Iranian Journal of Medical Ethics and History of Medicine

Exploration of moral necessities in the field of children’s cancer

Marjan Mardani Hamooleh

Moral necessities in the field of children’s cancer are among the most important issues in medical services. The present study was conducted to explore this issue based on a case discussed during the medical ethics round in Tehran Children's Medical Center. A 13 year-old girl diagnosed with left ovarian cancer 5 years ago stated that she had not been informed about the disease and the type of surgery by her family, doctors and the medical staff. The family even denied the child’s disease, but she was struggling to adapt to the situation and eventually recovered after chemotherapy and surgery. Findings of the present study showed that through observance of moral necessities, health workers can assist children suffering from cancer and their families to better adapt to the situation. This is possible by providing supportive resources to these children as well as their families

Features of surrogacy agreement from ethical and legal perspectives

Reza Omani Samani

Any contract in the Iranian legal system contains features that need to be explained in order to better understand the exact terms of agreement. Some such features are related to whether the contract is irrevocable or voidable, gratuitous or with considerations, and may bear upon accountability and suspension, formality or contentment, and so on. In surrogacy, the sperm and egg of an infertile couple are fertilized and then transferred to another woman's uterus to carry till birth, when the child is delivered to the owners of the sperm and egg. The specific features and uncertain nature of surrogacy specify the standing of this type of contract among others. The present article is aimed to examine the features of surrogacy agreements from ethical and legal perspectives

Axiology of illuminationism and its implications in professional ethics for psychologists and psychotherapists

Davoud Dehghan

Axiology is an important topic of discussion in philosophical schools that deals with aesthetics and ethics. Axiology is related to ethics in its general sense and professional ethics in specific. Today, moral systems are seeking to answer man’s needs in various areas including professional ethics for psychotherapists. In this article, we have examined the axiology of illuminationism as the basis of our view and a major Islamic philosophy in order to draw from it the principles and methods of professional ethics for psychologists and psychotherapists. Sohrawardi, the founder of illuminationism, has offered certain instructions for the purification of ego. The aim of this article is to extract from this axiological system some implications that would be beneficial to psychotherapists. The method used in this research is descriptive-interpretive. Capacity, honesty, justice, benevolence, trustworthiness, commitment, respect for human dignity and secrecy are among the ethical principles of Illuminationism, and if psychotherapists can apply these values, their treatments and therapies will be more effective.

An overview of eugenics and its legitimacy throughout history

Leila Khastkhodaei

Eugenics or the science of breeding humans is a movement based on biological concepts that advocate policies for improvement of the human population genetics. It has also served as a determinant factor and reference in many social disciplines including law and punishment during certain periods in history. In fact, based on eugenic policies, which were affirmed by biologists, health experts and physicians, many people were sentenced to elimination from the society’s gene pool and thereby underwent sexual sterilization. Such practices were approved by economists and jurists involved in the executive affairs of many countries as well. Publication of two separate journals about eugenics and the corresponding empirical data confirming the influence of genetics on behaviors along with the solidity of eugenics-related policies demonstrate the scientific significance of this movement in its heyday. This public legitimacy started to decline, however, after sterilization of tens of thousands of mentally or physically handicapped people by Nazi Germany and the ascending criticism on moral and scientific bases of eugenics, which almost led to the exclusion of the subject in public. In this essay, eugenic concepts, relevant policies and its legitimacy throughout history are discussed to provide a better outlook for adopting more effective strategies in public health policymaking

Post-structuralist ethics and nursing codes of ethics: opportunities and threats

Ali Imanzadeh

Nursing theories have their roots in philosophical schools, and acceptance of a school of philosophy can direct the theoretical and clinical activities of a nurse.The present paper used a qualitative and explanatory-applied method. After a review of the general features of post-structuralism and post-structuralist ethics, the challenges and opportunities of post-structuralism in nursing and nursing codes of ethics were discussed.Ethics is one of the areas of nursing that have been affected by the arrival of post-structuralism. Ethics in post-structuralism is nomadic, based on discourse, democratic, relative, rhizomatic and anti-authoritarian.Despite the positive outcomes of post-structuralism in nursing, some features of this philosophical school presents challenges to nursing ethics. Some of these challenges that are in contrast with nursing codes of ethics are the relativism in ethics, anti-authoritarianism, rejection of hierarchy, representation and paternalism.

