Showing 174 results for Medical
Amirhossein Mardani, Maryam Nakhoda, Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
Since research misconduct can be considered as an adaptive reaction against the limitations, pressures, and demands arising from inappropriate functions of the research system, to manage it, the activities of the research system should be investigated and traced during the path of transferring research policies (macro level) to research development programs in institutions (meso level) and research implementation by researchers (micro level). By introducing the macro-meso-micro analytical framework, this study clarified the tasks, strategies, and activities formed at three levels of the research system of medical sciences in Iran; from macro policies of research (macro) to operational plans for the development of research in universities and research centers (meso) and researchers as research conductors (micro). For this purpose, three analytical levels of the research system were explained and defined according to the assumptions of this framework. By performing a qualitative content analysis of the relevant texts, those activities that could be useful at different levels to support the research integrity were identified and presented as different strategies. The results showed that the research system, based on the existing analytical framework, is not seen as a mere macro-system without regard to the interaction of its parts, but rather a system in which there is cross-sectional influence and interaction among the components. This approach can improve the focus, clarity, and capability to study research misconduct, and by using micro, meso, and macro levels, it can trace challenges in the interactive path of various activities and functions of the research system and their intertwining.
Saeed Nazari Tavakkoli, Saeed Ghadirzadeh Toosi,
Volume 17, Issue 1 (3-2024)
Abstract
Treating patients whose lives are in danger or threatened by irreparable harm, is an obligatory act. However, sometimes, due to old age, the severity of the disease, or the lack of definitive treatment, the patient faces a situation where, according to the diagnosis of the medical staff, starting or continuing the treatment has no effect on patient recovery, or the effect is so insignificant that is ignored in medical practice. This study was conducted using a descriptive and analytical method based on library resources to compare “futile treatment” in medical ethics with “Israf” (extravagance) in Islamic jurisprudence so as to indicate the level of conceptual compatibility between these two concepts. Moreover, considering the illegitimacy of extravagance in jurisprudential teachings, it was attempted to explore whether it is illegitimate, according to Islamic rules, to perform futile treatment. To do so, first, futile treatment and its characteristics in medical texts were defined. Second, the ethical considerations of performing such treatment were explained based on the teachings of medical ethics. Third, extravagance was analyzed in terms of concept, topic, and sentence by referring to valid lexical, jurisprudential, narrative, and interpretative resources. Finally, based on a comparative study, the level of compatibility of futile treatment with extravagance was investigated. The findings of this study showed futile treatment is an example of extravagance as it causes the waste of personal or public property, lacks rational purpose, and does not lead to patient recovery or promotion of health status. Therefore, futile treatment is not considered an obligatory act but even an illegitimate one as it is a clear example of extravagance. In addition to punishment in the afterlife, it entails civil liability as it results in the loss of others’ property.
Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
Defensive medicine refers to actions taken by doctors and other medical professionals to protect themselves against potential threats and risks, particularly to prevent patient complaints or convictions in court, which is carried out in various forms including positive and negative defensive medicine. Since the primary motivation behind such actions, often viewed as morally unjustified, is to avoid legal proceedings and lawsuits, court rulings against doctors can intensify these behaviors. Reports of criminal sentences against some doctors in Iran and reactions from professional associations highlight the significance of this issue. This study examined the effects of such sentences on the healthcare system by referring to available documents and data on the widespread prevalence of defensive medicine in Iran, offering some suggestions for managing the issue. The objective of the study was to emphasize the importance of acknowledging the defensive motivations of doctors in healthcare and its influential factors, particularly the fear of criminal convictions, which can increase defensive behaviors among doctors and amplify their negative impacts on the healthcare system.
Elham Malekzadeh, Zahra Alizadeh Birjandi,
Volume 17, Issue 1 (3-2024)
Abstract
This study examined the history of the establishment and evolution of Tehran’s insane asylum during the Qajar and Pahlavi periods. The significance of this study in medical history lies in its exploration of the founding of one of Iran’s earliest medical institutions and the factors that influenced its subsequent transformations. Given its focus on the development of insane asylum (Dar al-Majanin) and the public’s appeals for its improvement, this study offers valuable insights into the social history of the period. Employing a descriptive-analytical approach and relying on unpublished archival documents, this study presented a narrative of the history of madness that shed light on the untold stories of the mentally ill (Majanin) and prevailing societal beliefs about them. These beliefs profoundly influenced the treatment of patients within these institutions. The findings revealed that while the care provided to the mentally ill improved during this period, ongoing challenges persisted due to limited resources and a growing patient population. The prevailing attitude of officials toward the mentally ill was primarily one of containment, aimed at protecting the public from perceived threats.
