Iranian Journal of Medical Ethics and History of Medicine

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The study of scientific output in the humanities plays a crucial role in the scientific and cultural development of society. The main objective of this applied, descriptive research was to evaluate articles related to medical history in Iranian humanities journals published between 2001 and 2021 AD (1380 to 1400 SH). Using a quantitative content analysis method, 256 articles from 40 reputable journals were identified and analyzed. The findings indicate an increasing trend in the quantitative production of scientific output in the field of medical history over the past two decades. The most prevalent thematic areas were "health, hygiene, and nutrition" and "medical concepts, types of diseases, and treatment methods." Journal for the History of Science was the most prolific publication. The majority of articles were written in Persian and focused on the Islamic and Qajar periods. The keywords "Iran," "Reza Shah," and "famine" were the most frequently used. Conversely, researchers paid less attention to topics such as medicine in travelogues, medical ethics, women's medicine, and veterinary medicine. Similarly, historical periods like the Buyid, Seljuk, Zand, Afsharid, and contemporary (post-Islamic Revolution) eras received less scholarly focus. This study demonstrates that the scientific output in Iranian medical history has formed an evolving indigenous pattern, concentrated on the Islamic and Qajar periods and health-related topics. However, there is a clear need to address neglected periods and foster interdisciplinary approaches.
 

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Curriculum is one of the most crucial tools for achieving educational objectives.The hidden curriculum refers to the emotional atmosphere and unwritten conditions that exert the greatest influence on the values and emotions of learners in medical sciences, particularly in the field of nursing.This qualitative study was conducted with the aim of elucidating the hidden curriculum in the teaching of professional ethics in nursing, employing a grounded theory approach. Purposeful sampling was initiated and continued with theoretical sampling through in-depth semi-structured interviews with 14 participants(students, nurses,and faculty members),along with observations and field notes, until theoretical saturation was achieved.Data analysis was performed using the Corbin and Strauss(2008)method.The data analysis revealed that the main concern of the participants was "ineffectiveness in managing interactions resulting from weaknesses in communication and individual skills of nurses." The core strategies they adopted to address this concern included "faculty members' professional competence in serving as role models for learners," "introducing exemplary nurses and role modeling," and "the necessity of enhancing professional skills for patient care." The consequences of these strategies were "enhancement of nurses' satisfaction with care based on professional ethics,""facilitation of professional behavior improvement in clinical settings,"and "development of patient-needs-based care.""Promotion of nursing care based on adherence to professional ethics"was extracted as the main variable of the study.Accordingly, attention to individual and environmental factors, as well as the role of faculty members in teaching professional ethics,can serve as a foundation for designing targeted interventions aimed at improving clinical interactions and reducing the theory-practice gap in clinical settings.
 

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The article is a letter to the editor and does not have an abstract.

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Surrogacy is considered as one of the selective methods for infertile women especially those who don't have womb. As this method is controversial and the sides should be analyzed both ethically and legally, the purpose of this study is to scrutinize the attitude of infertile women who visit Hazrat Masoumeh Infertility Centre in Qom for surrogacy.
This cross-sectional study  conducted on  300 infertile women. The information were gathered from a two part questionnaire which in one part there was personal information and the other part was for phrases related to attitudes. The earned data were analyzed by descriptive test analysis and P<0.05 was considered significant.
The results showed that 61.3% of infertile women were in favor of surrogacy and 38.7% were against it. The highest priority in terms of attitude was the fear of an emotional relationship between the surrogate mother and the baby, and also the problems of delivering the baby from surrogate mother to the applicant couple. There was a logical statistical relation between the infertile women's attitude  and age, educational level of the woman, educational level, the educational level of infertile women's partners, years of infertility and income of the bread winner( P<0.05).
As the attitude of vast majority of the study samples  was positive and as it is important to know about opinions and preferences of families to make this action lawful, wider investigations in this field in more variable groups is recommended.

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The aim of this study was to explore experiences of family members of patients confronting brain death diagnosis and the request for organ donation.
A qualitative study was designed focusing on content analysis. Data collection process included 38 unstructured in- depth interviews with relatives of 26 brain death patients who were candidate for organ donation and field notes. Sampling method began as purposive and continued as theoretical until saturation.
Five main themes were extracted from the current dataset that indicated family experiences and perceptions of brain death concept while being informed. The themes were included internal conflict, internal barriers against external realities, imminent sense of loss and grief, surrender and acceptance.
The results showed that facing the diagnosis of brain death for relatives and family members is a condition surrounded by many challenges, ambiguities and conflicts that is become more complicated when emotional responses related to grieving and defensive psychological reactions emerge. So it is recommended before any organ request, at first medical team provide conditions for brain death acceptance. Respecting family members experiences and their perceptions about the situation will resolve their internal ambiguities and conflicts. At this situation requesting organ donation seems to be rational.

