Ethical challenges in clinical decision-making in the era of new technologies: Experiences from low income countries

Patient related challenges included; inappropriate demand, ability to make informed decisions and balancing self-interest vs. public interest. Clinician related challenges included; the use of unfair criteria, lack of explicit criteria and processes, lack of evidence, potential for abuse, physicians' dual role, autonomy and moral distress. Most of these were directly influenced by the extreme lack of resources, and decisions made at the meso- macro and global levels with regards to research and development and investing in new technologies for LICs. Hence addressing these challenges require concerted efforts at all levels, ensuring that decisions are guided by ethical values; and not only the clinicians' duty.