Hosein Fasihi, Dr. Syyed Ahmad Fazeli,
Volume 17, Issue 1 (3-2024)
Abstract
In the realm of philosophy, numerous thinkers have offered profound, and at times amazing, insights into the nature of existence. Among them, Spinoza stands out with his unique perspective, establishing a deep connection between ethics, religion, and the divine nature. Spinoza posits that religious texts, beyond their religious teachings, serve a motivational role in inspiring moral behavior. He locates the foundation of virtue within human nature and essence, arguing that the moral quality of actions is not inherent but is derived from God as the ultimate source of good and evil. Ultimately, adhering to the principle of universal necessity, Spinoza extends this concept to ethics, viewing it as an expression of divine nature. This perspective implies that morality and all human actions unfold within the framework of natural and divine necessity. An examination of Spinoza's views reveals a profound unity between humanity and the divine, characterized by a harmonious and interactive relationship between religion and ethics. Within Spinoza's philosophical system, these two categories are aligned, guiding individuals toward happiness and virtue. This innovative approach not only enriches our understanding of Spinoza's thought but also, by bridging religion, reason, and health, opens avenues for reconsidering medical ethics and spirituality in the contemporary world. This study, through a critical analysis of Spinoza's views, lays the groundwork for future investigations into moral philosophy, religion, and medical ethics, fostering a constructive dialogue between tradition and modernity.
Hamidreza Namazi, Navid Ravan,
Volume 17, Issue 1 (3-2024)
Abstract
Medical considerations about aging are as old as medicine itself. However, due to the controversy about whether aging should be classified as a disease or merely a stage of life, geriatric medicine was separated from medicine with a considerable lag. The differentiation of geriatrics from other medical specialties is not rooted in subjecting a specific organ of the body or specific pathophysiological processes but based on a particular stage of life. On the other hand, different stages of life, such as old age, are also subjects for medicalization. Therefore, geriatric medicine may sometimes be threatened by geriatric medicalization and its associated harms. In addition, the relativity and ambiguity in defining the concept of aging and its dependence on social contexts can lead to confusion in understanding the subject matter of geriatric medicine. Mitigating these harms requires philosophical and ethical reflection on health and disease concepts as well as on the essence of aging. Considering that Iran is expected to face an aging crisis in the coming decades, this philosophical reflection at different levels among researchers in the philosophy of medicine and medical ethics, researchers and practitioners in geriatrics, as well as among civil society, can lead to separating geriatric medicine from geriatric medicalization, hence increasing the integrity and efficiency of geriatric medicine, and promoting the health status of the elderly.
Alireza Heidari, Seyed Hamed Atashi, Farideh Kouchak, Zahra Khatirnamani,
Volume 18, Issue 1 (3-2025)
Abstract
Addressing patients’ non-medical needs reflects the desires of patients and their families to engage more actively in decision-making and treatment processes. The present study aimed to assess the level of responsiveness to the non-medical needs of hospitalized patients. This was a cross-sectional study conducted using a descriptive-analytical approach. A total of 392 patients hospitalized in Shahid Sayad Shirazi and 5 Azar educational-therapeutic hospitals, affiliated with Golestan University of Medical Sciences in Gorgan, were included in the study. Participants were selected through systematic random sampling. Data were collected using the validated and reliable responsiveness questionnaire developed by the World Health Organization (WHO). The mean (±SD) age of participants was (45.17 ±16.92) years, with 55.1% being male. The mean (±SD) overall score for the importance of responsiveness was (33.37 ±4.45), which was above the average. The majority of patients (over 65%) rated all dimensions of responsiveness as very important or extremely important. The most important dimension from the patients' perspective was the quality of the surrounding environment (95.9%), while the least important was the confidentiality of personal information (34.7%). The mean (±SD) overall score for responsiveness performance was 54.54 (0.70 ± 8), which was above the average. The overall score of the responsiveness performance and importance in Sayad Shirazi and 5 Azar educational hospitals was above average. Dimensions deemed important by patients but with weaker performance should be prioritized, and educational and therapeutic centers should pay more attention to patients’ non-clinical expectations.
