Current state of ethical challenges reported in Saudi Arabia: a systematic review & bibliometric analysis from 2010 to 2021

Abstract

Background Over the past few years, five domains of importance about the current state of bioethics in Saudi Arabia have shaped the perspective of most research: doctor-patient relationship, informed consent, do-not-resuscitate, organ donation, and transplantation, medical students’ knowledge and attitudes about medical ethics curriculum. This systematic review aimed to systematically identify, compile, describe and discuss ethical arguments and concepts in the best-studied domains of bioethics in Saudi Arabia and to present cultural, social, educational, and humane perspectives. Methods Six databases were searched using Boolean operators (PubMed, Embase, Web of Science, Scopus, CINAHL, Google Scholar) from December 2020–June 2021. The search and report process followed the statement and flowchart of preferred reporting items for systematic reviews and meta-analyses (PRISMA). Resutls The search resulted in 1651 articles, of which 82 studies were selected for a final review and assessment. There is a gradual increase in research, whereby a substantial increase was observed from 2017. Most of the published articles focused on ‘Organ Donation & Transplantation’ with 33 articles, followed by ‘Doctor-Patient Relations’ with 18 publications. Most of the published articles were from Central Province (33), followed by Western Province (16). The authorship pattern showed a collaborative approach among researchers. The thematic analysis of keywords analysis showed that ‘Saudi Arabia,’ ‘attitude PHC,’ ‘organ donation,’ ‘knowledge and education,’ and ‘donation’ have been used the most commonly. Conclusion This systematic quantitative synthesis is expected to guide researchers, stakeholders, and policymakers about the strengths and gaps in knowledge and attitudes regarding medical ethics in Saudi Arabia, both among the general public and health professionals.

Ethical uncertainty and COVID-19: exploring the lived experiences of senior physicians at a major medical centre

“…Issues relating to DNR orders, conflicts of interest, patient-provider relationships, justice and reproductive choice are routinely recognised as areas of ethical concern. [51][52][53] Subsequently, several studies recommend more professional ethics codes, clear practice guidelines and a locally informed and culturally sensitive bioethics discipline. 52 53 Attention to moral responsibility is further evident in Saudi ethical scholarship relating to the pandemic.…”

“…In recent years, the identification of specific ethical challenges in the Saudi context has also garnered the attention of researchers. Issues relating to DNR orders, conflicts of interest, patient–provider relationships, justice and reproductive choice are routinely recognised as areas of ethical concern 51–53. Subsequently, several studies recommend more professional ethics codes, clear practice guidelines and a locally informed and culturally sensitive bioethics discipline 52 53…”

Challenges Associated with End-of-Life Care in Saudi Arabia

“…Some of these are common to humanity and transcend cultures, religions, and regions (common morality), while others include responsibilities and professional standards (particular morality) [1][2][3]. Bioethics comprises principles that focus on medical/clinical ethics (issues in healthcare), research ethics (issues in the conducting and implications of research), environmental ethics (issues that arise due to relationships between human activities and the environment), and public health ethics (issues in public health) [3][4][5].…”

“…These principles are also part of the Islamic bioethics applicable in Saudi Arabia, where interest in various codes of medical ethics, as a separate area of scientific research, has grown over the past few years [2][3][4]. In addition, the medical sector in Saudi Arabia is governed by Islamic ethics requiring adherence to Islamic medical ethics, including the observance of fatwas-religious decisions that healthcare providers follow in the Muslim world [3][4][5]. Despite these well-established principles and fatwas covering a wide range of social, religious, and bioethical topics, healthcare providers in Saudi Arabia often face dilemmas in their daily practice [3][4][5].…”

“…In addition, the medical sector in Saudi Arabia is governed by Islamic ethics requiring adherence to Islamic medical ethics, including the observance of fatwas-religious decisions that healthcare providers follow in the Muslim world [3][4][5]. Despite these well-established principles and fatwas covering a wide range of social, religious, and bioethical topics, healthcare providers in Saudi Arabia often face dilemmas in their daily practice [3][4][5].…”