Iranian Journal of Medical Ethics and History of Medicine

Organizational behavior: ethical or unethical

Hossien Dargahi

Political behaviors are a group of practices that are not essential in organizations, but can impact organizational resources and their reward systems. Employees and managers try to demonstrate political behavior to gain power. Today, most organizational behavior researchers have focused on the perception of political behaviors and how these behaviors are presented with regard to ethical considerations. Therefore, this review is aimed to study the goals, reasons, outcomes, and morality or immorality of political behaviors and power in organizations. The current paper is the result of a literature review that was conducted by using Medline, Ovid, Elsevier, Google, Pub Med, Scopus, Springer, and Cochran library search engines and through selection of 5 key words and 110 references out of which 41 references were ultimately chosen. Most political behaviors are the consequences of employees' personal differences and organizational specifications. Some employees follow moral political behaviors and the rest prefer immoral ones, although it seems difficult to establish which political behaviors are moral and which ones are not. We believe that political behaviors that are based on ethical considerations should be consistent with organizational interests. Seeing as political behaviors are a fundamental component of organizational conduct, they cannot be eliminated therefore, managers should believe in the political nature of their organizations and determine their political strategies and try to employ these strategies to the advantage of their organizations.

Euthanasia: the difference between act and quit

Gholamhossein Tavakoli

Euthanasia has been the subject of much controversy during the last three decades. In ethics most philosophers divide it into active and passive euthanasia and consider the first option to be immoral. There are some thinkers, however, who deny any moral significance in such a distinction. Among them and perhaps the first in this arena is James Rachels who is followed by other thinkers like Jonathan Bennett and Michael Tooley. Rachels poses his equivalence theory. By this he means that assuming the stability of other factors in a given circumstance and focusing on the variable of act and omission alone we would find that there is no moral difference between the two. He tries to defend his theory by the way of parallel examples and parity of reasons. We are going to evaluate his arguments by explaining and then criticizing them. In this regard we will examine briefly some counter-examples, and then we will have a look at some answers of other philosophers like Philippa Foot and Will Cartwright. We try to assess these refutations and finally we are going to offer two answers in the hope that these answers solve the problem.

Changes in creation and germ cell engineering: ethical analysis

Fatemeh Torof

Human germ cell engineering is a modern technology researched with the aim of studying perennial hereditary mutations in herbaceous, animal and human generations. It has led to abundant arguments and discords among ethics and law experts. Possible changes in the human genome that are identified - according to deceleration of human genome and human rights - as the heritage of humanity and the fundamental unity of all members of the human family lead to questions about the relations between this technology and the normal process of creation. At first glance it seems that human germ cell engineering may lead to innovations in the ordinary institution of creation and the old customs of reproduction. Pursuing the contrasting viewpoints on human germ cell engineering, we can observe an essential and material concern about "changing God's creation" or "interference in the will of God"."Changing God's creation" is a current term in Islamic juridical and moral literature. It performs the main role in the legal destiny of genetically engineered creations so the assertion of this phrase about a being can lead to its natural prohibition. The majority of Moslem interpreters maintain that creation bears upon man's Godly disposition, which is unchangeable. In this research, adopting a dominant approach, the author thinks that the process of human germ cell engineering is not exclusively a sample for the term "changing God's creation". In this article we will try to analyze the potentials of the subject of change in genetic engineering of the human germ cell while taking into consideration the holy religion of Islam.

Confidentiality: a comparative study between medical ethics principles and Islamic ethics

