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Showing 266 results for Ethics
Ethical Considerations in Post-Crisis and Disaster Rehabilitation
Mohammad Javad Hosseinabadi Farahani,
Volume 17, Issue 0 (12-2024)
Abstract
Rehabilitation in disaster contexts, as part of the overall medical response, faces unique challenges, particularly during the early stages of post-disaster intervention. This is largely due to the relatively new integration of rehabilitation into disaster management. The four principles of bioethics—autonomy, beneficence, non-maleficence, and justice—are essential considerations in immediate post-disaster relief efforts and in the subsequent long-term rehabilitation processes. This review study involved a purposeful search of reliable databases using predetermined keywords, covering the period from 2000 to 2024. The reviewed studies highlight several ethical dilemmas in delivering rehabilitation services after crises and disasters. These challenges arise due to factors such as:
· Resource limitations,
· Insufficient focus on rehabilitation within health systems,
· Shortages of rehabilitation specialists,
· Inadequate follow-up cares post-discharge,
· Limited awareness of the significance of rehabilitation, and
· Stigma associated with disability.
Despite these challenges, it is critical to uphold the four principles of biomedical ethics even in crisis situations. Adhering to these principles ensures that rehabilitation services align with professional norms, ethical standards, and the medical aspects of the local culture. Furthermore, policies aimed at enhancing the status and importance of rehabilitation immediately after crises and disasters must emphasize the equitable distribution of resources.

Oversight of Research Ethics Committees in Knowledge-Based Projects
Saeed Biroudian,
Volume 17, Issue 0 (12-2024)
Abstract
Effective oversight of scientific research is essential for ensuring adherence to ethical and legal principles, particularly in medicine and health sciences. This oversight plays a crucial role in maintaining research validity and safeguarding human health. As knowledge-based and technological projects continue to expand, the responsibilities of ethics committees become increasingly significant. Recognized as independent and credible entities, these committees conduct rigorous reviews of research initiatives. This article critically examines the significance, methodologies, and impact of ethics committee oversight on the quality and credibility of scientific research in knowledge-based projects. This study employs a review methodology, synthesizing data from established guidelines and regulatory frameworks governing ethics in biomedical research, as outlined by the National Committee on Ethics in Research of the Ministry of Health and Medical Education. Additionally, a comprehensive review of relevant scientific literature and empirical studies was conducted, focusing on the oversight of approved projects from reputable contemporary sources. The analysis indicates that knowledge-based projects require heightened ethical scrutiny compared to other research initiatives. This necessity arises from the imperative to adhere strictly to ethical standards outlined in research proposals. Rigorous oversight significantly enhances research quality while mitigating ethical violations. Furthermore, active engagement by ethics committees fosters a stronger commitment among researchers to uphold ethical principles. By offering targeted guidance and training, these committees contribute to the development of high-quality research proposals. Effective oversight by ethics committees is instrumental in enhancing the quality and credibility of scientific research, particularly in emerging technologies and knowledge-based projects. This oversight not only reduces ethical infractions but also strengthens public trust in research findings. Therefore, continuous advancements in ethical training and researcher awareness are imperative. Improving oversight mechanisms will further elevate ethical standards and reinforce responsible research practices within this domain.

Promoting Ethical Motivation in Health Care Organizations: Ethical Accreditation of Healthcare Service Facilities: A Review Study
Seyed Ali Enjoo ,
Volume 17, Issue 0 (12-2024)
Abstract
Organizational ethics in healthcare literature encompasses a set of complex and interrelated topics. It is regarded as the frontier of medical ethics or the next stage in the evolution of bioethics. To effectively address organizational ethical issues within healthcare organizations, it is crucial to understand both the similarities and differences between competing concepts. Moreover, the presence of financial and contractual concerns often makes it challenging to motivate managers to enhance the ethical climate of their organizations. This study aims to develop a deeper and more comprehensive understanding of organizational ethics in the healthcare system. This review study involved a comprehensive search of the literature on healthcare system ethics, utilizing the following databases: PubMed, Scopus, Web of Science, and CINAHL. Additionally, grey literature from published books on Healthcare Organization Ethics and websites of organizations such as JCAHO and VBN were also included. The search strategy employed a combination of keywords such as 'health ethics,' 'organizational ethics,' 'health organizations,' 'ethical decision-making,' 'manager motivation,' and 'CEO incentives.' Only English-language sources with accessible full-texts were considered. All search results were reviewed, and duplicates were removed. This study offers a comprehensive overview of the existing literature on organizational ethics in healthcare, providing a detailed map of key texts in the field.
 

