Showing 12 results for Shamsi Gooshki
Amirhossein Mardani, Alireza Parsapour, Ehsan Shamsi Gooshki,
Volume 11, Issue 0 (3-2018)
Abstract
This research reviews the scientific productions of the field of biomedical ethics based on articles published in Iranian scientific journals in Farsi (Persian language). The findings showed that from 2003 to 2017, researchers have published 1238 Persian articles in this field. The average annual growth rate of published articles is 23.17 percent, but this growth has been declining since 2013. The citation rate of articles (0.4 per article) suggests a small impact. Shahid Beheshti University of Medical Sciences and Tehran University of Medical Sciences with the publication of 36% and 33% had the largest share in the publication of articles, respectively. Biomedical ethics research was interdisciplinary and researchers from the medical, nursing, and law sciences played a major role in compiling and publishing them. The topics such as medical ethics, medical education, and Islamic ethics were, repetitive subjects in articles, respectively. Only 22% of these articles referred
directly to funding provided by universities and research centers.
Jila Sadighi, Nazila Nikravan Fard, Zahra Hatami, Ehsan Shamsi Gooshki,
Volume 13, Issue 0 (3-2020)
Abstract
More than two decades have passed since the establishment of research ethics committees in Iran. With many years of experience of research ethics committees, Iran Ministry of Health and Medical Education revised previous regulations and developed “Regulation on the Establishment, Leveling, and Duties of the Biomedical Research Ethics Committees”. Following publish and notification of “Regulation on the Establishment, Leveling, and Duties of the Biomedical Research Ethics Committees” in 2014, research ethics committees formed in national, academic, and organizational levels. In this regard, due to cooperation of the Iran Ministry of Health and Medical Education with the Iran Ministry of Science, Research and Technology, “the single article of the Act for Prevention and Combating Fraud in Scientific Publications” was approved in the Parliament of Iran in 2017; its executive bylaw was notified for implementation by the Cabinet of Ministers in 2019 and accordingly research ethics committees found a legal status in Iran. For promotion and update of the mentioned regulation and adaption to the Act, the secretariat of the national ethics committee proposed revised version of the regulation after obtaining opinions of stakeholders and several expert meetings. Then the new regulation entitled “Regulation on the Establishment, Procedures, and Duties of the Research Ethics Committees” was approved by the Iran National Committee for Ethics in Biomedical Research and the High Council of Medical Ethics of Iran in 2021. Structure of the committees in the new regulation includes “the National Committee for Ethics in Biomedical Research”, “Regional Research Ethics Committee”, “Institutional Research Ethics Committee”, “Biomedical Research Ethics Committee”, and “Specialized Committee”. This article introduces this new regulation.
Mahshid Safaei, Maghsoud Farasatkhah, Ehsan Shamsi Gooshki,
Volume 15, Issue 1 (3-2022)
Abstract
In the health system, professional problems and organizational obstacles cause patient fatigue, physician exhaustion, and ultimately interpersonal issues between the patient and the physician, including lack of mutual understanding and erosion of trust. Therefore, trust, as the central core of social capital, plays a significant role in the quality of interpersonal and intergroup interactions. The trust between the patient and the doctor and its general expansion requires a set of organizational considerations and professional principles in the health system. The purpose of this qualitative research was to analyze organizational and professional factors affecting trust between the patient and the physician. The data were collected through semi-structured interviews in the health service centers located in Tehran. Using purposeful sampling and snowball, a total of 39 participants were interviewed until theoretical saturation was reached. Using the systematic approach of grounded theory (GT) and ATLAS.ti software, the data were categorized and analyzed in three stages of open, axial and selective coding. The findings show that the professional-organizational components effecting on trust between physicians and patients include three components of "adaptable professional management", "adaptable insurance" and "adaptable policy" and nine sub-components as described in the article. These components are the composing elements of the structure and infrastructure of professional development in health system, which can restore the relationship and interaction based on trust between the patient and the physician in health system. The other strategic researches are needed to develop strategies and executive policies to increase the trust between the patient and the physician.
Mohammad Hossein Eftekhari, Alireza Parsapour, Ayat Ahmadi, Bagher Larijani, Neda Yavari, Ehsan Shamsi Gooshki,
Volume 16, Issue 0 (ویژه نامه کاربست طرح های دو گروه اخلاق و آموزش پزشکی 2023)
Abstract
Defensive medicine is performing actions that have no medical indication and benefit for the patient (positive defensive medicine) or refraining from performing risky actions that have a medical indication and benefit for the patient (negative defensive medicine). These actions are carried out by the physicians with the sole motive of protecting themselves against complaints or tensions such as the protest of the patient or colleagues and usually cause physical, psychological, or economic harm to the patient or the institution that pays the treatment fee, such as insurance organizations. It can have consequences in terms of the quality of care and the efficient use of limited health resources. Factors such as the physician’s concerns about lawsuits and proceedings may lead to defensive behaviors. This study presented suggestions for the management and prevention of such behaviors, including three main categories related to the strategies for the reformation of the patient complaint handling system, social strategies for the management and prevention of defensive medicine, and managerial-organizational strategies. These strategies are based on the findings of a mixed-methods research including an unsystematic review of resources and a qualitative study conducted using semi-structured interviews. The results have been discussed by the Medical Ethics Committee of the Academy of Medical Sciences of Iran.
