Prof. Rafia Ghubash

2017

Ethical issues facing research integrity in the Arab region

TWAS – ARO Roundtable on Responsible Science

28-29 November 2017

Bibliotheca Alexandrina Conference Center

ETHICAL THINKING

15

– A shift from seeing oneself as the moral universe (egocentrism) to following

social rules (e.g. one should stick to the speed limit) to holding reasoned

principles (e.g. one should adjust one’s car speed for the benefit of other road

users even in the absence of a speed limit).

Figure 1. Indicators of progression in ethical reasoning.

Main ethics issues

The main areas that are addressed during the Ethics Appraisal procedure and in the Ethics Self-Assessment guidance document include:

1. Human embryos and foetuses

2. Human beings

3. Human cells or tissues

4. Personal data

5. Animals

6. Non-EU countries

7. Environment, health & safety

8. Dual use

9. Exclusive focus on civil applications

10. Potential misuse of research results

11. Other ethics issues This presentation shall neither be binding nor construed as constituting commitment by the European Commission

1-Ethics issues Checklist: 2- How do I deal with the issues? 3- What do you need to provide? 4- Background documents and further reading

Self-Assessment Guidance Key Document

This presentation shall neither be binding nor construed as constituting commitment by the European Commission

H2020-ITN-2016 Coordinators Day

Ethics & Research Integrity

Timea BALOGH

Research Executive Agency

Unit REA-A1

First Epidemiological study in UAE 1988 -1992

Summary of Diagnostic Breakdown of Cases

According to ICD-9 Coding Categories

Depressive Disorders 13.7%

Anxiety Disorders 7.0%

Psychotic Disorders 1.9%

Total Mental Disorders Rates 22.7%

Northern European Countries 7.5 to 12.2

Mediterranean 19.4 to 22.6

United Arab Emirates 22.7

Africa 27.0

Prevalence Rates Comparison of Mental Disorders in Females in Different

Populations

Prevalence Rates of Mental Disorders in Females in Dubai

1st Study:

Attitude- behaviour Difference in Socio-Cultural Change

Scores in Relation to Psychiatric Morbidity

Group Non-cases Cases

N % N %

A 30 62.5 18 37.5

B 66 78.6 18 21.4

C 74 83.1 15 16.9

D 53 79.1 14 20.9

2 = 8.0, df = 3, p = 0.047

Minus values: bahaviour score is more than attitude score

Plus values: attitude score is more than bahaviour score

Group a: attitude index-behaviour index >0.1

Group b: attitude index-behaviour index 0 to <0.1

Group c: attitude index-behaviour index <0 to –0.1

Group d: attitude index-behaviour index <-0.1

Post Partum Psychiatric Morbidity:

The Dubai Study

Psychiatric Morbidity- Prevalence of caseness

• (SRQ>6) 24.5%

• (1st Week ) using (EPDS) 17.8%

• (8th week) using (PSE) 15.8%

• (30th week) using (PSE) 4.2%

(Rafia Ghubash, and M. T. Abou-Saleh et al)

2nd Study:

3rd Study:

Community-Based Psychiatric Survey in the UAE:

Al-Ain Study – 1998

Overall rate 7%

Women 22%

Men 24%

Depressive Disorder Male Female Overall

2.5% 9.5% 6.0%

(Prof. M. T. Abou-Saleh, Dr. Rafia Ghuvash and Dr. Tewfik Daradkeh)

3rd Study:

Measuring the Health of the Nation United Arab Emirates Health & Lifestyle Survey 2000 (UAEHALS2000)

• Describe health status of UAE nationals

• Assess life style including diet, physical activity and smoking

• Study health care utilization

• Compare findings with other regional & international surveys

Objectives

Acknowledgement

1.UAE University – financial support

2.Ministry of planning, central dept. of statistics – sample, data collection in Abu-Dhabi

3.Ministry of health & Ministry of Interior – data collection in Al-Ain and Abu-Dhabi

4th Study:

Many More …

17

International publications per year (1996-1999)

0

2

4

6

8

10

12

14

Saudi UAE Tunis Egypt Kuwait Morroco Lebanon Jordan

Ethics in Psychiatry

“ETHICS” – What the Word Means

Ethos () is the root of ethica (), both terms are important for

understanding the meaning of right and wrong.

The Greek word ethos refers to the basic orientations or disposition of a

person toward life, the word was used to refer to what a person carries

within himself

• Interior attitude

• Disposition

• Relationship to him/herself and to the world around him/her

• Ethos, in the sense of a person’s very inner being, is the root or font of all

particular acts.

Contemporary medical ethics emphasize concern with external acts

Medical ethics in our day, however, is so preoccupied with particular

actions that the older, original meaning is ignored.

General and Global Principles

Respect for human life and recognition of the inherent worth

and dignity of individuals and their right to confidentiality.

Respect for persons recognizes all people as autonomous

agents and requires that their choices (consent or refusal) be

observed.

Doing good (beneficence) and doing no harm (non-

malfeasance) are two complementary ethical principles that

impose affirmative duties on researchers to maximize any

benefits for subjects and minimize risks to them.

Justice requires that all humans be treated equally.