An Islamic Bioethics Framework for Decision-Making on the Life Support of Periviable Newborns
Forouzan Akrami,
Volume 17, Issue 0 (12-2024)
Abstract
For many years, the question of whether or not to resuscitate periviable newborns has been a topic of debate among perinatologists, neonatologists, and ethicists. Unlike other studies that focus on the value and sanctity of human life during intrauterine development, the present study seeks to address the ethical question of what constitutes the right decision regarding life-support measures for newborns born at peri-viability ages, within the ethical norms of the Islamic tradition. This study assumes the inherent value of every moment of human life and acknowledges the human dignity of individuals from the time of conception. This multi-method study was conducted in three parts: (1) a review of the ethical frameworks presented for supporting the lives of periviable newborns, (2) an explanation of the principles of Islamic bioethics based on common Sunni and Shiite sources, and (3) the development of an Islamic bioethics framework. According to the ethical principles of the Islamic tradition—contrary to secular biomedical ethics—first and foremost, efforts should be made to preserve and prolong the life of periviable newborns regardless of their anticipated quality of life. Second, in decisions involving life and death, the priority is not the preferences of the infant's parents but rather the saving of the infant's life and its preservation by the physician and medical team. Nonetheless, parental participation in the decision-making process is essential. Preserving life, however, is not an absolute obligation; the aim of life-support measures is not merely to extend the infant's life for a short period but to do so in proportion to the prognosis and expected benefits. Specifically, these measures should be considered when there is a significant probability of the newborn’s survival. This requires a case-by-case assessment of risks, taking into account the newborn’s clinical condition, as well as regional resources and conditions. It is recommended to use the proposed Islamic bioethical framework to develop a clinical guideline that includes criteria for classifying infants born at the edge of viability based on their clinical condition. Ethical decisions to intervene should then be based on the infant's clinical state, probability of survival, and the resources available in the region.

Investigating the Factors Influencing Moral Courage in Nurses: A Systematic Review
Morteza Javanmardi , Seyede Elahe Karimipour , Zahra Bakhshizadeh , Mohammad Hossein Taklif, Negin Farid,
Volume 17, Issue 0 (12-2024)
Abstract
Moral courage, encompassing the ability to act ethically in the face of adversity and uphold ethical principles, is crucial for nurses. This systematic review aimed to investigate the factors influencing moral courage among nurses. A comprehensive literature search was conducted using keywords such as "moral courage," "ethics," "nurses," and "courage" in major databases, including PubMed/Medline, Web of Science Core Collection, Scopus, Google Scholar, Irandoc, SID, and Magiran. The search included publications in both English and Persian with no time limitations. After excluding duplicates and screening the initial 2577 studies, 21 studies met the inclusion criteria. The review adhered to the PRISMA guidelines for reporting systematic reviews, ensuring ethical considerations were maintained throughout the selection, extraction, and analysis processes. The review revealed that moral courage in nurses is influenced by a multifaceted array of factors. Individual factors such as age, gender, work experience, and type of employment (e.g., permanent vs. temporary) were found to influence moral courage. Higher education, particularly possessing a master's degree or higher, and participation in medical ethics training were significantly associated with increased moral courage. Ethical sensitivity, defined as the ability to recognize and appreciate ethical dilemmas, was a significant facilitator of moral courage. A supportive work environment, characterized by factors such as strong ethical leadership, open communication, and adequate resources, was found to positively influence moral courage. Conversely, ethical distress experienced in challenging clinical situations can negatively impact moral courage. This review demonstrates that moral courage among nurses is influenced by a complex interplay of individual, professional, and environmental factors. Enhancing moral courage requires a multi-pronged approach, including strengthening nursing education with a robust emphasis on ethics training, fostering a supportive and ethically sound work environment, and implementing strategies to mitigate ethical distress. These interventions can significantly contribute to improved clinical practice and enhanced patient care.

