1. Orientation to laws, ethical theory, and ethical principles
1: List the sources of Islamic Law: Qur’an, sunnat, ijma, qiyaas
2: List sources of European Law: statute and common law
3: List the 5 purposes of the Law: morality (din), life, progeny, intellect, and property /resources
4: List the 5 principles of the Law: intention, certainty, injury, hardship, custom
5: Define the various types of legal rulings
7: Discuss the relation of ethics to law: the Islamic vs European perspectives
8: Explain the following Islamic ethical principles: intention, certainty, harm, hardship, and custom.
9: Explain the ethical principles enunciated by Childress and Beauchamps: autonomy, beneficence, nonmalefacence, and justice.
10: Explain religious approaches to ethics: Christian, Buddhist, Hindi, Jewish, Confucian and Taoist
11: List the main provisions of the following international ethical codes: Hippocratic, Nurenberg, Helsinki
2. Introduction to Family Medicine
The family
1. Describe the family as a natural social unit.
2. Describe the fiqh aspects of marriage
3. Describe fiqh guidelines for parents and relatives
4. Describe ethico-legal-fiqh issues of child protection: definition of child protection, limits to parental rights, state intervention to protect children.
Culture
1. Describe the concept of culture: definition, relativism, relation to personality, ethnocentrism
2. Define and illustrate the concept of trans-cultural ethics.
3. List and describe elements of a life-style: essentials of life, dress and ornamentation, entertainment, social failure
Transitions in the status of life: Transitions in the status of health:
1. Describe health: definition, quality, determinants, individual, family, community, protection, and promotion
2. Describe disease / illness: definition, classification, causes, positive and negative attributes and consequences
3. Describe treatment of disease: cure vs prevention, curability of all disease, complementation between prevention and cure, modalities of treatment, doa, and condemnation of superstition.
3. Consultation skills
Consent
1: Discuss patient autonomy: definition, legal and conceptual basis, significance in health care, limitations, patient autonomy vs physician paternalism, second opinion, conflict between human rights and requirements of medical treatment).
2: Discuss physician autonomy with regard to procedures against personal beliefs
3: Discuss competence / capacity: definition, conditions, and testing
4: Discuss informed consent: definition, process, and who asks?
5: Explain the scope of consent: physician choice, physician of a different gender, consent to treatment, and refusal or treatment.
6: Discuss conditions for validity of consent: understanding, disclosure, weigh info, voluntary, aware can refuse
7:List information for informed consent: diagnosis, prognosis, treatment alternatives, risks and benefits
8: Discuss capacity to consent: gal vs specific, tests for capacity, enhancing capacity
9: Discuss consent / refusal for the incompetent (young children, older children, the mentally ill, and the unconscious).
Privacy and confidentiality
1: Define and describe privacy and confidentiality
2: Explain the basis/rationale of confidentiality
3: Describe truthfulness and its role in healthcare
4: Summarize ethico-legal guidelines on disclosure
5: Describe conflict of duties regarding confidentiality and disclosure
6: Discuss special issues relating to disclosure of family or genetic information.
7: Discuss the generation and handling of medical records
8: Discuss ethico-legal aspects of disclosure to the media.
9: Discuss disclosure by doctors with dual obligations
10: Discuss guidelines for physician in court: as a witness of facts vs expert witness
4. Common Health problems in KSA
1. Discuss ethico-legal issues that arise in the treatment of anemic patients
2. Discuss ethico-legal issues in treatment of patients with coagulation disorders
5. Concept & Element of Family Medicine
Patient hygiene and taharat
1: Describe fiqh guidelines for patient hygiene
2: Describe fiqhi guidelines for patients with the following: colostomy, urinal, and discharging fistula
3: List medical procedures that do not nullify wudhu
4: Describe guidelines for wudhu for patients with the following conditions: skin lesions, wounds, bleeding, urinary incontinence, fecal incontinence; limbs immobilized by plaster of paris, hemiplegia, extreme sensitivity to cold or heat, dysfunctional uterine bleeding
5: Describe dry ablution, tayammum: definition, conditions of recommendation: skin and cold, etiquette, soil / sand in the hospital
6: Describe ritual bathing, ghusl, for the sick.
Physical Acts Of Worship For The Sick:
1: Describe fiqh guidelines for salat in the following circumstances: salat with musculoskeletal and neurological disability, joining and shortening salat for a reason; salat for immobilized patient, salat for the blind and deaf, salat in extreme cold/hot weather, salat with extreme thirst or hunger, salat with hemiplegia, salat with vestibular disorders, salat with postural disorders, salat with dysfunctional uterine bleeding
2: Describe fiqh guidelines for saum in the following circumstances: diabetes, ulcers, vomiting, diarrhea
3: Describe fiqh guidelines for hajj in the following circumstances: hajj with muscoskeletal and neurological disability, hajj for the blind and deaf, hajj with vestibular disorders, and hajj with postural disorders.