Nasrin Nejadsarvari

Confidentiality is one of the oldest principles of the medical profession that impacts on the relationship between physician and patient, the personal interests of patient and physician and consequently social welfare. While emphasizing the necessity of confidentiality, religious teachings consider disclosure of others' secrets a sin that deserves punishment thereafter. Nowadays, medical developments and the invention of new diagnostic and therapeutic procedures as well as the vastness of the informatics world make disclosure of patients' secrets easier than ever. This review article is the result of a descriptive study, and the information was collected using reliable library and internet resources. It will first expound the concepts and principles of confidentiality in medical ethics as well as Islamic ethics, and will then proceed to a comparative review of the similarities and differences in these two sets of ethical views on the issue of confidentiality. In addition to the emphasis of medical ethics and Islamic ethics on the necessity of confidentiality in order to win public trust, both sets of teachings cover two areas of personal and public discretion, while in Islamic ethics, the issue extends to a third from, namely religious confidentiality. This makes Islamic ethics more comprehensive in the sense that based on Islamic teachings, the person who keeps someone's secret will also be rewarded in the Hereafter. Also, in medical ethics, only the behavior of the health staff is evaluated and their moods and motives are not taken into consideration, while Islamic ethics pays attention to human dispositions and therefore confidentiality is more stable and can maintain its efficiency without external supervision.

Nursing advocacy in teaching hospitals of Kerman University of Medical Sciences: nurses’ attitude

Mohadeseh Motamedjahromi

Nursing advocacy is an essential aspect of nursing professionals' ethics that promotes patients' autonomy, safety, and rights. It seems that nurses' attitudes toward nursing advocacy can affect their role as patients' advocates and improve the nurse-patient relationship. This study aimed to investigate nurses' attitudes toward patient advocacy in educational hospitals in Kerman.The data for this descriptive-analytical study was collected using a self-administered questionnaire by quota sampling among 385 nurses from four teaching hospitals of Kerman and analyzed using the SPSS software including descriptive and inferential statistics. Overall the nurses' attitude toward nursing advocacy was relatively positive. There was a significant relationship among nurses' attitude and age, sex, nursing experience and participation in workshops, while we could find no significant relationship between nurses' level of education and their attitude. The nurses' attitude in mental hospitals was more appropriate than others, and the majority of participants were confident that they were suited for the advocacy role.The cognitive aspect of nurses' attitude was stronger than the behavioral aspect. Despite the lack of significant effect of education, more nursing experience led to more willingness to play the advocacy role. In psychiatric hospitals, nurses with more independence and stronger relationships with the patients became more familiar with the needs of patients so these nurses made more effort to defend them. It seems Iranian nurses have felt morally obligated to defend their patients for many years. In order to support nurses' advocacy role in our country, we believe it is necessary to reinforce this attitude in nurses through holding ethical workshops.

Association of ICU nurses’ demographic characteristics and moral distress

Tahereh Ashktorab

Moral distress is one of ICU nurses' major problems that can happen due to various reasons and may have several consequences. Considering that certain variables can be related to moral distress and turnover intention in nurses, this study was done to determine the correlation between ICU nurses' demographic characteristics and their moral distress and turnover. In this correlational study, 159 ICU nurses were selected from medical universities of Iran. Data collection instruments included a demographic questionnaire, ICU nurses' moral distress scale, and Hinshaw and Atwood's turnover scale. Data analysis was done by using SPSS 17_.The findings showed high level of moral distress and turnover in ICU nurses. The results revealed a positive statistical correlation among ICU nurses' age, their work experience, the ratio of nurses to ICU beds and their moral distress. However, there was no correlation among sex, marital status, educational degree, work shift and moral distress. Similarly, moral distress and intent to turnover did not have a statistical correlation.The results showed that increasing recruitment of young nurses and nursing staff, and diminishing ICU nurses' moral distress and turnover intention are essential.

Criteria of trust in the physician-patient relationship

Amirahmad Shojaei

Trust is an important factor in the relationship between physician and patient. Trust between physician and patient is an important factor in improving patient and physician satisfaction, but it will not materialize unless we define trust and its criteria. Since trust fulfillment is dependent on its criteria, in this study we tried to define these criteria. First, we explicated the meaning and concept of trust through review articles, then we proceeded to content analysis, and lastly, the logical conclusion was obtained. In this article we have expressed scientific opinions and extracted 23 components from the cited opinions. We concluded that trust can be analyzed from three perspectives: the perspective of patients with 5 criteria, the physicians' view with 2 criteria and the perspective of an observer of the physician-patient relationship with 9 criteria.

Afshin Farahanchi