Hamid Kavyani Pooya,
Volume 18, Issue 1 (3-2025)
Abstract
Education in Iran, as in the rest of the world, has a long history, and with the foundation of inclusive national governments, due to the interaction of civilizations and adaptation of scientific achievements, education and educational institutions and centers have undergone major changes and transformations. Accordingly, this study aimed to examine different methods of teaching medical sciences and transferring medical achievements to scholars and those interested in this profession in the history of Iran until the end of the Safavid era through a library-based method. Data were collected from original medical resources, travelogues, and reliable historical documents and evidence in Arabic, Persian, and English. Data were then described and analyzed using domestic databanks. The findings indicated that throughout the history of Iran, particularly in the Islamic civilization, medical education and sciences have been transferred both theoretically and practically. In modern terms, this involved lectures (theory) and clinical training (practice). Nevertheless, there have been differing opinions regarding the importance and priority of each method, and the period under study witnessed significant evolution and changes in improving the ways medical concepts have been conveyed to scholars.
Reza Taghi Zade Naieni,
Volume 18, Issue 1 (3-2025)
Abstract
The plague of 1896 AD/1314 AH was one of the most devastating epidemics in history that occurred in Bombay, India. This disease had a profound impact on human societies, particularly Islamic societies, and on the pilgrimage of Muslims between 1896 and 1899. This historical review study analyzed the consequences of the plague outbreak in Bombay, India, in 1896 AD/1314 AH on the pilgrimage process of Muslims in the mentioned year and the following years. This study also examined the type of exposure of Muslims to this disease and the restrictions imposed by the governments of the time. Data were collected from historical resources such as reports in Hajj travelogues, historical documents, Arabic press news, recent research by Western researchers, and scientific articles. The findings indicated that the ruling governments attempted to prevent the spread of the disease and reduce casualties by establishing and developing quarantine facilities, dispatching medical teams, shortening the permitted duration of pilgrims’ stay in Saudi Arabia, and persuading Muslims to forgo the Hajj pilgrimage. The success of these preventive measures hinged on two main factors: first, the necessary executive power to enforce restrictions, and second, the mitigation of economic insecurity for communities simultaneously affected by illness and pilgrimage. Furthermore, the acceptance of these limitations was significantly influenced by Muslim perceptions of the restrictions and their cultural and religious backgrounds.
Farshid Mohammadmousaei, Zeinab Raiesifar, Seyed Ali Mousavi, Nastaran Khorsandi Bahar, Fatemeh Esmaelzadeh,
Volume 18, Issue 1 (3-2025)
Abstract
Maintaining patient privacy is a fundamental right of patients and an ethical duty of healthcare professionals. The present descriptive, cross-sectional study was conducted in 2022 to compare the perspectives of patients and staff in obstetrics and gynecology operating rooms in Mashhad, Iran, on the extent to which patient privacy was preserved. Patients were selected using random sampling in the operating rooms of hospitals affiliated with Mashhad University of Medical Sciences. Data were collected through a demographic information form and a standardized questionnaire to assess hospitalized patients’ privacy. Data were analyzed via SPSS-22, utilizing descriptive and inferential statistics, with a significance level of P<0.05. The mean ages of patients and staff participating in this study were 39.07±12.56 and 31.65±8.42 years, respectively. The mean score of preserving privacy from the patients' perspective was 38.92±22.41, whereas from the staff's perspective, it was 64.26±8.02, and the difference was statistically significant (p=0.0001). The lowest scores in both groups for personal privacy were 4.97±8.77 for patients and 13.37±2.66 for staff. Results indicated that the staff perceived the level of preserving patient privacy to be above average, while patients considered it below average. Therefore, given the patients’ specific conditions, high stress levels, and physical and mental limitations to support themselves, it is essential to implement targeted training and take necessary measures to encourage the staff to pay more attention to patient privacy and raise patient awareness in this regard.
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.
Davood Rasouli, Elham Ramezanpour, Sohrab Nosrati, Akram Zhianifard, Zahra Nouri Khaneghah,
Volume 18, Issue 1 (3-2025)
Abstract
Professional ethics, as a critical aspect of medical ethics, holds significant importance in healthcare professions that directly involve human lives. Accordingly, this study aimed to compare adherence to professional ethics principles among operating room (OR) students and staff in selected teaching hospitals affiliated with Iran University of Medical Sciences during 2021–2022. This cross-sectional descriptive study included 200 OR staff from six hospitals (selected via stratified quota sampling) and 60 OR students (recruited via convenience sampling). Data were collected using a demographic questionnaire and Kadushin’s Professional Ethics Questionnaire (2002) and analyzed in SPSS-24 using descriptive statistics (median and interquartile range) and inferential tests (Chi-square and Mann-Whitney U tests). Results indicated strong professional ethics in 98.4% of students and 75% of staff. Students scored significantly higher in loyalty and accountability (median score, P < 0.0001), while staff outperformed in honesty (median score, P = 0.003). No significant differences were observed in other dimensions. Overall, both groups demonstrated favorable professional ethics. These findings can guide educational interventions and developmental programs to further enhance professional ethics in these populations.