Basic Concepts in Psychiatric Ethics

• Every patient must be offered:

– Best therapy available

– Protection from harm

– Proper care.. respecting patient’s autonomy

– Informed consent ..The patient must trust the physician to disclose intimate concerns

• Confidentiality:

– Situations, which override confidentiality

– Threats to confidentiality

– Legal protection of confidentiality

Relationship of Law and Ethics

Central to all medical ethics is the conflict between the

autonomy of the patient (e.g. concerning consent) and

the duty of care of the doctor (e.g. in negligence, consent

to treatment)

–Principle of autonomy i.e. patient has the right to control his/her own body.

–The law may also define absence of consent (in spite of patient saying ‘yes’ ) on basis of legal invalidation of ‘apparent consent’.

–What does consent mean?

–There is no valid (ethical) consent without all elements satisfied.

–How do you define each element?

Code of Ethics

• Consider first the well-being of the patient.

• Honor your profession and its traditions.

• Recognize your limitations and the special skills of others in the prevention and treatment of disease.

• Protect the patient's secrets.

• Teach and be taught.

• Remember that integrity and professional ability should be your only advertisement.

• Be responsible in setting a value on your services.

The Canadian Medical Association Code of Ethics Annotated for Psychiatrists.

Prepared by Clive Mellor, MD

Hawaii Declaration

To obtain the patient's consent before he is

presented to a class or meeting. All reasonable

measures should be taken to ensure that the

anonymity and reputation of the patient is

preserved.

Psychiatrist’s Rights

• To refuse to accept a patient

• To discontinue, or arrange alternative

treatment

The refusal to accept a patient, or the

discontinuation of care, should be adequately

explained to a patient beforehand, and the

alternatives which are available to the patient

discussed.

“Societies that discriminate by gender pay a

high price in their ability to develop”

The World Bank

(Engendering Development, 2002)

International and regional initiatives for

the empowerment of women scientists

Gender advisory board

The IPAZIA UNESCO program

UNIFEM Arab States Regional Office (UNIFEM ASRO)

L’Oreal for Women in Science

UNESCO chairs “Women, science and Technology”

Third World Organization for Women in Science (TWOWS)

ESCWA Centre for women

International Network of Women Engineers and scientists (INWES)

“Data bases for Arab women specialized in S&T should be created and a periodical bibliography giving their curriculum vitae and achievements should be prepared. The information gathered should be circulated between Arab countries and international organizations through information networks such as the Internet .”

“The interaction of Arab Women with Science and

Technology”- The Abu Dhabi Declaration

September 2003 A regional meeting was held in Cairo in which it was

decided that an Arab Network for Women in Science and

Technology (ANWST) would be established.

2003-2004

Two preparatory meetings were then held at the

Arabian Gulf University

Representatives from academic institutions, NGOs

and private sector were invited to participate in these

meetings

Launching the ANWST network : February 6-7, 2005

The Arab Network for Women in Science and Technology was launched in

Arabian Gulf University in the Kingdom of Bahrain under the patronage of

H.H. Shaikha Sabeeka Bint Ibrahim Al-Khalifa, Wife of His Majesty the King of

Bahrain and Chairwoman of the Supreme Council of Women

ANWST: Goal

To build an integrated scientific

community capable of meeting the

challenges of sustainable development in the Arab Region

through empowering women and

strengthening their effective

participation and contribution in

science, technology and

innovation.

ANWST: Objectives

Crafting strategies,

Build bridges

Enhance awareness

Capacity building of Arab women

Training opportunities

Serve as a catalyst

ANWST : To achieve

Fostered participation of young women in the field of science and

technology.

Acknowledged presence of Arab women in the management of public and

private sector endeavors.

Strengthened collaboration and improved communication among women

scientists in the Arab region.

Enhanced visibility of Arab women scientists in scientific societies and

professional meetings.

Increased training and research opportunities to Arab women, especially

marginalized/underprivileged, through study grants and fellowships.

Election of the first ANWST executive board ( 2005 )

ANWST Meeting in Alexandria : March 2005

SCIENCE

29 April 2005 American Association for the Advancement of Science (AAAS), Washington DC, U.S.A .

Volume 308, number 5722, page 629

Not alone. As one of only two women to lead a university in the Arab world, epidemiological psychiatrist Rafia Ghubash belongs to an exclusive club. But the 49-year-old president of the Arabian Gulf University (AGU) in Bahrain is working hard to lose that status. This month Ghubash launches a network to help more women scientists attain leadership positions and to attract more women into science. The initial goal will be "to simply make them aware of how many they are and provide role models," says Ghubash. That awareness, she hopes, will counter pressure on women with undergraduate science degrees to become "teachers, nurses, or to drop out entirely to raise families". Only a few hundred women from the 22 Arab countries have signed up for the network so far, but Ghubash expects "at least a million" after its official launch at a meeting of women scientists at AGU on 15 May. A Web site based at AGU will hold forums on issues such as gender bias and feature a scientific newsletter. In a few months, women will be able to post their CVs online and hunt for scholarships and jobs. CREDIT: ARABIAN GULF UNIVERSITY

Pioneers

Challenges facing ANWST

Initial Challenges :

To agree on the definition

of “ women scientists”

To develop a mechanism

for an effective fund-

raising campaign.

Today ....

To be able to

accommodate the flood

of interest and

enthusiasm from Arab

women scientists in

ANWST since the

launching of the network .

Arab

Network for

Women in

Science and

Technology

Presented by:

Professor Rafia Ghubash

Former President of Arabian Gulf University

President-ANWST Executive Board

A catalyst for

empowering Arab women

in science and

technology

ANWST: Where do we

go from here?