Iranian Journal of Medical Ethics and History of Medicine

A short review of virtual courses of bioethics in the authenticated universities of the world

farzaneh zahedi

Proposing an ethical guideline in stem cell research in Iran

nasrin Nejad Sarvari

Surveying brain death from the perspectives of jurisprudence and criminal law

Ali Akbar Farahzadi

Brain death is a subject in our society which can be mistaken with coma or other types of life status similar to death. To assess the legal status of a brain dead patient, it is necessary to determine whether a person afflicted with brain death is dead or alive. Do they meet the criteria for biological death? Or in precise words, do Islamic laws for the dead apply to them? Several questions arise in this regard, which give more importance to this issue from the viewpoint of Islamic jurisprudence and law, and all answers depend on our definition of brain death, and whether we find brain death an instance of the separation of body from soul. There has been much research around this issue and the laws in many countries and religions, including Christianity and Judaism, have been disambiguated. In Iran, however, brain dead patients are considered alive, while brain death should be legally considered absolute death like in many medically advanced countries (UK, Germany, France, and USA). The authors aim at examining this issue from the viewpoint of Fiqh and law, and its disambiguation.

The position of physicians in ancient Iran and Hamurabian law

fatemeh Karachiyan sani

One of the oldest codes - Hammurabi's Code - available in the field of medicine contains descriptions of the duties of physicians and heavy penalties for their neglect. Albeit, religious books have pointed out these issues as needed. Among these, the text of Avesta pays particular attention to physicians and their duties, and was one of the sources of inspiration for medical laws at its time. In the text, it is stated that physicians were selected from members of the clergy, and surgeons had to perform three surgeries on non-Zoroastrians who believed in Ahura Mazda. If this requirement was not achieved, they would lose their right to surgery or practice, but if successful, they could operate on the followers of Ahura Mazda without fear. Here we intend to discuss the laws and ethics of ancient Iran and the rights and duties of the physicians by exploring the literature of the time.

Considering human cloning according to the anthropological view of Kant

Leila Nikouenejad

Cloning, especially human cloning, is the latest technology of the present time and has become known as "the debate of the century". Since its appearance, the technique has created global concern for scholars. The physical injury ensuing from the manipulation of women ovaries, nucleus and embryo, potential mental and spiritual harm, incurable disease and early aging are among concerns in this regard which necessitate research and investigation. Providing a precise philosophical framework to alleviate these concerns and end the battle between scholars of natural sciences and humanities over this technology calls for more research and investigation with a deep and philosophical view.In the present manuscript titled "Human cloning technology with a view to Kant's anthropology", first philosophical thoughts and ideas of Kant about human beings are reviewed, his anthropologic thoughts and ideas were analyzed. Finally we conclude that human cloning conflicts with Kant's accounts in anthropology because according to Kant, humans have cognition, free will, and self-discipline, and they have the right to human dignity. According to Kant's anthropology, human cloning technology, whether for therapy or reproduction, should be declared illegal.

The obstacles of reporting nursing errors in Iran: a qualitative study

Fatemeh Hashemi

Reporting professional errors is an essential step towards improving patient safety not only in hospitals but also outpatient healthcare centers. Unfortunately, nurses, like many other members of the medical team, do not report most of their mistakes and errors in performance. The objective of this study was to assess possible determinants of the tendency to report nursing errors by exploring the experiences of clinical nurses and nursing managers in this regard. In this qualitative study, 115 nurses employed by hospitals and specialty clinics of Tehran and Shiraz Universities of Medical Sciences were enrolled. Data were collected through 17 sessions of semi-structured discussion groups, and contents were examined and analyzed based on an empirical-analytic approach. The main patterns observed in this study included 1) nurses' overall perception of error, 2) obstacles in reporting nursing errors, 3) motives of reporting error. Reporting errors can provide valuable information for prevention of future errors and improvement of patient safety. Overall, considering the obstacles and motives of reporting nursing errors, there is need for codes and regulations in which the process of reporting error and the components of error are clearly determined and defined.

Trolley dilemma and its implication in active and passive euthanasia

Naser Aghab Babaee

Theologians describe the difference between active and passive euthanasia as in the former, we kill hopeless patients terribly suffering from an incurable disease and in the latter, and we let them die. The present research aimed at exploring for a solution to an ethical dilemma by which the difference between foundational concepts of the two types of euthanasia can be examined. Another objective of the study was to assess personal characteristics regarding this judgment. One hundred and five students were recruited, and in addition to reading the trolley problem and answering the related questions, they responded to a six-point scale self-assessment on morality and a short 20-point scale questionnaire on the five principle personality factors. Results showed that 83.8% of respondents found it immoral to kill one person in order to save 5 lives. Respondents' gender, religiousness and personality had no significant effect on their responses regarding the footbridge dilemma (P<0.05). Nonetheless, extroversion had an almost significant relationship (P=0.056, r=0.19). According to the results of the present study, the difference between "killing" and "letting die" is clear to most people, and they do not prefer killing even when there is more benefit than loss. Responses to the trolley problem were independent of personal characteristics, nonetheless, the quality of extroversion is suggested a as a potential determinant of agreement with active euthanasia.

Iranian patients views about surrogate decision maker

Fariba Asghari

Decision making by a surrogate on behalf of incompetent patients is based on the ethical principle of "respect for autonomy". The increase in advanced health services has lead to more instances of decision making for incompetent patients receiving such services, and the treatment team usually asks a family member to serve for this purpose without being aware of the patient's preference. This study was conducted to assess patients' wishes and preferences regarding surrogate decision makers and determinants of such preferences.The study was cross-sectional, and samples were selected randomly from patients presenting at Farabi Eye Hospital clinics who were 18 years of age or older. Questionnaires were completed through interviews. Two hundred patients between 18 and 83 years old were interviewed. About 52% (n=105) were men, and 73% (n=77) were married. Among the married, the spouse was chosen as the surrogate decision maker in only 51% of cases. Among singles, boys preferred their father in 36% (n=9) of cases, while girls chose their father in 5.6% (n=1) of cases and the most frequent choice was other unmentioned people (33.3%, n=6). Most patients (93.5%) wished to be asked about their surrogate decision maker upon admission.Results of this study demonstrated that the people we usually consult for decisions concerning patient treatment are significantly different from patients' preferred surrogate decision makers. We suggest leaving the choice of surrogate decision maker to the patient while they are conscious.