Zahra Khalilzadeh-Farsangi, Samaneh Fallah-Karimi,
Volume 18, Issue 1 (3-2025)
Abstract
With increasing life expectancy and a growing elderly population worldwide, elder care has become a major priority for health systems. These care services are accompanied by numerous ethical challenges, and neglecting them can negatively affect the dignity, rights, and quality of life of older adults. This study aimed to address the question: “What ethical challenges are faced in elder care?” Accordingly, a systematic review was conducted guided by PRISMA guidelines. To identify relevant studies, PubMed, Scopus, Web of Science, SID, and Google Scholar were searched for the period 2013–2025, using the keywords “Ethical Challenges”, “Elderly Care”, “Nursing”, and their Persian equivalents. Inclusion criteria were original articles (qualitative, quantitative, experimental, or quasi-experimental) with a direct focus on ethical challenges in elder care, written in Persian or English, and with full-text availability. Exclusion criteria included letters to the editor and conference abstracts. The quality of the studies was assessed using the appraisal tool proposed by Gifford. In total, 31 eligible articles were included in the final analysis. The results indicated that ethical challenges in elder care can be classified into four main categories, including autonomy, justice, beneficence, and non-maleficence. Subthemes included privacy preservation, shared decision-making, end-of-life care, equitable resource allocation, and the prevention of physical and psychological harm. The findings underscored the necessity of strengthening ethics education and informing policymaking in elder care.
Soudabeh Mehdizadeh, Ehsan Shamsi Gooshki,
Volume 18, Issue 1 (3-2025)
Abstract
The Declaration of Helsinki, as a fundamental document of ethics in medical research involving human participants, has been periodically revised since its adoption in accordance with theoretical and scientific advancements, emerging ethical issues in research, and the experiences gained over time. In the latest revision completed in 2024, significant changes and amendments have been made. This study examined the changes and revisions made in the latest version of the declaration in comparison to its previous version from 2013. Fundamental revisions in the recent update include a requirement for adherence to ethical principles in research not only by physicians but also by other researchers, the replacement of “subject” with “participant,” and the emphasis on the voluntary nature of informed consent. Attention to environmental sustainability, precise design to prevent research waste, and a focus on scientific integrity are among the other amendments in the new revision of this declaration. Other modifications and revisions made in the recent edition include the promotion of individual and public health as the ultimate purpose of research, the provision of sufficient resources for research ethics committees and strengthening their independence, the importance of local ethical review, consideration of the preferences and values of participants who are unable to provide voluntary and informed consent, and the necessity of adhering to the ethical principles of the declaration during public health crises and emergencies. Given the changes made, it is recommended that the national ethical guidelines for medical research involving human participants in Iran be revised based on the 2024 revisions.
Mohsen Shahriari, Maryam Sadat Hashemi, Arash Najimi, Mohammad Zare Reshkoieh,
Volume 18, Issue 1 (3-2025)
Abstract
The fundamental nature of nursing care lies in maintaining patients’ human dignity. Protecting the dignity and high value of humanity is the focus of the nursing profession. This study aimed to compare the effectiveness of mobile application-based and webinar-based professional ethics education on maintaining patient dignity among nursing students. This was a quasi-experimental study with a two-group pretest-posttest design involving 90 undergraduate nursing students. One group received professional ethics education via webinars, while the other received training through a mobile application-based program. Data were collected using a demographic information form and a questionnaire assessing nursing students’ views on maintaining patient dignity. The findings showed that before training, the mean total scores for human dignity were 99.96 ± 17.43 in the webinar group and 99.59 ± 16.28 in the mobile application group, with no statistically significant difference (p=0.62). After training, the mean human dignity score was significantly higher in the mobile application group (111.15±14.69) than in the webinar group (104.34 ± 15.38), and this difference was statistically significant (p=0.02). The findings indicated that professional ethics education delivered via a mobile application was associated with a greater improvement in nursing students’ views on patient dignity compared to webinar-based education. Mobile-based education offers a self-directed, flexible learning method, enabling students to have continuous access to educational content without time or place restrictions. It is recommended that medical universities in Iran consider developing and integrating educational applications into their curricula.