A Review of the Ethical Challenges Surrounding Abortion and Related Perspectives in Islamic Societies
Mohammad Chahkandi, Yasaman Sadeghi, Vajihe Tanoumand ,
Volume 17, Issue 0 (12-2024)
Abstract
Induced abortion remains a significant global health concern, with an estimated 73 million procedures performed annually. While legal and medical frameworks vary across countries, many Islamic societies grapple with ethical dilemmas surrounding abortion. This review examines the ethical challenges surrounding abortion within the context of Islamic perspectives. A comprehensive literature search was conducted using the keywords "abortion," "Islam," and "ethics" in combination with Boolean operators (AND, OR) within PubMed, SID, Google Scholar, and other relevant databases. The search was conducted by three independent researchers. Inclusion criteria included articles published between 2014 and 2024 with the keywords appearing in the title, abstract, or keywords, and full-text availability. After removing duplicates, 11 articles met the inclusion criteria. The decision to undergo elective abortion is influenced by various factors, including the desire for pregnancy, maternal and fetal health status, family dynamics, social stigma, and legal and religious regulations. While Islam generally prohibits abortion, ongoing debates arise from challenges related to access to safe abortion methods and the protection of women's rights. Despite the religious prohibition of abortion, restrictions on access to safe abortion services do not eliminate the practice but rather drive women towards unsafe methods, leading to significant physical and psychological harm, particularly among vulnerable populations. Moreover, limitations on prenatal screenings can result in the birth of infants with genetic defects. These factors raise important questions about the effectiveness and ethical implications of restrictive abortion policies in Islamic societies. Ensuring access to safe and legal abortion services, along with comprehensive sexual and reproductive health education, is crucial for improving maternal health outcomes and upholding women's rights within these contexts.

Ethical Challenges of Artificial Intelligence in Academic Writing and Dissemination
Amirmohammad Azarakhsh, Mohammadreza Dinmohammadi, Kian Nouroozi Tabrizi, Kowsar Nouri,
Volume 17, Issue 0 (12-2024)
Abstract
In recent years, artificial intelligence (AI) has significantly impacted the publication of research articles, transforming the landscape of academic writing and dissemination. However, the integration of AI in this process presents significant ethical challenges that require careful consideration. This review study utilized a comprehensive search strategy, employing keywords such as "artificial intelligence," "publication ethics," "ethical challenges," "academic integrity," and "research dissemination" to identify relevant articles in scientific databases including PubMed, Scopus, CINAHL, and Google Scholar. The search included articles published between 2010 and 2024 in both English and Persian. Research articles, systematic reviews, and case reports that included the specified keywords in their titles and abstracts were selected. A total of 150 articles were screened, and 50 relevant studies were included for detailed analysis. The analysis identified several ethical challenges associated with the use of AI in academic publishing. Concerns regarding academic integrity are paramount, as AI-generated content can blur the lines between original research and automated writing, raising concerns about authorship and plagiarism. Furthermore, the reliance on AI tools for data analysis and manuscript preparation can raise questions about the accuracy and validity of research findings. additionally, the potential for bias embedded within AI algorithms is a significant concern, as it can influence the selection of research topics, the framing of research questions, and even the peer review process. The lack of transparency in AI-driven editorial processes can further undermine trust in academic publishing. This review underscores the urgent need for robust ethical frameworks and regulations to guide the responsible use of AI in academic publishing. Increased awareness and training among researchers and editors regarding the ethical implications of AI are crucial. Interdisciplinary collaborations are essential to address these challenges effectively and ensure the integrity and trustworthiness of academic research in the AI era.
 

