medical students serve in district hospitals. The initial bill was for three years, and now it requires two years long service. A protest was observed in the medical students and doctors’ community. The primary purpose of this bill was to increase the human resources in district hospitals.
- Violence & Microaggression in healthcare environment (KBG)
KBG should deliberate and draft recommendations to the concerned authorities and engage relevant bodies. But for that, our own stance and ideas should be clear in our own thought processes. A draft should be made, and revolved among the members before sending it to the authorities.
For this purpose, KBG should also have committed activists to take the cause further.
*****
Date: August 3, 2021
Time: 8.30 am – 10.00 am
- Case Presentation by Dr. Tashfeen Ahmad: Ethics of Reckless Behavior during COVID-19
Dr. Tashfeen presented cases comprising reckless behavior by COVID-19-positive people which jeopardized public safety. Though reckless behavior is unethical, sometimes laws, policies, and systems perpetuate reckless behavior.
- Case-Based Discussion (no case, just discussion)
*****
Date: Tuesday, December 07, 2021
Time: 8.30 am – 10.00 am
- Presentation on “ethics of handling a not-so-good surgeon” (Dr. Tashfeen Ahmed)
Dr. Tashfeen discussed the ethical discourse of health professionals’ incompetence. In his presentation, he mentioned a case where a surgeon working at a university hospital noticed a relatively high complication rate of procedures performed by her colleague. She discussed the concerned matter with the Head of the Department but no action was taken as there was no formal complaint against that surgeon.
Most recently a patient underwent surgery for the third time because the first two surgeries failed by the same surgeon. She was concerned that the patient was being harmed by the technical inadequacy of her colleague and she was having difficulty finding an avenue where the concern may be addressed and resolved.
Dr. Tashfeen termed the surgeon’s incompetency a very glaring issue and said that the medical practitioners are well aware of the fact as it happened everywhere. However, unfortunately, there is no literature with “surgeon’s incompetence” in the title, and he considered it a probable bias in publication.
Furthermore, he raised a number of ethical concerns in the presentation:
- Is the Head of the Department justified in refraining from action without any formal complaint?
- Does a doctor have a moral responsibility to inform such concerns to higher authorities?
- What institutional mechanisms are required to assure no harm to the patients in case of apparent technical inadequacies?
- Does anonymous reporting have a place in such scenarios?
- Are there any guidelines of PMC/ PMDC in this regard?
- The second presentation on “Shifting attitudes and practices of GPs – planning for research to improve ethical practice” (by Dr. Naveed Noor)
The presentation was focused on the study background & research questions along with the research findings, interventions and ideas.
The research was mainly focused on incentives offered by pharmaceutical companies to general practitioners in Pakistan. As a result, GPs are prescribing unnecessarily. 80% of the urban population relies on private GPs, therefore, this conflict of interest is highlighted as an important ethical concern.
The aim & objective of this study is to increase awareness among the GPs of such unprofessional practices.