Showing 36 results for parsa
Ali Vasheghani Farahani, Majid Maleki, Reza Golpira, Hooman Bakhshandeh, Mojtaba Parsa, Mahnaz Mayel Afshar, Sima Kashanian Fard, Shiva Khaleghparast, Mohsen Rezaei, Seyed Ahmad Rezaei,
Volume 8, Issue 1 (5-2015)
Abstract
Medical professionalism has recently received attention in Iran, so we aimed to assess it in a single specialty educational hospital.In the present study, we evaluated observation of medical ethics principles from the viewpoints of physicians, nurses and patients. Eight principles of medical ethics were evaluated in these three groups through modified questionnaires containing 43 questions for physicians, 42 questions for nurses, and 25 questions for patients. The mean scores of those principles are as: enhancing professional efficiency (68.7 ± 23), confidentiality (67.9 ± 21), maintaining an appropriate relationship with the patients (61.7 ± 21), improving access to services (59.6 ± 21), distributing limited resources fairly (60.2 ± 25), knowledge production (61.4 ± 23), promotion of trust through management of conflicts of interests (64.8 ± 23), and perform professional responsibilities (59.6 ± 23). There were significant differences in the two parameters of “enhancing professional efficiency” and “confidentiality” between the viewpoints of the patients and the viewpoints of physicians and nurses (P < 0.0001). The difference in “maintaining an appropriate relationship with the patients”, “improving access to services”, and “distributing limited resources fairly” was significant between the viewpoints of the nurses and that of the patients and physicians. The viewpoints of the nurses and patients were significantly different only in “knowledge production”, “promotion of trust through management of conflicts of interest”, and “perform professional responsibilities” (P < 0.0001). With respect to these significant differences, the nurses’ viewpoint regarding “enhancing professional efficiency” may be more dependable due to their more accurate knowledge of the physicians’ performance and more extensive contact with them. This has also resulted in significant differences between nurses and patients or physicians in other principles as well.
Saeedeh Saeedi Tehrani, Alireza Parsapour, Bagher Larijani,
Volume 9, Issue 2 (8-2016)
Abstract
Genetic research was initially limited to the screening and diagnosis of known hereditary diseases. After the completion of the Human Genome Project (HGP), studies became concerned with the diagnosis and treatment of many non-communicable diseases threatening the public health. Aside from this, genetic engineering, in its new form, is also concerned with the development of recombinant medications, genetic enhancement, and genetically modified organisms and their applications. The climax of these achievements is the advent of transgenic creatures. These are organisms with a genetic makeup different from their natural one created through biotechnology. Transgenic products have become more popular in recent years, especially in agriculture and livestock sectors. At the same time, genetics and biotechnology are trying to keep pace with modern advancements. Genetic modifications have resulted in larger yields in agriculture and livestock as well as the development of new medications and vaccines. Despite the large profits that genetic engineering and transgenic organisms can bring for us, they may pose dangers in certain fields. Furthermore, there are ethical concerns about the application of these technologies.
The present study attempted to address the ethical issues in new genetic technologies and analyze them with regard to the four principles of bioethics. For this purpose, keywords were first looked up in scientific sources and the data were classified; ethical considerations were then analyzed in the light of the four principles of bioethics.
In the results section first the merits of such products for humanity and their contributions to saving the limited available resources are pointed out; subsequently, potential threats in some fields are addressed, along with considerations about the mass production and consumption of genetically engineered products, autonomy of individuals, the importance of raising awareness about the pros and cons of genetically modified organisms (GMOs), and their labeling. Finally, equity is addressed, and general benefits and harms, costs and effectiveness are discussed.
Mojtaba Parsa, Bagher Larijani, Kiarash Aramesh, Saharnaz Nedjat, Akbar Fotouhi, Mir Saeid Yekaninejad, Nedjatollah Ebrahimian,
Volume 9, Issue 6 (3-2017)
Abstract
Informal payments in clinics raise ethical concerns in healthcare delivery. This cross-sectional questioner survey aims to evaluate the prevalence and related factors of informal payment in healthcare system in Iran.
The study was carried out in 2013, prior to the implementation of the government' Health System Reform among physicians with different specialties. The questionnaire were distributed among the participants during the congresses and continuing medical education programs.
In results; of the total specialist physicians, 276 returned the questionnaires. The response rate was 81.17%. and out of 276 returned questionnaires 257 fulfilled the inclusion criteria. The prevalence of informal payments, among the physicians who were susceptible to receiving informal payments, was relatively high (63.8%). The physicians who practiced in the private sector, as well as physicians who practiced in Tehran and those who had a positive attitude towards the informal payments, received more informal payments. From the viewpoint of the respondents, the main cause of informal payments was unrealistic/unfair tariffs and the main consequence of informal payments was the rising costs of patient care.
