Iranian Journal of Medical Ethics and History of Medicine

The definition of disaster is diverse but certainly the similarity between disaster and normal condition is negligible. The most important characteristic of critical condition is the number of human victims. Therefore each critical condition needs medical intervention and the presence of health care providers is necessary.
Health care services are divided into two categories one in normal situation and the other in the critical condition so the ethical considerations and responsibilities of the health care providers will differ accordingly.
Our approach for explaining medical ethics or ethics in health care n critical conditions is two dimensional including the responsibilities of health care providers and ethical problem solving. The second dimension needs systematic approach which is not possible in this article. In the case of the responsibilities of health care providers we may focus on individualized viewpoint or systematic and strategic view point however the later is more complete and acceptable.
From systematic viewpoint three important issues should be considered ethical principles, ethical codes and multi dimensional ethical charter of each organization.
In this review we aimed at describing some ethical principles and codes of conduct and the ethical principles of Red Cross and Red Crescent as well.
In conclusion, critical conditions are far wider and there are full range of special situations in which no unique solution can be followed. It is necessary to determine the diverse fields affecting the condition and solve the resultant ethical issues in a problem oriented manner.  In addition medical ethics should be considered as one of the most important priorities of the Ministry of Health and other related organizations.

Trust is a key element in the physician-patient relationship. Imam Jafar Sadiq (A.S.) stated that the proficient and trusted physician is in equal level of a just jurisprudent. Ancient ethical texts put much emphasis on physicians to be trusted. Nowadays, trust is a component of social health we believe that in the physician-patient relationship, trust has a significant impact on the practice, and increases the effectiveness of treatment and the satisfaction of patient and physician? also patient autonomy is preserved, health is positively reinforced, and patients will be more serious and less negligent with expenses, treatment, and follow up. This paper is a review/analytical article, and aims at classifying trust and examining its role in communication between physician and patient. If limited to practice, trust in the physician - patient relationship is divided into two types:

1- Unconditional trust, which means full confidence with no autonomy

2- Conditional trust, which entails maintaining autonomy.

 In the first type, where patient's autonomy is foregone, both patient and physician can be blamed. The patient is to blame due to an absence of self confidence and lack of participation in decision making and treatment, and the physician might in his place have the tendency to patronize. In this article we emphasize the importance of trust and warn against paternalism and conclude that if doctors truly comprehend the meaning of trust, they will try to avoid paternalism.