Zahra Aghabeiglooei, Jamal Rezaei Orimi, Seyed Mohammad Hashemimehr, Roshanak Saghebi, Morteza Mojahedi, Seyyed Amir Hosein Latifi, Mehdi Salehi, Seyed Abdollah Mahmood,
Volume 18, Issue 1 (3-2025)
Abstract
Evaluating and analyzing scientific productions play a crucial role in enhancing the quality of research and effectively managing research resources. This study aimed to quantitatively assess the content of theses in the field of the history of medical sciences in Iranian universities from 2013 to 2022. This applied study was conducted using the quantitative content analysis method. The findings revealed that the highest number of theses were completed in 2022 (19.2%), with topics related to traditional medicine and traditional pharmacy being the most prevalent. Descriptive and descriptive-analytical studies were the most common research methods. Moreover, the most frequent keywords included “Medical History”, “Traditional Medicine”, and “Iranian Medicine” and their Persian equivalents. Regarding historical periods, the Islamic period (from the emergence of Islam to the early Safavid era) accounted for the highest number of theses, while the contemporary period had the lowest. The results indicated a research focus on traditional medicine and the Islamic period, highlighting the need for further exploration of other historical periods and the use of qualitative methods to deepen understanding of historical complexities.
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.
Akram Heidari, Morteza Heidari, Baqer Larijani, Professor Ali Mohammad Mosadeqrad,
Volume 18, Issue 1 (3-2025)
Abstract
Spiritual health refers to having purpose and meaning in life and a sense of belonging to something beyond the self, which strengthens inner peace, satisfaction, and happiness. This qualitative study was conducted in 2024 using an interpretive phenomenological approach. Through semi-structured interviews with 47 policymakers, managers, faculty members, staff, and students, a total of 183 benefits of spiritual health education in universities of medical sciences were identified. These benefits were categorized into six groups: benefits for faculty members, students, staff, patients, society, and the university. For faculty members, spirituality education leads to enhanced ethical awareness, increased motivation, job satisfaction, professional commitment, and improved quality of education. Students, by strengthening spirituality, gain greater communication and empathy skills, experience reduced stress and anxiety, and demonstrate improved professional competencies. Healthcare staff benefit from reduced medical errors, increased resilience, improved social relationships, and enhanced quality of care. Patients receiving spiritual care experience lower levels of stress and depression, improved mental health and quality of life, and a more rapid course of treatment and recovery. At the societal level, spiritual health education contributes to more positive social behaviors and the development of a healthier community. Furthermore, universities implementing such education can design more comprehensive curricula, promote interdisciplinary research, strengthen professional ethics, and train holistically oriented healthcare professionals, thereby increasing their credibility and productivity. Spiritual health education in Iranian universities of medical sciences, by exerting positive effects on faculty members, students, staff, patients, society, and the university itself, results in the improvement of psychological and professional well-being, the enhancement of educational quality, and the increased productivity and credibility of the higher education health system of the country.
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.
Sayyed Mohammad Taghi Hosseini Vardaniani, Dr Ahmad Salami, Sayyed Morteza Hosseini, Jannat Mashayekhi,
Volume 18, Issue 1 (3-2025)
Abstract
The vegetative state is a condition in contemporary medicine that raises numerous ethical, jurisprudential, and legal challenges. The most fundamental question when confronting this condition concerns whether individuals in such a state are considered alive or deceased, as subsequent rulings and implications are typically contingent upon the answer to this question. Some contemporary Islamic jurists, drawing upon the jurisprudential division of life into “stable life” and “unstable life”, have deemed individuals in a vegetative state to be deceased, given their lack of volition and consciousness. This study argues that the concept of “unstable life” does not apply to these individuals, particularly in cases of persistent and chronic vegetative states where the possibility of regaining consciousness, however remote, exists. Furthermore, the continued function of the brainstem and the non-fulfillment of the medical and legal criteria for brain death in many systems affirm that the designation of “deceased” is incorrect. From an Islamic perspective, the definitive separation of the soul from the body, which is the condition for the occurrence of death, cannot be ascertained in the vegetative state. Ultimately, in circumstances of doubt regarding the life or death of a person in a vegetative state, this uncertainty constitutes a “case-specific doubt”, and by applying the legal principle of “presumption of continued life”, the individual must be deemed alive and all the corresponding legal and religious consequences of life must be accorded to them.
