Iranian Journal of Medical Ethics and History of Medicine

Professional ethics is a part of the ethics of the individual component of each discipline. Whether it is in the field of medicine from the viewpoint of the Qur'an and the traditions, or how this context is discussed, is the focus of this article. With reference to the most important principles of the principles governing the medical education system, we are going to explain these principles. The applied method is descriptive and with a Quranic-narrative approach. In addition to reviewing some verses of the Qur'an, the most important issues were considered as the principles of professional ethics, especially in relation to the medical profession. However, there are also other research projects that can be done. Consideration of the articles and resources that are relevant to this discussion has been considered for further research. In order to investigate the ethical principles governing the relations between students and students in the field of medicine, first, with an interpretive look at each verse, the ethical propositions of the constituent and the contents and orientations of each verse were extracted and then the lead role was included. Also, the concepts, orientations, and leadership role of each verse were extracted. The most important things to note are: 1- Extracting ethical verses based on the study of contemporary interpretations, 2- Extracting the concepts and moral themes expressed in the interpretations, 3- Finding the connection between ethical concepts,  4-Addressing the leadership role of each of the ethical concepts,  5-Categorization of common subjects and subjects of verses.

The conflict of interest is a situation in which professional judgment and performance in the primary interest and obligation tend to be unduly influenced by a secondary interest. Pharmacy is one of the main rings in the process of providing healthcare services. In this process conflict of interest may occur frequentlywhich occasionally has influence on the professional and moral duties of pharmacists that as a result may put the interst of the patients at risk. Taking care of patients is the first duty of pharmacist and they always must make evry effort to avoid any situations that puts the interests of the patientincluding their health, financial or non-financialposition at risk. The pharmacist must be aware of conflict of interest that exist in the drugstore as well as its effects on their professional and moral responsibilities. They also need to be able to manage them through scientific policy and logical skills. These issues and challenges may happen in terms of the relationship between the pharmacist and patients, other people or organizations, such as the relationship between doctors and pharmacists, pharmacists and pharmaceutical or non pharmaceutical companies, irrational relationship between pharmacists and patients. Although various guidelines for managing conflict of interest have been developed, there is a lack of policy on how to manage conflict of interest in pharmacy. In this study, the situations of conflict of interest and how it affects the professional relations of pharmacist with others was considered and this result was achived that the pharmacy have to be asuitable and appropriate place to give services for patients and the first priority of pharmacists must be the patients’ treatment benefits and interest
 

Writing treatise on Islah al-Adwiat (Reducing the Side-Effects of Drugs) is one of the most important issues in Islamic medicine. During the first few centuries of Islamic civilization, four important treatises were written on this subject, which established the scientific tradition that formed the bases of the subsequent pharmacological formation. This paper addresses the tradition of writing books on reducing the side-effects of purgatives and it also critically edits and translates the books written by three prominent scholars – Hubaysh b. Atham of Damascus, Qusta b. Luqa of Balbak and Muhammad Zakaria Razi – relying on the surviving manuscripts. The research objective followed by this paper is examining and analyzing the purgatives as an important class in the pharmacological and medical books of the Islamic era.
Almost all books on medicine and pharmacology written in the old medical tradition have a section or a chapter devoted to the detailed introduction of purgatives and counteracting their side effects. Examining these bits, one may trace the main structure of the tradition, which continued for many centuries. Besides, comparing them may provide an appropriate perspective to look at the history of pharmacology. To this end, images of the material included in those books were obtained from libraries and museums, which have housed such books for almost a millennium. Then they were analyzed along with translating and editing.
It may be concluded that pharmacologists belonging to the old medical paradigm would use drugs to treat conditions of bad health caused by changes in the patient’s humors; the drugs, however, would cause some side-effects along with removing humors and residues, leading to a change in the main humor of the body. The pharmacologists; therefore, introduced the drugs, their harms, as well as the best type of the drug to be used and finally suggested some methods in detail to reduce their side effects

Substantial concerns about the research integrity in Iran have caused research misconducts to be issue for studies. But adequate recognition about causal factors is a necessary part of clear and explicit policy in order to manage the research misconducts and supply the research integrity. This study attempted investigating the available evidence on the reported research misconducts in the Iranian research and its causal factors. Therefore, 30 studies on the Iranian research misconducts were studied. The detected factors to research misconducts based on the reported evidence included: 1. Structural factors such as publication pressure, scientific promotion policies, research funding and job preservation; 2. Organizational factors such as research environment, regulatory-control activities on research and teaching research activities; 3. Personal factors such as research skills, degree orientation, financial benefits, understanding and moral judgment. The analytical model of causal factors was designed. Therewith, cultural and situational factors have received less attention in the literature and they have major focus on the obvious types of research misconduct (data fabrication, Falsification and Plagiarism), especially plagiarism.

