This baseline study was conducted to find out the knowledge, attitudes and practices of medical ethics among the undergraduate medical interns who did not have structured ethics curriculum in their course. A descriptive, cross-sectional study was carried out using a self-administered structured questionnaire among the medical undergraduate interns of Maharajgunj Medical Campus, the pioneer medical college of Nepal which enrols 60 students in a year. A total of 46 interns participated in the study. The most common source of knowledge on (...) ethics was lectures/seminars (35.7%) followed by experience at work (24.5%), training (21.4%) and own reading (17.3%). The main contents of Hippocratic Oath were known to 98.8% while 60.9% knew the main contents of Nepal Medical Council (NMC) code of ethics. Great majority (91.3%) regard ethics as very important in medical profession. “Doctors know the best irrespective of patients’ opinion” was disagreed by only 39.1% indicating the paternalistic attitude. However, 78.3% were in favour of adhering to the patient’s wish. None of the participant agreed to abandon confidentiality. Only about one-fourth (26.1%) claim to encounter ethical dilemma every day while the highest number (43.5%) had once in a month. To deal with the situation of ethical dilemma, majority approached to immediate supervisor followed by head of the department and colleagues. Eighty-seven percent of participating interns were involved in research activities involving human subjects. Only one of the participants had encountered the ethical issue on end-of-life and it was do-not-resuscitate consent in a terminally ill patient. On implementation of the curriculum on medical ethics focus should be - principles of biomedical ethics, sensitive ethical dilemmas like end-of-life care and practical experiences with participation in deliberations of the ethics committee. (shrink)

This article presents newly discovered data that provides new insights into eighth- century Nepalese history. The data is based on a stone inscription dated to Licchavi Saṃvat 173 (748 ce), here edited and translated for the first time. The inscription not only attests to the continuity of Licchavi dynastic rule through to the middle of the eighth century CE, but additionally reveals a matrimonial and military alliance between the Licchavis and a dynasty called Rāṣṭrakūṭa, possibly the Rāṣṭrakūṭa family attested in (...) the Indragaḍh inscription dated Vikrama Saṃvat 767 (710–11 CE). In contextualizing the historical data that can be extracted from the surviving portions of the inscription, we examine and reassess some of the strategies used by the Licchavi Kingdom to negotiate its position in the tumultuous political landscape of greater North India during the seventh and early eighth centuries. In the introduction and annotations, the article also provides observations on the inscription text’s literary style and script, as well as on certain aspects of Licchavi- period religious culture as reflected in it. (shrink)

In recent years, the relationships between systems of symbolic representations and cities have given rise to an often rich and stimulating consideration among various specialists in human sciences, namely, historians, anthropologists, semiologists and sociologists, among others. Urban conglomerates can no longer be conceived as simple assemblages of more or less functional constructions. The city is as much a mental concept as it is a physical reality. It is made up of images that give it a meaning. It does not exist (...) independently of the sum of subjective interpretations that are continually made by its inhabitants. Our Western perception of the city may be influenced by romanesque literature or the memory of a painting, in other words, by imaginary worlds. It varies according to individual memory: each of us is attached to the different urban spaces of his souvenirs, emotions arising from family history or the duration of a lifetime. These personal projections are all the more important because they command a certain number of daily actions and furnish a framework of orientation to every citizen. They contribute to giving a moral quality to urban space and transform physical objects into concepts, into more or less determined signs. (shrink)

The earthquakes which struck Nepal’s capital in 2015 were humanitarian disasters. Not only did they inflict tragic loss of life and livelihoods, they also destroyed parts of the Kathmandu Valley’s unique UNESCO World Heritage site. These monuments were not just ornate structures but living monuments playing central roles in the daily lives of thousands, representing portals where the heavens touch earth and people commune with guiding deities. Their rehabilitation was also of economic importance as they represent a major source (...) of tourist income and employment. Unfortunately, the social and political desire for rapid reconstruction resulted in the swift removal of many traditionally constructed foundations and their replacement with modern materials without assessments of whether they contributed towards the collapse of individual monuments. These actions, combined with the wholesale removal, mixing and dumping of modern and historic debris, contributed to a second, equally destructive, cultural catastrophe – irreversible damage to Kathmandu’s Medieval fabric, in a process which frequently excluded local communities and custodians. This case study draws from our collective reflections and lessons learned from our attempts to enable equitable and ethical research partnerships between UK and Nepali colleagues as well as local communities in the debris of the Kasthamandap, Kathmandu’s eponymous monument. After briefly describing the potential of mobilising archaeologists in post-disaster contexts and outlining the challenges of undertaking research in such a setting, our case study utilises the TRUST Code to assess the character and success of our multidisciplinary collaboration in a time of crises. (shrink)

