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issn:2229-340
1.  The major medical ethical challenges facing the public and healthcare providers in Saudi Arabia 
Background:
Despite the relatively high expenditure on healthcare in Saudi Arabia, its health system remains highly centralized in the main cities with its primary focus on secondary and tertiary care rather than primary care. This has led to numerous ethical challenges for the healthcare providers. This article reports the results of a study conducted with a panel of practitioners, and non-clinicians, in Saudi Arabia, in order to identify the top ten ethical challenges for healthcare providers, patients, and their families.
Materials and Methods:
The study design was a cross-sectional, descriptive, and qualitative one. The participants were asked the question: “What top ten ethical challenges are Saudis likely to face in health care?” The participants were asked to rank the top ten ethical challenges throughout a modified Delphi process, using a ranking Scale. A consensus was reached after three rounds of questions and an experts’ meeting.
Results:
The major 10 ethical issues, as perceived by the participants in order of their importance, were: (1) Patients’ Rights, (2) Equity of resources, (3) Confidentiality of the patients, (4) Patient Safety, (5) Conflict of Interests, (6) Ethics of privatization, (7) Informed Consent, (8) Dealing with the opposite sex, (9) Beginning and end of life, and (10) Healthcare team ethics.
Conclusion:
Although many of the challenges listed by the participants have received significant public and specialized attention worldwide, scant attention has been paid to these top challenges in Saudi Arabia. We propose several possible steps to help address these key challenges.
doi:10.4103/2230-8229.94003
PMCID: PMC3326764  PMID: 22518351
Bioethics; ethical issues; ethics priorities; medical ethics
2.  Permanent Diversion Stomas: “Guidelines for Muslim Physicians and Patients” 
Background:
Ethical issues in medical practice are increasing in number, diversity and complexity and posing professional diemmas for physicians. It is the duty of Muslim physicians in collaboration with jurists, to resolve these issues.
Objectives:
These guidelines aim at answering the following two questions:
1. On religious grounds to what extent is a Muslim patient bound ground to accept surgical treatment requiring permanent diversion of stool and urine?
2. What should be the role of medical staff in convincing the patient aril his relatives to accept diversion stomas.
Methods:
1. Identification of the consequences of diversion stomas.
2. Verification of the religious rule in relation to seeking treatment.
3. Identify the effect of carrying a stoma bag on the patient's purity during worship
4. Outline the role of the medical staff in convincing the patient vial his relatives to accept a needed stoma
Results & Discussion:
A Muslim patient needing a permanent diversion stoma has a religiously proven duty to listen to the instructions of a proficient physician in order to save himself if safety is most probable. Carrying a stoma bag does not interfere totally with patients purity. The exact role of medical staff in convincing the patient and his relatives to accept the procedure is discussed.
PMCID: PMC3437123  PMID: 23012221
Diversion Stomas; Ileostomy; Colostomy; Islamic Medicine
3.  Developmental Milestones and Additional Disabilities in Children attending ESN/M School in Dammam, Saudi Arabia 
Information about the extent of additional disabilities presented and experienced by the mentally retarded children is essential for proper health services planning for this group.
The objective of this case-control study was to identify the developmental milestones and additional disabilities of mildly mentally retarded male children. Sixty-nine parents of mildly mentally retarded male children (MMR group) and a similar number of matched parents of normal male children (control group) were interviewed and a questionnaire was completed.
Generally, the MMR group children smiled, sat, walked, talked and became continent for urine and bowel significantly later than the control group. Additional disabilities in the children of the MMR group were in the form of speech (65%), visual (28%), limb weakness (20%), hearing (16%), convulsive disorder (15%) and other disabilities (10%).
Well structured health education and I.Q. screening programs were recommended for early detection of mental retardation and subsequent entry to special education. Institutes for mentally retarded children in the Kingdom need to be better vocationally equipped. The role of Family and Community Physicians in early detection and management was also emphasized.
PMCID: PMC3437154  PMID: 23012212
Mental Retardation; Disabilities; Saudi Arabia

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