Iranian Journal of Medical Ethics and History of Medicine

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Because of complications of medical treatments, informing patients about the rate of treatment success, potential risks, and side- effects, is considered as an indispensable part of treatment contracts. Patients' deprivation of this information can be considered as a major obstacle in obtaining informed consent. Clearly treatment without patients' or their legal guardians informed consent may lead to civil and penal liability for the physicians.
Consenting without getting enough information about the disease, and its treatment is the most important issue in this regard. Now can such consent be valid and legalize the treatment or not? In this article informed consent and the physicians duty of informing patients are compared in three legal systems of Iran, England and France and then the physicians' duty of notification will be analyzed and some suggestions for safeguarding patients rights will be offered.

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Considering the importance of medicine and the ever-increasing developments in medical research, the implementation of such research according to the ethical principles and criteria of creditable national and international declarations is of great significance. According to these declarations, the researcher has the highest responsibility to observe the rights and safety of participants. The present study intends to survey the rate of observance of research ethics in proposals approved at Urmia University of Medical Sciences between the years 2003 and 2008. Three hundred and twenty four research proposals that had been approved between 2003 and 2008 were evaluated retrospectively. Related checklists (self- constructed ones and World Health Organization checklists) were completed for each project, a statistical analysis of the results was done by SPSS software, and descriptive statistics were subsequently extracted.  A summary of the most important results is as follows: In 85.5% of the proposals, the ethical considerations part was completed. In 68.4% of the cases the participants were aware of participating in the study and in 67.9% of the cases the informed consent of participants was obtained, 50.9% of which was in written form. Among clinical trials, in 80% of the proposals informed consent was obtained, 85% of which was written. Out of 60 clinical trials, 37 projects (62%) were confirmed by the ethics committee. Considering the results obtained in this study, principles of research ethics were applied more closely in this study compared to similar studies in Iran. It seems this is due to the establishment and launch of regional ethics committees in 2003 and afterwards. However, in order to bring these measures closer to current standards, holding educational workshops for honorable members of scientific boards and students is recommended. Moreover, more accurate supervision of ethics committees, especially in clinical trials and animal experimentations, seems to be beneficial.

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Presumption of innocence is one of the fundamental principles of criminal law that has its roots in moral and religious principles. Presumption of innocence is consistent with human nature, and special attention has been paid to it in Islam. For this reason it has been included in our constitutional law as well as in the constitutions and ordinary laws of other nations, and this indicates its significance. In Shiite jurisprudence there are two major theories on the responsibility of physicians as “daman al-tabib”. Most jurists (famous) consider the physician responsible even if he or she has committed no fault. Only a minority of jurists (less-known) consider the physician to have no responsibility. Islamic criminal law believes the physician to have absolute liability, although medical practices have become more sensitive than in the past and medical incidents have increased as a result of new technology and new methods of treatment. The present study intends to adopt a new approach to rules and principles of jurisprudence, and study the necessity of using them according to the requirements of time in solving everyday problems. Moreover, the study seeks ways to prevent the regression of those rules. Therefore, it seems essential that the golden principle of presumption of innocence be applied to physicians as the manifestation of God's healing, and more attention be paid to it.

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Recent provisions to the Islamic Penal Code have provided favorable regulations that absolve the skilled physician from absolute liability and adjust liability according to fault. The revised code adopts a new approach by allowing physicians more freedom while providing added protection, which is consistent with ethical standards and Jurisprudential principles. The present paper aimed to investigate the development process of statutory laws in Iran regarding medical liability and at the same time analyze articles of the Islamic Penal Code of 2013 on the subject. Some articles have been found to contain ambiguities that need to be modified. As an instance there seems to be a conflict between Article 492 and Clause 1 of Article 496 that should be resolved as it pertains to a case of the cause and the perpetrator (physician and nurse). In these situations the doctor orders and the nurse acts, and it is therefore necessary and proper that physicians not be absolved from liability.

