Attitude and willingness on gamete donation among medical students:An experience from a state university in Sri Lanka

Objective:To assess the attitude and willingness of medical students of the Faculty of Medicine,University of Jaffna,regarding gamete donation.Methods:An institutional-based descriptive cross-sectional study was conducted at the Faculty of Medicine,University of Jaffna,from September 2022 to May 2023 among undergraduate medical students who gave their voluntary participation.A self-administered questionnaire was used as a study instrument to collect data regarding their attitude and willingness toward gamete donation.Results:A total of 345 participants were recruited and their sociodemographic data revealed that 56.8%of the participants were female,62.3%aged between 26 and 30 years,and 92.2%were unmarried.Many of them received information regarding gamete donations during their clinical appointments.Over half(67.8%)of them showed a negative attitude towards gamete donation.Regarding willingness,only 39.7%of participants had a positive approach for being a gamete donor;among them,84.7%preferred anonymous donations.Religion and ethnicity had a significant influence on their attitudes and willingness.In addition,male was also found to be more willing to donate gametes.Conclusions:Most medical students have negative views about gamete donation.Imparting awareness and knowledge of assisted reproductive technology and gamete donation within medical students'sociocultural and ethical backgrounds might facilitate a change in attitude towards gamete donation amongst future medical practitioners.

Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Exploring the intersection of the medical metaverse and healthcare ethics:future considerations and caveats

The medical metaverse and digital twin are set to revolutionise healthcare.Like all emerging technologies their benefits must be weighed against their ethical and social,impacts.If we consider the advances of medical technology as an expression of our values,such as the pursuit of knowledge,cures and healing,an ethical study allows us to align our values and steer the technology towards an agreed goal.However,to appreciate the long-term consequents of a technology,those consequences must be considered in the context of a society already shaped by that technology.This paper identifies the technologies currently shaping society and considers the ethical,and social consequences of the medical metaverse and digital twin in that future society.

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

There is shortage of organs,including kidneys,worldwide.Along with deceased kidney transplantation,there is a significant rise in live kidney donation.The prevalence of prediabetes(PD),including impaired fasting glucose and impaired glucose tolerance,is on the rise across the globe.Transplant teams frequently come across prediabetic kidney donors for evaluation.Prediabetics are at risk of diabetes,chronic kidney disease,cardiovascular events,stroke,neuropathy,retinopathy,dementia,depression and nonalcoholic liver disease along with increased risk of all-cause mortality.Unfortunately,most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period.There is lack of prospective long-term studies to know about the real risk of complications after donation.Furthermore,there are variations in recommendations from various guidelines across the globe for donations in prediabetics,leading to more confusion among clinicians.This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients.This review focuses on pathophysiological changes of PD in kidneys,potential complications of PD,other risk factors for development of type 2 diabetes,a review of guidelines for kidney donation,the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.

Designing a medical ethics curriculum in ophthalmology

Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology training program.A number of barriers exist in most ophthalmology departments:trainees may think ethics is of secondary importance compared to core basic and clinical science topics;most ophthalmology faculty have no formal degree in medical ethics;there is limited didactic time with competing academic,clinical,and surgical priorities;work-hours regulations may limit the time available to deliver“para-professional”lectures;and there is a belief that the medical ethics lectures during medical school is a sufficient amount of coursework to last through a physician’s career with no need for continuing professional development.The four pillars of medical ethics are beneficence,non-maleficence,autonomy,and justice.In addition,morals,ethics,and professionalism are important aspects of sound medical practice.A curriculum specific to medical ethics in ophthalmology can be developed in any of our sub-specialties and include lectures,curated readings,case rounds,and clinic wrap-up sessions.Ethical considerations are part of everyday clinical practice,and a structured ethics curriculum can be incorporated into ophthalmology training programs.The concept of backward design can be used to structure the curriculum,starting with the expected outcome,then designing authentic assessments,and finally putting together a learning plan that has students actively involved in ethical discussions.This paper will provide a guide to developing an ethics curriculum for an ophthalmology training program utilizing the concept of backwards design and guide the reader through the process of developing expected learning outcomes,authentic assessments,and a unified learning plan.

