Iranian Journal of Medical Ethics and History of Medicine

Ethical climate is an important part of organizational culture which affects all aspects of individual characteristics and its improvement in health care centers causes better response of nurses to moral stress and ultimately promotes the quality of medical services. The aim of this study was to determine the nurses' perception of the ethical climate governing in clinical environment in the teaching hospitals of Shahrekord University of Medical Sciences in 2018. This study was a descriptive-correlational study performed on 300 nurses by purposive sampling method. Two questionnaires used for data collection included demographic information and Olson ethical climate questionnaire. Data analysis was performed using linear regression and mean (SD) tests and by SPSS version 20. The results of the study showed that the overall score of moral climate in the participants was 3.79 ± 0.67. The highest and lowest ethical climate scores in this study were related to the dimension of nursing managers (3.86± 0.74) and physicians (3.58 ± 0.79), respectively. Also, a significant relationship was observed between variables such as years of experience and age with the dimensions of the ethical climate (p<0.05). According to the score of ethical climate obtained in this study, which is less than some studies conducted in this field in Iran. Considering the importance of the ethical climate and the consequences of defects in this issue, it is necessary for hospital managers to make appropriate plans to set up a favorable ethical climate on clinical environment in their most important priorities.

Medicine is a profession in which emotional and moral intelligence play an effective role in improving the quality of medical care for patients, mental health, and increasing job satisfaction. The aim of the present study was to investigate emotional and moral intelligence among different physicians. This study was conducted as a descriptive study. The statistical population consisted of all physicians in Mashhad in 2019. Among them, 213 physicians were selected by convenience sampling method and completed questionnaires. The data collection tools were the Bar-On Emotional Quotient Inventory (EQ-i) and the Moral Intelligent Questionnaire. Data were analyzed by Analysis of Variance (ANOVA) and independent t-test. The results showed that among physicians, female physicians, married, over 60 years old, and with a work experience of 30 years and more had more emotional intelligence. The results also showed that physicians over 60 years and a work experience of 30 years and more had higher moral intelligence. Therefore, it can be concluded that educating and selecting medical students and physicians based on measuring emotional and moral intelligence can give them better ability to solve problems and be more resilient when exposing to crises and difficult situations

Failure to follow professional ethics in midwifery will lead to harmful risks, including an increase in maternal and infant mortality. The aim of this study was to investigate the barriers to professional ethics in midwifery clinical care from midwives ’viewpoints in hospitals specializing in obstetrics and gynecology in North Khorasan province in 2018. This cross-sectional descriptive study was performed with the participation of 141 midwives working in specialized obstetrics and gynecology hospitals in North Khorasan province, using classified sampling. The data collection tool was a questionnaire consisting of two parts: demographic information and barriers to professional ethics, in three areas: environmental and managerial and personal care. Data were analyzed using SPSS software version 22 and descriptive and inferential statistics. From the perspective of midwives, all three categories of environmental factors (73.94%), personal care (64.66%) and management (64.97%) were among the barriers to professional ethics. The most important barriers to professional ethics in the managerial dimension are staff shortages (80%), in the environmental dimension, biological changes in the body during work shifts (85.2%) and in the personal dimension, dissatisfaction with basic needs, such as insufficient income or adequate rest in midwifery (80.9%), was. Given the importance of observing professional ethics and the issues and problems arising from non-compliance, it is suggested that managers and officials make the necessary planning by hospitals to remove the barriers mentioned by midwives.

Applying the principles of professional ethics by nurses creates a suitable social and psychological environment for patients. The purpose of this study was to determine the level of nurses' awareness of the principles of professional ethics and barriers towards its observance in public hospitals in South Khorasan province in 2019.The present study was a cross-sectional study that was performed on 230 nurses in South Khorasan province by multi-stage sampling method. Data collection tools were a checklist of demographic information and a questionnaire about nurses' awareness and barriers of the principles of professional ethics. Data were analyzed by SPSS V.22 software using descriptive and inferential statistics. In this study, the mean ± SD age of participants was 32.34 ± 5.73 years. The mean score of participants' awareness was moderate level and the first obstacle to professional ethics from the perspective of nurses was the environmental domain. The most important obstacles to professional ethics were dissatisfaction from basic needs, unreasonable expectations of patients and their attendants from nursing staff and nursing staff shortages, respectively. Since nurses' awareness of the principles of professional ethics is moderate level, so holding professional ethics workshops, removing environmental barriers, and providing favorable conditions for nurses including improving the conditions of wards and increasing staff and meeting their expectations in the fields Various such as adequate rest, adequate income and planning appropriate shifts are recommended.