Assessment of the Level of Adherence to Ethical Principles in Research by Researchers at Iranian Medical Sciences Universities (Eight Regions)
Batool Zeidabadi, Khadijeh Ahmadzadeh, Zeinab Khademi, Reza Sadeghi, Farnoosh Ghomi,
Volume 17, Issue 0 (12-2024)
Abstract
Research ethics is a fundamental component of the scientific process and is crucial for ensuring the integrity and reliability of research outcomes. Researchers must recognize that the results of their studies can impact individuals and societies. Therefore, accountability and transparency in conducting research are of particular importance. Adherence to ethical principles not only enhances the scientific credibility of researchers but also contributes to the advancement of science and technology. This study aimed to assess the level of adherence to research ethical principles among researchers at Iranian Medical Sciences Universities. This descriptive-analytic, cross-sectional study focused on researchers from Iranian universities of medical sciences. The data collection tool was a research ethics compliance questionnaire, which was distributed to researchers at medical universities in Region Eight. The questionnaire contained 40 items across 9 dimensions: respect for subjects' moral rights, free thinking, professional responsibility, social responsibility, accuracy, emotional impartiality, honesty, Originality, and legitimacy. Data were analyzed using SPSS version 24 software. In addition to descriptive statistics, Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests were also applied. A total of 230 researchers participated in the study, 193 of whom were faculty members. The results indicated that the average score for adherence to ethical principles in research was 3.174, reflecting a high level of adherence. The results also revealed that the dimensions of legitimacy and accuracy had the highest average scores (21.7 and 22.5, respectively). Significant differences were observed in adherence to ethical principles based on educational degree, academic rank, age, and work experience (p < 0.05). Spearman's correlation indicated a significant inverse relationship between adherence to ethical principles and educational degree, meaning that higher educational levels were associated with lower adherence to ethical principles in research. Overall, the findings of this study show that most researchers in the eight regions of Iranian medical sciences universities adhere to ethical principles in research at a high level.

Assessment of Compliance with the Patients’ Rights Charter by Healthcare Staff from the Perspective of Hospitalized Patients in Shahid Rahnemoon Hospital, Yazd
Tahereh Shafaghat, Elahe Rahmani Samani, Elnaz Haiery, Atiyeh Dehghan Niri, Zahra Raisi,
Volume 17, Issue 0 (12-2024)
Abstract
An efficient healthcare system relies on active participation and a strong relationship between healthcare providers and recipients. Observing the Patients’ Rights Charter is an essential aspect of delivering high-quality healthcare services. However, the existence, formulation, and dissemination of the charter do not ensure its implementation and compliance. Therefore, evaluating adherence to the charter is critical. This study aimed to assess compliance with the Patients’ Rights Charter at Shahid Rahnemoon Hospital, Yazd. This applied, descriptive-analytical study was conducted cross-sectionally at Shahid Rahnemoon Hospital, Yazd, in 2024. The study population included all hospitalized patients in the hospital. Cluster random sampling was used, and a standardized questionnaire developed by Parsapour et al. measured adherence to the Patients’ Rights Charter. Data analysis was performed using the Mann-Whitney and Kruskal-Wallis tests via SPSS software version 26. The findings revealed that patients perceived an average level of adherence to the Patients’ Rights Charter in Shahid Rahnemoon Hospital (mean ± SD: 53.99 ± 11.10). The highest compliance was observed in the domain of respect for patients and protection of privacy (mean ± SD: 78.12 ± 2.65), whereas the lowest compliance was reported for the existence of a complaint resolution system (mean ± SD: 2.97 ± 1.74). Patient satisfaction, a vital indicator of healthcare quality, is closely linked to the observance of patients’ rights. To improve compliance, it is recommended to:
1. Raise staff awareness about the importance of adhering to patients’ rights.
2. Educate patients about their rights through staff training and media campaigns.
3. Develop plans by hospital management to address areas of non-compliance.
4. Foster greater collaboration between staff and patients.
5. Follow up on violations of patients’ rights and implement legal measures to ensure compliance.
6. Regularly monitor adherence to patients’ rights to enhance patient satisfaction and staff commitment to ethical practices.