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Abstract Ethical and moral values lie at the root of employee behavior and activities. Hence, observance of professional ethics and the related benefits are among the most fundamental research topics in organizational areas. This descriptive-correlational research was performed according to the practical study objectives and through adopting a data collection approach. With the aim of exploring the mediating effect of organizational identification on the relationship between professional ethics, organizational citizenship behavior and job deviation behavior, a sample of 225 employees and hospital specialists were chosen from the cities of Maku, Showt and Poldasht using random stratified sampling. Data were gathered through standard questionnaires of Van Dick’s organizational identification, professional ethics, citizenship behavior and deviation behavior. In order to evaluate the relationship among variables measured in a conceptual model, Structural Equation Modeling was used. The results showed that there is a positive and significant relationship between organizational identification and professional ethics (r = 0.177) and organizational citizenship behavior (OCB) (r = 0.179). Findings also showed that the relationship between professional ethics and citizenship behavior and deviation behavior is mediated through organizational identification. In the above-mentioned model, all regression weights were statistically significant, except for the relationship between professional ethics and deviation behavior. The results of this study indicated that professional ethics strengthened organizational identification on the one hand, and organizational identification strengthened citizenship behavior and reduced the deviation behavior of the employees and hospital specialists on the other hand.

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Chronic renal failure in infants is a life-threatening condition that can also severely affect their families. Patients and their families are under great physical, mental and social pressure, and therefore require medical, palliative and supportive care. Moreover, ethics has an important role in care for these infants and their families. The purpose of this study was to identify an ethical approach to providing medical, supportive and palliative services for infants with chronic renal failure and their families. The study was based on a case report in the Medical Ethics Grand Rounds of the Children's Medical Center in Tehran, Iran. The case pertained to a male newborn infant with diagnosis of renal failure. Assessments indicated severe bilateral hydronephrosis and multicystic dysplastic kidneys accompanied by high creatinine levels. The patient underwent surgery but further evaluations revealed a low glomerular filtration rate accompanied by elevated blood pressure. The physicians suggested insertion of a catheter for CAPD (continuous ambulatory peritoneal dialysis) after the initial peritoneal dialysis until a kidney transplant was performed. The proposal, however, was rejected by the parents and the patient was discharged by their consent. A few weeks later, the infant expired at home. It seems that health professionals need effective ethical strategies to offer medical, supportive and palliative services for infants with chronic renal failure and their families

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The Declaration of Helsinki is one of the most important international documents in medical research ethics on human subjects which has been revised 7 times and the last revision was in 2013. Researchers must be informed of the principle of Helsinki declaration and the latest changes in order to respect the rights of participants in medical research. In this study, the last version of the declaration are compared with the previous version (2008). The evaluation of the changes and challenges of the final revision can be helpful in modification of the ethical codes of our country. The 2013 version included a number of important changes; it has been categorized into more clear and detailed sections. So this version has a better structure and more practical as well. The 2013 version places more emphasis on vulnerable groups and includes a separate section on the compensation and treatment of injuries due to research. The revised version of the Declaration of Helsinki also emphasizes obtaining of the informed consent (even in researches on material or data contained in biobanks) and post-trial access.

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Reproduction and fertility are considered a substantial need for the survival of the human race and has seen its ups and downs. Advances in Assisted Reproductive Technology (ARTs) have brought some changes as well as challenge in human reproduction. For instance, involvement of a third-party in pregnancy has become a challenging practice. Given the rapid application of ARTs in Iran, obscure aspects and consequences associated with this technology need to be elaborated. The present study aimed at investigating the identity and rights of children resulting from ARTs based on the existing laws and the opinions of the contemporary Shi’ite Grand Ayatollahs. First, by reviewing the sources of Islamic law as well as searching the legal and reliable electronic resources -using key terms such as parentage, guardianship, embryo donation and infertility- the existing laws and regulations about ARTs have been analyzed. Then, by a qualitative method, written opinions of some contemporary Shi’ite Grand Ayatollahs regarding the identity and the rights of a child born by involvement of a third party were collected. The result shows inconsistency between the opinion of the contemporary Islamic jurists and the existing law about embryo donation. Islamic Jurists believe that the child of embryo donation does not belong to the recipient couple. However, according to the Embryo Donation Act, in particular with regard to the duties placed upon infertile couples, who receive the donated embryo, implicitly accept the recipient couple as the parents of the child. This eventually leaves the child with an identity crisis besides deprivation of citizenship rights in some cases. Accordingly, as the current rules and legislations of Iran conflicts with views of the Islamic jurists, to resolve this problem, a revision to accept the recipients as legal parents of the child is necessary.

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