Iranian Journal of Medical Ethics and History of Medicine

---

---

---

---

No abstract####

---

---

---

No Abstract####

---

---

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.

---

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.

---

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.

---

---

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.

---

In the middle age (500–1500), while European countries were struggling with frightening epidemics such as plague, smallpox, tuberculoses, leprosy, and their medical treatments were based on superstitions and fanaticism, scientists such as Avicenna and Rhazes laid the foundation of the golden period in medicine. In the late periods of golden centuries, during the Mogul invasion of Iran, Rashidaddin Fazlollah Hamadani devoted a great deal of effort to preserve the knowledge by foundation of the knowledge city of Rabé Rashidi and Daralshafa (Medical and Health Service College) in Tabriz. Rashidaddin established a successful health management system which was accordance with the current modern health management systems. The objective of this review is to present a clear perspective of a successful Iranian Islamic model of health delivery system 700 years ago. The review was conducted in the form of descriptive bases of original documents with a systemic approach. Findings show a successful management experience in health system in terms of stewardship, resource allocation, provision of health services and financing which appears to be in accordance with the World Health Organization (WHO) declaration in 2000. Promotion of team working, employment of fulltime and part-time physicians, implementation of a fair and functional economic structure, health economic, sustainable financial mechanisms, public insurance, home care provision, and isolation of communicable diseases in hospitals can be considered as examples of a successful Iranian Islamic health management system. It can be concluded that as Iranian health management system is faced with many different challenges, gleaning lessons from successful national historical experiences can play a key role in the establishment of a competent system based on our Islamic and national values and in accordance with modern scientific achievements.

---

In this paper, the author aims to study orthodox and protestant points of views on human cloning and investigate on their arguments for and against it. Both ideologies have abolished both reproductive and therapeutic cloning and put forward an argument against them. The only liberal view which allows therapeutic cloning, but refrains from explicitly commenting on reproductive cloning, is a cult of protestant religion. It can be concluded that although reproductive human cloning can't be prohibited by account of their reasons, therapeutic cloning can be forbade by the reason of protecting the life right. This perspective shows that there is a fundamental consistency in Christianity's teaching about both kinds of cloning, because this religion prohibited all sorts of it.

---

Generally, when moral values and ethical principles are concerned, human beings are considered as the sole subject of these fields. It is then concluded that the only living creatures with some privileges and obligation towards their own bodies and also, towards their other human counterparts are humans. An emerging issue, particularly in the past recent three decades, has been the expansion of the ethical community to be inclusive of other living creatures, namely animals. Novel branches of science such as animal ethic are increasingly challenging the traditional view of ethics and aim to include animals in ethical community. In this article, a descriptive study and systematic review of literate was carried out on different aspects of animal ethics and the specific codes applicable to animals was studied in order to shed some light on the animal ethics and on what basis they are subjects to ethical considerations. As animals are proven to have the ability of perception and demonstrated to be able to feel and differentiate good and bad experiences, they are considered as being the subject of ethical considerations. Therefore, human beings should be responsible for their behavior towards animals in different aspects.

---

In this paper, different definitions of moral conflict and moral dilemma at two levels of recognition and observing moral duties are taken into consideration and some instances of usage of conflict in physiology (conflict of stimulant and goals) and sociology(conflict of roles and norms)are mentioned. Also concepts and constraints used in the moral dilemma, especially the concept of "ought to" and the concept of "Inescapable of wrongdoing" are surveyed in a logical analysis. If in definition of moral dilemma, the concept of “ought to” and “duties” being transformable to “commensurable reasons” and their justificatory values, many of apparent moral dilemmas will be solvable and only if the values contained in the duties, being incommensurable and non-infringement, moral wrongdoing will be inevitable. In this research, it will become clear that why and how proponents of the possibility of moral dilemmas under pressure of logical argument against the possibility of moral dilemmas and criticisms of opponents, in order to provide the necessary features for a genuine dilemma have suggested variety and supplementary definitions of moral dilemmas such as: natural, disjunctive, two shape and prohibition definitions. Natural definition of moral dilemma represents a situation in which the agent sees himself as both a moral duty, while he can't do it well. In disjunctive definition agent is required to perform either task. In two shape definition (consisting of the "ought to" and "ought not to"), on the one hand the agent ought to do and on the other hand ought not to do the same. In prohibition definition, the agent should not perform any of the two while he has no choice but to do one.

---

End stage patient control and autonomy are core principles in human bio-medical ethics and key components of end-of-life (EOL) care. Albeit, according to modern medical ethics principles the centrality of the patient as decision maker may not be relevant to culturally diverse groups of end stage people. The purpose of this article is to present results of a literature review of end stage patient control and their family position within the context of end of life support. The review revealed that the interaction between medical control and ethical values in end of life support is multifaceted and unpredictable. According to the recommendations of American College of Physicians/American Society of Internal Medicine End-of-Life Consensus Panel and some other world class medical and ethical societies, culturally effective end of life support includes the following essential elements • acceptance of and respect for cultural differences among all end stage patients • willingness to negotiate and compromise when world views differ • understanding of one's own values and biases • contact and communication skills that enhance empathy • information of the cultural practices of patient groups should be seen on a regular basis and • attention that all patients are individuals and may not share the same views as others within their own ethnic group According to the above description, applicants identified five domains of quality end of life support: 1. receiving adequate pain control 2. avoiding inappropriate prolongation of the dying process 3. achieving a sense of control 4. relieving burden on loved ones and 5. strengthening relationships We emphasize that, despite above mentioned points and advices maintaining a sense of control is an essential element in the end of life support for some individuals, further study of the interplay between ethnicity, desire for control, and achieving a good death is needed.

---

---