Iranian Journal of Medical Ethics and History of Medicine

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Confidentiality is one of the oldest principles of the medical profession that impacts on the relationship between physician and patient, the personal interests of patient and physician and consequently social welfare. While emphasizing the necessity of confidentiality, religious teachings consider disclosure of others' secrets a sin that deserves punishment thereafter. Nowadays, medical developments and the invention of new diagnostic and therapeutic procedures as well as the vastness of the informatics world make disclosure of patients' secrets easier than ever. This review article is the result of a descriptive study, and the information was collected using reliable library and internet resources. It will first expound the concepts and principles of confidentiality in medical ethics as well as Islamic ethics, and will then proceed to a comparative review of the similarities and differences in these two sets of­­­­ ethical views on the issue of confidentiality. In addition to the emphasis of medical ethics and Islamic ethics on the necessity of confidentiality in order to win public trust, both sets of teachings cover two areas of personal and public discretion, while in Islamic ethics, the issue extends to a third from, namely religious confidentiality. This makes Islamic ethics more comprehensive in the sense that based on Islamic teachings, the person who keeps someone's secret will also be rewarded in the Hereafter. Also, in medical ethics, only the behavior of the health staff is evaluated and their moods and motives are not taken into consideration, while Islamic ethics pays attention to human dispositions and therefore confidentiality is more stable and can maintain its efficiency without external supervision.

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Euthanasia has been the subject of much controversy during the last three decades. In ethics most philosophers divide it into active and passive euthanasia and consider the first option to be immoral. There are some thinkers, however, who deny any moral significance in such a distinction. Among them and perhaps the first in this arena is James Rachels who is followed by other thinkers like Jonathan Bennett and Michael Tooley. Rachels poses his equivalence theory. By this he means that assuming the stability of other factors in a given circumstance and focusing on the variable of act and omission alone we would find that there is no moral difference between the two. He tries to defend his theory by the way of parallel examples and parity of reasons. We are going to evaluate his arguments by explaining and then criticizing them. In this regard we will examine briefly some counter-examples, and then we will have a look at some answers of other philosophers like Philippa Foot and Will Cartwright. We try to assess these refutations and finally we are going to offer two answers in the hope that these answers solve the problem.

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Moral dilemmas caused by modern diagnostic and therapeutic advances in medical science have increased the need to address medical ethics a hundredfold. Medical ethics is a "science", so the method needs scientific work. In order to achieve the objectives of any science, we need to define and resolve the ambiguities surrounding it. Notwithstanding the definitions presented in conjunction with the science of medical ethics, still some issues remain unclear about it.An important part of our knowledge consists of the answers to what things are, and that is nothing but definitions. Definitions comprise the bulk of our perceptions and therefore need to be employed.This review article is the result of a descriptive study. The data were collected through studying credible textbooks and searching internet resources and related articles. While emphasizing the need to clarify the definition of science and characteristics of logical definition, this paper evaluates some of the definitions of medical ethics and by showing their weak points, notes that there is a need for a logical definition of this science and the necessary consideration

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In the nursing profession, ethical practice is contingent upon the nurses’ ability to determine the ethical issues in their vocation, and their sensitivity to these issues in the nurse-patient relationship. In order for the health system to have a strong and solid foundation, this sensitivity must be formed in nursing students during the early stages of their education. Educational environment and clinical experience each affect ethical sensitivity in their own way. The purpose of this study was to determine and compare the ethical sensitivity of third and fourth year nursing students and nurses in Islamic Azad University, Mashhad branch during 2014.

In this cross-sectional study Lutzen’s Moral Sensitivity Questionnaire was used, and its validity and reliability was confirmed. According to the formula for sample size, 110 persons were sampled in each group. Sampling was performed randomly among the third and fourth year students, and in two stages among the nurses: first cluster, and then randomly. Data were analyzed using descriptive and analytical statistics by SPSS software.

The mean and standard deviation of moral sensitivity was 3.33 ± 0.36 in nursing students, and 3.27 ± 0.35 in nurses, and the independent t-test showed no significant difference between the two groups (df = 218, t = -1.06, P > 0.05). Moreover, there was no statistically significant difference between the mean scores of moral sensitivity based on demographic characteristics.

It was concluded that the ethical sensitivity of nurses and nursing students of Islamic Azad University, Mashhad branch was satisfactory, which can be considered as a point of strength for policy makers of the health system.

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