Ethical Considerations in Televisits: A Framework for Safe and Effective Implementation
Fatemeh Rahimi,
Volume 17, Issue 0 (12-2024)
Abstract
Televisits offer significant potential for enhancing healthcare accessibility, reducing costs, and improving patient satisfaction. However, their effective implementation requires careful consideration of ethical principles to ensure patient safety, privacy, and quality of care. This paper examines key ethical considerations for televisit implementation across three stages: pre-visit, during-visit, and post-visit. Pre-visit considerations include careful patient selection to ensure suitability for remote care, establishing a strong physician-patient relationship based on trust and obtaining informed consent, and demonstrating cultural sensitivity and inter-professional coordination. During the televisit, optimal technical conditions are critical, including reliable internet connectivity, high-quality audio-visual equipment, and a conducive physical environment. Comprehensive and transparent documentation of the televisit encounter is essential. Post-visit considerations include evaluating patient experiences, addressing any identified issues, and ensuring timely follow-up for continuous quality improvement. Ethical considerations extend beyond the clinical encounter. Addressing technical challenges such as data security, privacy breaches, and equitable access for all populations, including those with disabilities, is crucial. Transparent reimbursement mechanisms and ongoing education for both patients and healthcare providers are essential for successful televisit integration. The successful implementation of televisits requires a multi-faceted approach that addresses ethical considerations at all stages. Developing comprehensive guidelines, adhering to international standards, and establishing robust oversight mechanisms are essential for ensuring the safe, effective, and equitable utilization of this innovative technology in healthcare delivery.
 

The Impact of Professional Ethics Training on the Spiritual Care Competence of Emergency Nurses
Milad Kazemi Najm, Tahereh Toulabi, Abbas Abbaszadeh, Rasoul Mohammadi, Nasrin Imanifar,
Volume 17, Issue 0 (12-2024)
Abstract
Nurses, as the largest group of healthcare workers globally, are responsible for providing holistic care to patients. Holistic care encompasses physical, mental, social, and spiritual dimensions. This study aimed to determine the effect of professional ethics training on the spiritual care competence of emergency nurses. This two-group field trial study with a pre-test and post-test design was conducted with 84 nurses working in the emergency departments of Lorestan University of Medical Sciences. Participants were selected through stratified random sampling. The intervention group participated in four workshops. The study tool was the Spiritual Care Competency Questionnaire. Data analysis was performed using SPSS, employing descriptive statistics (mean, median, and percentage) and inferential statistical tests, including repeated measures ANOVA, independent t-tests, and Fisher’s exact test.
The study included two groups: intervention (n = 42) and control (n = 42). Most participants in both groups were women. A significant difference was observed in the average total spiritual care competence scores and its dimensions (excluding the self-knowledge subscale) over different time points in the intervention group (P < 0.001). However, for the self-knowledge subscale, no significant difference was found in the average scores between the control and intervention groups at different time points. The results of this study demonstrated that professional ethics training improves nurses' spiritual care competence. By conducting workshops, training programs, and in-service courses on professional ethics and spiritual care, the quality of nursing care can be enhanced, ultimately improving patient safety. It is recommended that healthcare policymakers and nursing managers prioritize professional ethics as the foundation of all nursing practices. Employing innovative and engaging methods, such as the scenario-based approach used in this study, can further support the development of professional ethics in nursing.

Investigating the Ethical Challenges of Nurses in End-of-Life Care at Home for Elderly Patients: A Review Study
Nayereh Baghcheghi, Zahra Maddah,
Volume 17, Issue 0 (12-2024)
Abstract
With the increasing elderly population and the growing demand for home healthcare and end-of-life care services, nurses are facing expanded duties and responsibilities. This intensification of responsibilities can expose them to significant ethical challenges. This study aimed to investigate the ethical issues nurses encounter in providing end-of-life care at home for elderly patients. This review study involved a comprehensive search of databases including PubMed (Medline), Google Scholar, ISI Scopus, ProQuest, Science Direct, SID, IranDoc, IranMedex, and Magiran. The keywords used were: nursing ethics, ethical challenges, end-of-life care, and home care, along with their Persian equivalents. The search covered literature published between 2000 and 2024. The review identified several prominent ethical challenges faced by nurses in home-based end-of-life care, including: lack of attention to patients’ rights and independence, disrespect for the dignity of elderly patients, inadequate empathetic care, poor communication, and unsafe home environments for nurses. These challenges may lead to moral distress, as well as psychological and emotional consequences for both the care providers and the elderly patients. Given the serious ethical challenges nurses face in end-of-life home care for the elderly, it is essential for them to be well-versed in ethical principles relevant to this context. Enhancing awareness and competence in ethical practices can help nurses uphold patient rights, promote autonomy, and provide high-quality, compassionate care through effective communication and support.

