A2 Refereed review article in a scientific journal
The application of medical ethics in the developing countries - A neurosurgical perspective
Authors: Hossain, Iftakher; Hutchinson, Peter; Kawsar, Khandkar; Kolias, Angelos; dos Santos, Adriana Libório; Esene, Ignatius N.; Thango, Nqobile; Baticulon, Ronnie; Laki, Beata; Ammar, Ahmed
Publisher: ELSEVIER
Publishing place: AMSTERDAM
Publication year: 2024
Journal: Brain and Spine
Journal name in source: BRAIN AND SPINE
Journal acronym: BRAIN SPINE
Article number: 103921
Volume: 4
Number of pages: 7
eISSN: 2772-5294
DOI: https://doi.org/10.1016/j.bas.2024.103921(external)
Web address : https://doi.org/10.1016/j.bas.2024.103921(external)
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/458940787(external)
Introduction: Neurosurgery is one of the rapidly evolving specialities of medical science, where the neurosurgeons have to provide evidence-based interventions in life threatening conditions maintaining the ethical standards.
Research question: This narrative review sheds light on the current hindrances of the ethical aspects of neurosurgical practice in low and middle-income countries (LMICs) and provide some feasible solutions for future.
Material and methods: A literature search was conducted using PubMed, Scopus and ISI web of knowledge focused on articles in English with the words "medical ethics" together with the words "neurosurgery", "ethical practice", "low and middle-income countries", "surgical innovation", "randomized clinical trials" and "outcome" alone or in combination.
Results: Due to the lack of neurosurgeons and essential infrastructures in LMICs, the practical application of medical ethics is more complicated in the field of neurosurgery. Main obstacles to conduct preclinical and clinical research in the LMICs are the lack of proper ethics committees, quality data, trained manpower and sufficient research funding. Implementation of randomized clinical trials (RCTs) is also difficult for the neurosurgeons working in LMICs.
Discussion and conclusion: To improve the situation, socio-economic development, including educating the citizens of these countries about their rights, functional regulatory bodies like medical and dental councils, teaching the neurosurgeons about the internationally recognized medical ethics, quality control regulations by the ministry of health and welfare, and more funding for the health care sectors are urgently needed. Global collaboration is needed to help the LMICs to provide their patients international but "customized" standard care.
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Funding information in the publication:
The Integra EANS Research Grant (IH), The Finnish Medical Foundation (IH), The Päivikki and Sakari Sohlberg Foundation (IH), The Paulo Foundation (IH), The Finnish Cultural Foundation (IH), Government's Special Financial Transfer tied to academic research in Health Sciences (Finland) (IH), Maire Taponen Foundation sr (IH), and NIHR Research Professorship and the NIHR Cambridge BRC (PJH). Special note: The abbreviation LMICs is one category of the countries classification by their income. In this classification, World Bank differentiates low-income countries (LICs), low- and middle-income countries (LMICs), lower-middle-income countries (LoMICs), upper middle-income countries (UMICs), and high-income countries HICs. In short, that means, poorer regions belong to the LICs, LMICs and LoMICs, e.g. most of Africa, a big part of Asia, part of Southern Europe, etc., and the richer ones belong to the UMIC and HIC, such as North America and a part of Latin America and the Caribbean. Main GNI (Gross National Income) intervals: LICs with $1135 or less GNI per capita, LMICs between $1136 and $ 4465 GNI per capita, UMCs between $ 4466 and $ 13,845 GNI per capita, and HICs with $ 13.846 or more GNI per capita. See more: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups (last visited: December 05, 2023)
