A. Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor) A. Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor) Abyad Medical Center & Middle East Longevity Institute Azmi Street, Abdo Center, 2nd Floor PO BOX 618, Tripoli LEBANON Tel & Fax: 961 6 443684/5/6 Email: aabyad@cyberia.net.lb Web: www.amc-lb.com

This is the fifrth issue this year with many papers dealing with important ethical issues in nursing education and practice.

The ethical issues of sterilization among mentally retarded women was raised by one author. The author raised three questions 1) Is there any excuse for the permanent sterilization of a mentally retarded woman?, 2) Is it ever appropriate to assume the mentally retarded incapable of consenting to the procedure of sterilization? 3) Does sterilization to those women protect them from sexual exploitation? According to American College of Obstetrics and Gynecology, 65% of parents of severely retarded women had thought of sterilization as had 63% of parents of moderately retarded women?

Two thirds of these parents had difficulty dealing with menstrual hygiene. Parents of mildly retarded women were three times more likely to consider tubal ligation than hysterectomy. It is clear that there no clear answers for these issues.

Another paper dealt with Legal and Ethical Issues of Euthanasia. Euthanasia is one of the issues that has been subject of intense debate over time. The paper discusses the legal and ethical debates concerning both types of euthanasia. It focuses on both the supporter of euthanasia and the opponent to euthanasia. Several statement for the Euthanasia argument are discussed: a merciful response that alleviates the suffering of patients which is sometimes wrongly perceived to be otherwise unrelievable; the autonomy in which the patient has the right to make his own choices; the regulation and legislation of existing practices of euthanasia to protect health care providers and patients. In this heated debate religious, political, ethical, legal and personal views are also included. Among all these, those who desperately want to end their lives because they simply cannot go on in any way are the ones who suffer. Every individual or group has a different viewpoint regarding euthanasia. Euthanasia is considered practical, emotional, and religious debate.

A paper explored nurses’ perceptions regarding pain assessment and pain management for patients with Myocardial Infarction in a coronary care unit; a qualitative design, using semi structured interviews. The author used a qualitative content analysis approach to analyze the interviews by doing the manual analyzing and having different themes.The authors concluded that Critical care nurses need more skills and knowledge to practice good pain assessment and effective pain management when they deal with patients who have myocardial infarction pain. In this study patients who are non-verbalizing of their pain lack the proper assessment of pain due to inability to communicate their pain. More research is needed in this area of pain assessment and management especially for patients with myocardial infarction.

The effect of alopecia on men and women has been documented in the literature, and cooling scalp to prevent alopecia has been documented. An integrative review of 9 articles to determine how more effect of chemotherapy-related alopecia among gender and the effect of cooling scalp to prevent alopecia was conducted. The author concluded that there is a need to do more specific study on cooling scalp among a man and type of cancer to bring more effective result of use this method because it is very cheap and easy to apply and the result of most previous research was that it had a positive effect.

A single group crossover study from Iran aimed to assess the effects of earplug on perception of sleep in patients who were admitted to CCU. Of the 30 patients, 17 were men. The mean age of patients was 58 ±11.8 years. Using ear plug has a statistically significant increase in the quality of sleep in three subscales (disturbance, effectiveness, and supplementation) (P<0.05). The authors concluded that patients in coronary care unit (CCU) are at risk of sleep deprivation. The use of ear plug is an easy and cheap method to improve the perception and quality of sleep in CCU patients.

Another paper dealt with an important issue in modern life which is child obesity has been doubled which acts as the major contribution to the chronic and disability disease that arises specially in Australia. This is due to it having a heavy impact on economic and health related issues to the country. The authors concluded that there is a need to elaborate on the preventive measures in order to control the negative impacts of it on the children especially occurring in Australia. This would not only affect the economic factors of the country but also the health related issues that would or might rise in future.