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Presented to the Muslim Medical Professionals
Ramadhan Workshop Mombasa August 3, 2013 by Professor
Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard)
INTRODUCTION
·
Social responsibility is awareness/care/giving
back to society
·
Student social responsibility
·
Physician social responsibility
·
Hospital social responsibility
·
Corporate social responsibility = good done
without legal obligation
·
Blood donation can be described as a prosocial
behavior, and donors often cite prosocial reasons such as altruism, empathy, or
social responsibility for their willingness to donate.
·
Most blood donors appear to have high levels of
the primary prosocial characteristics (altruism, empathy, and social
responsibility) commonly thought to be the main motivators for donation, but
these factors do not appear to be the ones most strongly related to donation
frequency.
Steele WR,et
al. Transfusion.
2008 Jan;48(1):43-54.
PREPARING THE MEDICAL
STUDENTS FOR COMMUNITY SERVICE
·
Medicine should be taught as a social service
with the human dimension dominating the biomedical dimension.
·
Medicine should be practiced as mutual social
support.
·
Medical education should prepare the future
physician to provide service to the community.
·
The student should require skills of
understanding and responding to community needs by spending part of the
training period in a community setting away from the high technology hospital
environment.
PREPARING
THE STUDENT FOR SOCIAL LEADERSHIP
·
The medical school curriculum and experience
should be a lesson in social responsibility and leadership.
·
The best physician should be a social activist
who goes into society and gives leadership in solving underlying social causes
of ill-health.
·
The physician as a respected opinion leader
with close contact with the patients must be a model for others in moral
values, attitudes, akhlaq, and thoughts.
·
The physician must give leadership in
preventing or solving ethical issues arising out of modern biotechnology.
PREPARING THE STUDENT TO
ALLEVIATE SOCIAL INEQUITIES
·
Material deprivation causes social and
psychological stress in addition to the physical impact of inadequate
nutrition, housing and sanitation.
·
Socially conscious physicians must be involved
in programs to eradicate poverty and assure a reasonable standard of living.
·
The physicians are called upon to look after
the weak and the less privileged: the widows, the poor, and the wayfarer.
COMMUNITY-BASED EDUCATION. 1
·
There is an increasing emphasis on community
and preventive medicine in many medical schools as an introduction to service
in less privileged areas.
·
Traditionally, the service vocation in medicine
called for training the student to serve in a poor or rural area or slums of
the big cities to learn social responsibility
·
Involvement of the student in community-based
education should be real and not cosmetic. The student must actually deliver
useful service and should live among the poor for a reasonable amount of time
as a fully-fledged professional.
·
Medical schools have not been very successful
in inculcating the spirit of self-less service in depressed rural or urban
areas. Physicians are reluctant to serve in rural areas.
COMMUNITY-BASED EDUCATION. 2
·
Community-based education has three specific
objectives: (a) understanding lifestyles, health behaviors, and health beliefs;
(b) knowing morbidity and mortality patterns by direct experience; and (c) acquiring
problem-solving skills.
·
Community-based education is thought to help
the student address social needs and responsibility to society.
·
Community-based learning will make the student
more sensitive to society’s problems.
PRIMARY HEALTH CARE AND
SOCIAL RESPONSIBILITY:
·
The concept of primary health care (PHC) that
essentially refers to the first point of contact of a patient with the health
care system. PHC can be simple in a rural area or quite sophisticated.
·
We can envisage medical education in the future
taking place in primary care settings in both its simple and sophisticated
modes to learn social responsibility directly
THE PHC STRATEGY AIMS TO
TRAIN THE PHYSICIAN TO
·
Respond to health needs and expressed demands
of the community;
·
Work with the community so as to stimulate
healthy life style and self-care;
·
Educate the community as well as the
co-workers;
·
Solve, and stimulate the resolve, of both
individual and community health problems;
·
Orient their own as well as community efforts
to health promotion and to the prevention of diseases, unnecessary sufferings,
disability and death; work in, and with, health teams, and if necessary provide
leadership to such teams;
·
Continue learning lifelong so as to keep their
competence up-to-date and even improve it as much as possible.
·
Social responsibility is a value orientation,
rooted in democratic relationships with others and moral principles of care and
justice, that motivates certain civic actions.