Youth constitute one third of total population in Nepal. This paper looks at the work and motivation of youth volunteers in disaster management in Nepal in order to evaluate how these ideas and values among the youth played roles in the re-construction of the Nation from the 2015 Earthquake. The study used primary data through group interviews with volunteers of Youth’s UNESCO Club in Kathmandu city who were actively involved in disaster-relief programs at Sindhupalchowk, Kathmandu, Bhaktapur and Ramechhap (...) districts, together with key informant interviews and case studies. Findings from the study shows most youth joined in the volunteer program on their own initiative. They are concerned about issues including personal safety, quality and appropriate training, coordination, wrong attitudes, gender inequality and media coverage. People engaging in similar acts may have different underlying motivations for doing so. Findings from the study shows that mostly, the volunteers are motivated based on their values which are welfare of others or unselfishness. Other underlying motives include opportunity to learn, career prospects, social pressure, to reduce feelings of guilt and enhance one‘s self-esteem. Activities for taking forward their work includes ensuring quality and appropriate training and appropriate gears and tools for search and rescue work, awareness raising, recognition and visibility of their work. Psychosocial counseling is important after rescue operations, as it is important to heal the psychological wounds after an emergency or a critical event. The study suggests involving volunteers in all stages of disaster management planning process. It is a matter of combined responsibility that volunteers are recognized for the contributions and their needs are ensured for them to accomplish their efforts successfully. (shrink)

Dear Readers,Welcome to this issue of our beloved Bangladesh Journal of Bioethics! In this sweltering heat we are all seeking for some cool and comfort. We bring this issue of BJB on different ethical practices and bring up related questions. Are we respecting the rights of every human being when we are either doing research or practicing health service provision? What are the minimum norms and standards to be maintained or are we circumventing those? The issue looks into different issues (...) and provides us with indepth information, queries, fears and reservations.In the article on Knowledge, attitude and practice of medical ethics among medical intern students in a Medical College in Kathmandu, Ramesh P Aacharyaand Yagya L Shakya, report on a Knowledge Attitude and Practice survey of 46 medical undergraduate interns of Maharajgunj Medical Campus. The result of the survey is quite interesting. ‘Doctors know the best irrespective of patients’ opinion was agreed upon by 35 %, ‘Confidentiality cannot be kept in modern era and should be abandoned’ was strongly disagreed by 34.8% and disagreed by 60.9%. The Authors hope that the findings will assist the faculties to strengthen the teaching of medical ethics and guiding the interns for ethical professional conduct. In the article titled Organizational Justice and Employee’s Service Behavior in the Healthcare Organizations in Bangladesh is an agenda for Research, Md. Nuruzzaman and Md. Humayun Kabir Talukder present a conceptual framework and a set of hypotheses regarding the relationships among distributive justice, procedural justice, interactional justice, employee’s citizenship behaviour, role prescribed behaviour and counterproductive behavior in the healthcare organizations in Bangladesh. The authors state that the purpose is to assist the policy makers and service providers in identifying desirable and undesirable HRM practices in order to maintain optimum level of employee commitment for ensuring quality and efficient service delivery to the communities. Though the article is theoretical it may be useful for the policy makers and service providers. If an operational research could be carried out to test the hypothesis the practical utility of the concept could be tested in Bangladesh.Zoheb Rafique in the article Ethical Justification of Conducting Research Trials in Lower and Middle Income Countries Including Pakistan: The Responsibilities of Research Enterprises explores the ethical aspects of research sponsored by commercial agencies. He looks into the factors that influence selection of a study site for a sponsored trial particularly in traditional countries like Pakistan where cultural values add to the problem in assuring that research is conducted in an ethical manner. In this paper, the Author discusses the responsibilities of researchers and funders in low and middle income countries like Pakistan and the ethical justifications of doing research trials in developing countries. He concludes that research participants should be fully informed about the research trial and their participation and it is their right to know all risks and benefits so that they have the option of rejecting participation.The article on Ethical aspects of Dhaka University Tele-medicine System by Ahmed Raihan Abir provides and analysis of the tele- medicine system in Dhaka University. The Author is a member of an extended group at Dhaka University (DU) which has been developing telemedicine equipment and data acquisition software to promote telemedicine practice in Bangladesh. Recently the Telemedicine group of DU and a local NGO named SAMAMA with support from Service innovation fund (SIF) of the Prime Minister Office (PMO) of Bangladesh took the initiative to establish eight rural telemedicine centers and one expert center for the field trial of telemedicine in Bangladesh. The aim of this paper is to examine the ethical challenges of such health care system and the effort to overcome these problems before starting the field trial. The author looks into the details of Data confidentiality and security, Responsibilities of Doctor and Rural Technician, Quality of service and Implications of telemedicine in Bangladesh. He concludes that DU telemedicine project will essentially bring the services of qualified medical experts to the doorsteps of the common people throughout the country, even in the remote rural areas. Although a telemedicine cannot match a face to face consultation, DU tele-medicine system is much better than no consultation at all.Sifat Rahman in the article on Ethical Issues of Fair Subject Selection in Research provides an overview of the criterion for maintaining ethical standards for conducting research. The Author reviews the three fundamental conditions to be met for adhering to strict ethical standards which are: Respect for Persons by protecting the autonomy of people, treating them with courtesy and respect and obtaining informed consent.; Beneficence which incorporates the philosophy of "Do no harm" while maximizing benefits for the research project and minimizing risks to the research subjects; and Justice by ensuring that reasonable, non-exploitative, and well-considered procedures are administered fairly. Finally the Author concludes that Researchers must be truthful and conduct no deception.Dear Readers, as you can see from the above ethics and maintaining the values in research and services are of utmost importance in the improvement of the quality of life. Through our queries, questions and sense of respect for every living being can our endeavors to ensure ethics in all spheres of development be successful.Dear Readers, please keep on sending your articles, notes or thoughts to us. Your participation will make a difference in the quality of our lives.Best regardsTahera AhmedEditor. (shrink)

