L1. Introduction to medical ethics & professionalism course (28.09.16)

FMC (28.09.2016)
Dr Ghaiath Hussein, MBBS, MHSc. (CAN), PhD (UK)

Outline of the session
This session will help you get answers to the following questions:
• What is this course about?
• What are the main topics that will be covered in the course?
• How is the course structured?
• How you are going to be assessed?
For More Info: http://ghaiathme.wixsite.com/mep-course 2

Course Ground rules ‫للمقرر‬ ‫المنظمة‬ ‫القواعد‬
‫الطبية‬ ‫األخالقيات‬ ‫لكورس‬ ‫المنظمة‬ ‫القواعد‬
•‫محاضرة‬ ‫كل‬ ‫وفي‬ ‫كورس‬ ‫كل‬ ‫في‬ ‫النية‬ ‫استحضار‬(‫بالحق‬ ‫والتواصي‬ ،‫الخلق‬ ‫وحسن‬ ،‫العلم‬ ‫طلب‬)...
•‫من‬ ‫بأكثر‬ ‫المحاضرة‬ ‫بداية‬ ‫موعد‬ ‫عن‬ ‫بالتأخير‬ ‫يسمح‬ ‫ال‬10‫دقائق‬
•‫حضور‬ ‫يسجل‬ ‫أن‬ ‫دون‬ ‫المحاضرة‬ ‫من‬ ‫الثاني‬ ‫الجزء‬ ‫يحضر‬ ‫أن‬ ‫للمتأخر‬ ‫يمكن‬
•‫الكبرى‬ ‫القاعة‬ ‫داخل‬ ‫أشربة‬ ‫أو‬ ‫أطعمة‬ ‫أي‬ ‫بتناول‬ ‫يسمح‬ ‫ال‬(‫الكبرى‬ ‫القاعة‬ ‫قواعد‬)
•‫من‬ ‫ألكثر‬ ‫الغياب‬25%‫االمتحان‬ ‫من‬ ‫الطالب‬ ‫يحرم‬ ‫الكورس‬ ‫من‬(‫درجاتك‬ ‫يزيد‬ ‫االيجابي‬ ‫الحضور‬)!
•‫الهزاز‬ ‫أو‬ ‫الصامت‬ ‫على‬ ‫الجواالت‬(‫األساتذة‬ ‫يشمل‬ ‫هذا‬)!
•‫زمالءك‬ ‫وعلى‬ ‫المحاضر‬ ‫على‬ ‫تشوش‬ ‫الجانبية‬ ‫األحاديث‬
•‫المحاضرة‬ ‫بداية‬ ‫في‬ ‫المحاضر‬ ‫توجيه‬ ‫حسب‬ ‫يكون‬ ‫بعدها‬ ‫أو‬ ‫المحاضرة‬ ‫أثناء‬ ‫األسئلة‬ ‫طرح‬
•‫الكورس‬ ‫ومنسق‬ ‫الطالب‬ ‫قائد‬ ‫مع‬ ‫بالتنسيق‬ ‫يكون‬ ‫األكاديمية‬ ‫النشاطات‬ ‫مواعيد‬ ‫أو‬ ‫المجموعات‬ ‫في‬ ‫تغيير‬ ‫أي‬
•‫مراجعتك‬ ‫من‬ ‫تأكد‬‫المقرر‬ ‫لموقع‬‫وعمل‬‫المحدد‬ ‫الوقت‬ ‫في‬ ‫منك‬ ‫المطلوبة‬ ‫المهام‬
•‫عن‬ ‫اال‬ ‫مباشرة‬ ‫المقرر‬ ‫منسق‬ ‫مع‬ ‫التواصل‬ ‫يتم‬ ‫ال‬‫المجموعة‬ ‫قائد‬ ‫او‬ ،‫الموقع‬ ‫في‬ ‫التواصل‬ ‫نموذج‬ ‫تعبئة‬ ‫طريق‬(Leader)
‫االلكتروني‬ ‫البريد‬ ‫طريق‬ ‫وعن‬–‫فقط‬ ‫للطوارئ‬ ‫الهاتفي‬ ‫االتصال‬WhatsApp‫معتمدة‬ ‫او‬ ‫رسمية‬ ‫وسيلة‬ ‫ليس‬

What this course trying to achieve?
This course presents the students to:
• the basics of the ethical practice of healthcare provision by the physician, and
• the professional standards that the students should meet in any of students’ roles
as a doctor.
• The doctors’ duties as team-member, practitioner/clinician, researcher,
manager/planner, educator, and patient advocate.
• learn how to maintain and develop their competence, and
• appropriately respond to ethical issues encountered in practice,
• maintain appropriate relations with their patients, colleagues and society and be
empathetic to the physical and moral suffering of patients.