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Moral distress is considered as an important issue in nursing. Nurses participation in ethical decision making and taking deliberate action are facing them with many ethical challenges in their work environment. Confronting those challenges can lead to moral distress. This descriptive study was conducted to determine moral distress and its contributing factors from the perspective of oncology nurses in Tehran teaching hospitals in 2011. Data collection was done through a demographic questionnaire, the Moral Distress Scale – revised (MDS-R) and a questionnaire on moral distress related factors administered to all oncology nurses with inclusion criteria. Findings showed that nurses reported a high level of moral distress overall. The highest level of moral distress was associated with giving inadequate information to patients about informed consent and carrying out a physicians’ order for unnecessary tests and treatments. A significant correlation was found between oncology nurses’ age, their work experience and employment status with moral distress. Institutional factors such as managers’ support, nurses’ autonomy and having determined duties had the greatest effect on moral distress from oncology nurses’ view. Oncology nurses commonly encounter situations that are associated with high levels of moral distress, and therefore strategies need to be developed in order to mitigate moral distress.

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Nurses encounter challenging ethical issues in practice that can make decision making tough for them. The purpose of this study was to determine the moral sensitivity of critical care nurses in clinical decision making and its correlation with their caring behavior in teaching hospitals of Bandar Abbas in 2012.This research is a descriptive analytic study with intensive care unit nurses as its participants. A demographic and background questionnaire, a standard questionnaire of the nurses’ moral sensitivity, and a caring behavior questionnaire were used to collect information. Data were analyzed using SPSS16 software, descriptive statistics, Mann-Whitney U test, Kruskal-Wallis, and Spearman’s correlation.The mean score of the nurses’ moral sensitivity was 70.15 ± 6.90 (maximum score was 96 and minimum score was 49) that was moderate in 85.6% of the nurses. The mean score of the nurses’ caring behavior was 108.90 ± 10.62 (maximum score was 120 and minimum score was 69). There was no significant correlation between moral sensitivity and caring behavior scores, but both scores were significantly associated with the place where the nurses were working. The dimension of respect for patient autonomy had a significant relationship with participation in medical ethics seminars or workshops.The moral sensitivity of the nurses in this study was moderate and did not have a significant correlation with caring behavior scores. In view of the fact that nurses deal with serious situations in patient care that call for adequate ethical abilities for decision-making as well as good performance, it is necessary for them to be familiar with and sensitive to ethical issues related to their profession.

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Abortion is a challenging issue. It is proposed as a problem in medical philosophy and medical ethics texts. In dealing with abortion, graduate medical students may be influenced by different situations, or make a decision according to their conscience. Therefore they should acquire a satisfactory level of ethical development to deal with these issues during their years of education.Some things that are important for education on abortion are law, religious and moral reasoning, understanding the moral reasoning of people who request an elective abortion and related ethical philosophies. If health providers want to make the right decision and manage the patient suitably, they should be aware of the moral reasoning of the abortion applicant, religious moral reasoning, legal issues, and the ethical philosophies related to elective abortion, so they can do the best thing when dealing with abortion applicants. Sometimes the abortion applicant or the health provider thinks that abortion is an ethical action, but according to religion and the philosophy of ethics it is not. Therefore supporting health may be warranted by educating medical students on ethics as well as religious rules and legal issues.

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Medical ethics is a set of moral values that apply principles and responsibilities to the practice of medicine and is a fundamental part of medical education. The current study investigated the effectiveness of the medical ethics curriculum and the best method for its implementation from interns’ point of view. The current cross-sectional descriptive study was carried out in July 2012. The research tool was a questionnaire developed in the medical ethics department and handed to all interns. The validity and reliability of the tool was confirmed using content validity and internal consistency (α= 0.72) methods respectively. Data was analyzed using SPSS software and reported by the use of descriptive statistics, particularly mode, as a measure of central tendency.Seventy-one interns (60%) responded to the questionnaire, 54% of whom were female and 55% in the second internship year. In response to the achievement rate of expected outcomes such as the extent to which the educational objectives have been reached, and the suitability of content with the needs felt in real clinical situations, modes were all ranked in the ategory of "low". The modes of the responses to the stressfulness of different ethical situations were mainly ranked in the category of "high". To assess the best methods for teaching knowledge as well as medical ethics skills and attitudes, the following were the mode of interns' responses: group discussion (38%) for teaching the basics, and presentation of a case with the solution (70%) for teaching clinical ethics. The most appropriate methods of student evaluation were considered patient management problem and performance evaluation in the ward by 25 (36%) and 21 (31%) of interns respectively.The current study showed the effectiveness of medical ethics curriculum was low and the students requested presenting this course in a more practical way. It would appear that a two unit theoretic course does not have the efficiency to modify students’ attitudes and behavior to encounter challenging ethical situations, and therefore fundamental changes are suggested.

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Ali Afzal Ghate’ Ghazvini was a renowned physician, scholar, and calligrapher of the Safavid era whose personality and efforts in the field of medicine have not been fully recognized thus far. Among his works, three medical treatises can be of use in researching the medicine of the Safavid era. The present article adopts a descriptive-analytic method to introduce one of these treatises, Favaed-al-Afzalieh, and present a survey of its content in addition to the author’s biography. The findings here are based on the three chapters of this medical classic, which indicates the encyclopedic nature of this treatise. Favaed-al-Afzalieh reveals details on a variety of practical medical issues prevalent in the Safavid era, and is considered outstanding due to the volume of all the medical information it contains. The present study discusses the standing of this treatise in the history of medicine along with a suggestion to revise and publish this valuable, comprehensive work and reintroduce it to the world of medicine.