This study showed that, unfortunately, more than half of the participants did not believe or did not decisively consider informal payments as unethical. This confirms the importance of physicians’ education about the unethical practice of informal payments. However, compare to private sectors, more supervision in public sector may be the main cause of less prevalence of informal payments in public hospitals.
In conclusion: Developing ethical guidelines to prevent informal payments as well as more realistic and fair tariffs would help to decrease the incidence of informal payments.
Neda Yavari, Alireza Parsapoor,
Volume 10, Issue 0 (3-2017)
Abstract
Increasing attention to individual liberties in last decades, has led to considering respect to patients autonomy and involvement in making medical decisions as a critical ethical principle. In spite of a general emphasis on the Importance of the mentioned principle, there is a wide controversy about the logical limitations of respect to patients' wishes and preferences in medical decision making. While a significant number of theoreticians believe in necessity of considering rigid limitations for respect to patients' autonomy, others emphasize on respect to patients' absolute and unconditional right of self-determination. This article explains and analyzes each group's main arguments and finally suggests a functional and logical approach to the principle. This method helps avoidance of disadvantages of unconditional respect to patients' preferences while considering autonomy as an important ethical maxim.
Rasool Esmalipour, Mojtaba Parsa,
Volume 10, Issue 0 (3-2017)
Abstract
The conflict of interest is a situation in which professional judgment and performance in the primary interest and obligation tend to be unduly influenced by a secondary interest. Pharmacy is one of the main rings in the process of providing healthcare services. In this process conflict of interest may occur frequentlywhich occasionally has influence on the professional and moral duties of pharmacists that as a result may put the interst of the patients at risk. Taking care of patients is the first duty of pharmacist and they always must make evry effort to avoid any situations that puts the interests of the patientincluding their health, financial or non-financialposition at risk. The pharmacist must be aware of conflict of interest that exist in the drugstore as well as its effects on their professional and moral responsibilities. They also need to be able to manage them through scientific policy and logical skills. These issues and challenges may happen in terms of the relationship between the pharmacist and patients, other people or organizations, such as the relationship between doctors and pharmacists, pharmacists and pharmaceutical or non pharmaceutical companies, irrational relationship between pharmacists and patients. Although various guidelines for managing conflict of interest have been developed, there is a lack of policy on how to manage conflict of interest in pharmacy. In this study, the situations of conflict of interest and how it affects the professional relations of pharmacist with others was considered and this result was achived that the pharmacy have to be asuitable and appropriate place to give services for patients and the first priority of pharmacists must be the patients’ treatment benefits and interest
Mojtaba Parsa, Azam Khorshidian,
Volume 10, Issue 0 (3-2017)
Abstract
The emergence of different types of economic relations and the desire of professionals to earn more income has led to new challenges such as conflicts of interest in the dental profession. The community expects dentists to prioritize the health and the interests of their patients in their professional activities. In this regard, one of the most important dilemmas is the confrontation between the professional duties of dentists and their profit. Business goals being preferred rather than providing specialized knowledge services by dentist is a major concern, which can lead to patients’ distrust. Fee splitting, Self-referral, receiving gifts from the patient and industrial companies are among the most significant type of conflicts of interest in the profession, which are discussed in this article in the form of four clinical cases.
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.