·
Given its relevance for building stronger
relationships and communities, the development of social responsibility within
individuals should be a more concerted focus for developmental scholars and
youth practitioners.
·
During childhood and adolescence, the
developmental roots of individuals' social responsibility lie in the growth of
executive function, empathy and emotion regulation, and identity.
·
Efforts to cultivate children and adolescents'
social responsibility in the proximal settings of their everyday lives should
emphasize modeling prosocial behaviors, communicating concerns for others, and
creating opportunities to practice civic skills.
Wray-Lake L,
et al. New Dir Child
Adolesc Dev. 2011 Winter;2011(134):11-25.
·
Teaching Personal and Social Responsibility
(TPSR) model (Hellison, 2003) through physical education and its relationship
with short-term outcomes for elementary school students.
·
The research question did better fidelity yield
better student outcomes?.
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Higher fidelity of implementation had better
student outcomes
·
This study is the first to directly examine the
connection between TPSR implementation fidelity and student outcomes.
Pascual C
et al,Res Q Exerc Sport. 2011
Sep;82(3):499-511.
·
Social responsibility refers to one's sense of
duty to the society in which he or she lives.
·
The Professionalism and Community Service
(PACS) dental module at the University of British Columbia is based upon
community service-learning and helps dental students to understand the
challenges faced by vulnerable segments of the population as they actively
reflect on experiences gathered from didactic and experiential activities.
·
Three components aspects of the program:
contribution to the Classroom and Community, Value of Diversity in the
Community, and Exercise of Responsibilities.
·
Follow-up studies are needed to explore the
impact of community-based dental education upon students' perceptions and
understanding of social responsibility and professionalism regarding under served communities.
Brondani MA. J Dent Educ. 2012 May;76(5):609-19.
·
The purpose of this study was to explore
student perceptions and values of a community engagement experience based upon
frequency of participation.
·
One time only participants demonstrated
increased self-awareness, contemplating change, and capacity to serve
·
More than one time participants described a
deeper understanding of community, impact on others, and professional
transformation.
·
The results suggest incorporation of
community-based learning experiences into academic curriculum may be beneficial
in the students' preliminary understanding of social responsibility.
Furze J,
et al Physiother Theory Pract.
2011 Aug;27(6):411-21.
·
The purpose of our study was to assess changes
in dental students' attitudes and beliefs about community service and changes
in cultural competencies after participation in a two-year program of
non-dental community service (Student Community Outreach Program and Education,
SCOPE).
·
Over time, statistically significant changes
(p<.05) in student attitudes and beliefs were found
·
Overall, this study provides support for the
addition of a non-dental community service-learning program into the
preclinical curriculum.
Rubin RW
et al. J Dent Educ. 2008 Oct;72(10):1114-21.
NURTURING SOCIAL RESPONSIBILITY THROUGH COMMUNITY SERVICE-LEARNING: LESSONS LEARNED FROM A PILOT PROJECT.
·
We developed and implemented a new CSL option
in the integrated medical/dental curriculum and assessed its educational
impact.
·
CSL enabled a deeper appreciation for the
vulnerabilities that people who are marginalized experience; students gained a
greater insight into the social determinants of health and the related
importance of community engagement;
·
Students developed useful skills in health
promotion project planning, implementation and evaluation. Community partners and faculty tutors
indicated that equal partnership, greater collaboration, and a participatory
approach to course development are essential to sustainability in
·
CSL can play an important role in nurturing a
purposeful sense of social responsibility among future practitioners. Our study enabled
the implementation of an innovative longitudinal course (professionalism and community service) in all 4 years of
the dental curriculum.
Dharamsi S,
et al. Med Teach.
2010;32(11):905-11.
·
There is a growing demand for educating future physicians
to be socially responsible. I
·
A physician's place in society is closely tied
to a moral sense of responsibility related to the agreed-on professional
characteristics of physician hood in society, the capacity to carry out that
role, and the circumstances under which such professionals are called to
account for failing to act appropriately according to that role.
·
The requirement for social responsibility is a
moral commitment and duty developed over centuries within societies that
advanced the notion of a "profession" and the attendant social
contract with society.
·
A curriculum focused on developing social
responsibility in future physicians will require pedagogical approaches that
are innovative, collaborative, participatory, and trans formative.
Dharamsi S,
et al. Acad Med.
