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Evaluation of Regional and Institutional Research Ethics Committees’ Effectiveness in Iran: Results from a Study Using a Self-Assessment Tool
Mahshad Noroozi, Ehsan Shamsi Gooshki, Saeedeh Saeedi Tehrani, Fatemeh Bahmani, Mina Forouzandeh, Saeed Biroudian, Nazila Nikravan Fard, Mahshad Goharimehr, Akram Hashemi,
Volume 16, Issue 1 (3-2023)
Abstract
The research activities of developing countries have increased over the last two decades. The expansion and decentralization of ethics committees necessitates appropriate performance evaluation. In 2023, a cross-sectional study was carried out on the Iranian research ethics Committees using the checklist called "Research Ethics Committee Self-Assessment Tool". The checklist was translated into Persian and revised based on the opinions of research ethics experts and the approved “regulation of establishment, grading, and description of duties for research ethics committees”. The electronic checklist was sent to the senior members of 269 research ethics committees. After gathering the data, it was analyzed using SPSS software. The response rate was 83%. The average overall score was 152.11 ± 25.173, or 69.14% of the maximum. The two sections (including continuing review (monitoring) and committee resources received less than 50% of the average score. The 138 research ethics committee scores were excellent and 85 committees were in the good range. The findings revealed that average scores are influenced by activity years, the number of monthly meetings, the presence of an approved annual budget, an approved quality improvement program, and having specific administrative staff. Completing the self-evaluation tool can raise the National Committee authorities' awareness about the adherence of the research ethics committees to the imperative standards. It can also lead to each committee's awareness of its strengths and challenges. Revision of national regulations governing the establishment, grading, and description of committee duties and then future self-evaluation can facilitate upgrading and improving the performance of ethics committees.

Financial Relationships and Conflicts of Interest Between Physicians and Patients: Guideline to Professional Ethics for Medical Practitioners, Medical Council of Islamic Republic of Iran
Saeed Biroudian,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
Conflicts of interest, particularly financial ones, pose a significant ethical challenge in the medical field. They can compromise clinical decision-making, erode patient trust, and ultimately diminish the quality of healthcare. This study reviewed ethical documents and guidelines published by the Medical Council of the Islamic Republic of Iran, including the Charter of Rights for the Medical Community. A comprehensive review of relevant scientific literature on conflicts of interest in healthcare was also conducted. The analysis revealed that financial relationships between physicians and external entities, such as pharmaceutical companies, can create conflicts of interest that negatively impact patient care. These conflicts can erode patient trust and lead to suboptimal clinical decisions. The Medical Council's ethical guidelines address these concerns by emphasizing the importance of transparency regarding financial ties and relationships. They advocate for the disclosure of such relationships to patients and the implementation of educational programs to enhance physician awareness of ethical principles and conflict-of-interest management strategies. Adherence to the ethical guidelines established by the Medical Council of Iran is crucial for effectively managing conflicts of interest in the physician-patient relationship. By prioritizing transparency, disclosure, and ongoing education, healthcare professionals can mitigate potential conflicts and maintain the highest standards of ethical conduct in patient care.

Oversight of Research Ethics Committees in Knowledge-Based Projects
Saeed Biroudian,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
Effective oversight of scientific research is essential for ensuring adherence to ethical and legal principles, particularly in medicine and health sciences. This oversight plays a crucial role in maintaining research validity and safeguarding human health. As knowledge-based and technological projects continue to expand, the responsibilities of ethics committees become increasingly significant. Recognized as independent and credible entities, these committees conduct rigorous reviews of research initiatives. This article critically examines the significance, methodologies, and impact of ethics committee oversight on the quality and credibility of scientific research in knowledge-based projects. This study employs a review methodology, synthesizing data from established guidelines and regulatory frameworks governing ethics in biomedical research, as outlined by the National Committee on Ethics in Research of the Ministry of Health and Medical Education. Additionally, a comprehensive review of relevant scientific literature and empirical studies was conducted, focusing on the oversight of approved projects from reputable contemporary sources. The analysis indicates that knowledge-based projects require heightened ethical scrutiny compared to other research initiatives. This necessity arises from the imperative to adhere strictly to ethical standards outlined in research proposals. Rigorous oversight significantly enhances research quality while mitigating ethical violations. Furthermore, active engagement by ethics committees fosters a stronger commitment among researchers to uphold ethical principles. By offering targeted guidance and training, these committees contribute to the development of high-quality research proposals. Effective oversight by ethics committees is instrumental in enhancing the quality and credibility of scientific research, particularly in emerging technologies and knowledge-based projects. This oversight not only reduces ethical infractions but also strengthens public trust in research findings. Therefore, continuous advancements in ethical training and researcher awareness are imperative. Improving oversight mechanisms will further elevate ethical standards and reinforce responsible research practices within this domain.

Nurse's Ethical Challenges During Global Crises: War and Beyond
Fatemeh Roudi, Hedayat Jafari, Mohammadreza Jalilfar, Seyed Mohammad Mirshafiei, Seyed Tohid Hoseini, Soodabeh Eslami,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
Nurses are critical healthcare providers during global crises, particularly in situations of armed conflict and war, where they face unique and often overwhelming ethical challenges. These professionals are tasked with making immediate and difficult decisions under extreme conditions. This study aims to thoroughly examine the ethical challenges encountered by nurses during global crises, with a particular focus on armed conflicts and wars. This systematic review analyzed articles sourced from PubMed, Scopus, ScienceDirect, Magiran, and Google Scholar databases, using the following search terms: "nursing ethics," "war," "global crises," "ethical considerations in nursing during war," and "nursing ethics in armed conflicts." Following a thorough review and filtering process based on the study's objectives, seven articles were selected for inclusion. The findings highlight several ethical challenges faced by nurses during wartime. These challenges include: allocating limited resources under dire circumstances, providing care to both combatants and civilians without bias, maintaining patient confidentiality while cooperating with military authorities, and delivering care in hazardous and unpredictable environments. The ethical issues nurses encounter in global crises, particularly in war, include: 1) the tension between professional duty and political or military affiliations, 2) the ethical dilemma of allocating scarce resources in critical conditions, 3) the decision of which patients should be prioritized for treatment, and 4) the significant risks to life involved in providing care in conflict zones. Nursing care during global crises, especially in wartime, presents profound ethical dilemmas that demand rapid and sound decision-making. Adequate training in nursing ethics tailored to wartime conditions, as well as robust support for nurses in these high-pressure environments, are critical to addressing these challenges effectively.

The Importance of Patient Autonomy in Home Care: A Systematic Review
Mohammadreza Jalilfar, Hedayat Jafari, Fatemeh Roudi, Seyed Tohid Hoseini, Soodabeh Eslami, Seyed Mohammad Mirshafiei,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
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.

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