Jannat Mashayekhi, Zeinab Derakhshan, Alireza Parsapoor,
Volume 12, Issue 0 (3-2019)
Abstract
The human moral or, in other words, his human dignity has long been the subject of discussions among various thinkers. Almost all theories that have addressed this issue are in principle the dignity of man and the supremacy of his position in relation to all beings, but what makes a different perspective on this topic is the criterion of this dignity and excellence. Making essential decisions for the fetus, including preserving the fetus or abortion, is one of the main applications of the principle of human dignity and is directly is influenced by its human and ethical status. Two groups of theories have focused on the issue of the dignity of the fetus: secular theories and theories based on religions and schools. The secular ideas, have some attractions that human intuition accepts them to some extent, but none is free of criticism, and the critique of each theory is all remarkableness and worthwhile. Hence, this article, while it is reviewing some of the secular views and the views of religions and schools on the status of the embryo and addressing some criticisms of them, provides the dominant human-being theory of fetus based on Shi'a thought and introduces the valuable position of man from fetal times. Finding the root of human dignity by relying on human thought and without resorting to revelation inspiration is faced to serious challenges. Human embryos, due to the ability to become human, have been at the beginning of being a valuable place that increases the value of fetal age when it increases its age so that it is not worthy of human dignity with God's soul. But because its granting by the Lord on the basis of the religious teaching perception, the egg cell should not only be eliminated, but also should be taken care of and protected due to its potential to become human
Mahmoud Motevassel Arani, Mojtaba Parsa, Seyed Hesamoldin Sayyedin , Nikzad Isazadeh, Abdolrahman Rostamian , Mohsen Parwiz, Hossein Dargahi,
Volume 13, Issue 0 (3-2020)
Abstract
Organizational culture is defined as prominent values and a set of key characteristics govern the organization. Paying attention to the importance of organizational culture increases staff’s productivity and job satisfaction. Therefore, the aim of this study was identification, counting and classification of organizational culture components based on Islamic-Iranian values by synthesizing approach and looking at health care organizations. First, 892 indicators were identified and counted by application of Pearson and English databases and using organizational culture, Islamic – Iranian culture, indicators, component, and health care organizations as key words, consideration of inclusion and exclusion criteria, field literature review, data entry into Excel software. Then using Delphi method and opinions of seven cultural elites in Tehran University of Medical Sciences, and after performing 11 stages, repetitive indicators in terms of meanings, concepts, and examples were merged and grouped into 39 components. Moreover, the extracted components were divided into three levels of organizational culture and the application of the components of each level in organizations were presented. Therefore, it is recommended the final components and application of each of them be used as an organizational charter in Tehran University of Medical Sciences.
Fezzeh Salimi, Mohammad Bagher Parsapour, Zahra Nikkhah Farkhani,
Volume 15, Issue 1 (3-2022)
Abstract
Corona is a global crisis that has affected government systems. The transition from crisis to crisis requires prudent measures. Governance is a continuous process through which conflicting interests are harmonized and cooperative actions are taken. The latest theory in this concept is good governance, which is doubly important in times of crisis. Good governance is the product of the favorable participation of the three institutions of government, civil society and the private sector. The components of good governance are numerous from the perspective of the World Bank, the United Nations, and thinkers in this field. The National Anti-Corona Headquarters was established by the order of the Supreme Leader and based on the approval of the Supreme National Security Council in March 2020 to take appropriate decisions regarding the treatment of Covid-19 disease, including announcing closures and other restrictive measures in case of violation of health instructions. In this research, with a descriptive-analytical method, an attempt has been made to explain the components of good governance in this period according to the unique legislative approvals in this field, while determining the competence of the mentioned headquarters in regulating. From the authors' point of view, the approvals of the Corona National Headquarters as one of the sub-councils of the Supreme National Security Council are beyond the ordinary law and among the existing components; Efficiency and effectiveness, transparency and accountability and pivotal consensus were recognized.
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.
Amirahmad Shojaee, Fazlollah Hasanvand, Hamidreza Namazi, Mojtaba Parsa, Kobra Rashidi,
Volume 16, Issue 1 (3-2023)
Abstract
Professional ethics is based on human values, tasks, rights and responsibilities and affects the professional and organizational conditions of nurses. In this regard, the aim of this study was identifying framework of the dimensions of nurses' professional ethics from the point of view their and physicians. This study was done with qualitative method, using semi-structured interview, with the participation of 26 physicians medical ethics specialist, clinical specialist, clinical assistant and intern and 20 nurses based on theoretical saturation with the purposeful sampling method and after obtaining informed consent from them. Content analysis method was used for data analysis, which was done in MAXQDA version 18 software. Findings showed professional ethics was based on a four-dimensional framework; The professional ethics of nurses in relation to the patient (six sub-components), in relation to colleagues in different job categories (four sub-components), in relation to the profession (three sub-components) and in relation to the hospital and medical organizations (two sub-components). The reliability of the coding of the components was obtained based on the Kappa index equal to 0.88. Therefore, it can be said. Framework of the dimensions professional ethics of the point of view of nurses found meaning in relation to themselves and others (patients, colleagues, organization and profession). The nurses, knowing and observing the details and nature of these communications, as well as the individual rights of these people from their own point of view; they can properly implement the principles of professional ethics in advancing the goals of the organization and increasing the quality of service provision and the satisfaction of others and raising the status of the profession.
