Iranian Journal of Medical Ethics and History of Medicine

The concept of Islamic medicine, which differs from traditional medicine and even Muslims’ medicine, has become more and more popular in recent years in Iran, especially in religious cities. In the present article, we have addressed the extremist approach of the claimants of Islamic medicine (which considers itself a competitor of modern medicine and traditional medicine).Our theoretical basis for the ethical criticism of this approach has been the principlism of "Beauchamp and Childers". Thereby, we have attempted to challenge the clinical position and medical performances of extremists in the Islamic medicine on the basis of four principles of "justice, autonomy, beneficence, and non-maleficence". Then, we have concluded that the claim of the Islamic medicine cannot, in the present circumstances, satisfy the principle of distributive justice. It also violates patients' autonomy by making unfair judgments and fears about modern medicine. It is very prone to harm clients by refusing scientific evaluation of medicines and therapies and lacking a valid certification system.  Accordingly, we  particularly challenged the attribution of this process to Islam.  This attribution may cause serious damage to the religious beliefs of the clients.

The purpose of this study was to perform a narrative review and documentary research in the history of community medicine specialty formation and the needs for its existence in health systems. We searched and reviewed related literature and documents in English and or Farsi (printed or online). Data was extracted and findings were categorized, summarized, and reported. About a century ago community medicine specialty was formed to respond to major health challenges of that time such as neglecting the effects of social determinants on populations’ health and total separation between clinical care and public health. Community medicine professionals are able to address many of the current health problems such as inequalities in health, fair financing problems, increasing demands and costs and disease-based health system approaches. They can be the leading advocates to emphasize the importance of social determinants in health of populations. They can promote communications with influencing institutions outside the health system to improve the health of the communities. This discipline can pave the way for the health systems to tackle the most important contemporary health challenges. Lack of attention to this discipline may hinder the achievement of sustainable development goals and health promotion of the communities. More support from officials and utilizing the skills of community medicine specialists can help health systems not only to better respond to the health needs of the society but also to facilitate the achievement of their main goals.

Nurses are among the members of the treatment team who have the most contact with Corona Virus Disease- 2019 (COVID-19) patients and their ethical decision-making is inevitable during patient care. On the other hand, nurses' motivation to implement end-of-life care is influenced by their attitude, awareness, and moral reasoning. The aim of this study was to investigate the level of ethical decision making of nurses and its relationship with the attitudes of end-of-life care of patients with COVID-19 in hospitals affiliated to Hamadan University of Medical Sciences in 2021. In this study, 180 nurses working in hospitals affiliated to Hamadan University of Medical Sciences were selected by convenience sampling method. Data collection tools included: demographic Information questionnaire, Nursing Dilemma Test (NDT) questionnaire, and Frommelt Attitudes towards End-of-Life Care questionnaire. According to the results, there is a direct relationship between nurses' ethical decisions and the attitude of end-of-life care (<0.05, r=0.819). The mean score of nurses' ethical decision-making indicates the low level of ethical decision-making (39.19 (5.3)) and the mean score of nurses' practical considerations (20.62(4.2)) showed that the process of nurses' ethical decision-making is relatively influenced by environmental factors. Also, the average score of nurses' exposure to moral challenges indicates that nurses are familiar with similar situations. The mean score of nurses' attitudes toward end-of-life care was reported at an undesirable level (81.58(7.8)). According to the results, by identifying the factors affecting nurses' ethical decision-making and educational planning to improve their decision-making level, it is possible to improve the quality of patients care while improving nurses' attitudes toward end-of-life care.

With the increasing need for home nursing care, patient autonomy emerges as a crucial ethical principle in delivering care services. Therefore, this study aimed to investigate the importance of autonomy and individual independence in home-based patient care. In this systematic review, articles from PubMed, Scopus, ScienceDirect, Magiran databases, and Google Scholar search engine, published within the last 10 years, were used to search for articles related to autonomy and independence in home nursing care. The keywords used in the search were: "patient autonomy", "home nursing care", "nursing ethics" and "autonomy in nursing home care".  After reviewing and filtering the articles based on the study's objectives, 20 articles related to autonomy in home nursing care were included in this systematic review. The findings of these studies indicated that various factors can influence patient autonomy at home-care, including: · Individual factors: age, gender, physical and mental health status of the patient; · Family factors: family support, family relationships, family culture; · Social factors: social support, access to social resources; · Organizational factors: care policies, organizational structure, organizational culture.  Considering these findings and their comparisons, it can be concluded that to promote patient autonomy at home, all the mentioned factors should be considered. Some of the suggested solutions to promote patient autonomy are: · Educating the patient and family about patient autonomy; · Strengthening family support for the patient; · Providing social support services to the patient; · Developing care policies that support patient autonomy; · Improving organizational structure and culture.  Patient autonomy is one of the essential ethical principles in home nursing care. Considering the factors affecting patient's autonomy, comprehensive solutions should be considered to promote it. Patient and family education, strengthening family support, providing social support services  and improving organizational structure and culture are among the effective solutions in this field.