Farzad Zakian Khoramabadi, Alireza Parsapour, Bagher Larijani, Amirhossein Takian, Ehsan Shamsi Gooshki,
Volume 16, Issue 0 (ویژه نامه کاربست طرح های دو گروه اخلاق و آموزش پزشکی 2023)
Abstract
The right to access health services as a part of fundamental human rights, affected by the conditions and facilities of governments and the international status, has always faced challenges. Despite the clarity of the general policies and upstream documents in the Iranian health system regarding the need to provide immigrants and refugees with health services and Iran’s membership in the relevant conventions, the implementation of the provisions of these documents is not consistent and complete for various reasons, including the inadequacy of laws related to immigrants and refugees and the incorrect implementation of some existing laws. The first draft of the ethical guidelines for providing health services to immigrants was prepared by the research team using the results of a review of relevant documents as well as a qualitative study and finalized according to the opinions of the participants in a panel of experts. In this draft, after explaining the values and ethical principles governing the provision of services to Afghan immigrants, the suggested guidelines and assignments were presented to the main stakeholders involved, including the policymakers and macro planners of the health system, institutions and centers providing health services, professionals and health service providers, professional organizations, civil society activists, media and non-governmental organizations, and medical research and education authorities and researchers.
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.
Amirhossein Mardani, Maryam Nakhoda, Ehsan Shamsi Gooshki,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
Research misconduct cases reviewed by ethics committees serve as a valuable source of data for managing potential future misconduct. This study examines the reported cases within closed research misconduct files of the National Committee for Ethics in Biomedical Research of Iran, aiming to identify common manifestations of misconduct and influential factors across various activities within the research system. Documentation from 100 closed cases reviewed by the National Committee for Ethics in Biomedical Research during 2016 and 2017 was analyzed. A documentary research method and qualitative content analysis were employed. Using a directional analysis approach, the manifestations and factors contributing to misconduct in each case were extracted and categorized. Subsequently, causal relationships between the reported factors were defined. Twenty-one manifestations of research misconduct were identified, most of which involved undesirable micro-level activities, particularly the failure to adhere to ethical standards in research publication. Although negative impacts were observed at the meso level, including issues with research oversight, training in research standards and skills, journal management structures, and administrative and financial structures within universities, macro-level activities and deficiencies in research system performance—such as inadequate investment and financial resource allocation—were not addressed. Twelve causal relationships contributing to research misconduct were identified, highlighting how inadequate performance across different levels of the research system—including administrative structures for research approval and funding, research infrastructure, research evaluation, training, journal management, and oversight mechanisms—can interact and exacerbate misconduct. A key finding was the insufficient reporting of reasons for research misconduct in case documentation. Ethics committees appear to lack significant focus on analyzing the underlying causes of misconduct. Detailed and precise reporting of misconduct reasons, alongside independent studies, would provide decision-makers with valuable insights for preventing future occurrences.
Shiva Khaleghparast, Saied Bagheri Faradanbeh, Samaneh Karimian, Fahimeh Khosrobeigi Bozchaloei, Seyed Ebrahim Hoseini Zargaz, Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
The electronic health record system (SPAS in Iran) records information related to the health of individuals in an electronic format. It is the center for collecting health information and data on outpatients and inpatients. This system records information such as the patient's full name, marital status, gender, date of admission, level of education, occupation, type of admission, and other relevant medical data. The core values and ethical requirements of SPAS include safeguarding citizens' rights, respecting individuals, observing justice and fairness, transparency, encouraging participation, and accountability. In this study, the ethical aspects of SPAS were evaluated using the model proposed by the World Health Organization (WHO) for ethical evaluation. This model emphasizes fundamental ethical principles such as human well-being and health, respecting individuals and communities, justice, and fairness. Concerning human well-being and health, SPAS can prevent unnecessary and redundant interventions and provide physicians with quick access to an accurate patient history. Furthermore, the system ensures the confidentiality of information, which is essential to respect individuals and communities. Regarding justice and fairness, the system can improve access to health services for disadvantaged and remote areas. Moreover, SPAS adheres to procedural ethical principles such as solidarity, transparency, participation, and accountability. Therefore, by critically examining the ethical dimensions of the electronic health record system (SPAS), the findings of the present study provide valuable insights for policymakers, health professionals, and regulatory organizations to ensure the ethical and efficient performance of electronic health record systems in Iran.
