Seyedeh Mahboobeh Rezaeean, Zahra Kazemi Gelian, Ghasem Kazemi Gelian, Zohreh Abbasi, Elahe Salari, Mahbubeh Tabatabaeichehr,
Volume 14, Issue 0 (3-2021)
Abstract
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.
Sasan Moogahi, Farkhondeh Jamshidi, Negar Parvizi, Ali Mohammadi Sepahvandi,
Volume 14, Issue 0 (3-2021)
Abstract
In medical centers, compliance of personal and social behaviors with ethics and religious standards is very important and requires constant evaluations. Therefore, the present study was conducted to determine the compliance of medical affairs with the standards of the Holy Sharia from the perspective of patients and interns in the teaching hospitals of Jundishapur University of Medical Sciences in Ahvaz in 2020. This was a descriptive cross-sectional study and the statistical population consisted of 204 interns and 385 patients referred to the teaching hospitals of Jundishapur University of Medical Sciences in Ahvaz. Sampling was done randomly. Data were collected by data collection form and questionnaire from patients and interns which was collected by the researcher including 17 questions. Data were analyzed by SPSS version20 software and descriptive and inferential statistics. From the interns' point of view, there was a significant difference (P <0.05) between the compliance of medical affairs with the standards of holy sharia in different hospitals and gender, but there was no significant difference in different ages and marital status (P> 0.05). From the patients' point of view; There was no significant difference (P >0.05) between the compliance of medical affairs with the standards of the Holy Sharia based on gender, age, education, marital status, and hospital. From interns and patients point of view, compliance with Holy Sharia standards were 45.1% and 40.5%, respectively. According to the results of the present study, physical space and more medical staff in both genders are required to fully comply medical affairs with the standards of the Holy Sharia in all the examined hospitals.
Mehdi Basouli , Seedeh Derakhsh,
Volume 14, Issue 0 (3-2021)
Abstract
In recent decades, on the one hand, we have faced atmospheric phenomena and environmental changes, and on the other hand, with the emergence of new diseases called emerging diseases. Managing emerging diseases requires an ethical approach to control and care for them. Ethical problems raising from new diagnostic and therapeutic advances in medical science have increased the need to address medical ethics. One of these emerging diseases of the present century, which is faced by almost the whole world and its problems, is coronavirus (COVID-19). The present study was conducted with the aim of assessing attention of medical staff towards ethical considerations in the care of patients with COVID-19. In this study, in addition to the use of articles published in English related to this disease from late 2019 to early 2020, as well as using national researches by different research groups, different dimensions of the disease is reviewed; Interviews were conducted with the COVID-19 recovered patients who were hospitalized in Shahid Sadoughi Hospital in Yazd Province from the beginning of February 2020 to the end of October 2020. Studies showed the need to put ethical considerations in the care of patients with COVID-19 by training health care providers about professional ethics and medical ethics in the pandemic of the virus in order to optimally manage the disease
Roya Malekzadeh, Afshin Amirkhanlou, Ghasem Abedi, Fereshteh Araghian Mojarad,
Volume 14, Issue 0 (3-2021)
Abstract
The rapid spread of COVID-19, lack of standard treatment, time constraints, and lack of resources are challenges around the world. Considering the importance of ethics in providing care to patients with emerging diseases, this study was conducted to explain the ethical challenges in care and treatment for patients with COVID-19. The present study was conducted by qualitative content analysis during 2019. Participants were 22 infectious disease physicians and nurses of COVID-19 care wards with at least five years of experience in hospitals of Mazandaran province. Data were collected through semi-structured interviews based on the purpose and method of snowball after obtaining informed consent from participants and continued until data saturation. Data analysis was performed using Granheim Lundman method. Guba and Lincoln proposed criteria were used for the accuracy and robustness of the study. In the present study, five main themes and 18 sub-themes were extracted. Respect for patients' rights, maintaining patient independence, preventing the effects of stigma and discrimination against patients, lack of comprehensive support, and lack of support and accountability of the authorities were the main ethical challenges in caring for patients during the admission period. According to the findings of the study, solutions to address ethical challenges, protect patients' rights and provide quality care through informed and ethical decision-making to increase patient satisfaction and improve their health are recommended.