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.

Studying the history of medical ethics and analyzing the dynamics and effects of renowned physicians of the Islamic era and the exploitation of this precious heritage is indispensable. Therefore, in this research, by descriptive-analytic approach, , the books of Teb Al-fukhara and Al-Masakin, Ibn al-Jazar, Full medical industry, Ahvazi, Law in Medicine of Ibn Sina, and Kharazmshahi Save of Jorjani were investigated, by analyzing the guidelines and ethical recommendations contained in the physician and patient interactions, as well as their practical applications in this regard, six important principles of Islamic medical ethics were attained: trust in God, profitability, harmlessness, trusteeship, compassion, and goodness. Two principles of profitability and harmlessness have been more emphasized than other ones, which can indicate the significance of these two ethical principles in Islamic teachings. The ethical issues in the field of medical sciences during the Islamic period did not have the diversity, breadth, and necessity of the present. Thus, in pre-natal and human-era discussions, only the prohibition of abortion is mentioned and there is no debate about the end-of-life care of the patient.

Gandhi Shapur was one of the largest medical centers in the late Sassanid and early Islamic schools in Baghdad. The doctors, who often had a field teaching at Gandhi Shapur, moved to the city during their transfer to Baghdad, and accordingly they gave a kind of scientific center to the capital of the new Islamic government. Among the doctors of this scientific center was the Bakhtiyad dynasty, which in this study we explored the role of this family in medicine. The study shows that Jundishapur University hosted a large number of Greek, Indian, Nestorian scholars and scholars working at the center, and the head of the Faculty of Medicine was led by the Bakhtiyad family. The desire of the Abbasid caliphs to boost the city of Baghdad such as the Sassanid Centers of Science and Technology, and their success in that area, were the factors that invited the scientists from Jindi Shapur and the caliphate support from them. The transfer of scientific activities of Ajar George Bin Bakhtih from Jindi Shapur to Baghdad was an introduction to the decline of the scientific star of this center and the influence of Iranian culture on Islam. Several factors such as the scientific need, attention and support of caliphs from scientists and conversion of the city of Baghdad to the center of the sciences were the causes for invitation of the Bakhtiyad family to Baghdad. In this study, we assess the activities of the Bakhtiyad family in  the government of Abbasid caliphs.
 

Reflecting on the Qara – Khitai of Kerman (from 619 to 704 A.H. / 1223 to 1305 A.D.), we can see that the rule of the dynasty, some women of Qara – Khitai, with expertise and competence into political, economic, scientific and cultural even reached into the kingdom of Kerman. Among these women the one that can be mentioned is -Qutlugh Terken (Terken Khatun), who was directly and indirectly involved in Kerman government for more than 40 years. So, the main question of this article is to assess measures of Qutlugh Terkan for promotion of Kerman's medical condition and further investigation of patients' rights. One of the findings of the present study was that Terken Khatun, build and equipped hospitals in Kerman with best facilities about eight hundred years ago, she also constructed an advanced school to train a new generation of intellectuals including physicians.

Medical Philosophy is essential part of medical ethics and history. I has long history and owes its current status to developments resulted by historical, philosophical, social, and cultural experiences. The most important reflection of its revolution is its influence on the goals and missions of higher education in different time periods. In this study, two of the most important philosophical perspectives towards the medical education are compared with the aim of investigating possibilities and limits of each perspective in general education, specialized education, and treatment. The descriptive-analytical method is used for this comparison. These two perspectives are: 1) biomedical philosophy, which is based solely on human biological mechanisms, and 2) humanistic philosophy, which is based on the integrity of the human being. The results of this study show that medical education from the perspective of the biomedical philosophy focuses on specialized education, and treatment from this perspective is performed in the form of a patriarchal relationship. Whereas, from the humanistic perspective, general education is based on the integrity of the human being (including biological, psychological, and ontological) together with the specialized education. Treatment in this approach is achieved through a collaborative relationship between the physician and the patient.