Amirhossein Mardani, Maryam Nakhoda, Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
Since research misconduct can be considered as an adaptive reaction against the limitations, pressures, and demands arising from inappropriate functions of the research system, to manage it, the activities of the research system should be investigated and traced during the path of transferring research policies (macro level) to research development programs in institutions (meso level) and research implementation by researchers (micro level). By introducing the macro-meso-micro analytical framework, this study clarified the tasks, strategies, and activities formed at three levels of the research system of medical sciences in Iran; from macro policies of research (macro) to operational plans for the development of research in universities and research centers (meso) and researchers as research conductors (micro). For this purpose, three analytical levels of the research system were explained and defined according to the assumptions of this framework. By performing a qualitative content analysis of the relevant texts, those activities that could be useful at different levels to support the research integrity were identified and presented as different strategies. The results showed that the research system, based on the existing analytical framework, is not seen as a mere macro-system without regard to the interaction of its parts, but rather a system in which there is cross-sectional influence and interaction among the components. This approach can improve the focus, clarity, and capability to study research misconduct, and by using micro, meso, and macro levels, it can trace challenges in the interactive path of various activities and functions of the research system and their intertwining.
Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
Defensive medicine refers to actions taken by doctors and other medical professionals to protect themselves against potential threats and risks, particularly to prevent patient complaints or convictions in court, which is carried out in various forms including positive and negative defensive medicine. Since the primary motivation behind such actions, often viewed as morally unjustified, is to avoid legal proceedings and lawsuits, court rulings against doctors can intensify these behaviors. Reports of criminal sentences against some doctors in Iran and reactions from professional associations highlight the significance of this issue. This study examined the effects of such sentences on the healthcare system by referring to available documents and data on the widespread prevalence of defensive medicine in Iran, offering some suggestions for managing the issue. The objective of the study was to emphasize the importance of acknowledging the defensive motivations of doctors in healthcare and its influential factors, particularly the fear of criminal convictions, which can increase defensive behaviors among doctors and amplify their negative impacts on the healthcare system.
Leila Masoudiyekta, Ehsan Hassanpour Pazevar , Alireza Parsapour, Ehsan Shamsi Gooshki, Mohammd Jalili, Amirahmad Shojaei,
Volume 18, Issue 1 (3-2025)
Abstract
Moral distress constitutes a significant challenge for healthcare professionals, arising when individuals find themselves unable to act in accordance with their personal and professional values due to both internal and external pressures. Healthcare professionals may face scenarios that prompt them to question the ethical acceptability of their decisions and treatment practices, often feeling powerless in the face of perceived unethical changes. This study sought to explore the experiences of moral distress encountered by emergency medicine physicians and nurses in the emergency department. This study was conducted using qualitative content analysis. Data were collected through semi-structured interviews with 25 healthcare providers selected via purposive sampling. Data analysis was conducted using MAXQDA 2018 software. The results indicated that the experiences of moral distress among emergency medicine physicians and nurses in the emergency department can be classified into four primary categories including those related to: 1. patient rights, 2. medical staff and colleagues, 3. management, and 4. professionals. Notably, factors such as overcrowding, inadequate staffing, discrepancies between salaries and workloads, and poor management of human and physical resources emerge as significant contributors to moral distress in the emergency department of Imam Khomeini Hospital. To improve patient care quality, it is essential to implement strategies that enhance triage processes, prioritize human resources, align resources with patient needs, monitor patient attendance, and develop a comprehensive protocol for staff.
Soudabeh Mehdizadeh, Ehsan Shamsi Gooshki,
Volume 18, Issue 1 (3-2025)
Abstract
The Declaration of Helsinki, as a fundamental document of ethics in medical research involving human participants, has been periodically revised since its adoption in accordance with theoretical and scientific advancements, emerging ethical issues in research, and the experiences gained over time. In the latest revision completed in 2024, significant changes and amendments have been made. This study examined the changes and revisions made in the latest version of the declaration in comparison to its previous version from 2013. Fundamental revisions in the recent update include a requirement for adherence to ethical principles in research not only by physicians but also by other researchers, the replacement of “subject” with “participant,” and the emphasis on the voluntary nature of informed consent. Attention to environmental sustainability, precise design to prevent research waste, and a focus on scientific integrity are among the other amendments in the new revision of this declaration. Other modifications and revisions made in the recent edition include the promotion of individual and public health as the ultimate purpose of research, the provision of sufficient resources for research ethics committees and strengthening their independence, the importance of local ethical review, consideration of the preferences and values of participants who are unable to provide voluntary and informed consent, and the necessity of adhering to the ethical principles of the declaration during public health crises and emergencies. Given the changes made, it is recommended that the national ethical guidelines for medical research involving human participants in Iran be revised based on the 2024 revisions.
