Iranian Journal of Medical Ethics and History of Medicine

Commitment of scholars and cultural characters to ethical values: A brief review of ideological and ethical merits of Dr. Hasan Habibi

Samaneh Tirgar

A thorough understanding of the characters, attitudes, and lifestyles of renowned scholars is of paramount importance for any nation. Dr. Hasan Habibi (1936-2012) was a prominent figure in science, theology, literature, and culture of Iran. The late Dr. Habibi was a pious and patriotic politician who was fully committed to safeguarding the pillars of the Islamic Republic of Iran and the Islamic Revolution. In this article, we aim to review some of his works and explore the memories of his family and acquaintances in the hope to shed some light on his manners, viewpoints, and lifestyle. Moreover, the first author’s personal remembrances of the late Dr. Habibi and his moral virtues are presented here, particularly with focus on his final years during which he was bedridden for a long period. Moreover, we aim to illuminate his ideas in terms of promoting science, supporting scholars, and building the infrastructure needed to expand the boundaries of science. We hope that this article will provide a model both for bedridden patients in Iran and the physicians and researchers who deal with them on a daily basis.

Favaed-al-Afzalieh: a treatise on medicine and its standing in the Safavid era

Ali Akbar Jafarey

Ali Afzal Ghate’ Ghazvini was a renowned physician, scholar, and calligrapher of the Safavid era whose personality and efforts in the field of medicine have not been fully recognized thus far. Among his works, three medical treatises can be of use in researching the medicine of the Safavid era. The present article adopts a descriptive-analytic method to introduce one of these treatises, Favaed-al-Afzalieh, and present a survey of its content in addition to the author’s biography. The findings here are based on the three chapters of this medical classic, which indicates the encyclopedic nature of this treatise. Favaed-al-Afzalieh reveals details on a variety of practical medical issues prevalent in the Safavid era, and is considered outstanding due to the volume of all the medical information it contains. The present study discusses the standing of this treatise in the history of medicine along with a suggestion to revise and publish this valuable, comprehensive work and reintroduce it to the world of medicine.

Ethical issues regarding fertility preservation for women

Shima Behnammanesh

Fertility preservation consists of a set of procedures that help people maintain their reproductive ability in order to have a genetic child in the future. Nowadays, these procedures are widely accepted as long as they fall within the two categories of medical or social justification. In the first category, patients may lose their fertility due to diseases or treatment-related complications, while, in the second, healthy patients wish to preserve their ability to have children in the future for social and personal reasons. Since these procedures are considered invasive, many questions and criticisms have been raised about their application in the case of healthy women who seek them merely on account of aging.In this descriptive-analytic study, ethical issues were retrieved from books, papers, international guidelines, theses, declarations and instructions, and even some weekly journals, using keywords related to fertility preservation such as embryo cryopreservation, oocyte cryopreservation, and women’s reproductive autonomy. In cases of medical necessities, fertility preservation is considered acceptable and consistent with the principle of beneficence, which is the most important principle of medical ethics. As for cases that only have social justifications, some argue that they contradict the principle of non-maleficence. Nevertheless, a large number of feminists and scholars believe in women’s reproductive autonomy and therefore consider them ethical, provided that certain conditions are observed.

Is There A Right to Reproduction?

Mohammad Rasekh

Reproduction is one of the basic abilities of human beings. This is often realized in a natural way, though in certain cases new methods and technologies provide infertile couples with the opportunity to realize their wish to have children. In recent years, the term “right to reproduction” has emerged, and sometimes emphasis is placed on the obligation of governments to satisfy this right. However, it seems that the ambiguity of the aforementioned term may create serious problems in our understanding of the subject matter and, in consequence, affect the manner in which it is handled in the society. In this paper, in addition to discussing the concept of rights, it is argued that the right to reproduction may be embodied both by a claim right and a liberty right, even though the latter is only a justifiable and acceptable way of representing the right to reproduction. Therefore, this right entails the freedom to bear children and to pursue provision of the requirements, including utilizing ART. As in the case of other human rights, this should be in balance and proportion with public interests, in such a way that in particular circumstances, such as problematic population situations, it may be protected or prevented by the government.