2011 Sep;86(9):1108-13.
·
Socially engaged nurses participate in public
service because of their strong sense of civic and social responsibility.
·
The purpose of this study was to describe how
experienced nurses contribute nursing knowledge in public service, rationale
for their service, and types of service activities.
·
The major finding of this study is that all
participants fully embraced the concept of public service as an integral
component of their professional identity.
·
Data were organized around the themes of what
participants did in their public service and why they did it. Participants
viewed public service as their responsibility as a professional nurse.
Riley JM. Nurs Outlook.
2010 May-Jun;58(3):142-7.
·
This study explores how dentists explain the
concept of social responsibility and its relationship to issues affecting
access to oral health care by vulnerable segments of the population.
·
There was a belief that social responsibility
in dentistry is dominated by economic imperatives that impact negatively on the
policies and practices directing access to care.
·
Despite the highly critical stance on dentistry
as a business, there was practical recognition of the economic realities of
dental practice.
·
Those who focused on social responsibility as a
professional obligation highlighted the privileges of self-governance along
with the accompanying duty to serve the welfare of everyone and not just those
who are socioeconomically advantaged.
Dharamsi S,
et al. J Dent Educ. 2007 Dec;71(12):1583-92.
·
This paper describes how a school of nursing
has conceptualized and embodied social responsibility in its core values, curricular
design, admission standards, clinical practice, and service learning
opportunities.
·
The school's engagement in the process of
practicing social responsibility and clarifying its meaning and application has
made apparent the natural linkage between social responsibility and
professionalism and the deep and complex relationship between social
responsibility and nursing itself.
·
Claiming social responsibility as a core value
and working to refine its meaning and place has increased the school's commitment
to it, concomitantly impacting
education, practice, and recruitment and evaluation of faculty and students.
·
The school views the conceptualization of
social responsibility as a deepening and unfolding evolution, rather than as a
formulaic understanding, and expects that its ongoing work of claiming social
responsibility as a core value will continue to be enriching.
Kelley MA et al. Int J NursEducScholarsh.
2008;5:Article28. Epub 2008 Jul 14.
·
producers of addictive goods who claim to be
socially responsible while marketing a product clearly identified as harmful
and also get a profit
·
communication on damage,
·
restraining selling practices towards light
users can be profitable but increases social cost
·
development of safer products
Massin S. SocSci Med. 2012
Jun;74(12):1856-63.
·
A prerequisite for the success a healthy
population and a healthy work force. This requires raising corporate social
responsibility (CSR).
·
health literacy can become a strategic asset in
CSR
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a majority of companies already show
health-related employee programs on their corporate websites but only a few are
focused specifically on advancing health literacy.
·
businesses can create a health-friendly
environment
·
business can stimulate the workforce to manage
their own health, seek information, and make decisions in terms of promoting
health and well-being
·
transforming information into knowledge and
increased awareness among employees.
Sørensen K,
Brand H. J Health Commun.
2011;16Suppl 3:322-7.
·
A study was conducted to determine what
Corporate Social Responsibility (CSR) orientation and viewpoint future
radiology professionals may have.
·
Study participants may initially consider
patient care more important than profit maximization.
·
These specific future radiology professionals
will not need laws, legal sanctions, and intensified rules to force them to act
ethically.
·
They may need ongoing training as to the
necessity of profit maximization if they seek the highest quality of care
possible for their patients.
Collins SK
et al. Radiol Manage. 2011 Jan-Feb;33(1):40-3.
·
The decisions and actions of health care
managers are oftentimes heavily scrutinized by the public. Given the current
economic climate, managers may feel intense pressure to produce higher results
with fewer resources.
·
A study was conducted to determine what
corporate social responsibility orientation and viewpoint future health care
managers may hold.
·
The results of the study indicate that future
health care managers may hold patient care in high regard as opposed to profit
maximization.
·
However, the results of the study also show
that future managers within the industry may continue to need rules, laws,
regulations, and legal sanctions to guide their actions and behavior.
Collins SKHealth Care
Manag (Frederick). 2010 Oct-Dec;29(4):339-45.
·
The purpose of this paper is to analyze the
Spanish mobile phone industry to determine how mobile phone companies and
certain institutions can improve protection for children who use mobile phones.
