This document summarizes a study conducted on the major medical ethical challenges facing public and healthcare providers in Saudi Arabia (KSA). The study utilized a modified Delphi method involving surveys of ethics committees from hospitals in major KSA cities to identify and rank issues. Over three rounds, participants reached consensus that the top 10 ethical challenges were: 1) patient identification and rights, 2) confidentiality, 3) medical negligence, 4) consent forms, 5) Islamic medicine and ethics of Muslim doctors, 6) research ethics, 7) equitable resource distribution, 8) dealing with healthcare teams, 9) patient requirements for resuscitation, and 10) examining patients of the opposite sex.

1. The Major Medical Ethics
Challenging Facing the Public
and Health Care Providers in
K.S.A
(http://www.jfcmonline.com/article.asp?issn=22308229;year=2012;volume=19;issue=1;spage=1;epage=6;aulast=Alkabba)
By
Dr. Abdulaziz Fahad Al Kabbaa
Faculty of Medicine
King Fahad Medical City
KSAU-HS

2. Table of
Contents

3. Medical Services are one of the
priorities and highly needed in
developed country like K.S.A. However,
common problems occurred in our
kingdom are ethical issues.
Good medical ethics provide good
medical services.

4. Major ethical issues in KSA
In this research, ranking the top
ethical challenges can be an
effective and valuable way
bringing them to the public

5. This research focuses on
major ethical issues
By the end of it, we should be aware of
the most important major ethical issues
facing the health care providers and public in
K.S.A.

6. Review Literature
Medical ethical challenges have been
discussed widely in the literature as isolated
ethical issues in health care.
A modified Delphi Study was
conducted with twelve clinical bio-ethicist
members of the Clinical Ethics Group of the
University of Toronto Joint Centre for
Bioethics..

7. One question was asked
what do you think are the top ten ethical
challenges that Canadians may face in
health care?
The panel was asked to rank the top ten
ethical challenges throughout the Delphi
process & consensus was reached after
three rounds

11. Cont…
The research also seek perceptions
and ethical problems generated within
medical staff on medical industries.
Many of the challenges listed by the panel
have received significant public attention.
In this research, different results may
be achieved according to the difference
in both culture and system.

12. Aims of this Study
It aim of this study is to:
Explore the Major Medical
Ethical Issues that challenges
and facing the public and health
care providers in K.S.A.

13. Specific Objectives
The specific objectives of this study are to :
1.
2.
To explore the major medical ethical
challenges and facing Saudi public & health
care providers in K.S.A
To know and rank the major ethical issues in
K.S.A.

14. Methodology
Study Design
This is a cross-section study. (Qualitative
Study)
Study Area
This study is conducted on three majors
cities of K.S.A that considered abundant
numbers of medical and academic
: institutions, namely
Riyadh, Jeddah and Dammam
( Tiaf,Tabuk, )

15. Cont…
Study Population
The study population consists of members
of Ethics committee in the majors’ health
institutions (hospitals) and/ or having experience
in medical ethics field and medical administration
(CEO) in KSA.

16. Sampling Technique:
Random Sample of four (4) hospitals in
Riyadh, two (2) in Jeddah & two (2) in
Dammam. Besides, one in Taif and
another one in Tabuk

18. Cont…
The hospitals are:
A. Riyadh
1.King Fahad Medical City (KFMC)
2.National Guard Hospital (KFNGH)
3.Military Hospital (RKH)
4.King Khalid University Hospital (KKUH)
B.
Jeddah
5.King Faisal Specialized Hospital
6.King Abdul-Aziz University Hospital (KAUH)

19. Cont…
C. Dammam
7.Dammam Central Hospital
8.King Faisal Specialized Hospital
D.
Others
9. Taif – Military Hospital
•
Tabuk – Military Hospital

20. Data Collection Tool & Analysis
Data Collection Tool & Analysis
Method
Method
In this study Delphi Method which is
validated & used in similar international study
in Canada has been applied in this study.
It has three steps:
Step 1the participants were asked to list the
top 10 medical ethics challenging health care
provider in our culture (Saudi Arabia).
They were requested to email their responses
back to the investigators.

21. Step 2:
These forms were collected and entered
to SPSS file (Version 17)and frequencies
of the ranks were obtained.
These frequencies were ranked from the
highest values to the lowest.

22. Ethical Issues in Saudi Arabia as described by Health Care Professionals
Items
Frequency
Rank
Patients Identification and Rights
55
1
Confidentiality
41
2
Medical Negligence (Medical Error(
31
3
Consent FORM (as a patient or as a research person)
30
4
Islamic Medicine & Ethics of Muslim Doctors
29
5
Research Ethics
27
6
Equity of Resource Distribution
27
7
Dealing with Health Care Team
25
8
Patients Require Resuscitation (DNR)
22
9
Examining Opposite Sex
17
10
Physicians Rights and Duties
12
11
The Effect Health System on Decision Making
12
12
Conflict of Interest
10
13
Legitimate Necessity
9
14

23. Cont…
The results of this ranks were resent again
to the respondents and they were asked to
re-rank them, If they don’t agree about the
item s’ importance.
They were requested to email the new list
back again to the researchers .


24.  These forms were collected and
entered to SPSS file and
frequencies of them were
obtained.
 It were re-ranked again from the
highest frequencies to the lowest.

25. Do you
agree?
Items
Rank
Patients Identification and Rights
1
Confidentiality
2
Medical Negligence (Medical Error)
3
Consent FORM (as a patient or as a research subject
4
Islamic Medicine & Ethics of Muslim Doctors
5
Research Ethics
6
Equity of Resource Distribution
7
Dealing with Health Care Team
8
Patients Require Resuscitation (DNR)
9
Examining Opposite Sex
10
Physicians Rights and Duties
11
The Effect Health System on Decision Making
12
Conflict of Interest
13
Legitimate Necessity
14
Abortion (Legal)
15
Yes
No
Your New
Rank

26. Step 3:
A panel consists of you -as highly
professional expertise in the field- are
invited to this meeting to decide the top
10 major ethical issues facing the Saudi
community in this meeting.
The final list top 10 will be compared with
the international result (Canadian Study) .

27. MEDICAL ETHICAL ISSUES CHALLENGING FACING
THE PUBLIC AND HEALTH CARE Providers in K. S. A.
The 10 medical ethics- which have been agreed upon by
the expertise- are as follow:
1- Patients Rights
2- Equity of resources
3- Confidentiality of the patients
4- Patient Safety
5- Conflict of Interest
6- Ethics of privatization
7- Informed Consent
8- Dealing with opposite sex
9- Beginning and end of life
10-Health Care Team Ethics

28. THANK YOU