26.9.07

Libya and medical ethics

Working in a public hospital in Libya opened my eyes on so many things but one of my biggest concerns is The Medical Ethics issue ,I already knew the same as most of the Libyans that our hospitals filled with unethical doctors and health care staff and how in our hospitals the way the patient treated is less than a prisoner anywhere else in this world ,but it was shocking to live this fact and to see all the violation of the patients privacy and the way the doctors treat the patients , I don't know if all this because the medical ethics wasn't introduced as a studying material in Medical school until recently or is it because all the hospital staff doctors and nurses feel like they are above the law and no one will judge them when things go wrong .

It's just so sad to see a doctor with no ethics and to see a patient treated as a subject not as a human being , private hospital or public it doesn't matter because the same mentality working in either places, that what makes almost 90% of the Libyans go to Tunisia for therapy or check up , even most of the hospitals in Tunisia are working only to get as much money as they can from the Libyans but I can't blame the people who go there because I know at least they will get the attention and the psychological support that they will never find here, and it's not only our doctors and health staff who make all these people seek health care outside Libya but also the shortage of everything in our hospitals starting from the plaster to the Imaging machines .

there is a lot more to add but I will leave you with this nice article I read in the Libyan Medical Journal


Medical ethics in Libya: where to start?

Elmahdi A. Elkhammas, MD, FACS

Department of Surgery,
Division of Transplantation, 343 means Hall, 1654 Upham Dr., Columbus, Ohio, 43210, USA



When it was decided that I will write the editorial for the second issue of the Libyan Journal of Medicine, I was not sure where to start. There are many topics that are related to global health issues and many are specifically related to the health system in Libya. For this issue, I decided to start some discussion on medical ethics as it relates to the Libyan medical culture. In our culture we tend not to inform the patient about the seriousness of his or her illness especially if the case is terminal. We do tell the family and some times other relatives. We even answer questions about it during social events. This means that the patient’s lack of information is complicated by lack of privacy and confidentiality. We have very little time to sit with the patient and discuss the issues with him. Of course the situation is better in private practice (anecdotal, but no scientific studies). Some consultants tend to make rounds as they wish without respect to their teaching duties or their patients needs. Others have neglected patients after a major surgical procedure and not visited the patient at all until the patient’s death. Is it a wrongful death? The answer is beyond the scope of this editorial. It is not unusual to be sarcastic and make fun of the older patient who present with symptom of sexual dysfunction and remind him that he is too old for that and he should be ashamed of himself. The social status of the patient is a key factor for how he or she will be talked too and treated. If you are rich or poor, high ranking official or average human being, young person or old, presented to a Government hospital or to a private clinic, all of the above criteria may make a difference in how the patient is received or treated.

I have to admit that the issue is very complex. Most of the ethical or unethical behavior of physicians of my generation was obtained as part of the cultural and the religious backgrounds. No courses on medical humanity and ethics were taught as part of medical school curriculum. One might argue that common sense and the basic principles of our religion should be adequate to lead us to the ethical behavior. That might be true to some extent, but when you see your teacher’s behavior over seven years in medical school, and during the time you spend with him or her (attachment, internship, house officer) you will certainly be influenced. Therefore, it becomes our responsibility to read about medical ethics and to develop the correct courses with the help of professionals in the field.

It is our obligation to be the role models for the new generation of physicians and medical professionals. It is our obligation to show our students and residents that the patient is not a number. The patient is a human being who is suffering from illness, and came to you as an expert in the field to solve his problem. If we learn to show them that, then we will also show them that we need to talk to the patient with respect, honesty and full truth. We need to listen to them and give them a chance to explain all their symptoms. We show the students how we take patients’ complaints seriously. It does not matter if the case is in a general hospital or a private clinic. We need to go back to a very basic principle which tells us that if you lack knowledge you cannot teach it. So if you lack the ethical behavior, then you cannot teach medical ethics. I am stressing our role as seniors to start with ourselves and improve our ethical behavior. We also need to make sure that we have a strong course of medical humanity and medical ethics being taught at our medical schools.

