Traditionally clinicians have determined their patients' resuscitation status without consultation. This has been condemned as morally indefensible in cases where not for resuscitation (NFR) orders are based on quality of life considerations and when the patient's true wishes are not known. Such instances would encompass most resuscitation decisions in elderly patients. Having previously involved patients in CPR decision-making, we chose formally to explore the reasons behind the choices made. Although the patients were not upset, and readily decided at the time (...) of initial consultation, on later analysing the decision-making we found poor understanding of the procedure, poor recall of information given and in some cases evidence of harm. This may be attributed to impaired decision-making capacity of elderly hospitalised patients as previously shown, or to the discomfort precipitated by having to contemplate the apparent immediacy of cardiac arrest by these patients. We propose that subscribing to autonomy as a general principle needs to be balanced against particular cases where distress may be caused by, or result in, diminished competence and limited autonomy. (shrink)

Adolescent pregnancy results from the complex interaction between various internal and external vulnerabilities. These vulnerabilities persist after the infant's birth when the adolescent becomes a parent. Adolescent parents are unfairly stereotyped as unmotivated and incompetent. Some legislations prohibit adolescents from giving consent on the grounds of incompetency. Despite being different, “competency” is frequently used interchangeably with “capacity”; thus, incompetent individuals are often mistaken to lack capacity. Consequently, legally incompetent adolescents who became parents are frequently disregarded during their infant's decision-making process. (...) This article discusses the distinction between the competence and capacity of adolescent parents, the various vulnerabilities that contribute to an adolescent's incompetency, and advocates respect for the adolescent's capacity in making decisions for her infant. We propose a workflow for obtaining informed consent for infants born to adolescents ethically guided by the respect for individuals principle while staying within the country's legal framework. (shrink)

Even though there is a significant amount of scholarly work examining the ethical issues surrounding human genomics research, little is known about its footing in Malaysia. This study aims to explore the experience of local researchers and research ethics committee (REC) members in developing it in Malaysia. In‐depth interviews were conducted from April to May 2021, and the data were thematically analysed. In advancing this technology, both genomics researchers and REC members have concerns over how this research is being developed (...) in the country especially the absence of a clear ethical and regulatory framework at the national level as a guidance. However, this study argues that it is not a salient issue as there are international guidelines in existence and both researchers and RECs will benefit from a training on the guidelines to ensure genomics research can be developed in an ethical manner. (shrink)

The term non-governmental organisations (NGOs) has been well-known for the development of human rights, charity works and organisational developments. On the other hand, some NGOs also have their specialised roles to help the community such as in conflict resolution, cultural preservation, policy analysis and information provision. Apart from that, there are many categories of NGOs: Islamic-oriented non-governmental organisation (IONGOs), faith-based organisation (FBO), humanitarian NGOs (HNGOs) and government organised NGOs (GONGOs). However, in this research, the researchers focus on how IONGOs compare (...) with NGOs in assisting the lesbian, gay, bisexual, and transgender (LGBT) community based on four hijrah NGOs: Persatuan Islah Movement, Persatuan Insaf Pahang, Hijrah Republique Network and Usrah Iqrak. These four NGOs were chosen because of their roles in assisting the LGBT community. In this research, the researchers adapt the qualitative research by using a case study method; phenomenological approaches and a document analysis have also been applied as well. The result shows that these four IONGOs are different from the NGOs based on the seven typologies applied: intersection, distinct, substantive, subset, co-existing, atomistic grouping and constitutive. The implications of this article highlight the fact that IONGOs are different from the LGBT NGOs in Malaysia as they focus more on spirituality and an Islamic pathway. Hence, future research should include focus group interviews with all the members in NGOs that assist the LGBT hijrah in the community. Contribution: This study contributes to LGBT hijrah community and its relationship towards the establishment of Islamic-oriented non-governmental organisation (IONGOs). (shrink)

A modified version of the SEIR model with the effects of vaccination and inter-state movement is proposed to simulate the spread of COVID-19 in Malaysia. A mathematical analysis of the proposed model was performed to derive the basic reproduction number. To enhance the model’s forecasting capabilities, the model parameters were estimated using the Nelder–Mead simplex method by fitting the model outputs to the observed data. Our results showed a good fit between the model outputs and available data, where the model (...) was then able to perform short-term predictions. In line with the rapid vaccination program, our model predicted that the COVID-19 cases in the country would decrease by the end of August. Furthermore, our findings indicated that relaxing travel restrictions from a highly vaccinated region to a low vaccinated region would result in an epidemic outbreak. (shrink)

Vaccination is an important tool for handling healthcare programs both in developed and developing countries. The current global scenario calls for a more‐efficacious, acceptable, cost‐effective and reliable method of immunization for many fatal diseases. It is hoped that the adoption of oral vaccines will help to provide an effective vaccination strategy, especially in developing countries. Mucosal immunity generated by oral vaccines can serve as a strong first line of defense against most of the pathogens infecting through the mucosal lining. Advances (...) in elucidating the mechanism of action of oral vaccines will facilitate the design of more effective, new generation vaccines. There are promising developments in the use of different agents to effectively deliver the vaccine candidate. It is hoped that ongoing research may be able to set another cardinal point, after polio vaccine, in eradicating infectious diseases. BioEssays 29:591–604, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

This book explores the ethical and governance concerns of stem cell technology, taking a comparative approach between countries of differing socio-economic status. The book provides a typology of different stem cell types and discusses key ethical issues surrounding the use of human stem cells in research. Topics covered include the moral status of human embryos, various religious perspectives, and the challenges posed by unproven stem cell interventions. The book also examines the existing governance frameworks in the UK, Singapore, and Malaysia, (...) identifying the laws, guidelines, and advisory bodies established to address the identified ethical issues. Applicable lessons on establishing robust regulatory frameworks, fostering public trust, and ensuring responsible research practices are outlined. By providing a comparative analysis of the interplay between ethics, governance, and the socio-economic contexts of these three commonwealth countries, this book will interest health law, research ethics and bioethics scholars. (shrink)