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The informatory of the inpatients' informed consent: a survey in selected hospitals
Milad Amini, Seyyed Mohammadhadi Moosavi, Seyyed Mohsen Mohammadnejad,
Volume 2, Issue 3 (9-2009)
Abstract

Modern Care and Ethical Challenges: Emerging Needs and Considerations
Aliasghar Pishdad , Soolmaz Moosavi,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
Scientific advancements and emerging technologies in healthcare - such as Artificial Intelligence (AI), the Internet of Things (IoT), and telemedicine -have created unprecedented opportunities to enhance the quality of care. These innovations enable physicians and patients to achieve faster and more accurate methods in diagnosis, treatment, and monitoring. However, they also introduce new ethical challenges that require careful analysis and appropriate solutions. This study was conducted as a Scoping Review aimed at exploring and elucidating various dimensions of modern care. The methodological framework proposed by Arksey and O'Malley, along with its enhancements by Levac et al., was employed. The main steps included:
1. Research Questions
  • The review focused on the following key questions:
  • What is modern care, and what are its main dimensions?
  • What factors and evidence influence the design and delivery of modern care?
  • What are the major challenges associated with modern care?
  • What are the potential strategies to address these challenges?
2. Search Strategy Development
Reputable scientific databases including PubMed, Scopus, Web of Science, and Google Scholar were searched using relevant keywords such as “modern care,” “contemporary healthcare,” “innovative care,” and “advanced patient care.” Boolean operators were applied to refine the search strategy.
3. Study Selection
Inclusion and exclusion criteria were as follows:
  • Inclusion: Articles related to modern care, published within the last 10 years, in English or Persian, addressing challenges, strategies, or innovative care approaches.
  • Exclusion: Studies focused solely on traditional care or lacking full-text access.
  • Initial selection was based on titles and abstracts, followed by full-text screening
4. Data Extraction and Analysis
Key data were extracted using standardized forms, including study characteristics (year, location), definitions of modern care, focus areas, and main findings. A qualitative approach was used for data analysis, and core themes were identified. Findings were categorized into three major areas:
  • Types of Advanced Technologies and Applications in Care
  • Ethical Challenges in Modern Technology Use
  • Proposed Strategies for Addressing Ethical Challenges
1. Artificial Intelligence (AI)
  • AI algorithms assist in analyzing complex data, pattern recognition, and treatment outcome prediction. Their applications are significant in medical imaging, genetic data analysis, and patient outcome forecasting.
2. Internet of Things (IoT) in Healthcare
  • IoT enables real-time monitoring through connected devices, useful in remote monitoring and chronic disease management.
3. Telemedicine
  • Telemedicine provides patients in remote areas or at home with access to healthcare services, reducing the need for in-person visits and enhancing patient comfort.
Ethical Challenges in Modern Care
  1. Privacy and Data Security
    • Modern technologies, especially AI and IoT, require the collection and analysis of vast amounts of sensitive patient data, posing significant privacy risks and opportunities for unauthorized access.
    • Solution: Employ advanced security systems, data encryption, and adherence to privacy regulations such as GDPR.
  2. Automated Decision-Making by AI
    • AI systems may suggest or even make treatment decisions, sometimes without human oversight. This could result in ethically inappropriate decisions that overlook human and emotional aspects.
    • Solution: Ensure that AI-based decisions are supervised by medical professionals and account for human factors.
  3. Accountability and Responsibility
    • Determining responsibility in case of errors or failures in automated systems is complex. Is the medical team liable, or the technology provider?
    • Solution: Develop clear guidelines and legal frameworks outlining responsibilities and oversight mechanisms.
  4. Equity in Access to Advanced Services
    • Advanced care may not be accessible to all, especially in low-income areas or developing countries, leading to healthcare and social inequalities.
    • Solution: Plan for equitable access and provide support to underserved communities.
  5. Use of Genetic Data and Personalized Medicine
    • Although personalized medicine based on genetic profiling improves outcomes, it also raises concerns about genetic discrimination and privacy breaches.
    • Solution: Establish strict laws and ethical standards for handling genetic data.
  6. Changing Roles of Physicians and Patient Trust
    • Automation may diminish the central role of physicians, potentially undermining patient trust.
    • Solution: Reinforce the human element in care and ensure physicians maintain their role as primary decision-makers.
Proposed Strategies to Address Ethical Challenges
  1. Education and Empowerment of Medical Teams and Patients
    • Familiarity with new technologies and their ethical implications helps care teams make informed decisions. Patients should also be aware of their rights and data privacy issues.
  2. Development of Comprehensive Regulations
    • Clear and enforceable legal frameworks that uphold ethical standards and protect patient privacy are crucial.
  3. International Collaboration and Knowledge Sharing
    • Global standard development and sharing of best practices can enhance ethical use of medical technologies.
  4. Establishment of Ethics Committees and Oversight Bodies
    • Ethics committees in healthcare and research institutions can assess and manage emerging ethical concerns. Close monitoring of technology use is essential.
  5. Assessment of Long-Term Impacts
    • Longitudinal studies are needed to understand the long-term consequences of modern technologies, supporting better decision-making.
Modern healthcare technologies offer vast potential for improving quality of life. However, they also introduce new ethical challenges. Addressing these requires integrating ethical principles with scientific innovation and strategic planning. This article underscores the importance of comprehensive legislation, education, and maintaining the human role in medical processes to reduce these challenges and strengthen patient trust in modern care.

The Role of Ethics in Emergency Care for the Elderly
Soolmaz Moosavi ,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
The elderly population is rapidly increasing, and as a result, the demand for emergency services for this age group is also growing. Due to their specific physical and mental conditions, the elderly are exposed to numerous ethical issues and challenges when receiving emergency services. These issues are significant because their physical and mental conditions can prevent them from making decisions independently and achieving informed consent. The aim of this article is to examine the ethical challenges associated with the care of the elderly in the emergency department and to provide suggestions for improving this care. This educational narrative review article examines and analyzes ethical challenges in elderly care in the emergency department using reliable sources and articles between 2005 and 2024. Keywords included "medical ethics," "elderly care," and "emergency," and sources were extracted from reliable scientific databases such as PubMed, Scopus, and Google Scholar. Ethical challenges in elderly care in the emergency department include maintaining the independence of the elderly, obtaining informed consent, ensuring privacy and confidentiality, decision-making at the end of life, observing justice and fairness, maintaining honesty, providing psychological and emotional support, offering compassion and empathy, upholding professional principles of education and awareness, communicating effectively with the family, managing pain, and ensuring patient comfort. Although developed countries have long faced the issue of aging, in recent years, the growth rate of aging in developing countries has accelerated. These countries face major challenges in elderly care due to inadequate infrastructure and rapid demographic changes. Ethical challenges in caring for elderly patients in emergency rooms are among the most important issues that healthcare teams face. These challenges are exacerbated by the physical and mental sensitivity of the elderly, the complexities of treatment, and the need for rapid decision-making. Adherence to ethical principles, along with ongoing education of caregivers, can improve the quality of care for the elderly in emergency situations and prevent physical and mental harm. Therefore, in addition to knowledge and skills, caring for the elderly requires adherence to ethical principles and humane behavior. By following these principles, a sense of trust and peace can be fostered in the elderly. Some suggested solutions include educating and raising awareness among healthcare teams, strengthening communication with family and legal representatives, using ethical standards, encouraging the elderly to prepare a medical will, and utilizing psychological and physical assessments.
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