 

Recent developments in the digital domain and its influence in the health sector have led to the development of digital health technologies. The development of these technologies in addition to the benefits such as lowering medical care costs and improving the quality of patient care, has introduced new ethical challenges into the field of medicine. In this study, 25 articles were identified on the ethical challenges in digital health technologies by using literature review. These articles were in areas of mobile health, electronic health records, telemedicine, electronic health, wearable and big data technologies. The ethical challenges found in the articles reviewed in the field of digital health include: the privacy challenges that are due to the creation of huge data sources in this type of technology, how to ensure access justice, challenges for determining the responsibilities of surgical and technical members in telemedicine technologies, changing the patient's role, challenges regarding data ownership and patient access to raw data, the challenge of balancing the privacy of patient information and data sharing in advancing the community's science and health big data, and guaranteed quality of provided health information. These surveys can be effective in identifying challenges and developing ethical guidelines before developing and applying these types of technologies.

Direct-to-consumer genetic testing are marketed directly to customers and provides people access to their genetic information without necessarily involving a healthcare provider or health insurance company. Such tests can be helpful in managing and monitoring people's health, but the ethical and legal issues related to these services are completely new and require a comprehensive consideration. The present paper studies the challenges of such tests by analyzing information collected through the library method. Expanding the scope of such tests, it seems more important than ever the need to educate on such tests, build an appropriate infrastructure, the regulatory systems and designing a framework for DTC-GT companies.

 

The human moral or, in other words, his human dignity has long been the subject of discussions among various thinkers. Almost all theories that have addressed this issue are in principle the dignity of man and the supremacy of his position in relation to all beings, but what makes a different perspective on this topic is the criterion of this dignity and excellence. Making essential decisions for the fetus, including preserving the fetus or abortion, is one of the main applications of the principle of human dignity and is directly is influenced by its human and ethical status. Two groups of theories have focused on the issue of the dignity of the fetus: secular theories and theories based on religions and schools. The secular ideas, have some attractions that human intuition accepts them to some extent, but none is free of criticism, and the critique of each theory is all remarkableness and worthwhile. Hence, this article, while it is reviewing some of the secular views and the views of religions and schools on the status of the embryo and addressing some criticisms of them, provides the dominant human-being theory of fetus based on Shi'a thought and introduces the valuable position of man from fetal times. Finding the root of human dignity by relying on human thought and without resorting to revelation inspiration is faced to serious challenges. Human embryos, due to the ability to become human, have been at the beginning of being a valuable place that increases the value of fetal age when it increases its age so that it is not worthy of human dignity with God's soul. But because its granting by the Lord on the basis of the religious teaching perception, the egg cell should not only be eliminated, but also should be taken care of and protected due to its potential to become human

Several definitions for medical futility has been proposed in the literature. Medical futility is defined as the condition in which an intervention, either for diagnosis, prevention, treatment, rehabilitation or other medical goals, has no benefit for the individual patient. This critical review aimed to increase the understanding of physicians and other healthcare providers on the issue of futility in complementary and alternative medicine (CAM). Our comprehensive search resulted in more than 1000 studies; unrelated studies were excluded by title and abstract screening, then 219 full-texts were read and finally, 118 studies were included. The conclusion concerning whether or not it is morally acceptable to provide a futile treatment in CAM, becomes a controversial issue based on different approaches. Using futile treatments is not acceptable according to the duty-based approach, and the principle of justice. In contrast, the case-based approach  and the principle of autonomy of the patient, hold that such treatments could be morally acceptable. Based on utilitarianism, only evidence-based treatments can be morally discussed, and those CAM therapies that have been shown to be futile, should be prohibited; thus health care providers must not offer them to patients since it would be a kind of deceit. We suggest that more comprehensive studies should be performed to clarify the boundary between placebo, nocebo, and futility.

Waqf (donation) has a long history in human history and can have a high impact on economics, society, and culture. One of the most influential fields of the waqf is on human health. This study is a descriptive study. In this article, after reviewing the tradition of waqf and charity throughout history, and the experiences of charity in other countries, including the Pasteur Institute of Paris, the role of waqf in establishment and promotion of Pasteur Institute of Iran is reviewed and the benefactors of this institute are introduced. The headquarters of the Pasteur Institute of Iran in Tehran and its branches in Shemiran, Khalid Islambouli, Amol (north) and Hamadan (west) are donated by the charities for diagnosis, production of vaccines, and research in the field of contagious diseases’ control and prevention.  In Iran, most cases of waqf on health have been dedicated in the field of treatment, but Pasteur Institute of Iran is a successful example in the field of public health and specialized health services. One of the ways to expand waqf is to explain the effects of these endowments in society. Investigating the role and influence of Pasteur Institute of Iran in promoting public health can be a good explanation of the impact of these endowments in the field of health. It is suggested that Pasteur institute of Iran and its persistent effects be explained to the beneficent, so that some of the future endowments be extended to areas such as public health and diagnostic services.

