Iranian Journal of Medical Ethics and History of Medicine

Virtue ethics and ethical decision-making in medicine

ensieh madani

Virtue ethics is an agent-centered approach that is concerned with good and bad character rather than right or wrong action. It is based on the virtues and moral character of the agent. Morality of the physician is emphasized in medicine as well, which demonstrates its affinity with virtue ethics. Nevertheless, a theory of applied or medical ethics should provide a criterion for ethical decision making by instructing what should be done, something which, according to some philosophers, is incompatible with virtue ethics. This article aimed to demonstrate how virtue ethics can offer rules and guidelines by resorting to the moral agent and emphasizing virtues, and help physicians to make decisions when faced with dilemmas. For this purpose, examples about abortion and selling kidneys for transplantation were provided.Some of the most important advantages of virtue ethics include: context-dependence and attention to relevant realities the importance of emotions and the likely motivations of the people involved and finally emphasis on exemplar based on the sensitivity and practical wisdom of the virtuous agent. These advantages cause virtue ethics to be better positioned than other approaches to solving problems in medical ethics.

A review of the Islamic approach to education in medical training

Nikzad Iesazadeh

The precepts of Islamic education are founded on a practical and all-inclusive system that is aimed to develop man in all aspects of his life based on Quranic guidance (Quran and Ravayat). The individual is at the heart of Islamic education, and therefore has a specific place in Islam and is considered sacred and blessed.As a rule, medicine is targeted at the physical wellbeing of man. Consequently, Islamic education can play can play an important role in medical training and may be traced in the Quran and Revayat.Instructors and students are at the core of education and learning, and their development will result in the moral, spiritual and technical advancement of the society. Medical schools aim to cultivate young talents and educate experts in the health industry, and are naturally essential for the development of a nation. This can be achieved through the attempts of capable and motivated instructors within the educational system.The present study is a review of the Islamic approach to medical training and the techniques of developing motivated and capable scholars and students in order to achieve Islamic educational goals.

Telemedicine: benefits, disadvantages and ethical challenges

Mahshad Noroozi

Nowadays, electronic communications technology propounds new forms of the patient-physician relationship in the field of medicine. Effective communication between the patient and the physician can play a crucial role in the process of treatment. This new form of communication greatly influences promotion of the health system by improving access to inexpensive and fast services regardless of geographic boundaries. In times of crisis, telemedicine plays an important role in delivering health services to deprived areas in a just manner. Usage of communications technology is inevitable, and due to the virtual nature of this kind of medical communication, recognition of certain ethical considerations seems essential. Successful examples of telemedicine are abundant throughout the world and usage of this technology is a helping solution for inadequacies in the healthcare system. In Iran, because of the geographical extent of the country, this technology can provide access to medical services in some cases.In order to achieve the best outcome in telemedicine, it is essential to respect confidentiality, privacy, informed consent and commitment to professionalism in this field.

Reproductive right: the concept, the examples, and its origin from Islamic, ethical and liberal rights

Mohadeseh Moeinifar

In the modern world, reproductive right is considered among the basic human rights in countries such as America and Britain. There has been growing interest in the subject and its various aspects including contraception and assisted reproductive technologies, which are giving rise to the ongoing debates. National and international legislators, governments and religions are striving to resolve the controversy among individuals and between individuals and governments and devise the perfect legislation that will cover all aspects of the subject and control all activities in this area.In the realm of bioethics and law, the issue is introduced as a right not duty, while in Christianity and Judaism it falls under the category of duty. In Islam, on the other hand, childbearing decision-making is left to the couple, which highlights the teachings of Islam regarding reproduction. In this paper, we attempted to offer a comparative study of four different points of view regarding the issue of reproductive rights