The design of Hindu temple follows the design of vastupurusha-mandala as described in several Hindu texts on architecture. The design of temple is divided into ground plan and vertical alignment, the superstructure. Herein the present study, our focus is on architecture of the superstructure, especially Shikhara style of superstmcture, in the temple of Nepal. Shikhara style architecture came into Nepal from Lidia over a millennium ago. The purpose of this research is to understand the significance of Shikhara Style temples in (...) the capital of Nepal, the Kathmandu valley. The first segment of the study reports the overall architecture of Hindu temple and then the common styles of architecture of superstructure (vertical alignment/tower) applied in building the temples in Nepal, which involves the Shikhara Style, the Pagoda Style, and the Stupa Style. The Shikhara style architecture is described in detail while other two are briefly discussed. The second segment of the study introduces some of the recognized temples of the Kathmandu valley that have Shikhara style architecture. And finally summing up everything, the conclusion of this research tries to recognize, acknowledge and bring to the fore the significance of Shikhara style temples in Nepal and also wrap the research by understanding the concept of architecture through pre-ancient perspective. (shrink)

Tucked away in the foothill of a mountain in the Kathmandu Valley, Mātā Tirtha defies the description of a sacred tirtha. It is neither situated between the confluences of two rivers nor is it dedicated to the God Viṣṇu, as are most of the tirthas in India. And yet, Mātā Tirtha continues to become popular within the valley among citizens of all faiths. What is unique about Mātā Tirtha? This paper sets out to trace its origins by examining its (...) history, folklore, and the myths that surround the sacred site. Positioned as a tirtha, it is dedicated specifically to the mother—the mothers of all men and women whose mothers have passed away. For that reason, Mātā Tirtha stands out as unique. Nothing similar is to be found in India. In terms of geography, Mātā Tirtha has a unique place in the religious landscape of the Kathmandu Valley, while its historic sanctity dates back to the seventeenth century during the reign of King Pratapa Malla. Legend, however, pushes it back to an even earlier existence. Today, visitors of all religious persuasions come to Mātā Tirtha to honor their mothers who have passed away. (shrink)