Nursing Ethics in the Care of Elderly Patients: A Review of Challenges and Solutions
Alireza Zare, Mohammad Hossein Taklif, Alireza Javid, Zahra Amadeh, Negin Farid,
Volume 17, Issue 0 (12-2024)
Abstract
As the global elderly population continues to rise, nursing care for this demographic faces increasing ethical challenges. The elderly are particularly vulnerable, requiring specialized care that addresses their physical, psychological, and social needs. However, these needs often present ethical dilemmas, including issues related to autonomy, informed consent, fairness in resource allocation, and managing conflicts between patients and their families. This systematic review aims to identify the ethical challenges nurses face in caring for elderly patients and to propose solutions that enhance the quality of care. A comprehensive search was conducted across several reputable databases, including PubMed, Scopus, CINAHL, and Google Scholar, using keywords such as "nursing ethics", "elderly", "ethical challenges", and "ethical care". Articles published between 2010 and 2023 in English and Persian were considered for inclusion. After an initial screening, 40 eligible articles were selected for final analysis, and thematic analysis was used to interpret the data. The findings reveal several key ethical challenges for nurses in elderly care, including respecting patient autonomy, navigating decision-making processes in cases of cognitive decline, ensuring confidentiality, and managing family pressures. Additional difficulties include resource shortages, high workload, and limited access to ethics training. Proposed solutions to address these challenges include continuous ethics education, the development of comprehensive ethics protocols, and the formation of interdisciplinary teams to facilitate more informed decision-making. Addressing ethical challenges in elderly care requires robust planning and action from health systems. By establishing clear ethical guidelines, promoting ongoing education, and fostering a supportive work environment, the quality of care for elderly patients can be significantly improved. Further research should evaluate the effectiveness of these strategies in mitigating ethical issues within nursing practice.

Nurse's Ethical Challenges During Global Crises: War and Beyond
Fatemeh Roudi, Hedayat Jafari, Mohammadreza Jalilfar, Seyed Mohammad Mirshafiei, Seyed Tohid Hoseini, Soodabeh Eslami,
Volume 17, Issue 0 (12-2024)
Abstract
Nurses are critical healthcare providers during global crises, particularly in situations of armed conflict and war, where they face unique and often overwhelming ethical challenges. These professionals are tasked with making immediate and difficult decisions under extreme conditions. This study aims to thoroughly examine the ethical challenges encountered by nurses during global crises, with a particular focus on armed conflicts and wars. This systematic review analyzed articles sourced from PubMed, Scopus, ScienceDirect, Magiran, and Google Scholar databases, using the following search terms: "nursing ethics," "war," "global crises," "ethical considerations in nursing during war," and "nursing ethics in armed conflicts." Following a thorough review and filtering process based on the study's objectives, seven articles were selected for inclusion. The findings highlight several ethical challenges faced by nurses during wartime. These challenges include: allocating limited resources under dire circumstances, providing care to both combatants and civilians without bias, maintaining patient confidentiality while cooperating with military authorities, and delivering care in hazardous and unpredictable environments. The ethical issues nurses encounter in global crises, particularly in war, include: 1) the tension between professional duty and political or military affiliations, 2) the ethical dilemma of allocating scarce resources in critical conditions, 3) the decision of which patients should be prioritized for treatment, and 4) the significant risks to life involved in providing care in conflict zones. Nursing care during global crises, especially in wartime, presents profound ethical dilemmas that demand rapid and sound decision-making. Adequate training in nursing ethics tailored to wartime conditions, as well as robust support for nurses in these high-pressure environments, are critical to addressing these challenges effectively.

Pediatric Nurses' Adherence to Codes of Ethics: A Narrative Review
Naiire Salmani,
Volume 17, Issue 0 (12-2024)
Abstract
Codes of ethics serve as essential guides for nurses in all medical settings to implement ethical principles, and they are especially important in pediatric wards. Given the vulnerability of sick children, it is crucial for pediatric nurses to provide care grounded in ethical codes and guidelines. This study aimed to review pediatric nurses' adherence to these codes of ethics. This review study was conducted by searching for articles using keywords such as “nurse,” “care,” “codes of ethics,” and “children” (and their Persian equivalents) through databases including Google Scholar, PubMed, Scopus, and SID from 2013 to 2024. A total of 1537 articles were retrieved initially. After reviewing the full-text English or Persian articles, 23 were assessed for quality, and 10 were selected for analysis. Pediatric nurses' adherence to ethical codes encompasses several key principles, including respecting the patient's family, establishing trust-based relationships, maintaining the privacy of sick children, demonstrating patience, taking responsibility for errors in patient care, and ensuring non-discrimination between sick children and families. To effectively adhere to codes of ethics in pediatric care, nurses must provide ethical care that is both patient-centered and family-focused, using ethical principles as a foundation for their practice.