Perspectives of doctors, nurses and patients on physicians’ observance of professional ethics

Ali Vasheghani Farahani

Medical professionalism has recently received attention in Iran, so we aimed to assess it in a single specialty educational hospital.In the present study, we evaluated observation of medical ethics principles from the viewpoints of physicians, nurses and patients. Eight principles of medical ethics were evaluated in these three groups through modified questionnaires containing 43 questions for physicians, 42 questions for nurses, and 25 questions for patients. The mean scores of those principles are as: enhancing professional efficiency (68.7 ± 23), confidentiality (67.9 ± 21), maintaining an appropriate relationship with the patients (61.7 ± 21), improving access to services (59.6 ± 21), distributing limited resources fairly (60.2 ± 25), knowledge production (61.4 ± 23), promotion of trust through management of conflicts of interests (64.8 ± 23), and perform professional responsibilities (59.6 ± 23). There were significant differences in the two parameters of “enhancing professional efficiency” and “confidentiality” between the viewpoints of the patients and the viewpoints of physicians and nurses (P < 0.0001). The difference in “maintaining an appropriate relationship with the patients”, “improving access to services”, and “distributing limited resources fairly” was significant between the viewpoints of the nurses and that of the patients and physicians. The viewpoints of the nurses and patients were significantly different only in “knowledge production”, “promotion of trust through management of conflicts of interest”, and “perform professional responsibilities” (P < 0.0001). With respect to these significant differences, the nurses’ viewpoint regarding “enhancing professional efficiency” may be more dependable due to their more accurate knowledge of the physicians’ performance and more extensive contact with them. This has also resulted in significant differences between nurses and patients or physicians in other principles as well.

Investigating the relationship between moral and social intelligence, and nurses' attitude to patient education

Mozafar Ghaffari

Social and moral intelligence can enhance nurses’ amenability and affect their professional performance in treatment settings, where there is considerable personality and individual diversity. The aim of this research is to investigate the relationship between nurses' social and moral intelligence, and their attitude to patient education. This was a descriptive-analytic correlation study conducted on a statistical sample of 200 nurses selected from West Azerbaijan province during 2014 using the Cochran formula and cluster sampling. Lennick & Kiel’s Moral Competency Inventory, Thet’s Social Intelligence Scale and a researcher-compiled questionnaire on nurses' attitude to patient education were used for data collection. The data were analyzed by Pearson’s correlation coefficient and multiple regression analysis. A positive relationship was found between nurses' attitude to patient education and the social intelligence variable (r=0.422, P=0.001), subscale integrity (r=0.554, P=0.001) subscale responsibility (r=0.292, P=0.001), subscale forgiveness (r=0.283, P=0.002) and subscale compassion (r=0.353, P=0.001) of moral intelligence. The results of multi-variable correlation coefficient using input method indicated that social intelligence and the subscales of moral intelligence influence nurses' attitude to patient education (R2 = 0.426). Patient education is among the main responsibilities of nurses. The results of this study showed that there is a positive and significant relationship between social intelligence and the subscales of moral intelligence, and nurses’ attitude to patient education. It is therefore necessary to improve nurses’ social and moral intelligence through group training in order to enhance their educational role.

Respect for patient privacy in the teaching hospitals of Zanjan

Mansour Ghafourifard

Respecting patients’ privacy leads to increased satisfaction among hospitalized patients and can accelerate the healing process and reduce hospitalization time. This study aimed to determine the level of respect for patient privacy in the teaching hospitals of Zanjan city during 2012. In this cross-sectional study 256 hospitalized patients were selected by multistage sampling and completed the study questionnaire. The questionnaire consisted of two parts: the first part collected the participants’ demographic data and the second part examined the various aspects of patients’ physical privacy. Data were analyzed using SPSS version 21. The results showed that most of the samples (76.2%) were unaware of patients’ rights, and about half (49.2%) believed that their physical privacy was respected most of the time. Meanwhile, 56.3% of the patients declared that medical team members never closed the curtains during physical examinations and medical procedures. The mean score of observation of privacy was less for single patients (51.23 ± 14) compared to married patients (58.88 ± 13) (P <0.05). Based on our findings, most patients were not aware of their rights and some measures of physical privacy were not observed. Therefore, authorities must pay more attention to systematic planning in order to ensure that patients’ privacy is respected in all areas of health and education.