African journal of medicine and medical sciences
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The diagnosis of cancer can devastate the physical, emotional, and socio-economic life of an individual. Caring for most cancer patients presents serious ethical challenges to physicians and other health workers. Inclusion of cancer patients in research could be no less challenging. ⋯ However, where these are in place, the need for recourse to philosophical approach, especially virtue ethics in analyzing and resolving ethical concerns in clinical practice cannot be overemphasized. This paper highlights the burden of cancer in Nigeria and the ethical challenges of clinical management of cancer patients, using a case study. The role of clinical ethics and health research ethics committees as well as the justification for virtue ethics above principlism in handling ethical issues in cancer management and research in Nigeria were highlighted.
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Cancer is a worldwide public health problem causing increasing morbidity and mortality, particularly in the developing world. Underlying trends are changing the pattern of cancer and this is also being influenced by the HIV/AIDS pandemic, particularly in Sub-Saharan Africa. Even though the pattern of cancer varies across Africa, there are identifiable trends. ⋯ Training of health care workers to diagnose cancer and treat it effectively within limited budgets is needed. Research to develop these new treatments and others, particularly from natural products is urgently needed and this can be done safely within established health research ethics regulatory frameworks. Several opportunities for collaborative research and training include an update of the epidemiology of cancers in African females; the relationship between HIV and other carcinogenic viruses; biological factors making cancers in Africa more lethal; cheaper vaccines that will be more available and easier to store and hence can be included in the immunization programme in African countries and development of vaccines like the HPV against other uncommon serotypes of the virus.
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Operating rooms (OR) in hospitals represent big investments and must be utilized efficiently. Inaccurate scheduling of OR resources often results in delays of surgery or cancellations of procedures. These are costly to the patient, surgical team and hospital. ⋯ Another 50% of the respondents knew little about the mode of appealing against unfavourable allocation decisions. Participants' open ended responses revealed that hospital executives and a few consultant surgeons control the allocation of OR resources, with little recourse to OR personnel's concerns. If operating theatre stake holders are excluded in the planning, allocation and evaluation of OR resources, the efficiency required in surgical services would never be realized irrespective of the dexterity of the surgical team.