Objectives: to assess physicians’ and patients’ views in Saudi Arabia towards involving the patient versus the family in the process of diagnosis disclosure and decision-making, and to compare them with views from the USA and Japan.Design: A self-completion questionnaire was translated to Arabic and validated.Participants: Physicians from different specialties and ranks and patients in a hospital or attending outpatient clinics from 6 different regions in KSA.Results: In the case of a patient with incurable cancer, 67% of doctors and 51% of (...) patients indicated that they would inform the patient in preference to the family of the diagnosis . Assuming the family already knew, 56% of doctors and 49% of patients would tell the patient even if family objected . However, in the case of HIV infection, 59% of physicians and 81% of patients would inform the family about HIV status without the patient’s consent . With regards to withholding ventilatory support, about 50% of doctors and over 60% of patients supported the use of mechanical ventilation in a patient with advanced cancer, regardless of the wishes of the patient or the family. Finally, the majority of doctors and patients were against assisted suicide.Conclusions: Although there was more recognition for a patient’s autonomy amongst physicians, most patients preferred a family centred model of care. Views towards information disclosure were midway between those of the USA and Japan. Distinctively, however, decisions regarding life prolonging therapy and assisted suicide were not influenced to a great extent by wishes of the patient or family, but more likely by religious beliefs. (shrink)

OBJECTIVES: To study some ethical problems created by accession of a previously nomadic and traditional society to modern invasive medicine, by assessment of physicians' attitudes towards sharing information and decision-making with patients in the setting of a serious illness. DESIGN: Self-completion questionnaire administered in 1993. SETTING: Riyadh, Jeddah, and Buraidah, three of the largest cities in Saudi Arabia. SURVEY SAMPLE: Senior and junior physicians from departments of internal medicine and critical care in six hospitals in the above cities. RESULTS: A (...) total of 249 physicians participated in the study. Less than half indicated they provided information on diagnosis and prognosis of serious illnesses all the time. Physicians who were more senior and those who spoke Arabic fared better than other groups. The majority preferred to discuss information with close relatives rather than patients, even when the patients were mentally competent. Most of the physicians felt patients had the right to refuse a specific treatment modality, and 68% denied patients the right to demand such a treatment if considered futile. Further analysis showed that physicians' attitudes varied along a spectrum from passive to paternalistic with the largest group in a balanced position. CONCLUSIONS: In traditional societies where physicians are regarded as figures of authority and family ties are important, there is a considerable shift of access to information and decision-making from patients to their physicians and relatives in a manner that threatens patients' autonomy. Ethical principles, wider availability of invasive medical technology and a rise in public awareness dictate an attitude change. (shrink)

The spin-statistics connection has been proved for nonrelativistic quantum mechanics . The proof is extended here to the relativistic regime using the parametrized Dirac equation. A causality condition is not required.

In this paper, it is explained that a dialogical approach to complex argumentation can be fruitful for solving two important problems concerning the analysis of the argumentation structure. First, such an approach makes it possible to clarify the distinction between coordinative and multiple argumentation structures, and to identify clues in the presentation for each of these structures. Second, a dialogical approach can provide a basis for dealing more adequately with refutations of counterarguments.

The parametrized Duffin–Kemmer–Petiau wave equation is formulated for many relativistic particles of spin-0 or spin-1. The first-quantized formulation lacks the fields of creation and annihilation operators which satisfy commutation relations subject to causality conditions, and which are essential to the Quantum Field Theoretic proof of the spin-statistics connection. It is instead proved that the wavefunctions for identical particles must be symmetric by extension of the nonrelativistic argument of Jabs. The causal commutators of Quantum Field Theory restrict entanglement to separations of (...) the order of the Compton wavelength \. The entanglement manifest in the symmetric Duffin–Kemmer–Petiau wavefunctions is unrestricted. (shrink)