Saeedeh Saeedi Tehrani, Fatemeh Bahmani, Mina Forouzandeh, Akram Hashemi,
Volume 14, Issue 0 (3-2021)
Abstract
From the beginning of the COVID-19 pandemic, researchers aspired to produce an effective vaccine with appropriate efficacy and low side effects to mitigate the pandemic. It seems that vaccination is the only mean to save the world from this pandemic. In this article, we will review the ethical challenges of mass vaccination (focusing on the vaccine distribution and uptake), referring to the main principles of bioethics. Safe and standard manufacturing and passing scientific and ethical stages, as well as evaluation of efficacy and safety monitoring, are the main considerations in the production of vaccines. Justice requires that vulnerable and high-risk individuals be vaccinated sooner. Public vaccination must therefore be ethically prioritized. Individuals may for some reason resist vaccination. For example due to, the confusion caused by mass media information, public’s distrust of the medical profession, the proposed relationship between vaccination and development of certain diseases, and finally low death rate due to covid 19 in some groups, especially young and healthy individuals. However, as the disease is highly contagious and if it spreads, the death rate and hospitalization due to the disease rises sharply, and the consequences of the disease mainly affect vulnerable people, in moral decision-making, the benefits and harms of the vaccine for each person should be considered against the benefits for and harms to the society. In addition, to respect the individuals’ autonomy, cultural modalities and persuasive programs shall be considered. This article is aimed to address the ethical issues of the COVID-19 vaccine rollout while proposing practical solutions to handle them.
Samaneh Azizi, Ahmad Reza Mohtadi, Mahdi Bijanzadeh,
Volume 14, Issue 0 (3-2021)
Abstract
The relationship between physicians and operating room staff includes interaction between them in caring for the patient to achieve a common therapeutic goal and condition improvement. Present cross-sectional descriptive-analytical study aimed to examine viewpoints of physicians and operating room staff about their relationship in Ahvaz at 2019. The research samples were operating room staff and physicians working in three educational hospitals affiliated to Ahwaz Jundishapur University of Medical Sciences. Consecutive samples were icluded in the study. The research tool was a two-part questionnaire including socio-demographic information and questions about the professional relationship between the doctors and the operating room staff. Results showed that viewpoints of physicians and operating room staff about respecting ethics in their communications are good. In the group of physicians, 18.1% had a moderate viewpoint and 81.9% had a good viewpoint about communication with operating room staff. Among the operating room staff group, 4.8 percent had a bad viewpoint, 27.3 percent had a moderate viewpoint, and 67.9 percent had a good view point about their communication with physicians. Until reaching highest level of respecting professional ethics, any attempt to improve communication between physicians and operating room staff will result in positive outcomes for physicians and staff, and promote quality of their care for patients.
Sedighe Mohammadesmaeil, Mostafa Pahlevanzadeh,
Volume 14, Issue 0 (3-2021)
Abstract
The aim of this study was to investigate the effect of knowledge strategies on organizational performance with the mediating role of ethical leadership. The present research is a correlational-analytical study in terms of applied purpose. The statistical sample size is 196 people. Data analysis was performed using structural equations through smartpls3 software. Findings showed that knowledge strategies have an effect on organizational performance with the mediating role of ethical leadership. According to the software output, the probability statistic for the ethical leadership mediator variable is 8.475, which is greater than the critical value of the absolute value of 1.96. System-based strategies affect organizational performance by mediating the role of ethical leadership. According to the software output, the probability statistic for the mediating variable of moral leadership is 7.729. Human-centered strategies affect organizational performance by mediating the role of ethical leadership. According to the software output, the probability statistics for the ethical leadership mediator variable is equal to 9.075. In the health system as a knowledge-based organization, managers must plan to implement a system to evaluate the desired knowledge performance. On the other hand, ethical leaders use their potential capacities and abilities through the application of knowledge among employees to achieve organizational goals by establishing two-way communication with employees, and motivating them and placing rewards and punishments for employees in performing organizational tasks and activities.
Nahid Khademi, Fariba Asghari,
Volume 15, Issue 1 (3-2022)
Abstract
Confidentiality in AIDS patients is one of the necessities of medical ethics, which has attracted the attention of policymakers in the health field in the last few decades because, on the one hand, it increases the trust between patients and doctors. On the other hand, it encourages them to adhere to treatment and do necessary care to patients in order to prevent the transmission of the disease to others. However, it may lead to a breach of benevolence and others’ right to health and cause problems in providing health care. Here we discuss a practical solution for this problem through a clinical case presentation.
Fariba Asghari,
Volume 15, Issue 1 (3-2022)
Abstract
Many debates and news regarding not providing healthcare services to female patients based on wearing hijab were raised following the woman, life, freedom movement in Iran. In this editorial, the author first has an overview of the cases in which the doctor is ethically allowed to choose her patient, then recommend not to refuse patients based on wearing hijab, putting forward this argument that it can enhance social polarization and make discrimination in access to health care based on hijab a matter of concern to the society which in turn can cause distrust in the medical profession especially in Iran’s current situation. In addition, this editorial emphasizes that the Council of Medicine as the patient advocate should prevent the government limiting the access of women without hijab to health care services.