6. Old age and Osteoporosis
The human life cycle: middle age and the elderly
1. Describe middle age: definition, biological, social, psychological changes in men and women, the midlife crisis, menopausal problems: physical, psycho-social-sexual
2. Describe old age: definition, homeostasis vs homeostenosis, ageing vs disease, characteristics, physical decline, psychosocial functions, care for the elderly: home vs institution, research on the elderly, common health disorders, exemption of the elderly from social and religious obligations
3. Discuss after life: linear vs cyclic concepts.
Geriatric problems
1: Describe how geriatric physical dysfunction ( musculoskeletal, senses, nutrition) affect religious obligations (taharat, wudhu, salat, saum, hajj).
2: Describe how geriatric psychoneurological conditions and dementias affect the following social and religious obligations: civil and financial transactions, salat, saum, hajj
3: Describe guidance on how to deal with the following geriatric psychosocial dysfunctions: depression, dependency/loss of self esteem, sexual dysfunction, poor quality of life, and impaired ability to carry out civil transactions
4: Discuss in general rights and obligations in geriatric disabilities
5: Discuss ethico-legal guidelines for research on the elderly.
Orthopedic problems
1. Discuss ethico-legal issues relating to orthopedic problems: sprains & fractures, orthopedic fixation, osteomyelitis, malignant bone neoplasms (salat, hajj, work-related injury, workmen compensation, factory work with tremors, physical activity, rest, and sleep).
7. DM
1. List ethico-legal-fiqhi issues related to peripheral / diabetic neuropathy
8. Health promotion /prevention
Domestic problems
1. Describe ethico-legal-fiqh issues of addiction and substance abuse: nicotine, drugs, alcohol (causes, prevention and treatment, rehabilitation.
2. Discuss issues of poverty and its impact on health
3. Discuss violence in society.
4. Describe ethico-legal-fiqh issues of child abuse & neglect: definition and classification of abuse, sexual exploitation, child protection, best interests, physician reporting /non-reporting of abuse to authorities: benefits and risks
5. Describe ethico-legal-fiqh issues of women domestic abuse
Physical Activity
1. Discuss fiqh guidelines on physical activity in general: difference between physical activity and physical exercise, health, recreational, and other benefits
2. Discuss fiqh guidelines on standing, sitting, walking and running: purposes, bipedal locomotion, upright posture, dynamic and static balance, postural hypotension in prolonged salat
3. Discuss fiqh guidelines on sports: traditional, violent, participatory & non-participatory
4. Discuss Islamic concepts and fiqh guidelines on sleep and rest: definition, a form of death, purposes, etiquette, dreams, disorders, and legal competence of the sleeping person.
9. GERD,PUD+ non-ulcer dyspepsia
1. Discuss the impact on wudhu, salat, and saum of the following GIT conditions: nausea, vomiting /hemetamesis, peptic ulcer
2. Discuss the impact on wudhu, salat, and saum of the following GIT conditions: rectal bleeding, incontinence, and fistulae.
3. Describe ethico-legal-fiqh issues of renal colic: salat, hajj
10. Back pain
1. List ethico-legal-fiqhi issues relating to spinal injury
2.Describe ethico-legal-fiqh issues of vertebral column pain: spondylosis, intervertebral disease, sponylolidthesis, ankylosing spondylitis, root compression, etc: salat, hajj
11. Clinical skill lab
Diagnostic procedures (history, examination, and investigations):
1: Discuss ethico-legal-fiqh guidelines on history taking: consent, scope, lifestyle questions, confidentiality, and nasiha.
2: Discuss ethico-legal-fiqh guidelines on physical examination: consent, uncovering awrat, and physicians of opposite gender.
3: Discuss ethico-legal-fiqh guidelines on radiological examination: consent and confidentiality of images.
4: Discuss ethico-legal-fiqh guidelines on laboratory tests: consent, confidentiality, and disclosure
5: Discuss ethico-legal-fiqh guidelines on esophagoscopy and colonoscopy: wudhu, salat, and saum
6: Discuss ethico-legal-fiqh issues involved in the aggressive investigation of common symptoms: cost vs risk of missed diagnosis and legal liability for missed diagnosis
12. Thyroid problem (hypo + hyper)
Blood and endocrine and others:
LOB1: Describe ethico-legal-fiqh issues of patho-physiological disturbances: fever, dehydration, infections: wudhu, salat, hajj, civil and financial transactions.
LOB2: Describe ethico-legal-fiqh issues of hematological disorders: anemia, leukemia, lymphoma, coagulation disorders.