The system of Iranian medicine in the Qajar era was the continuation of the system based on the humors view. Accordingly, the incidence of most diseases was attributed to whole view of the quadruple imbalance of blood, soda, bile, phlegm. Preventive and therapeutic approaches were also carried out in the same cognitive atmosphere. The example of Smallpox disease, indicates such a view in the Qajar era. According to the findings of this research, in Qajar medical literature, the bumps of pus in the skin of is described to be hard, single or non-separated with different colors and was called as Jodri or Smallpox. In terms of cognitive aspects, physicians of Qajar era following former physicians classified Smallpox disease in terms of humor among the hot and wet diseases and described boiling of blood in the body as the cause of this disease. Exposure to this disease was through the two pathways preventive and therapeutic measures. In order to prevent the disease, the necessary orders was recommended by the physicians by “sette zarurieh” and especially avoidance of several behaviuors. In terms of therapy, along with several types of diets, different kinds of medicines was used to relieve the symptoms and complications of the disease at different body parts. This study is a review, it has been attempted to examine the nature and purpose of the descriptive and analytical method and the therapeutic approach to treating Smallpox disease in medical system of Iranian Qajar era. Required information and data have been created in a desk research.

In general, there are four types of policies in the world in relation to the issue of abortion, based on five basic approaches such as social, feminist, liberal, population-based, and religious-based. Each of these approaches provides a solution to the conflict between mother's rights and the right to life of the fetus, so based on the first three perspectives, abortion is permissible and based on the fourth view, it can be permissible or not and finally according to the religious view (Islam and Christianity) the abortion is forbidden. In the present paper, we tried to answer the main question by using the descriptive-analytical method, why in some of these approaches the right of the mother is preeminent, but in others, the right to life of the fetus proceeds? It seems that the way of Islamic legal system seems to be more logical, because in Western countries the rights of parents are always prioritized in the conflict between the rights of children and their parents. However, in the legal system of Islam, in addition to the moral orders, there are some principles that are anticipated to prevent the conflict of the rights of these two groups and the unequivocal predominance of one on another.
 

Infertility has been the main problem of infertile couples in history. However, infertility is solved with modern methods’ in recent decades. Embryo donation is one of the methods to infertile couples. In this method, sperm and oocyte of legal and religious couples are inoculated in the lab and the fetus is given to other legal and religious couples. However, people and doctors have doubts to agree or disagree with the views of contemporary jurisprudents. Then, the legislature passed the law of donating embryos to infertile couples in 2003. Although at the time, this law was very useful. However, there are shortcomings because of the brief writing of the law. The child's confidentiality to the fetus has not been determined. In this paper, the rights of Shia jurisprudence books and their adaptation to the opinions of the jurisprudents articles regarding the confidentiality of the embryo donation are discussed. Concluding different opinions from medical ethics and jurisprudential comments and laws, confidentiality of the mother’s womb to the child was proved. All provisions of the foster mother also runs. The confidentiality of the father will also be accepted according to several conditions.
 

Gene therapy entails the introduction of specific, functional genes into cells for therapeutic or preventive purposes. This process may be used in vitro or directly in vivo. One of the novel methods of gene therapy and genome editing that has been introduced in recent years and have made great changes in the field of genetic engineering and biotechnology is CRISPR-Cas gene-editing system. This system is faster, cheaper, more accurate and efficient than another genome editing one, such as TALEN and ZFNs. As with any other emerging process, the ethical concerns and challenges associated with the genome editing methods including the potential application of this technique for nefarious purposes, such as, bioterrorism, harmful mutations to the living being, and disrupting ecological balance. This review was prepared using the databases of Science Direct, Pub-Med, SID, Scopus,  Web of Science, and then, the selected papers were fully reviewed and information was extracted and summarized. According to the ethical and legal considerations surrounding the processes in gene therapy, it is expected that appropriate conditions will be provided to make the best use of gene therapy and to reduce concerns and possible abuses. The purpose of this review was to investigate ethical issues of the genome editing and gene therapy with an emphasis on the CRISPR-Cas system.