In medical centers, compliance of personal and social behaviors with ethics and religious standards is very important and requires constant evaluations. Therefore, the present study was conducted to determine the compliance of medical affairs with the standards of the Holy Sharia from the perspective of patients and interns in the teaching hospitals of Jundishapur University of Medical Sciences in Ahvaz in 2020. This was a descriptive cross-sectional study and the statistical population consisted of 204 interns and 385 patients referred to the teaching hospitals of Jundishapur University of Medical Sciences in Ahvaz. Sampling was done randomly. Data were collected by data collection form and questionnaire from patients and interns which was collected by the researcher including 17 questions. Data were analyzed by SPSS version20 software and descriptive and inferential statistics. From the interns' point of view, there was a significant difference (P <0.05) between the compliance of medical affairs with the standards of holy sharia in different hospitals and gender, but there was no significant difference in different ages and marital status (P> 0.05). From the patients' point of view; There was no significant difference (P >0.05) between the compliance of medical affairs with the standards of the Holy Sharia based on gender, age, education, marital status, and hospital. From interns and patients point of view, compliance with Holy Sharia standards were 45.1% and 40.5%, respectively. According to the results of the present study, physical space and more medical staff in both genders are required to fully comply medical affairs with the standards of the Holy Sharia in all the examined hospitals.

One of the most important issues in medical law is the issue of physician responsibility. The aim of this study was to investigate the relationship between belief in each of the physician's responsibilities towards the patient and responsibility. The research method is library and descriptive-correlation. An examination of various sources shows that there are four perspectives on the physician's responsibility to the patient. The results show that there is a positive correlation between the components of responsibility and physician responsibility perspectives, which are significant at the level of 0.01. Findings indicate that views 1 and 3 are more correlated with physicians' responsibility than other views. The degree of correlation between the dimensions of responsibility with the views that consider more responsibility for physicians is greater.

In recent decades, on the one hand, we have faced atmospheric phenomena and environmental changes, and on the other hand, with the emergence of new diseases called emerging diseases. Managing emerging diseases requires an ethical approach to control and care for them. Ethical problems raising from new diagnostic and therapeutic advances in medical science have increased the need to address medical ethics. One of these emerging diseases of the present century, which is faced by almost the whole world and its problems, is coronavirus (COVID-19). The present study was conducted with the aim of assessing attention of medical staff towards ethical considerations in the care of patients with COVID-19. In this study, in addition to the use of articles published in English related to this disease from late 2019 to early 2020, as well as using national researches by different research groups, different dimensions of the disease is reviewed; Interviews were conducted with the COVID-19 recovered patients who were hospitalized in Shahid Sadoughi Hospital in Yazd Province from the beginning of February 2020 to the end of October 2020. Studies showed the need to put ethical considerations in the care of patients with COVID-19 by training health care providers about professional ethics and medical ethics in the pandemic of the virus in order to optimally manage the disease

Since the release of COVID-19 epidemic in late December 2020, recommendations issued for personal protection by the World Health Organization and National Health Organizations around the world. The most prominent of which has the use of masks to prevent the spread of the virus. Despite the importance of this solution, many people still resist using the mask. Therefore, this study, by emphasizing the effect of individual beliefs and norms on consumer behavior, predicts the rate of wearing of mask by people with 4 factors: systemic thinking, individual-social responsibility, moral obligations and individualism. The statistical population of this research consists of citizens of Kashan city. A questionnaire has been used to collect data. The results of the mean tests indicate that women use masks more than men. Also, with increasing age and education, the use of masks has increased. The results of regression analysis test show that 4 predictors had predictive power. The rate of mask use has a positive and significant relationship with the variables of systems thinking, individual-social responsibility, moral obligations and a negative and significant relationship with individualism. Also, moral obligations (β=0.694; p-value<0.05) and systemic thinking (β=0.107; p-value<0.1) had the most and least effect on the criterion variable (mask wearing), respectively. According to the findings of this study, it seems necessary to create and develop a systemic thinking, pay attention to individual and social responsibilities, strengthen moral obligations and avoid individualism in relation to desirable collective behaviors to manage a pandemic crisis. As a result, implementing strategies to enhance these individual characteristics can help can help to strengthen and form desirable collective behaviors such as wearing a mask in the time of COVID-19.