Is it Possible to apply an Advance Directive in Iran’s Health System?
Amin Arman, Mina Mobasher, Mohammad Aminizadeh,
Volume 17, Issue 1 (3-2024)
Abstract

Deciding on whether to continue life-prolonging treatments for terminal patients is a major challenge in healthcare. Advance directive emerges as a proposed solution to this issue in the world. The patients record their preferences regarding the continuation of life-prolonging treatments while they still are able to make decisions. Although advance directive is morally justifiable from the perspective of principlism, respecting the patient’s right to autonomy and assessing the benefits and drawbacks of providing such services, the religious beliefs of patients, their families, and healthcare providers always exert a significant influence on this matter. In Islam, preserving human life heavily affects these decisions. Several juridical and legal rules can culminate in different decisions on the continuation or termination of life-prolonging treatments including the absolute legal power of the owner to exercise dominion[1] or control over property and permission of intervention in their body[2], the rules of prohibition on causing the death[3], the sanctity of human killing[4], the rule of prohibition of detriment[5], the concept of unstable life[6] in Article 372 of the Islamic Penal Code and the rules of preventing losses[7], and the rule of sanctity of idle[8]. Nevertheless, given various types of will in Islamic Jurisprudence and according to the contract of agreement[9], it is possible to record the patient’s request regarding how to continue the treatment. This study indicated that implementing advance directives in Iran’s health system requires a more accurate analysis of moral, legal, and jurisprudential foundations.

 
[1] (tasli¯t)
[2] (ezn dar tasarof)
[3](nafy al-d.arar )
[4] (Hormat Ghatl)
[5] (la¯ d.arar wa la¯ d.ira¯r fi¯ al-isla¯m)
[6] (Ghayr-Mustaqarr)
[7] (‘usr wa al-h. araj, al-)
[8] (hormat laghw)
[9] (agde solh)
[1]. (tasli¯t)
[2]. (ezn dar tasarof)
[3]. (nafy al-d.arar )
[4]. (Hormat Ghatl)
[5]. (la¯ d.arar wa la¯ d.ira¯r fi¯ al-isla¯m)
[6]. (Ghayr-Mustaqarr)
[7]. (‘usr wa al-h. araj, al-)
[8]. (hormat laghw)
[9]. (agde solh)

Proposing a Charter for Ethical Peer Review of Scientific Works in the Field of Health: A Commentary
Zahra Kazempour, Hasan Ashrafi-Rizi, Mohammadreza Hashemian,
Volume 17, Issue 1 (3-2024)
Abstract
The ethics of reviewing scientific works is a crucial aspect of research ethics in the field of health, where the outcomes significantly impact prevention, diagnosis, treatment, rehabilitation, and management, highlighting the importance of the quality of research results. Accordingly, this study aimed to develop a charter for the ethical peer review of scientific works in the field of health. The significance of this commentary lies in that researchers’ and reviewers’ adherence to ethical principles can contribute to enhancing the quality of scientific works aimed at prevention, diagnosis, treatment, rehabilitation, and management in the field of health. This charter can serve as a framework for scientific work review systems, assisting research managers in identifying the ethical components essential for reviewing scientific works in the field of health to develop effective research policies and plans. Moreover, it would help reviewers and practitioners at journals, research centers, and institutes, facilitating accurate, fair, and unbiased reviews of scientific works in the field of health.

