Riaz Sonia, Khan Ejaz Ahmad, Jafar Tariq
Department of Public Health, Health Services Academy, Quaid e Azam University, Islamabad, Pakistan.
J Ayub Med Coll Abbottabad. 2017 Jul-Sep;29(3):472-476.
Medical profession works within thin lines of professionalism and trust. Faith of the patients often breached but less reported among the Low and Middle-Income Countries (LMICs). In Pakistan, though the Pakistan Medical and Dental Council (PMDC) have its own code of medical ethics but there isn't much evidence on regulating ethical misconducts. Apart from the gross violations of the code of conduct, the "insensible" misuse of informed consent, confidentiality and privacy is very common. This study is an effort to explore practices of informed consent, confidentiality and privacy among health care providers along with assessment of perceptions of patients about ethical practices in two tertiary care hospitals of Islamabad, Pakistan.
We conducted eight homogenous Focus Group Discussions (FGDs), four each in both the public and private sector hospitals till the saturation was achieved.
Informed consent, in clinical practice, was found not being practiced. Confidentiality was not being uniformly applied in practices. Patients perceived the practices being contrary to the ethics. According to patients, ethical measures were found satisfactory in private hospitals. However, patients were not gratified fully with both the systems of healthcare delivery.
There is insufficient adherence to the ethical principles in clinical practice, in both public and private sector hospitals in Islamabad, Pakistan. Informed consent, privacy and confidentiality are time and time again unheeded due to lack of robust system of monitoring and penalties by the responsible authorities.
医疗行业在专业精神和信任的细微界限内运作。患者的信任常常被违背,但在低收入和中等收入国家(LMICs)中报道较少。在巴基斯坦,尽管巴基斯坦医学和牙科理事会(PMDC)有自己的医学伦理准则,但在规范道德不当行为方面缺乏足够证据。除了严重违反行为准则外,对知情同意、保密和隐私的“无知”滥用也非常普遍。本研究旨在探索巴基斯坦伊斯兰堡两家三级医疗机构中医疗服务提供者在知情同意、保密和隐私方面的做法,并评估患者对道德行为的看法。
我们进行了八次同类焦点小组讨论(FGD),在公立医院和私立医院各进行了四次,直到达到饱和状态。
研究发现,在临床实践中未实施知情同意。保密在实践中并未得到统一应用。患者认为这些做法违背了伦理道德。据患者反映,私立医院的道德措施令人满意。然而,患者对两种医疗服务体系都不完全满意。
在巴基斯坦伊斯兰堡的公立医院和私立医院,临床实践中对伦理原则的遵守都不够充分。由于缺乏负责当局强有力的监督和惩罚制度,知情同意、隐私和保密一次又一次地被忽视。