Iranian Journal of Medical Ethics and History of Medicine

Bioethics is an interdisciplinary course which includes public health. The public health is a general concept dealing with ethical, spiritual, cognitive, and physical issues. Ethical health is part of bioethics. This paper analyses the discourse between feminism and Islam regarding the influence of gender on ethics. Considering influence or lack of effect of gender on ethics is the most important difference in Islam and feminism. The essence of the difference is in ontology and epistemology principle of both views. Islam considers God as decisive ethic and ethical behaviours while feminism considers human as ethic decisive. In Islam, gender does not play role in origin of humanity and does not cause perfection or imperfection and strength or weak of being human. However, gender influences ethic and ethical behaviours and causes difference in ethical behaviours between man and woman. But, .in feminism view, gender does not affect not only humanity origin but also ethical issues and behaviours. feminism granting ethical similarity between men and women overlooks  ethic-gender roles leading to creation of a system that makes  man and woman  responsible for  and tends to  Bigender by proposing  gender similarity  between men and women ; this attitude  has unethical outcomes and affects  ethical health. This paper aimed to explain Islamic view (Quran and traditions) and outcomes of feminism view about gender effect on ethic along with investigating different sects of feminism.

Patients with advanced, progressive, non-curable, or hardly cured illnesses, found themselves in a situation where therapeutic measures have no effect in improving their condition and health status and they are gradually pushed toward death. Care provided to the patient, during this period, is known as end-of-life care which include life-sustaining treatments and palliative care. Life- sustaining treatments are such that give patient the chance for living longer but inflict lots of suffering upon the patient. While in palliative care, the patient probably survives for a shorter period, but suffers less. The question is whether the patient can choose between the two methods? Considering the Jurisprudential rule of “the necessity to safeguard human life”, most of the Muslim Jurists believe that the patient cannot rule out the first method (i.e. life- sustaining treatment). This study first examines the evidence of the rule, and explained the viewpoints of the Muslim Jurists about choosing between these caring methods, and proves that, despite accepting the rule, it is limited by the rules of “no hardship“ (la haraj) and “prohibition of detriment”(la zarar) and moreover the rule of “the domination”(saltanat). However, it can be said that, regarding the evidence of rule “the necessity to safeguard human life”, patients who are at this stage are excluded from the subject matter of this rule.

In the Qajar era, European countries deployed many doctors accompanied by their military, religious, and political groups to Iran consistent with their political goals and interests. Meanwhile, the role of France was more and more significant than the rest of European countries. This essay aims to introduce French physicians, to express the performance of French physicians in Iran during the Qajar period, to introduce the activities and extent of the influence of French physicians on the medicine of the Qajar period, and to examine the elements that advance the presence of French physicians in Iran during the Qajar era. This research was conducted using library resources and descriptive-analytical method. The findings indicate that the influence of French medicine on the developments of modern medicine in Iran was very significant, to the extent that the modern medicine was based on French physicians in Iran. Overall, the French effects on medicine in Iran can be found in two forms: establishment of the hospital and clinics and the formation of a health council. In addition, French physicians took important steps in the field of medical education such as ophthalmology, surgery, microbiology, vaccination, writing medical books, and quarantine to prevent communicable diseases. Therefore, French physicians, unlike other European countries, which only improved their health status, also evolved in the history of Iranian medicine. Finally it must be said the Qajar community was well-received by French medicine and physicians; Because both the Qajar court and the community were in need of medical care and the French government needed a comprehensive medical presence in Iran to achieve its political and economic goals.
 

The necessity of governing ethics is desirable in the work environments and is universally accepted. Ethical performance is based on the ethical criteria that employees are expected to adhere to. The purpose of this study was to determine the relationship between ethical educational needs and ethical efficiency in health workers of Sistan province. This is a descriptive correlational study. Data of 377 healthcare providers of Sistan rural areas were collected through a multi-stage cluster sampling method.  Information was collected with a valid and reliable questionnaire. The data were analyzed by SPSS 19 software using descriptive correlation, independent t-test, one-way ANOVA, and Pearson correlation coefficient. The results showed mean score of the need for ethical education of health care providers was relatively high (with respect to the maximum of the score), and the ethical performance of health care workers was low. There was also a significant and inverse relationship between score of ethical educational needs and ethical performance of health care providers (P >0.05). Based on the results, there was a significant and inverse relationship between ethical educational needs and ethical performance of health care providers. Providers who had a higher level of information and less educational needs had higher ethical performance. So, implementation of educational programs based on ethical educational needs is recommended for increasing ethical performance of health care providers as they are first-line practitioners who interact with people and health care clients.

Hospitalization in Intensive Care Units (ICUs) is a very stressful experience for the patient and family and their separation has not been confirmed in any of the studies. At present, ICU visiting is limited that makes several challenges. Therefore, this descriptive-exploratory study, aimed to explore strategies for overcoming the challenges of visiting  This was a descriptive-exploratory qualitative study conducted through in-depth semi-structured interviews with 35 participants in educational hospitals of Shahrekord University of Medical Sciences including 6 patients, 9 patients' family members or friends, and 20 nurses during 2018. Interviews were continued until data saturation and then data analysis was performed using inductive thematic analysis approach.  Participants stated two main themes for stepping out of visiting-related Challenges. (1) "Reducing the Need to Meet" through "Education about visiting rules", "Improving the Environment" and "Family Interaction" and (2) "Modified Meetings" through "Upgrading the Meeting Behind the windows", "using permanent monitor" and "flexible meeting". The ICU visits in Shahrekord hospitals, are limited like in other parts of the country. However, it is hoped that implementation of the extracted strategies in ICUs will solve many of visiting-related issues and eliminate the conflicting experience of patients, peers, and staff.

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

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

Avoidable suffering at the end of life refers to the unnecessary pain and distress experienced by individuals with terminal illnesses—pain that can often be alleviated through effective palliative care practices. Addressing this issue is critical for improving the quality of life for both patients and their families during this challenging period. The recognition of holistic care, which considers physical, emotional, spiritual, and social needs, has fueled efforts to enhance end-of-life care to reduce suffering and uphold patients' autonomy. Numerous studies indicate that many terminally ill patients endure avoidable physical and emotional pain as they approach death, highlighting gaps in healthcare delivery. For instance, research from the National Center for Health Statistics reveals that a significant number of hospice patients report unmanaged pain despite the availability of effective interventions. Psychological distress, including anxiety and depression, is also prevalent among terminally ill patients, underscoring the need for comprehensive care that integrates mental health support. Furthermore, neglecting spiritual and social needs can leave patients feeling isolated and despairing, exacerbating their suffering. Ethical considerations in pain management at the end of life remain a subject of debate, particularly concerning the principles of beneficence and non-maleficence. The principle of double effect, which permits actions to relieve suffering even if they may unintentionally hasten death, continues to spark controversy among healthcare providers, patients, and families. Additionally, ethical dilemmas arise in advanced care planning, particularly in respecting patient autonomy while navigating complex end-of-life decisions. Addressing avoidable suffering at the end of life requires a multidisciplinary approach that honors patients' values and preferences while striving to minimize unnecessary distress. As research and clinical practices advance, healthcare systems must prioritize strategies to reduce avoidable suffering and ensure patients' dignity during their final days.