·
We carried out a multivariate statistical
analysis using anonymous primary data from mobile phone companies, and
institutions and associations that protect children, to compare these
stakeholders' opinions and to put forward solutions.
·
We proved that, even though some European
countries have made an effort to provide safer ICT services, all stakeholders
still need to cooperate and agree on solutions to the commercial problems
associated with children using mobile phones.
·
This can be done by signing codes of conduct.
·
We found that even though some companies
implement measures to protect children from accessing harmful content via their
mobile phones, they do so for reasons of legal and not social responsibility.
De-Miguel-Molina
M, SciEng Ethics. 2011
Jun;17(2):245-70. Epub 2010 Mar 17.
·
The tobacco industry has used corporate social
responsibility tactics to improve its corporate image with the public, press,
and regulators who increasingly have grown to view it as a merchant of death.
·
There is, however, an intractable problem that
corporate social responsibility efforts can mask but not resolve: the tobacco
industry's products are lethal when used as directed, and no amount of
corporate social responsibility activity can reconcile that fundamental
contradiction with ethical corporate citizenship.
·
The results show that the industry has made no
substantial changes and in fact has continued with business as usual.
·
Although many of the tobacco companies' tactics
traditionally had been defensive, they strove for a way to change to a more offensive
strategy.
·
Almost without exception, however, their desire
to appear to be good corporate citizens clashed with their aversion to further
regulation and jeopardizing their legal position, perhaps an irreconcilable
conflict.
Friedman LC. J Law Med
Ethics. 2009 Winter;37(4):819-27.
·
Private-sector initiatives and partnerships-
collectively labelled corporate social responsibility (CSR) initiatives-may be
able to positively impact social status, earning potential, and access to
services and resources for socially-excluded populations.
·
This paper presents case studies of CSR
projects in Bangladesh that are designed to reduce social exclusion among
marginalized populations and explores whether CSR initiatives can increase
economic and social capabilities to reduce exclusion.
·
Increase job-skills and employment
opportunities for women, disabled women, and rehabilitated drug-users
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Provide healthcare services to female workers
and their communities.
·
The analysis found that CSR has potential for
positive and lasting impact on developing countries, specifically on
socially-excluded populations.
Werner WJ.
J Health PopulNutr. 2009
Aug;27(4):545-62.
·
This paper examines how and why health has
become a Corporate Social Responsibility (CSR) strategy for the global food and
drink industry (FDI) in the context of current governmental and public calls to
address mounting obesity rates.
·
The food industry, through CSR, may promote a
narrow epidemiological understanding of obesity, shifting blame from 'foods' to
'diet' and from 'diet' to 'sedentarism'.
·
CSR reporting and its associated practices have
enabled the food industry to assume some responsibility for obesity prevention,
thereby problematising the state's role in addressing its own 'public health'
crisis.
Herrick C.
Sociol Health Illn. 2009
Jan;31(1):51-65. Epub 2008 Aug 28.
·
Health advocates may be unaware of the scale,
nature and implications of tobacco industry CSR.
·
The investigation found that BATM's CSR
activities included assistance to tobacco growers, charitable donations,
scholarships, involvement in anti-smuggling measures, 'youth smoking
prevention' programs and annual Social Reports.
·
BATM has stated that its model is predominantly
motivated by social and stakeholder obligations. Its CSR activities have,
however, had the additional benefits of contributing to a favorable image,
deflecting criticism and establishing a modus vivendi with regulators that
assists BATM's continued operations and profitability.
·
It is imperative that health advocates
highlight the potential conflicts inherent in such arrangements and develop
strategies to address the concerns raised.
Barraclough S,
et al. SocSci Med. 2008
Apr;66(8):1784-96. Epub 2008 Mar 4.
·
The publication of the Report of the
International Bioethics Committee of UNESCO on Social responsibility and health
provides an opportunity to reshape the conceptual framework of the right to
health care and its practical implications.
·
The traditional distinctions between negative
and positive, civil-political and economic-social, legal and moral rights have
to be abandoned
·
All must have access to the 'excellence' of
scientific and medical progress.
·
'Responsibility' is on the governments and the states
within the limits of their ‘jurisdiction’ as well as the challenge are to
tackle at the same time the social and global determinants of health.
Semplici S. Med Health Care Philos.
2011 Nov;14(4):355-63.