LOB3: Describe ethico-legal-fiqh issues of skin disorders: eczema, psoriasis, SLE, etc. LOB4: Describe ethico-legal-fiqh issues of diabetes mellitus (pasa).
13. Slides common skin problems
1. Discuss fiqh issues relating to treatment of skin disorders: eczema, psoriasis, etc.
2. Discuss ethico-legal-fiqh issues in sexually transmitted disease: pre-marital screening, condoms for sexually active teenagers, confidentiality in treatment, partner tracing and notification.
14. Common Health problems in adolescent
1. Discuss adolescence: definition, physical changes, problems of transition, mismatch between biology and wisdom / experience)
2. Discuss youth: definition, stress career vs family, cognition vs emotion, idealism vs pragmatism, and morality vs hedonism.
15 Immunization
1. Describe ethico-legal-fiqh issues regarding public health measures in an epidemic without consent: quarantine, isolation, mass immunization, mass treatment.
2. Describe ethico-legal-fiqh issues regarding disease screening and surveillance.
3. Describe ethico-legal-fiqh issues regarding control of infectious disease: control and eradication, infectious disease control Act.
4. Describe ethico-legal-fiqh issues regarding vaccination / immunization: cost benefit analysis.
5. Discuss ethico-legal issues of isolation, contact tracing, and immunization for cases with contagious respiratory infections.
16. Clinical skill lab
Medical procedures:
1: Discuss the balance of benefit and injury in medical interventions: benefit>injury, benefit<injury, benefit=injury, choice between 2 evils, choice between legality and benefit, individual vs public interest, prohibited vs necessary, and double effect
2: Discuss the doctrine of double effect.
3: Discuss the concept of the slippery slope.
4: Discuss the distinction between ordinary vs heroic means in treatment
5: Discuss the difference in consideration between acts of omission vs acts of commission
6: Discuss the ethico-legal-fiqh issues involved in the use of drugs in sports
7: Discuss the ethico-legal-fiqh issues involved in HIV treatment: compulsory treatment of pregnant HIV+ve, and free retroviral drugs for HIV +ve.
8: Discuss the ethico-legal-fiqh issues involved in the prescriptions and administration of medications: ethico-legal issues, financial violations, conflict of interests, pharmacogenetics, regulations of drug administration, request for lifestyle drugs, and porcine derived anticoagulants
9: Discuss fiqh guidelines on medication and wudhu: oral and rectal routes, vomiting after medication.
10: Discuss fiqh guidelines on medication and saum: oral, rectal, intramuscular, intravenous, and sublingual.
17. Clinical Skills Lab
Surgical procedures
1. Discuss ethico-legal-fiqh issues in disclosure of surgical risk and consent
2. Discuss ethico-legal-fiqh issues in anesthesia: consent, wudhu, and salat
3. Discuss ethico-legal-fiqh issues in blood transfusion: safety, cross matching errors, consent/refusal, selling/buying, unwilling donors, donation by relatives, prisoners, and drug addicts.
4. Discuss ethico-legal-fiqh issues in resuscitation: without consent, principle of certainty about nett benefit, and doctrine of futility
18. Child Development
1. Discuss the intrauterine period: conception, stages, external and internal environments, and ethico-legal implication of the start of life, disorders
2. Discuss infancy and childhood: parenthood, physical, social, and psychosocial growth, and disorders
19. An Approach to a patient with chest pain
1. Describe ethico-legal-fiqh issues of dyspnea due to cardiovascular causes: salat, hajj, saum.
2. Describe ethico-legal-fiqh issues of dyspnea due to respiratory causes: pneumothorax, pulmonary embolism, chronic bronchitis, emphysema: salat, hajj, and saum.
3. Describe ethico-legal-fiqh issues of congestive cardiac failure: saum.
20. An Approach to a patient with Infertility
1. Discuss ethico-legal issues related to assisted reproduction
2. Discuss ethico-legal issues related to stem cell and embryo research
3. Discuss ethico-legal guidelines on genetic technology
21 An Approach to a patient with Depression
1. List ethico-legal-fiqhi issues relating to depressive conditions
2. Discuss the impact of personality disorders on social and religious obligations
3. Discuss the impact of psychiatric conditions on social and religious obligations
4. Discuss stigmatization in psychiatric conditions
5. Discuss issues of confidentiality in psychiatric conditions
6. Discuss the legal impact of loss of competence on religious, social, and civil obligations
7. Discuss ethico-legal issues relating to depression and suicide / para-suicide
22 An Approach to a patient with ( cough) Acute + chronic
1. Discuss the performance of religious obligations (salat, hajj, and saum) for patients with dyspnea due to respiratory causes (pneumothorax, pulmonary embolism, chronic bronchitis, emphysema)
23. Contraceptive Advice & Methods of Contraceptive
1. Explain the difference in legal consideration between contraception as a choice of a couple and contraception as public policy