What this course trying to achieve?
This course:
• covers the definition and basics of professionalism and the essential elements of
the medical profession, including moral and ethical principles and legal
responsibilities underlying the profession,
• provides an overview of many ethical issues that arise in the practice of medicine
and research,
• introduces students to the core elements of ethical reasoning around issues that
they could encounter in their future practice.
• is guided by our Islamic moral heritage represented by Quran and Sunnah, as well
the national and international guidelines and codes of ethics.

Structure of the curriculum
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 professional values that will
be studied in more detail in the following parts of the curriculum.
The topics covered in this section include:
• Introduction to the concepts of ethics, bioethics, and medical ethics
• Comparison between the western and Islamic approaches to medical ethics
• Overview on the professional duties of the doctor towards self, colleagues,
patients, and community.
• Professionalism in being a medical student and a doctor
• Basic national and international ethical principles and guidelines
• Overview on patients' rights

• Section II: Practical Aspects of Medical Ethics
• Patient's Autonomy and informed consent to treatment
• Privacy and confidentiality
• Medical Malpractice, Misconduct & Medical Errors
• Financial Aspects in Practice and Conflict of Interests (COI)
• How to manage ethical issues in clinical practice?
• Ethical issues in reproductive health and beginning of life
• Terminally Incurable Diseases and the End of Life (EOL) Decisions ‫والموت‬ ‫باالحتضار‬ ‫المتعلقة‬ ‫االحكام‬
• Resource allocation in the health-care system
• Islamic Fiqhi Rulings in Major Medical Specialties ‫الصحية‬ ‫الممارسة‬ ‫في‬ ‫والفقهية‬ ‫الشرعية‬ ‫الجوانب‬
• Legal aspects of medical practice in Saudi Arabia

• Section III: Ethical issues in health research and public health
This section includes the ethical issues that are encountered before, during and after the
conduct of research and public health activities.
• Historical background of research ethics
• Basic concepts in research ethics
• The ethical standards of research
• The concepts of benefit and harm in research
• Informed consent in research
• Research on vulnerable groups
• Privacy and confidentiality in research
• Conflict of interests in research
• Ethical issues in public health and health promotion

Overview on the timetable
Day
Time
8 am 9 am 10 am 11 am
Sunday
Seminar S1–Male
(MEP)
Seminar S1-
Females (MEP)
Dr. Amal
Seminar S3–
Male (MEP)
Monday
Seminar S2–Females
(MEP) Dr. Amal
Seminar S2–
Male (MEP)
Tuesday
Seminar S3-Fem.
(MEP) Dr. Amal
Wednesday
Lecture (MEP) Gp. L1
- Females
Lecture (MEP)
Gp. L2 - Females
Lecture (MEP)
Gp. L1 - Males
Lecture (MEP)
Gp. L2 - Males
Thursday
Lecture (MEP) Gp. L2
- Males
Lecture (MEP)
Gp. L1 - Males
Lecture (MEP)
Gp. L1 - Females
Lecture (MEP)
Gp. L2 - Females

How will you be assessed?
Assessment Method Mark/100
Seminars and oral presentations 10
Assignments (5 marks) and practical activities (5) 10
Mid-term exam 20
Course (Research) report and presentation:
The report (15 marks) & presentation (5 marks)
20
Final exam 40
Total 100

Attendance and active participation
• 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.
• Students are expected to show on time – every time!
• You may not be allowed to enter the lecture room after 15 minutes from the
start of the lecture.
₪Should you decide to come late, you will be asked to prepare a on-
minute talk about a selected topic of the course’s glossary.
• Remember, attendance is not just about signing in the attendance sheet!
You should participate and contribute to the session by asking and
answering questions, and positive contributions in group discussions.

Debates
• Most of the sessions will start with a 5-minute debate. It goes as follows:
• Two groups of student, each of three (randomly selected) students, seated next to
each other, will be given two contradicting statements about an ethical issue with
few hints.
• Minute ONE: Each team will read the statements an make an argument to defend
their positions from the ethical issue
• Minute TWO: Team 1 will present their argument
• Minute THREE: Team 2 will present their counter-argument
• Minute FOUR: The rest of the students will be given few chances to respond to
either of the teams.
• Minute FIVE: The rest of the students shall vote for the team with the better
argument.

Seminars and oral presentations (10 marks)
See previous seminar presentation
• You are expected to present several topics as students’ seminars.
• Students will be divided into groups, each of 5-8 students.
• Each group will be assigned a topic to be presented.
• The time for the seminar is about 20 minutes per topic.
• Each of the group members should present a part of the seminar and should
be ready to answer the posed questions.

Seminars and oral presentations (10 marks)
See previous seminar presentation
• The evaluation of the presentation is individual, i.e. each member
will have a different mark depending on his/her contribution and
his/her ability to answer the questions.
• Innovative ideas and ways of presentation may include making a
short movie, a role play, use of posters, or models, etc. (not only
PPT!)
• Every seminar should follow the ILOs of the session, which should
be discussed with the course coordinator or the group supervisor,
if present.

Assignments (5 marks)
• 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.