It makes sense to me if all medical schools in the country have one committee to develop such curriculum to be taught cross the country. There is a need for a code of ethics at all levels. We need Code of ethics for the secretary of health, faculties of medicine and all hospitals. We need to train and form ethics committees in all hospitals and teaching institutions.

As Libyan Journal of Medicine being the official publication of Ibnosina Medical Association, it makes sense that we follow Ibnosina (Avicenna) footsteps. He was the ideal physicians and philosopher who followed ethical principles with his profession. For that reason UNESCO established an Ibnosina prize for ethics in science during its 166th session (2002). The first prize was awarded to Professor Margaret A. Somerville, Professor of Law and medicine at McGill University, Montreal (Canada). I believe it is about time to make medical ethics part of our life in Libyan medical education and profession. Maybe one day we can nominate one of our professors to this prize. At this point I think it would be a challenging task to choose one.

24.9.07

عودة

السلام عليكم

أولا ولو انها متأخرة لكن كل سنة وانتو طيبين بمناسبة رمضان وانشاء الله ربي يتقبل صيامكم

شكرا لكل من حط تعليق او سأل عني وسامحوني علي التأخير في الاجابة لكن انشاء الله خلاص الايام هذي مكسد وإنشاء الله حنكتب علي بعض اليوميات الكويسة منها واللي تدره الكبد .

انا مش عارف امتي اخر مرة خشيت علي النت وشفت اي حاجة ثانية غير الإيميل يعني علي أساس مش فاضي و وقتي معبي ,انا صح كنت مشغول الفترة الماضية بامورمنزلية و دراسية والحمد الله كل شي تمام توا , خلاص كملت الدراسة وبديت في سنة الامتياز يعني وليت دكتور بس مازال من غير شهادة لكن اهو علي الاقل خششت راسي في معمعة المستشفيات وانشاء الله هالسنة تمر علي خير.

نسيت نقول مبروك لكل مشتركي LTT وأخيرا الADSL صار ب 20 دينار شهريا مع حصة 7 GB لكن يا فرحة ما تمت اي نعم الانترنت رخص لكن الخبزة سعرها ارتفع مش عارف كيف وامتي لكن صاحب الكوشة من ايام فاتو فنص فيا لما مديتله ربع وانا واخد 10 فردات قالي نحي زوز توا الثمانية بربع
امتي صار يا عمو
توا
شني هني بس
لا في كل مكان
شني السبب
الدقيق ناقص
وبعدين
فنص فيا وعرفت شني يقول في خاطره ( خود ولا خلي تره بلا تدريه كبد)
زمطت رياقتي و طلعت وانا نتمتم ( نحي من اللحية وحط في الشارب(
الباين اللي بنوفره من الانترنت بنحطه في الخبزة وخلاص وزي ما انتو عارفين حني الليبيين شعب خبزاوي يعني كل شي ناكلو فيه بالخبزة من نفاص الطن لطبيخة الفاصوليا بالكرشة وفيه ناس اي شي لازم ما تاكله بالخبزة كمثال زمان قري معاي واحد في المدرسة جايب سندوتش فسطه عصيدة ورب وعندي صديق ياكل في سندوتشات بالموز يعني فردة خبزة وفسطها موزة ولا موزتين , وصدقوني عمركم ما حتشوفو زحمة علي الكوشة زي ما عندنا الناس غير يسمعو الدقيق ناقص كلهم تجيهم النية في الخبزة ويبدو قريب يتقاتلو عليها , زمان وانا صغير لحقت شوية علي ازمة الكوش لما كانت بالطابور ( قصدي كمشة ناس والصحيح ياخد) وللأسف المنظر هذا بعد ما اختفي لفترة طويلة لكن السنة هذي الزحمة زي زمان واحرف .

الحمد لله علي كل حال وزي ما تقول جدتي انشاء الله هذا حد السو