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Introduction: Caring is the essence of nursing and medication process is an important part of nursing related interventions in the health care systems. Medical and/or nursing errors can lead to severe problems for both patients and nursing system. The purpose of this study was to investigate the ethical practice in medication process among nurses working in selected hospitals related to Tehran University of Medical Sciences.          

Materials and Method: This study is a descriptive–analytic research. Samples of the study were 305 nurses employed in adult units of selected hospitals. The research data gathering tools were a checklist and a questionnaire. Questionnaire included questions about demographic data and errors in medication process. Checklist included 17 questions related to expected behaviors regarded medication process. The researcher first completed the questionnaire and then the checklist was completed on two separate occasions at least 15 days apart. The data were analyzed using descriptive and analytic statistics such as Chi square, Fisher exact test and Pearson correlation coefficients.

Results: The majority of subjects were 26-35 years old, female and single. About half of nurses (49.6%) had undesirable performance in process of medication. Ethical practice had a significant correlation with type of ward (p=0.005), the mean number of occupied beds in a week (p=0.000), number of co-workers in the shift (p=0.001), educating (p=0.037), satisfaction with place of work (p=0.0043) and technical possibilities in the ward (p=0.029).

Conclusion: According to the results, the majority of nurses had an undesirable performance in medication process. It is suggested that managers, program planners and nursing teachers pay more attention to ethical practice in medication process in order to enhance performance of nurses in this field.

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Background & Aim: Moral sensitivity has various dimensions including personal sentiments, scientific competency, and reasoning and decision making capabilities. To achieve this, some personal traits and educational preparedness are needed. The aim of this study was to determine nurses’ moral sensitivity and its relationship with demographic and professional characteristics in hospitals affiliated to Tabriz University of Medical Sciences.
Methods & Materials: This descriptive, correlational study was conducted on 198 nurses working in the medical wards of hospitals affiliated to Tabriz University of Medical Sciences in 2016. Census sampling method was implemented. Data were collected through a demographic and professional characteristics form and the Moral Sensitivity Questionnaire (MSQ). The data were analyzed by the SPSS software version 13 using descriptive statistics, T test, Pearson correlation coefficient and ANOVA.
Results: The mean score for nurses’ moral sensitivity was 4.84±0.48 (out of 7). The highest scores were related to the domains of “Interpersonal orientation” and “following the rules”. The lowest scores were related to the domains of “experiencing moral conflict” and “modifying autonomy”. There was a significant and inverse correlation between age and “modifying autonomy” (P=0.008, r=-0.193) and also between age and “following the rules” (P=0.034, r=-0.156). Moreover, there was a significant and inverse correlation between work experience and “following the rules” (P=0.009, r=-0.187).
Conclusion: Given that the nurses gained a low score in the domain of “modifying autonomy”, it is suggested that client centered care and patient’s autonomy be emphasized in developing nursing curriculum and in service training programs.
 

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Background & Aim: White lie is one of the inevitable challenges that creates an ethical dilemma during the patient care process. White lie remains an abstract concept in caring process. The aim of this study was to analyze the concept of white lie in the caring process using a hybrid model.
Methods & Materials: A hybrid model of concept analysis including three phases was used in this study. In the theoretical phase, different databases including PubMed, CINAHL, Scopus, Science Direct, Google scholar, SID and Magiran were searched for finding relevant articles published in 1980-2018. The keywords were truth, white lie, care and deception (in Persian and English). In the fieldwork phase, semi-structured in depth interviews were conducted with nurses. In next step, by combining the two previous stages, the final analysis was performed.
Results: In the theoretical phase, the attributes of the concept were determined, including “harmlessness”, “without personal motivation” and “use in compulsion situations”. In the fieldwork phase, three main categories such as “the sweetness of the bitter truth”, “harmless sentences to prevent harm” and “temporary relief to balance the situation” were identified from the data analysis. By merging the concepts extracted from the theoretical and fieldwork phases, “white lie in the patient care process” was defined as “an ethical decision without personal motivation, which is chosen in unstable situations to prevent predictable harms to the patient in facing the bitter truth”.
Conclusion: Although a definition of white lie was developed based on the above three phases, the further development of this concept requires a deeper look at the Iranian-Islamic culture. Therefore, further research is recommended in other medical centers in the country.
 

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Background & Aim: The interdisciplinary nature of the profession of counseling in midwifery underscores the need for the establishment of an ethical framework to guide the provision of counseling services in various areas of midwifery and women's health. Consequently, the present study has been conducted with the objective of formulating code of ethics in midwifery counseling.
Methods & Materials: The present study is a developmental study using the Delphi method, which was conducted in three stages in 2020. The first stage involved qualitative content analysis to review the texts, and the development of an initial draft of ethical codes. In the second stage, expert opinions were sought from professionals specializing in medical and midwifery ethics to evaluate and make revisions to the initial draft. The third stage involved validation of the draft codes and their finalization.
Results: According to the results of the qualitative content analysis, a total of 182 codes were obtained from the texts and classified into eight categories. However, through the Delphi rounds, the number of categories was subsequently reduced to six, resulting in a decrease in the number of codes to 121. The identified categories included; "Professional competence", "Professional communication", "Management of client data", "Ethical considerations in tele-counseling", "Ethical considerations in midwifery counseling education”, and "Ethical considerations in research". These categories were established with a consensus level of 92.4%.
Conclusion: In this research, a set of ethical codes was obtained from the experts’ opinions in relevant disciplines from various universities across the country, with appropriate validity and consensus levels. These codes can be used in providing counseling services in midwifery, promoting safety and adhering to ethical principles and values.