On Evaluating University Teachers’ Morality and Ethics in the New Era

University teachers play an important role in promoting moral and political education among university students.Regular and long-term construction of teachers’morality and ethics will contribute to the success of the fundamental task of cultivating talents.The present study proposes that due to the multiple identities of university teachers,it is necessary to evaluate the construction of teachers’morality and ethics in terms of what to evaluate and how to evaluate?It is expected that the attempt will provide useful guidance for the construction of university teachers’morality and ethics.

The Value and Realization Strategy of Teacher Ethics Construction in Colleges and Universities under the Perspective of“Cultivating People by Virtue”

“Cultivating people by virtue”has become the foundation of China’s education,and is the top priority of college education.“Only the learned can become teachers,and only those who behave properly can become role models”.The construction of teachers’ethics in colleges and universities is the premise of realizing the fundamental task of moral education,the need of teachers,the key to realizing the great rejuvenation of the Chinese nation,and it is also the way to correct the bad atmosphere in colleges and universities.In the construction of teachers’ethics,teachers should understand their roles and improve their professional ethics,schools should improve the guarantee system of teachers’ethics construction,meanwhile,improve the status of teachers and create a social environment of respecting teachers and valuing teachers.

Levinas on the Ethics of the Other

The traditional mainstream of political philosophy establishes its thoughts on the subjectivity of“I”,which also formats its ethics of justice and freedom on the ground of selfness for itself and by itself.Political philosophers also incline to generalize and neutralize in labelling persons into the abstract concepts which ignore their particularity and diversity;as a result,this led to devastative consequence politically for the other,and also jeopardized the“I”.Hence Emmanuel Levinas provides his solution to this dilemma in an attempt to put the ethics of justice on the ground of the other.Justice for the other is the starting point for the political ethics.The other is the absolute infinity which cannot be encompassed by any conceptual generalization.It is otherness of the other that actually constitutes the selfness of“I”.The freedom of the other guarantees the freedom of“I”.Human being is initially ethical being.Justice for the other is the real foundation in securing justice for“I”.This mutual horizon of the other and I has primitive implication for the genuine ethics.

Recognition of Ethics and Sustainability:A Case Study of Coca-Cola

Corporate ethics and sustainable development are receiving increasing attention in today’s society.More and more companies are realizing that ethical and sustainable development is not only a requirement for fulfilling social responsibility but also a key factor for achieving long-term growth and sustainable competitive advantage.As a result,companies are integrating ethics and sustainability into their strategies,decisions,and operations to achieve both business success and social benefit.However,some companies shout sustainability and environmental protection slogans;the actual practice differs from the claim.This paper combined the planning and actual data of the Coca-Cola Company and found that the Coca-Cola Company was suspected of greenwashing.While Coca-Cola does contribute to the environment,there is a difference between what it does and what it says.As for the possibility of this problem,the article also makes a relative solution and assessment.

Hierarchical Media Ethics in the Digital Age: An Analysis of the “Primary School Student Lost Homework in Paris” Incident

In the digital age,traditional media ethics norms lack sufficient explanatory power and binding force in practice.This paper uses the“Primary School Student Lost Homework in Paris”incident as a case study to explore the ethical controversies surrounding the dissemination of this event.By adopting a hierarchical media ethics perspective,the paper dynamically examines the ethical conduct of various communicators,elucidates the ethical responsibilities of each party involved,and reveals the complexity of communication ethics in the digital age.

Exploring the Long-Term Mechanism of the Construction of College Teachers’Ethics in the New Era Under the Concept of“Sanquan Education”

This paper takes the long-term mechanism exploration of the construction of teachers’ethics in the new era under the concept of“Sanquan education,”aiming to explore how to establish a long-term mechanism of the construction to meet the needs of college education development under the background of the new era.A series of targeted measures and suggestions are put forward,including improving the system and mechanism,strengthening the education and training of teachers’ethics,and establishing the evaluation and assessment mechanism.The implementation of these measures can promote the formation of the long-term mechanism of the construction of teachers’ethics in colleges and universities,improve teachers’ethics and behavior quality,and provide strong support for the development of education in colleges and universities.

