Since its introduction in 2011, noninvasive prenatal testing (NIPT) has spread rapidly around the world. It carries numerous benefits but also raises challenges, often related to sociocultural, legal, and economic contexts. This article describes the implementation of NIPT in nine countries, each with its own unique characteristics: Australia, Canada, China and Hong Kong, India, Israel, Lebanon, the Netherlands, the United Kingdom, and the United States. Themes covered for each country include the structure of the healthcare system, how NIPT is offered, counseling needs and resources, and cultural and legal context regarding disability and pregnancytermination. Some common issues emerge, including cost as a barrier to equitable access, the complexity of decision-making about public funding, and a shortage of appropriate resources that promote informed choice. Conversely, sociocultural values that underlie the use of NIPT vary greatly among countries. The issues described will become even more challenging as NIPT evolves from a second-tier to a first-tier screening test with expanded use.
1 January 2020 in American Journal of Orthopsychiatry
This mixed-methods study aimed to explore the experiences of screening, assessment, diagnosis, and intervention for autism spectrum disorder (ASD) among 249 parents of children with ASD in Hong Kong. Participants completed a survey and responded to open-ended questions regarding their experiences and views of ASD service provision. The quantitative analysis focused on (a) assessing parents' experiences of key milestones, including the time to access, professional support and consultation, referral and follow-up, and (b) examining the correlates of the milestone experiences. Qualitative themes focused on the contexts of parents' difficulties and views of ASD service provision. A joint display presented the integration of converging the quantitative and qualitative data. There were significant delays from screening and diagnosis to intervention due to limited resources for ASD. Although the government surveillance system facilitated access to screening, a delay in the entry to intervention remained. Parents' narratives of frustration and confusion with ASD services reflected a lack of a coherent system for diagnosis and family needs assessment. Quality service provision for ASD requires integrated efforts of early identification, referral, and psychoeducational family support. Unbalanced resources between screening and intervention in public pediatric care settings should be addressed to meet the unmet needs of children with ASD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
27 October 2020 in International Journal of Ethics Education
Bioethics Education in the Anglo-European context developed since 1970 and was incorporated into the undergraduate and postgraduate education, residency training, and continuous education. In the Asia-Pacific region, bioethics education is less structured and often dependent on contextual constraints. This paper provides a cross-sectional analysis, describing institutional experiences in developing bioethics curriculum at two medical schools in Malaysia and Hong Kong. The medical programmes of the two institutions are distinctive in terms curriculum framework, teaching approach, and topic selection, and common challenges include implementation of bioethics courses, students’ resistance to bioethics, and limited teaching capacity, emerged as they evolve. The reported experiences revealed that there is room for improvement regarding how medical schools integrate bioethics education in regions where curriculum development remains at an early stage. At least, a bioethics education requires both top-down support from the faculty to improve teaching and educational quality, as well as from the bottom-up approach to empower students to raise awareness and concerns toward bioethics, and helps students developing reasoning through challenging issues.
1 January 2019 in Journal of Medical Education and Curricular Development
Introduction: A global trend in medical education is the inclusion of bioethics teaching in medical programme. The objective of this article is to describe the current state of bioethics education in the medical programme among Malaysian medical schools. Method: A national survey was conducted among Malaysian medical schools between January and March 2019. One representative from each medical school was invited to respond to the survey. Respondents were faculty members involved in teaching and assessment of bioethics in their medical schools, or/and in developing and coordinating bioethics curriculum. Descriptive statistics were reported. Findings: Out of 30 medical schools, 11 completed and returned the survey (overall response rate = 36.7%). Of these 11 schools, 6/10 (60%) were from public institutions while 5/20 (25%) were from private institutions. All except 1 school implemented a formal bioethics curriculum. A wide range of bioethics topics are currently taught in the medical programme. The majority involved in teaching bioethics were health care professionals (mainly clinicians), followed by lawyers. Lecture and attendance, respectively, are the most common teaching and assessment method. Major barriers to the implementation of bioethics education included limited qualified teaching staff (6/11 = 54.5%), no established curriculum to follow (5/11 = 45.5%), limited financial resources to hire qualified staff (4/11 = 36.4%), and no consensus among faculty members (4/11 = 36.4%). Conclusion: Bioethics education in Malaysia is relatively new and mostly limited by a shortage of scholars in bioethics. National support and institutional collaboration in providing bioethics training is the key to enhance the quality of bioethics education.