The rapid spread of COVID-19, lack of standard treatment, time constraints, and lack of resources are challenges around the world. Considering the importance of ethics in providing care to patients with emerging diseases, this study was conducted to explain the ethical challenges in care and treatment for patients with COVID-19. The present study was conducted by qualitative content analysis during 2019. Participants were 22 infectious disease physicians and nurses of COVID-19 care wards with at least five years of experience in hospitals of Mazandaran province. Data were collected through semi-structured interviews based on the purpose and method of snowball after obtaining informed consent from participants and continued until data saturation. Data analysis was performed using Granheim Lundman method. Guba and Lincoln proposed criteria were used for the accuracy and robustness of the study. In the present study, five main themes and 18 sub-themes were extracted. Respect for patients' rights, maintaining patient independence, preventing the effects of stigma and discrimination against patients, lack of comprehensive support, and lack of support and accountability of the authorities were the main ethical challenges in caring for patients during the admission period. According to the findings of the study, solutions to address ethical challenges, protect patients' rights and provide quality care through informed and ethical decision-making to increase patient satisfaction and improve their health are recommended.

The widespread and increasing number of deaths due to the Corona virus has caused many psychological injuries, including stress. Therefore, the aim of this study was to study the relationship between perceived stress and coping strategies of the family members of patients with Corona virus admitted to the Intensive Care Unit (ICU) of Ardabil medical centers. The present study is a descriptive-analytical study. Sampling was done by available method among the companions of patients with Corona virus infection admitted to the ICU (between May and September 2020). The number of research samples according to the results of a pilot study was estimated at 462 people. Available sampling method was used for sampling. Data collected included patient demographics, Cohen's Perceived Stress Questionnaire, and the Blinges-Moss Coping Styles Questionnaire. The collected data were analyzed using independent t-test, Mann-Whitney, Spearman and Chi-square tests and one-way analysis of variance by SPSS software version 24. The results showed that the mean and standard deviation of perceived stress were 44.80 ± 5.92 and emotion-oriented and problem-oriented coping styles were 19.08 ± 3.02 and 32.35 ± 5.54, respectively. Spearman correlation coefficient test showed a significant relationship between perceived stress with problem-oriented coping style (r = 0.321) and emotion-oriented coping style (r = 0.113) (p <0.05). This study showed that the companions of coronary patients admitted to the intensive care unit use more emotional coping methods, which results in increased emotional behaviors. Therefore, in order to help the psychological health of coronary patients, it is possible to strengthen the application of problem-oriented coping style by designing and implementing educational and supportive-care programs.

The relationship between physicians and operating room staff includes interaction between them in caring for the patient to achieve a common therapeutic goal and condition improvement. Present cross-sectional descriptive-analytical study aimed to examine viewpoints of physicians and operating room staff about their relationship in Ahvaz at 2019. The research samples were operating room staff and physicians working in three educational hospitals affiliated to Ahwaz Jundishapur University of Medical Sciences. Consecutive samples were icluded in the study. The research tool was a two-part questionnaire including socio-demographic information and questions about the professional relationship between the doctors and the operating room staff. Results showed that viewpoints of physicians and operating room staff about respecting ethics in their communications are good.  In the group of physicians, 18.1% had a moderate viewpoint and 81.9% had a good viewpoint about communication with operating room staff. Among the operating room staff group, 4.8 percent had a bad viewpoint, 27.3 percent had a moderate viewpoint, and 67.9 percent had a good view point about their communication with physicians. Until reaching highest level of respecting professional ethics, any attempt to improve communication between physicians and operating room staff will result in positive outcomes for physicians and staff, and promote quality of their care for patients.