The Relationship Between Moral Foundations and Organizational Culture Among Nurses at Vali-e Asr Hospital in Borujen in 2023
Fatemeh Badr, Mostafah Roshanzadeh, Somayeh Mohammadi, Mina Shirvani, Samaneh Dehghan Abnavi,
Volume 17, Issue 1 (3-2024)
Abstract
Considering the important role of health organizations and the behavior and performance of nurses in achieving organizational goals, the moral foundations of nurses can significantly influence their behaviors and decisions and shape the organizational culture and atmosphere. Therefore, the present descriptive-analytical study aimed to investigate the relationship between moral foundations and organizational culture among 200 nurses selected using the census method at Shahrekord University of Medical Sciences in 2023. Data were collected through a demographic information form along with questionnaires to measure moral foundations and organizational culture. Data were analyzed using SPSS software version 16 via descriptive statistics (percentage, mean, and standard deviation) and analytical tests (t-test, analysis of variance (ANOVA), correlation coefficient, and linear regression). Pearson’s correlation coefficient revealed a significant relationship between the mean scores of moral foundations and organizational culture among nurses (r=0.61, P<0.001). The coefficient of determination (R2=0.372) showed approximately 37% of the variance in organizational culture can be predicted by moral foundations. Among the dimensions of moral foundations, loyalty to the group, respect for authority, and purity significantly predicted organizational culture (P<0.001). The mean score of moral foundations among nurses was acceptable at 98.55±15.8, while the mean score of organizational culture was favorable at 105.74±25.7. Based on the findings from the present study it can be concluded that by creating a moral atmosphere and promoting moral values such as loyalty to the group, respect for authority, and purity in nurses, the organizational culture can be enhanced

Challenges and Considerations of Professional Ethics in Midwifery During the COVID-19 Pandemic: A Qualitative Content Analysis
Shahrbanoo Salehin,
Volume 17, Issue 1 (3-2024)
Abstract
The COVID-19 pandemic is a public health emergency that has challenged many ethical issues. This study aimed to investigate the challenges and considerations of midwifery professional ethics during the COVID-19 pandemic. Employing qualitative content analysis, raw data were collected through an extensive literature review, utilizing purposive sampling until data saturation was achieved. Data trustworthiness was ensured based on Lincoln and Guba's criteria and data were analyzed using an inductive method. A total of 4 themes and 17 main categories were extracted. The themes and categories included: 1. Ethical challenges in deciding on midwifery care and place of delivery (ethical challenges of home birth, ethical challenges of hospital delivery, facing ethical challenges), 2. Clinical ethical principles (beneficence, equitable distribution and justice, solidarity, trust, duty to care), 3. Ethical principles in management (equal concern and respect, minimizing harm caused by the pandemic, inter-sectoral cooperation, evidence-based decision-making), 4. Support for midwives' rights (psychological support for midwives, gender considerations among midwives, midwifery training, workplace health, support policies). Midwives encounter various ethical challenges in pandemics. Thus, developing an ethical framework for decision-making in pandemics can help address these challenges.

The Strategy of Nursing Managers in Ethical Decision-Making: A Qualitative Content Analysis
Mostafa Roshanzadeh, Ali Taj, Somayeh Mohammadi,
Volume 17, Issue 1 (3-2024)
Abstract
In the current health system conditions, the strategies adopted by nursing managers in their ethical decision-making can lead to different results for patients, nurses, and health systems. Therefore, the present study aimed to explain ethical decision-making strategies implemented by nursing managers. The present study was conducted using qualitative content analysis in 2022 at Shahrekord University of Medical Sciences. A total of 18 nursing managers were selected through purposive sampling and were interviewed using in-depth unstructured individual interviews. Data were analyzed using the method proposed by Graneheim and Lundman. The results revealed one main category (human-centeredness) and three subcategories (customer-centeredness, valuing employees’ dignity, and the conflict between respecting the rights of patients and employees and adhering to organizational policies). Nursing managers attempted to make their ethical decisions based on the principle of humanism by using customer-centeredness strategies, valuing employees’ dignity, and prioritizing the rights of individuals and employees over organizational rules. The results of the present study showed nursing managers make decisions in line with respecting the rights of patients and employees. However, sometimes these decisions conflict with the interests of organizations. In this regard, the existing obstacles that create the conditions for such conflicts should be identified. Increasing organizational commitment in managers can also be effective in decisions that benefit different groups of customers, personnel, and health organizations.

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