Compliance rate of midwives with the professional codes of ethics in Maternal Child Health Centers in Tehran

Leila Nasiriani

Ethical performance is one of the main components of offering quality care to women and mothers. The aim of this study was to assess the degree of compliance with the professional codes of ethics among the midwives employed in maternal child health centers in Tehran.This was a descriptive, cross-sectional study performed on 125 maternal child health center midwives in Tehran. Method of sampling was stratified and cluster sampling. The data collection tool consisted of a valid, reliable questionnaire including two sections: demographic information and 43 questions in 10 areas of professional ethics based on a 5-point Likert scale. Data analysis was performed by descriptive statistics via the SPSS software.The overall compliance with ethical codes among midwives was 3.866±0.522, and compliance rates in each of the 10 areas mentioned above were as follows: respect for human dignity: 3.77±0.676 observance of clients’ decision-making right: 3.62±0.58 obtaining informed consent: 3.48 ± 0.988 truth telling: 4±0.74 respect for clients’ privacy: 4.08±0.709 observance of the principles of beneficence and non-maleficence: 3.97±0.689 revealing clients’ information: 3.47±0.723 confidentiality: 3.83±0.844 fair treatment of clients: 4.14±0.802 and professional relationship with colleagues: 4.23±0.709.In order to improve the quality of midwifery services, more attention should be paid to teaching professional ethics in midwifery courses, and after extensive notification, compliance with ethical codes should be monitored.

The relationship between perceived organizational justice and quality of work life among the personnel of a selected hospital in Ahvaz

Ebrahim Mardani

Organizational justice can dramatically impact the personnel’s attitudes and behaviors and is therefore considered to be of great importance. Moreover, high quality of work life is known as the basic prerequisite to empower human resources in healthcare systems. The aim of this study was to determine the relationship between perceived organizational justice and quality of work life among hospital personnel.In this descriptive correlational study, the samples consisted of 268 staff members of a public hospital in Ahvaz. Samples were selected through census. Data were gathered by a demographic information questionnaire, Niehoff and Moorman Organizational Justice Scale, and Quality of Work Life Questionnaire. Data analysis was performed using descriptive and analytical statistics.Results showed that quality of work life among the hospital personnel in this study was moderate (64.2 %), relatively good (16%), poor (13 %) and good (6.8%). Dimensions of organizational justice including distributive and procedural justice had a significant relationship with quality of work life.Since there is a direct relationship between perceived organizational justice and quality of work life, hospital managers should pay attention to this issue, which will lead to enhanced quality of work life in personnel.

Moral distress and compassion fatigue in patient care: a correlational study on nurses

Mostafa Roshanzadeh

Moral distress is one of the ethical challenges that nurses face due to the nature of their career. Nurses' frequent confrontation with this phenomenon can have different outcomes such as frustration and boredom in providing patient care. This will lead directly to a decline in care quality and can hamper the accomplishment of health goals. Therefore, the present study examined the relationship between moral distress and compassion fatigue in nurses.This cross-sectional study was conducted on 260 nurses of intensive care units in Kerman who were selected through convenience sampling method. In this study, Corley’s moral distress scale and Figley’s Compassion Fatigue Scale were used for data collection. The collected data were analyzed using the SPSS software and descriptive and analytical statistics.The results of this study indicate that there is a significantly positive relationship between moral distress and compassion fatigue (P<0.05). From a total range of 0 to 5, the average score of moral distress was 3.5±0.8 in terms of intensity, and 3.9±0.55 in terms of frequency. The mean of compassion fatigue score was 3.5±0.68 from a range of 0 to 5.Moral distress and its association with compassion fatigue suggest that conditions contributing to moral distress can have an important role in the quality of care. It is clear that strategies should be adopted to prevent the occurrence of these conditions. Informing nurses about moral distress and its consequences as well as periodic consultations will play an important part in the identification and management of moral distress and its consequences.

The relationship between nurses' perceptions of moral distress and the ethical climate in Shahid Sadoughi University of Medical Sciences of Yazd

Elham Fazljoo

Considering the advances in today's world, the increased complexity of diseases and longer life expectancy, nurses experience a great deal of moral distress. One factor that is likely to contribute to the development of moral distress is the ethical climate prevailing in hospitals. This study aimed to assess the relationship between nurses' perceptions of moral distress and the ethical climate in Shahid Sadoughi University of Medical Sciences in Yazd. This correlational descriptive study used the Moral Distress Scale (MDS) and Hospital Ethical Climate Survey (HECS) to examine 370 nurses working in a number of hospitals including Shahid Sadooghi, Shahid Rahnemun, Shahid Afshar and Savaneh Sukhteghi. Data analysis was performed using SPSS18 and descriptive and analytical statistics. Findings showed that the intensity of perceived moral distress among nurses was 3.41±1.28, and their perceptions of the ethical climate were 3.22±0.78. There was a significant negative relationship between nurses’ perception of moral distress and the ethical climate (P=0.00). The findings of this study suggest that development of plans to improve the ethical climate prevailing in hospitals might decreases nurses’ perceived moral distress.