Effectiveness of Comprehensive Nursing Management in Enhancing Blood Donation Outcomes and Donor Experience: A Comparative Study

Objective:To assess the management effect of comprehensive nursing management on blood donation services in blood stations.Methods:Sixty-four individuals who donated blood at a blood station between September 2021 and September 2023 were selected and randomly assigned into two groups of 32 each.The first group received comprehensive nursing management,while the second group received routine nursing management.Blood donation indexes and observational indexes such as adverse reactions were compared between the groups.Results:The total blood donation volume and qualified blood donation volume were higher in the first group than in the second group.The amount of discarded blood and the rate of blood discards were lower in the first group compared to the second group(P<0.05).Additionally,the adverse reaction rate in the first group was lower,the blood donation comfort scores were higher,the psychological state scores were lower,and the quality of care scores were higher than those in the second group(P<0.05).Conclusion:Comprehensive nursing management can improve the efficiency of blood donation,reduce the rate of blood discards,decrease the incidence of adverse reactions,alleviate negative psychological states of blood donors,and enhance both the comfort level of blood donation and the quality of care provided.

The Price of Engineering Ethics, a Personal Story

There are costs for doing the right thing,but regret is not one of those costs.I learned this lesson the hard way throughout a 42-year engineering career.As a young engineer,raising a family,I was more adaptable to management mandates,i.e.,I was more willing to be unethical to keep my job to make money and have health insurance for my family.As I grew in age,experience,and stamina,I was less adaptable,i.e.,I was more ethical.This article tells this story through events at various times in my engineering career1.Ethics define how we do the right thing.

Perspectives from a publishing ethics and research integrity team for required improvements

It is imperative that all stakeholders within the research ecosystem take responsibility to improve research integrity and reliability of published research.Based on the unique experiences of a specialist publishing ethics and research integrity team within a major publisher,this article provides insights into the observed trends of misconduct and how those have evolved over time,and addresses key actions needed to improve the interface between researchers,funders,institutions and publishers to collectively improve research integrity on a global scale.

An overview on ethical issues about sperm donation

Beyond the scientific progress in assisted reproductive technologies （ART）, it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered and discussed by government and non-governmental agencies, the public, media and academic institutions in many countries. Recommendations and guidelines concerning sperm donation issues vary from country to country and between professional groups within countries. This paper attempts to present an overview of findings and reports from various agencies concerning the ethics of sperm donation. The following topics are considered： limiting the number of donor offspring; minimizing risk of infection and genetics from sperm donors; age requirements for sperm donors; and anonymity versus non-anonymity of sperm donors. The diversity of policies shows that each country has its unique set of guidelines tailored toward its own specific needs. Similarly, countries designing their own procedures and guidelines concerning reproductive medicine must tailor them toward their own needs and practical considerations. In China's Mainland, the anonymous policy for sperm donation should still be carried out, and the number of donor offspring should be revaluated. ART procedures must be conducted in a way that is respectful of those involved. Ethical principles must respect the interests and welfare of persons who will be born as well as the health and psychosocial welfare of all participants, including sperm donors.

Changing landscape in living kidney donation in Greece

Patients with end-stage renal disease in Greece are facing long waiting times to receive a kidney transplant from a deceased donor.Living kidney donation offers a valuable alternative that provides optimal outcomes and significantly expands the donor pool but still remains relatively underutilised.Developments around the world in the field of kidney transplantation mandate a change in current practice to include additional options for living donation through paired exchange,antibody-incompatible transplantation and other strategies,following careful consideration of the cultural and ethical factors involved in these complex clinical decisions.An increase in living donation rates may be achieved in several ways,including targeted campaigning to overcome potential barriers.Educating clinicians on transplantation will prove as equally important as informing patients and prospective donors but requires training and resources.Adoption of established practices and implementation of new strategies must be tailored to the needs of the Greek donor and recipient population.Local beliefs about donation,perception of associated risk and other social characteristics must be considered in the design of future strategies.Facilitating living donation in a safe environment with appropriate donor and recipient education will form the solid foundation of a new era of kidney transplantation in Greece.

Harnessing Blockchain to Address Plasma Donation Network Challenges

Plasma therapy is an extensively used treatment for critically unwell patients.For this procedure,a legitimate plasma donor who can continue to supply plasma after healing is needed.However,significant dangers are associated with supply management,such as the ambiguous provenance of plasma and the spread of infected or subpar blood into medicinal fabrication.Also,from an ideological standpoint,less powerful people may be exploited throughout the contribution process.Moreover,there is a danger to the logistics system because there are now just some plasma shippers.This research intends to investigate the blockchain-based solution for blood plasma to facilitate authentic plasma transfer.Blockchain parameters,including electronic identification,chain code,and certified ledgers,have the potential to exert a substantial,profound influence on the distribution and implementation process of blood banks.To understand the practical ramifications of blockchain,the current study provides a proof of concept approach that aims to simulate the procedural code of modern plasma distribution ecosystems using a blockchain-based architecture.The agent-based modeling used in the testing and evaluation mimics the supply chain to assess the blockchain’s feasibility,advantages,and constraints for the plasma.