Survey factors related to consent to organ donation in families of brain death patients in hospitals affiliated with Shahrekord University of Medical Sciences

neda parvin

In the past decades, the need for organ donation has increased while consent rate continues to remain inadequate. One of the most important limiting factors in organ donation is families’ refusal to grant consent, and therefore it is important to determine the circumstances influencing the phenomenon. The aim of this study was to investigate the factors affecting consent to organ donation in families of brain death patients in hospitals affiliated with Shahrekord University of Medical Sciences. For this purpose, a self-made questionnaire was distributed among 54 family members of brain death patients admitted in hospitals affiliated with Shahrekord University of Medical Sciences between 2003 and 2013. The data were reported as mean, frequency and percentage using the SPSS16 software. The average age of the deceased was 31.38 ± 13.72 years, and car accidents were the most frequent cause of brain death (59.3%) in this study. In addition, 72.2% of the deceased were male and 90.7% of them lived in or around the city of Shahrekord. About 37% of the families consented to organ donation. The average age of the family members who participated in the study was 42.15 ± 8.9 years. The most frequent reasons affecting families’ consent to organ donation were religious rewards (100%), confidence in the medical team and staff (100%), and confidence in physician diagnosis (100%).The findings of the study show that religion, faith and family ties affect the willingness for organ donation, and therefore specific attention should be given to these factors in educational programs. In the present study, religious beliefs and confidence in the performance of health care workers were highlighted as the most effective factors in consent to organ donation in brain dead patients' families. Consequently, in order to increase organ donation rate, special attention to these factors and proper planning is necessary.

An analytic-descriptive study of patient complaints in the clinical governance office of Imam Khomeini Hospital over a period of two years

Shahram Samadi

The present study is an overview of the causes of patient complaints against physicians and the medical staff in Imam Khomeini Hospital Complex, and strategies to reduce the complaints. For this purpose, complaints that had been filed with the clinical governance office of Imam Khomeini Hospital Complex in 2012 and 2013 were investigated. The information in the forms included age and sex of the plaintiffs, their level of education, type of complaint and similar details. Of the 309 complaints, 174 had been recorded in 2012 and 135 in 2013. The plaintiffs were males with a mean age of 50.5, and 69.6% of them had high school diplomas or lower. Most (16.2%) of the complaints pertained to the emergency department, while 48.5% and 22.7% of the complaints were related to doctors and nurses respectively. In 62.5% of the cases, the accused had been acquitted and 34% had been convicted. The main cause of complaint involved treatment and care at 40.1% and 36.6% respectively. In general, the most common causes of complaints were treatment and care for doctors, and lack of respect for nurses and others. Thus, more attention should be paid to the continuous education of medical students and residents during training years in order to increase the knowledge and skills of physicians. Other measures that can reduce complaints are: providing sufficient information to patients before diagnostic or therapeutic procedures improving the equipment in health centers educating the society and raising public awareness of the treatment process offering the necessary information during medical procedures obtaining informed consent careful choice of the medical team and assigning them to the right position and holding communication skills workshops.

The effect of personal and organizational factors on nurses’ knowledge oriented generosity: a research in Beheshti Hospital of Yasouj

Habibollah Ranaei Kordshouli

This study aims to investigate the effect of personal and organizational factors on nurses’ generosity in knowledge sharing. For this purpose, a questionnaire was used to gather the required data from the nurses in Beheshti Hospital of Yasouj. The data were then analyzed using descriptive tests (SPSS Software) as well as structural equation modeling (Smart PLS Software). The following factors were found to influence nurses’ generosity in knowledge sharing respectively: organizational culture (&beta: 0.25 T: 5.02), supervisory (&beta: 0.10 T: 4.63), and human resources management (&beta: 0.05 T: 4.36). Some personal factors affecting nurses’ generosity in sharing knowledge included: willingness to help others (&beta: 0.32 T: 4.18) and trust in colleagues (&beta: 0.16 T: 3.02), respectively, but the effect of nurses’ perceived self-efficacy on their generosity in knowledge sharing was not significant (&beta: 0.08 T: 0.54). It can therefore be concluded that both personal and organizational factors are effective on nurses’ generosity in sharing knowledge, although the former appears to have a greater influence.

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