Background The global migration of nurses from resource-constrained to affluent nations raises complex ethical concerns, often rooted in historical power imbalances and neocolonial legacies. The Nepal-UK Memorandum of Understanding (MoU) on nurse recruitment, while presented as a solution to workforce shortages, exemplifies this complex dynamic, prompting critical questions about its implications for individual nurses and the healthcare systems involved. Aim This qualitative study explored the ethical complexities and dilemmas associated with the Nepal-UK nurse recruitment Memorandum of Understanding (MoU). This bilateral (...) agreement has sparked debate about its potential impact on both individual nurses and the healthcare systems of Nepal and the UK. Research Design A qualitative exploratory design utilizing semi-structured interviews was employed. Data were analyzed using reflexive thematic analysis. Participants and Research Context Twelve Nepali nurses from two private hospitals in Kathmandu, Nepal, participated in the study. Ethical Considerations The study was approved by the Nepal Health Research Council. All participants provided informed consent and were assured of confidentiality and anonymity. Results Four themes emerged from the data: (1) The lingering legacy of colonialism casts a shadow on the Nepal-UK relationship, raising concerns about potential exploitation and unequal power dynamics. (2) Nepali nurses grapple with the ethical dilemmas of pursuing personal dreams while acknowledging their responsibilities towards their communities and Nepal’s healthcare system. (3) The MoU’s claims of ethical recruitment are scrutinized, with nurses questioning its fairness and sustainability. (4) The agreement is challenged as a potential band-aid solution that may perpetuate global health inequities rather than fostering a genuine partnership. Conclusions The Nepal-UK MoU, while offering opportunities for individual nurses, also raises alarms about brain drain, exploitation, and the perpetuation of global health disparities. The study underscores the urgent need for a paradigm shift in international nurse recruitment practices, prioritizing genuine partnership, equitable distribution of benefits, and sustainable solutions that address the root causes of healthcare workforce challenges in both source and destination countries. (shrink)

A single Sanskrit commentary exists for the Caṇḍamahāroṣaṇatantra—the Padmāvatī of Mahāsukhavajra—the only palm-leaf witness of which is preserved in a late thirteenth-century manuscript in Kathmandu. The tantra is relatively late, unmentioned outside Nepal, and the only in-depth study to date examines only the first eight of its twenty five chapters. No study or edition of the Padmāvatī exists. Here we present the first edition and translation of a complete chapter, the sixth paṭala, a section dealing mainly with transgressive sexual (...) practices. Some of the ideas and pragmatic details presented by the author, Mahāsukhavajra, are unique in Vajrayāna literature. (shrink)

AN INSPIRING TALE CENTRED AROUND ONE WOMAN'S JOURNEY IN NEPAL AND HER SURVIVAL OF A DEVASTATING EARTHQUAKE... For all those who didn't give up the good fight... Kate sees you. In 2013, Kate visited Nepal for the first time with no knowledge of the rich culture and depth of the place despite her years of interest in spiritual growth and learning. On this occasion, Nepal truly spoke to her heart, and she grieved this magical place upon leaving it, vowing to (...) return. Two years later, in 2015, once again Kate found herself back in Nepal. Drawing her back like a calling of the soul, this time, nothing could have prepared Kate for what was to happen... The earthquake happened while she was in Kathmandu. The journey of spirit and wisdom is found in an aspiring story of a woman who created a life from her own belief and strength. Her fate and passion for a country that became more than a home to her as she was crafted around a community. Share Kate's new world of Nepal as drawn out in glorious detail through Kate's delicate eye... and perhaps you will find your own inner purpose along the way. "An honest book about rediscovery that explores love, loss, sacrifice and courage. Kate's story is full of many moving challenges and lessons learned. A must read!" Sue, Indie Books reviewer. (shrink)

The teacher is one of the key factors in the transmission of curricular objectives to their students. Their knowledge and positive attitude toward students' ethnomathematics and its pedagogical approach play an important role to make classroom teaching culture friendly. This paper is intended to explore the in-service teachers’ knowledge of ethnomathematics and perception on the integration of the ethnomathematics approach in their teaching with respect to the demographic factors of in-service teachers such as gender, academic status, teaching experience, teacher training, (...) and nature of institution they associated. This study was conducted among 120 in-service mathematics teachers from 32 secondary schools in Kathmandu District. The explanatory sequential mix method was employed to carry out this study. The perception of in-service teachers on ethnomathematics pedagogy in their classroom teaching was measured with survey instruments in the first stage. For further justification of the results obtained from the quantitative data, six teachers with different demographic factors were interviewed in the second stage of the data collection process. The relationship between in-service teachers’ understanding on ethnomathematics and different demographic factors was investigated using the Pearson Chi-square test. From the statistical data analysis, it was found that there is no relationship between gender, academic qualifications, and teachers' training in their understanding of ethnomathematics. However, a significant relationship was found between the teachers' experience and nature of the institutions they were involved, and their understanding on ethnomathematics. In-service teachers have a similar understanding on ethnomathematics and their perception in the integration of the ethnomathematics approach in the teaching of school mathematics. (shrink)