Mojtaba Parsa,
Volume 16, Issue 1 (3-2023)
Abstract
Physician self-referral is the referral of a patient to a medical facility in which the referring physician has a financial interest. This can take two forms: internal referrals within the same office and external referrals, often involving joint ventures. Many claims, positive or negative, have been made regarding self-referral. Proponents claim that self referral causes, reduction of costs by fostering a competitive environment, encourage investment in health facilities particularly in underserved areas, financial benefits for both the doctor and the patient via cost reduction, and inhance the quality and accessibility of health services. Conversly, opponents, citing multiple studies, argue that self- referral may result in excessive and unnecessary utilization of healthcare services, leading to increased healthcare costs, low quality of services provided, and jeopardise patient safety. In certain countries, such as the United States and the Islamic Republic of Iran, ethical codes address self-referral. These guidelines either deem it unethical or require disclosure, accompnied by regulations to govern this practice.
Mojtaba Parsa,
Volume 16, Issue 1 (3-2023)
Abstract
This Article has no Abstract .
Mojtaba Parsa,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
"Under-the-table payment" refers to money a physician demands and receives from a patient, in addition to the established and approved medical tariff, typically for medical services such as surgical operations. This study aims to examine the ethical, legal, and juridical aspects of this phenomenon, which has become common among many physicians. This qualitative study is based on semi-structured interviews with 17 experts from various fields, including Islamic jurisprudence, law, professional ethics, philosophy of ethics, medical ethics, health economics, and social psychology. The interviews were analyzed using the conventional content analysis method. Additionally, the opinions (fatwas) of 11 Shia Grand Ayatollahs on under-the-table payments were obtained by posing a specific question to them. The findings from the expert interviews revealed several concerns regarding under-the-table payments, including:
· Disregard for patients' best interests, particularly causing harm to poor patients;
· Undermining trust between doctors and patients;
· Violations of national laws and public policies;
· Promotion of lawlessness;
· Breaches of medical and ethical obligations by physicians;
· Coercion or undue pressure on patients to pay such fees.
Experts emphasized that medicine is a profession in which patients' interests should take precedence over those of doctors, and in this practice, this fundamental principle is violated. Furthermore, in the fatwas issued by the majority of Shia Grand Ayatollahs - particularly those with governmental perspectives - nearly all deemed this practice impermissible, with some explicitly declaring it forbidden (haram). Receiving under-the-table payments is ethically, legally, and juridically problematic, and in some cases, is considered impermissible, particularly for the physicians involved. However, it is generally not considered problematic for patients who are coerced into making such payments.
Maryam Modabber, Mojtaba Parsa, Shiva Khaleghparast,
Volume 17, Issue 1 (3-2024)
Abstract
In the current era, the alarming increase in the number of patients with Alzheimer's disease has led to greater attention to issues related to care and alternative decision-making for this special group in society. The four ethical principles of "beneficence", "non-maleficence", "respect for autonomy", and "justice" serve as fundamental guidelines in medical decision-making. This study presents a case report of an elderly Alzheimer's patient and the ethical issues related to medical decision-making in the absence of a substitute decision-maker. Typically, for individuals lacking decision-making capacity, decisions are made by a substitute decision-maker and, in some countries, an advance care directive. In the absence of these, the medical team may make decisions in the best interest of the patient, considering the individual's cultural and social conditions, while taking into account the aforementioned ethical principles.
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.
Mojtaba Parsa, Soudabeh Mehdizadeh,
Volume 18, Issue 1 (3-2025)
Abstract
Domestic violence and abuse against women, particularly intimate partner violence, is a widespread public health problem. Domestic violence is associated with a wide range of physical and mental health issues and negatively impacts the health and well-being of the affected individual. Women who experience violence need support to mitigate the negative impacts of these violent acts. In this regard, health institutions play a critical role in providing comprehensive healthcare to women affected by domestic violence. Physicians' encounters with women experiencing domestic violence, especially in countries like Iran, where there are no clear guidelines on this matter, lead to challenges and ethical issues. This study explored some of these ethical issues and challenges by presenting a case study.
Parsa Farmahin Farahany, Zahra Torkashvand,
Volume 18, Issue 1 (3-2025)
Abstract
One of the key ethical-legal concerns in the medical profession is patients’ trust in the quality of care and adherence to professional standards. This viewpoint explored the ethical-legal dimensions of using surveillance cameras in Intensive Care Units (ICUs), focusing on a specific legal-ethical case. In this scenario, the patients’ family caregivers express doubt about the quality of care and request access to recorded footage. From an ethical-legal perspective, documenting events by the medical team—provided that privacy, data protection regulations, and visual monitoring standards are respected—can help safeguard patients’ rights, clarify staff performance, and prevent legal misunderstandings. While acknowledging the potential benefits, this study also outlined legal considerations, such as patient notification, access limitations, and data management protocols. The key conclusion is that the use of cameras in ICUs, if aligned with legal and institutional requirements, can enhance trust, demonstrate ethical compliance, and reduce legal complaints.