Nurses are among the members of the treatment team who have the most contact with Corona Virus Disease- 2019 (COVID-19) patients and their ethical decision-making is inevitable during patient care. On the other hand, nurses' motivation to implement end-of-life care is influenced by their attitude, awareness, and moral reasoning. The aim of this study was to investigate the level of ethical decision making of nurses and its relationship with the attitudes of end-of-life care of patients with COVID-19 in hospitals affiliated to Hamadan University of Medical Sciences in 2021. In this study, 180 nurses working in hospitals affiliated to Hamadan University of Medical Sciences were selected by convenience sampling method. Data collection tools included: demographic Information questionnaire, Nursing Dilemma Test (NDT) questionnaire, and Frommelt Attitudes towards End-of-Life Care questionnaire. According to the results, there is a direct relationship between nurses' ethical decisions and the attitude of end-of-life care (<0.05, r=0.819). The mean score of nurses' ethical decision-making indicates the low level of ethical decision-making (39.19 (5.3)) and the mean score of nurses' practical considerations (20.62(4.2)) showed that the process of nurses' ethical decision-making is relatively influenced by environmental factors. Also, the average score of nurses' exposure to moral challenges indicates that nurses are familiar with similar situations. The mean score of nurses' attitudes toward end-of-life care was reported at an undesirable level (81.58(7.8)). According to the results, by identifying the factors affecting nurses' ethical decision-making and educational planning to improve their decision-making level, it is possible to improve the quality of patients care while improving nurses' attitudes toward end-of-life care.

Human is spiritual dimensions that has legal status in health and disease. The purpose of this study was to evaluate the knowledge of nursing and midwifery students about patient rights in Iran Universities of Medical Sciences teaching hospitals’ in 2017. This study was a descriptive cross-sectional study in 2017 with convenience sampling method. Data was collected by a three-part questionnaire including demographic information, Knowledge about the Patient Rights Charter, and strategies for student information to deal with patient rights. Mann-Whitney and Spearman tests were used for data analysis. A total of 1219 undergraduate students participated in this study. The mean score of students' awareness of the Patient Rights Charter was 13.54±4.45 out of 29 points. 1007 students (82.61%) reported that education about patient right was sufficient. Direct correlation was between patient knowledge awareness score with pre-internship training (r = 0.461) and learning from instructor information (r = 0.512) and there was a negative correlation between self-education (r = -0.151) and other methods of information acquisition (r = -0.067). Given that most students did not consider the educational content taught in the field of patient rights to be effective, it can be concluded that these methods were ineffective and failed to convey the correct information. Therefore, revising of the Patient Rights Curriculum for Nursing and Midwifery students is recommended

The ethical climate in hospitals can influence nurses' ethical decisions. In other words, in the hospital where the nurse cannot use his moral courage, the patient's rights and interests are gradually ignored. Therefore, the aim of this study was to determine the relationship between perception of ethical climate and moral courage of nurses working in hospitals affiliated to Shahid Sadoughi University of Yazd in 2019. This was a descriptive-analytical study. A total of 204 nurses working in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd were included in the study by census sampling. Data were collected using demographic questionnaire, Professional Moral Courage (PMC), and Hospital Ethical Climate Survey (HECS) and analyzed by SPSS 18 software. The results showed that the mean score of ethical climate (3.35 ± 0.62) of 5 and the mean score of moral courage was 56.37 ± 5.46 out of 75. There was no significant relationship between ethical climate and moral courage (P≥0.05). Of demographic characteristics, gender had a significant relationship with the mean score of ethical climate (<0.05), but other demographic characteristics did not have a significant relationship with ethical climate and moral courage (>0.05). Considering influence of environments supporting nurses’ moral courage on optimal care to patients, development of plans by managers to promote nurses’ moral courage can lead to beneficial effects.

The medical terms currently used are derived from a variety of sources. These terms are often derived from an eponym. Eponyms are a long-standing tradition in medicine. Eponyms usually involve honoring a prominent physician-scientist who played a significant role in identifying the disease or the person who first reported the disease or the area where a disease first broke out in there. Eponyms are sometimes associated with myth, literature, and art. Of course, the mythological, literary, and artistic figures used in medicine as eponyms are mostly related to Greek and Roman mythology and English and German literature. However, without knowing the ancient records of a disease such as Sarsam (delirium), Barsam (pleurisy), Da'alfil (elephantiasis), Da'al-Raqs (chorea), Pisi (Vitiligo), Degg (languish), Zat-ul- reyeh (Pneumonia), and Zat-ul-Janb (pleurisy), one can specialize in medicine, but, recalling of literary and mythological letters, even those that have no practical application today or have been forgotten somewhere in the history of medicine, can soften medical science and allow us to link science and art. In this article, eponyms that are related to the sciences of anatomy and biochemistry are studied based on myth.