Assignments (5 marks)
• abide to the professional
academic conduct, especially
the proper citation without
the abuse of the internet.
• Plagiarism similarity score of
25% or more means that
students’ work will be
rejected and you will have to
resubmit students’ work.
• We take academic
misconduct seriously. So
should you.

Assessment of assignments:
Students’ assignments will be assessed based on the following criteria:
• 1- Originality of content
• 2- Novelty of content
• 3- Strength of arguments
• 4- Uniform editing
• 5- Proper citation

Mid-Term Exam (20 marks)
• The mid-term exam will be composed of (about 20) MCQs, with one best
answer, and 2-4 short essay questions.
• It may also 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.

Research report & Research presentation (20
marks)
• 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.
• We expect you (with students’ team) to find an ethical problem related to
the objectives of the course, study, and present and discuss students’ results
and conclusions from what you found. Finally, you should have practical
recommendations that you come up with at the end of the research.
• Students’ research is expected to contribute new knowledge to the scientific
community and not a repetition of what is already known about the subject.

Structure of the research report
• 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
students’ Word software]
• III. Acknowledgment: This section is to acknowledge the efforts of those who helped you in
students’ research.
• IV. Introduction: This is a key section. You need to tell the reader of students’ 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 students’ 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 students’ research.
• VI. Objectives (general and specific): use action verbs, and make them SMART (Specific,
Measurable, Attainable/Acceptable/Achievable. Relevant/Reliable and Time-bound)

Structure of the research report
• VII. Methodology: in this section, you tell the reader how you did students’ 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 students’ 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 students’
research.
• XI. References: This section contains the references that you used in students’ 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 Mendeley).
Discuss this option with students’ supervisor.
• Don't Plagiarize! This simply means that students’ work will get ZERO.

The case study
A case study will be typically composed of these sections:
• 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 students’
case, for example what are the Goals of Shariya (‫الشريعة‬ ‫)مقاصد‬ involved, which Fiqhi Maxims
(‫الفقهية‬ ‫)القواعد‬ 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 students’ approach to resolve the case.

A Fiqhi study ‫الفقهية‬ ‫الدراسة‬
• A Fiqhi study is a different format that can reflect students’ ability
to search and analyze. As you know, many of the practices and
medical interventions have been studied by the Scholars (Ulama).
• 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.
• May be you can consider Islamic approach to ethical issues in
specialties, like Emergency Medicine, Oncology, Anesthesia, etc.

Format and styling in writing and citation
Students’ 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

Format and styling in writing and citation
Students’ work should follow the following instructions:
v. Using Photos should be justified, with proper acknowledgment of
the source and copyright, if needed.
vi. Don’t' use colors other than black unless justifiable and needed. In
total, not more than two colors allowed.
vii. 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.
viii. All students’ work should be in Arial Font, double spaced, size of
font should be as follows:
Main headers/titles (Bolded size 16);
Subtitles (Bolded size 14);
Sub-subtitles (Bolded size 12); and the rest of the text (size 12).

The presentation associated with the research
• The presentation should summarize the whole work in 15
minutes presentation.
• 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.
• You need to make that presentation is relevant to the objectives.
• You should make sure that a copy of students’ presentation is
ready on the PC of the hall at least one hour before the
presentation.

Final Exam (40 marks)
• 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.

Communications and complaints
Website:
• The website (http://ghaiathme.wixsite.com/mep-course) 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.
Emails:
• You should have an active email, whether a college mail or otherwise. You
need to make sure you check your email at least twice a week.

Communications and complaints
Guidelines for sending emails and attachment:
• Make sure your sent email has a title (Subject). Emails with ‘no subject’ will be
probably ignored if not sent to spam.
• Make sure your email is signed. You have to end your email with your name,
level/batch, and group, if applicable.
• All email attachments should be named (i.e. have name), preferably in the
following format: Subject_sender_date. For example, if your name is Omar Ali and
you are sending the first assignment that you finished on 8th of September, 2016,
then the file should be named as “Assignment1_Omar-Ali_08-09-16”, or
“assignment1_Omar(08.09.16)”, or in any similar format.
• Emails should be related to the course only. Emails that are about any other
subjects may not be responded to.
• Emails should be written in a formal language.

Complaints and Appeals:
• In case you have a complaint against one of the teaching staff in the
course, permanent or visiting, or you want to appeal a decision that
concerns you (students’ mark in an assignment or a report), you have the
right to contact the course coordinator (through feedback link).
• If students’ appeal is against results of the mid-term or the final exam, you
need to contact the Students’ Affairs to explain to you the process you
should follow to have students’ paper re-marked.
• We assure you that the department and the college as a whole have zero-
tolerance against discrimination against students for any reason, whether
verbal of non-verbal. We will take students’ complaints seriously, and we
expect you to be serious in your commitment and compliance with the
academic guidelines that guide students’ attitude as medical students.

L1. Introduction to medical ethics & professionalism course (28.09.16)

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