Older liver grafts from donation after circulatory death are associated with impaired survival and higher incidence of biliary non-anastomotic structure

Background:Grafts from older donors after circulatory death were associated with inferior outcome in liver transplants in the past.But it has seemed to remain controversial in the last decade,as a result of modified clinical protocols,selected recipients,and advanced technology of organ perfusion and preservation.The present study aimed to examine the impact of older donor age on complications and survival of liver transplant using grafts from donation after circulatory death(DCD).Methods:A total of 944 patients who received DCD liver transplantation from 2015 to 2020 were included and divided into two groups:using graft from older donor(aged≥65 years,n=87)and younger donor(age<65 years,n=857).Propensity score matching(PSM)was applied to eliminate selection bias.Results:A progressively increased proportion of liver transplants with grafts from older donors was observed from 1.68%to 15.44%during the study period.The well-balanced older donor(n=79)and younger donor(n=79)were 1:1 matched.There were significantly more episodes of biliary nonanastomotic stricture(NAS)in the older donor group than the younger donor group[15/79(19.0%)vs.6/79(7.6%);P=0.017].The difference did not reach statistical significance regarding early allograft dysfunction(EAD)and primary non-function(PNF).Older livers had a trend toward inferior 1-,2-,3-year graft and overall survival compared with younger livers,but these differences were not statistically significant(63.1%,57.6%,57.6%vs.76.9%,70.2%,67.7%,P=0.112;64.4%,58.6%,58.6%vs.76.9%,72.2%,72.2%,P=0.064).The only risk factor for poor survival was ABO incompatible transplant(P=0.008)in the older donor group.In the subgroup of ABO incompatible cases,it demonstrated a significant difference in the rate of NAS between the older donor group and the younger donor group[6/8(75.0%)vs.3/14(21.4%);P=0.014].Conclusions:Transplants with grafts from older donors(aged≥65 years)after circulatory death are more frequently associated with inferior outcome compared to those from younger donors.Older grafts from DCD are more likely to develop NAS,especially in ABO incompatible cases.

Health-related quality of life of pediatric living donor liver transplantation donors who undergone donation surgery for 10 years

Objective:To investigate the quality of life(QOL)of living donor liver transplantation(LDLT)donors.Methods:The Euro Qol 5-dimensional questionnaire(EQ-5D)was used to measure the QOL of donors.Results:One donor repor ted“a little problem”of mobility(MO),and 2 donors(9.1%)repor ted“a little problem”of usual activities(UA).Moreover,there were 8 donors(36.4%)and 7 donors(31.8%)declaring“a little problem”of pain/discomfor t(PD)and anxiety/depression(AD),respectively.And both dimensions have a donor repor ting“moderate problem.”The mean visual analog scale(VAS)was 83.1±12.4.Conclusions:Donors can gain a stable and preferable QOL after donation in both the shor t and long terms.ED-5D application in the field of liver transplant could be an effective choice in QOL studies.

Kant and Confucius:Moral Ethics Behind Western and Eastern Approaches to International Relations

International relations(IR)as a discipline is currently experiencing a crisis that may be viewed as a protest against the Euro-centric theories in humanities and the Western view on global politics,some of the most vocal opponents coming from Asia,with China at its core.This paper aims to compare the principles that depict moral ethics serving as a base for political idealism in the West and the East with Kant’s views as a foundation for Western idealism and Confucius’s ethical theory as a ground for an ideal society from the Asian perspective.The comparison is conducted along the following axes:the notions of autonomy,will,and freedom,initially developed to depict an ideal world order in the Kantian view.As a result of this comparison,the common feature between the two types of ethics,namely the strive for human dignity,becomes apparent.In conclusion,the paper suggests that researchers should concentrate on common features in the two philosophies instead of juxtaposing their apparent differences,which politically reflect the opposition of individualism and collectivism.Stress on human dignity shall become a unifying factor in modern international politics instead.