2. Explain circumstances in which female contraception is allowed even if the husband refuses
3. List and explain guidelines on choice of contraceptive methods
4. List and describe allowed male contraceptive methods.
5. List and describe allowed female contraceptive methods
6. Explain the legal position regarding sterilization
7. List and explain demographic effects of wide-spread contraceptive use.
24. An Approach to a patient with Menstrual Disorder
1. Describe the impact of normal menstruation on religious obligations such as salat, hajj, saum. recitation of the Qur’an, and activities of daily normal living
2. Discuss the impact of pre-menstrual tension on social and religious obligations
3. Discuss the impact of irregular menstruations in the climacteric period on religious obligations (salat, saum, hajj) and social obligations (marriage and sexuality)
4. Discuss the impact of prolonged menstruation on saum, salat, and coitus
5. Discuss the impact of dysmenorrhoea on salat
6. Define menopause and discuss the ethico-legal-fiqhi implications of the following issues: early induction medically or surgically, artificial delay of menopause, and HRT
7. Discuss ethico-legal issues in use of HRT to treat menopausal disorders
8. Discuss ethico-legal and fiqh issues in dysfunctional uterine bleeding.
1. Discuss social and religious obligations for patients with osteoporosis and myasthenia
2. Describe how an immobilized patient can perform ablution
3. Describe 3 ways in which an immobilized patient can pray
4. Describe ethico-legal-fiqh issues of orthopedic problems such as sprains & fractures, orthopedic fixation, osteomyelitis, osteoporosis, malignant bone neoplasms: salat, hajj, work-related injury, workmen compensation, factory work with tremors, physical activity, rest, and sleep
5. Describe ethico-legal-fiqh issues of limb disorders: salat and hajj
6. Describe ethico-legal-fiqh issues of gait disorders (salat and hajj).
7. Describe ethico-legal-fiqh issues of involuntary movements:chorea, athetosis, spasticity etc: salat, hajj, work with moving machinery, driving, accidents in activities of normal living.
8. Describe ethico-legal-fiqh issues of myasthenia gravis: salat, saum, hajj).
9. Describe ethico-legal-fiqh issues of joint disorders with restricted/painful movements:
10. Describe ethico-legal-fiqh issues of osteoarthritis and rheumatoid arthritis: tayammum if cold exercabates the pain, salat, hajj, risk-benefit analysis of chronic pain medication, addiction to analgesics and opiates
26. Clinical Approach to a patient with incontinence
1. Describe ethico-legal-fiqh issues of urinary incontinence, fistulae, and catheters: wudhu, salat, and hajj
2. Discuss ethico-legal issues associated with chronic renal failure
3. Discuss fiqhi issues relating to renal colic
27. How to Approach to a patient with STDS
1. Discuss socio-religious issues relating to human sexuality and human sexual behavior: forms of sexual expression & behavior, regulation of human sexuality, moral/cultural relativism regarding sexual behavior, and guidelines on coitus.
2. Discuss the following ethico-legal-fiqhi issues relating to sexually transmitted disease: pre-marital screening, condoms for sexually active teenagers, confidentiality in treatment with the requirement for partner notification and contact tracing
3. Describe various forms of sexual perversion: background, antecedents, adverse effects, prostitution, abnormal coital behaviors, sexual paraphilias, and criminal sexual aggression, abnormal marital arrangements
4. Describe ethico-legal-fiqh issues regarding HIV testing: premarital testing, voluntary testing, counseling, confidentiality
5. Describe ethico-legal-fiqh issues regarding HIV prevention: free condoms in schools, sterile needles for IV drug users
6. Describe ethico-legal-fiqh issues regarding HIV victimization: discrimination in employment, immigration, and healthcare.
28. An Approach to a patient with Anxiety illness
1. Describe human drives and the genesis of emotions: positive and negative.
2. Discuss ethico-legal issues relating to anxiety disorders
3. Discuss ethico-legal issues relating to stress
4. Discuss ethico-legal issues relating to neurotic / anxiety / compulsive-obsessive disorders
29. How to deal with Medical Error
1. Define and illustrate negligence/malpractice
2. List and describe ingredients of a negligence suite
3. Describe methods of avoiding negligence suits.
4. Define and illustrate the standard of care in the Bolam principle as modified by Bolitho.
30. Documentation And Referral
1. Describe the generation and handling of medical records including the following aspects: the SOAPIE format, various forms of records, characteristics if an ideal record, omitting or removing information.
2. Discuss the legal ownership of medical records
3. Discuss ethico-legal-fiqh issues relating to the following: competent patient access to records, access to records of the incompetent
4. Describe issues relating to the storage and retrieval of records including record security and period of retention.
