Iranian Journal of Medical Ethics and History of Medicine

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Nurses have to cope with various forms of tension in the workplace on a daily basis. One of the factors affecting the moral distress experienced by nurses is the ethical climate prevalent in clinical environments. The present study aimed to establish the relationship between moral distress and nurses’ ethical work environment. This was a cross-sectional, correlational study on 210 nurses in select departments of medical/educational centers of the Tehran University of Medical Sciences in 2009. Data collection tools included a demographic questionnaire, Corley’s Moral Distress Scale, and Olson's Ethical Climate Questionnaire. Data analysis was performed using SPSS version 14. Findings confirmed that the nurses under study were tolerating an average amount of moral distress, although they did not perceive the frequency of morally stressful situations to be particularly high. There was no significant relationship between the moral distress of the nurses under study and their evaluation of the ethical climate of their workplace. Of the five factors affecting the ethical climate, there was a meaningful indirect relationship between managers and frequency of moral distress (P ≤ 0.04), and patients and frequency and intensity of moral distress (P = 0.001). The results obtained through this research indicated a need for authorities to pay more attention to medical/educational centers and devise various strategies in order to make work environments more ethical, so that nurses can continue to offer health care services in more relaxed environments and with less stress.

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Organizational justice is of great importance particularly for hospital personnel, and job stress has the potential to put their health at risk. The purpose of this study was to determine the relationship between organizational justice and job stress among the personnel of a hospital in Isfahan. In this correlation study, the samples consisted of 150 personnel that were working in a governmental hospital in Isfahan. Samples were selected through convenience sampling in 2012. Data were gathered by personal data questionnaire, Niehoff organizational justice questionnaire and job stress questionnaire. Data were analyzed by descriptive and analytical statistics. Results showed that job stress among hospital personnel varied from 48.6% (moderate) to 39.4% (mild) and 12% (severe). Moreover, findings showed there was a relationship between organizational justice in the domain of interactional justice and job stress among hospital personnel (r = - 0.18, P = 0.03). According to the findings, it is essential to pay attention to the concept of organizational justice in hospitals in order to decrease job stress among the personnel.

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In order to improve service quality, there are various committees in hospitals including ethics committees, which may be among the most important and necessary establishments within the health care system. Hospital ethics committees are designed to ensure proper clinical decision-making and are responsible for monitoring the ethical provision of services in hospitals. They also aim to assist patients and health care professionals without interfering in the physician-patient relationship. This article was part of a comprehensive review study performed in 2014 and 2015 by searching database not restricted to any particular period of time. The keywords used to search the sources available in English included “hospital ethics committee”, “healthcare ethics committee”, “clinical ethics committee”, and “institutional ethics committee”. Since ethical counseling is one of the main tasks of hospital ethics committees, their existence in hospitals appears to be essential. There have been few studies on the functions of hospital ethics committees in Iran, and it seems necessary to investigate the activities of these committees in the country. Moreover, it is recommended that the Ministry of Health and Medical Education take more serious actions to establish and monitor ethics committees in hospitals throughout the country.