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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.

The Effect of Using Student Reflective Narratives to Observe Dignity and Respect for Patients’ Rights in Clinical Education
Hoda Ahmari Tehran, Ahmad Mashkoori, Tayebeh Ilaghinezad, Maryam Tajadini,
Volume 17, Issue 0 (12-2024)
Abstract
Research shows that stress in medical students leads to burnout and a loss of respect for patients’ rights. These declines in mood and an increase in malpractice are particularly evident during the internship period. On the other hand, literature highlights the importance of reflective practice in education. This study investigates the effect of using student reflective narratives on observing dignity and respect for patients’ rights in clinical education. A mixed-methods study based on reflective learning theories (Gibbs' Reflective Model) was conducted over 12 months with 48 intern students. In a quasi-experimental design, 38 medical students were randomly assigned to either an intervention or a control group. Only students in the intervention group were allowed to engage in conversations with patients and inquire whether they had properly respected the patients’ rights and dignity. The students then reflected on their performances. In the first week, a pretest was conducted in both groups. The intervention group received reflective education and participated in reflection writing during the second and third weeks. In the final week, a post-test was conducted for both groups. To explore students’ perceptions of the effectiveness of reflecting on their performance, a qualitative content analysis was carried out, including 12 semi-structured interviews and 144 reflection notes. The mean scores of students’ performance regarding respect for patients in the intervention group improved significantly in the post-test (12.32 ± 1.21) compared to the pretest (9.85 ± 1.39) (p < 0.05). An independent t-test indicated that the difference in post-test scores between the two groups was significant (p = 0.01). From the interviews, four main themes emerged: improving empathy and understanding patients’ feelings, paying attention to patients’ humanistic dimensions, respecting patients’ autonomy and rights, and promoting interpersonal communication skills. This study demonstrated the positive emotional effects of reflective narrative writing interventions on medical students in observing dignity and respecting patients' rights. It is recommended to incorporate reflective narratives into medical education programs to enhance these qualities.

Ethical Challenges of Truth-Telling for Terminally Ill Patient
Neda Yavari ,
Volume 17, Issue 0 (12-2024)
Abstract
Communicating the truth about a terminally ill patient’s diagnosis and prognosis is a profound ethical challenge in healthcare. While patients have the right to know the details of their medical condition, grounded in the ethical principle of autonomy, healthcare providers often grapple with concerns about causing distress or hopelessness. These concerns sometimes lead to paternalistic approaches where information is either manipulated or withheld from patients in end-of-life stages. Research on the timing, method, and extent of information sharing with terminally ill patients has yet to reach a consensus. The challenge is further complicated by cultural differences regarding death, as well as varying family and social dynamics. This article explores the views and experiences of both healthcare providers and patients regarding the ethical challenges associated with truth-telling in end-of-life care. This qualitative study involved semi-structured, in-depth interviews with 27 healthcare providers, 20 patients, and 15 caregivers. Participants were selected through purposive sampling, and interviews were conducted until data saturation was achieved. The data were analyzed using conventional content analysis. The findings were organized into four key themes:
1.Diverse methods of truth-telling employed by healthcare providers, influenced by personal values, institutional policies, and cultural contexts.
2.Patients’ and families’ preferences for receiving information, which frequently conflicted with healthcare providers’ practices.
3.The impact of timing, manner, and setting of truth-telling on the emotional health of both patients and their families.
4.The necessity for a patient-centered approach that acknowledges the unique circumstances, values, and preferences of patients and their families.
This research highlights the ethical complexities involved in truth-telling for terminally ill patients. While respecting patient autonomy is fundamental, the manner and timing of delivering the truth are crucial to maintaining trust in the physician-patient relationship and safeguarding the patient’s mental health. Further research should focus on developing effective communication strategies and support systems for healthcare providers engaged in end-of-life care. Educational programs should prioritize improving communication skills, cultural sensitivity, and ethical decision-making to enhance best practices and alleviate the emotional challenges faced by healthcare professionals in this sensitive area.

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.

Compliance with the Right to Safe Motherhood and Its Predisposing, Reinforcing, and Enabling Factors Based on the Precede-Proceed Model from the Perspective of Midwifery Students
Maryam Kabirian, Seyedeh Mahboobeh Rezaeean, Rasul Alimi, Nayere Khadem, Robab Latifnejad Roudsari,
Volume 17, Issue 1 (3-2024)
Abstract
The right to safe motherhood encompasses several goals, including reducing maternal mortality, ensuring safe pregnancy and childbirth, and giving birth to healthy children. This study aimed to determine the degree of compliance with the right to safe motherhood and to identify its predisposing, reinforcing, and enabling factors based on the precede-proceed model from the viewpoint of midwifery students. This cross sectional study was conducted using the census method on 151 midwifery students at Mashhad University of Medical Sciences, Mashhad, Iran in 2021 and 2022. Data were collected through a demographic questionnaire, a researcher-made questionnaire to assess compliance with the right to safe motherhood, and a questionnaire to measure its predisposing, reinforcing, and enabling factors on a self-report basis. Statistical methods including Pearson’s and Spearman’s correlation coefficients were utilized to analyze data. The overall mean score of compliance with the right to safe motherhood was 116.6±38.8 with a range of 13-187. Regarding predisposing factors, 58.6% of students had an average to high level of awareness, 80.15% had a positive attitude, and 56.7% highly valued compliance with the right to safe motherhood. Concerning reinforcing factors, the encouragement by clinical mentors (94.8%) as well as legal support (94.6%), and in terms of enabling factors, proficiency and expertise in human resources (71.9%) were recognized as the most influencing factors in promoting compliance with the right to safe motherhood. Moreover, there was a strong positive correlation between enabling factors and compliance with the right to safe motherhood (r=0.950, p=0.488). The results suggest that from the perspective of midwifery students, the level of compliance with the right to safe motherhood is moderate. Given the relationship between enabling factors and compliance with the right to safe motherhood, educational and executive officials in midwifery are recommended to consider the role of these factors to improve the level of compliance with the right to safe motherhood to enhance the quality of midwifery services.

Explaining Perceptions of Discharge Against Medical Advice as a Patient’s Legal Right: A Qualitative Study
Hossein Motaarefi, Shahriar Sakhaei, Amin Soheili, Hassan Ebrahimpour Sadagheyani,
Volume 18, Issue 1 (3-2025)
Abstract
 Patients’ perceptions of healthcare service quality and satisfaction with their legal rights constitute the primary objective of the care team and should be considered a criterion for accreditation evaluation. In this regard, a thorough examination of healthcare providers’ and patients’ perceptions, emotions, and experiences regarding the reasons for ‘Discharge Against Medical Advice’—as a patient’s legal right—can help identify hidden factors influenced by temporal and spatial conditions. This qualitative study employed a conventional content analysis approach, involving semi-structured interviews with 24  healthcare providers and patients selected purposively. Researchers repeatedly reviewed recorded content and notes to code the data. Subsequently, key codes and themes were clustered, categorized into specific topics, and labeled. Finally, an interpretation of the obtained data reflecting the study’s approach was presented. Through conventional content analysis, 203 codes were extracted. After categorization, four subthemes, including human factors, processes, facilities, and environment, were identified under the core theme of “uncertainty and distrust” as reasons for discharge against medical advice. Discharge against medical advice is recognized as both a challenge for hospital accreditation and an adverse outcome for patients. Addressing uncertainty-related issues and fostering public trust through team collaboration and implementing novel policies can mitigate discharge against medical advice.

Is the Use of Video Recording Important in the Intensive Care Unit?
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.

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