Mozaffar Ghaffari, Lotfali Khani, Azam Mahmmodi,
Volume 15, Issue 1 (3-2022)
Abstract
Compassionate care is considered one of the important elements of patient-centered and oriented care that gives health to the patient. Therefore, this study was conducted with the aim of designing and explaining the model of compassionate care of nurses based on moral identity and compassion for the lives of others. The present research method was done according to path analysis. The statistical sample included 250 patients with covid-19 and 250 nurses working in the corona department of hospitals in West Azerbaijan province in 2021, which were selected by available sampling method. Rodriguez's compassionate care questionnaire, Black and Reynolds' moral identity questionnaire, and Chang's scale of compassion for others' lives were used to collect data. The data were analyzed using Pearson, Bootstrap and Sobel tests and also through SPSS and Amos software program, version 24. The results showed that the variable of moral identify in interaction with the mediating role of compassion for the lives of others in explaining the compassionate care of nurses. A total of 0. 41 of the variance of compassionate care was explained through model variables. The direct effect of moral identity (0. 47), compassion for the lives of others (0. 36) was observed and it was significant in explaining the compassionate care model. Also, the result showed that the indirect effect of moral identity was found to be significant through the mediation of compassion and also towards the lives of others (2. 96). Considering the variable mediating effect of compassion towards the lives of others in the relationship between moral identity and compassionate care of nurses, it seems that the growth or strengthening of compassion towards the lives of others and moral identity can promote the compassionate care of nurses.
Alireza Monajemi , Amir Hassan Mousavi,
Volume 15, Issue 1 (3-2022)
Abstract
Medicalization, in the sense of expansion of medicine in different aspects of human life and ultimately the transformation of medicine into a tool of social control and domination, is a common interpenetration in the literature. This concept, since its inception in the mid-twentieth century, has been an exclusive critique of modern medicine, meaning that branch of medicine based on biomedical paradigm. In this article, we argue that the conceptual shortcoming of this view and the reduction of medicalization to only one medical paradigm, lead to appear medicalization in the new outfit in the name of demedicalization and with more harmful aspects. By focusing on biomedical paradigm or biomedicalization, we neglected other types of medicalization like paramedicalization or CAMization, meaning expansion of Complementary and Alternative Medicine in different aspects of human life. This negligence makes the space to misuse of medicalization for more medicalizing issues. In the following, Iranian Traditional Medicine has been examined as one of the examples of CAM. By presenting historical examples, in the contrast of common understanding of many medical sociologists, we showed that medicalization is not an exclusive concept around modern medicine and its root go back hundreds of year, not just the last hundred year and not only in the western world.
Maasoumeh Barkhordari-Sharifabad, Seyedeh-Zahra Kaka-Tafti, Parnia Bastani, Farideh Mahmoudi-Hashemi,
Volume 15, Issue 1 (3-2022)
Abstract
Health care providers need moral sensitivity to provide effective ethical care Since spirituality is an integral part of morality, and spiritual intelligence is the basis of an individual's beliefs that affect his performance, this study was conducted to determine the role of spiritual intelligence in moral sensitivity of nursing students. This is a cross-sectional descriptive study that was conducted in 2021. The target population was nursing students studying in the first semester of 2021-2022 in Yazd, of which 153 people were selected by simple random sampling. In order to data gathering, questionnaire of King's spiritual intelligence and Lutzen's moral sensitivity was used. The validity and reliability of the instruments have been determined in previous research. Data were analyzed using descriptive statistics (mean and standard deviation, frequency distribution) and inferential statistics (Pearson correlation test and T test) by SPSS software version 16. Results indicated the mean of moral sensitivity (64.24 ±10.46) and the mean of spiritual intelligence of nursing students (53.90 ±34.13) were moderate. There was no statistically significant relationship between spiritual intelligence and moral sensitivity (P=0.245). Therefore, it is necessary to conduct studies to investigate the mediating factors that may affect these variables for a better and deeper understanding.
Maasoumeh Mangeli, Zahra Rezahosseini, Hossein Sabzaliani,
Volume 15, Issue 1 (3-2022)
Abstract
Providing nursing care based on ethical values requires nurses to have ethical sensitivity. Determining the factors related to moral sensitivity can help to identify strategies to promote this ability. The aim of this study was to investigate the relationship between nurses' ethical sensitivity and work environment index. This descriptive-correlational study was performed in the presence of 135 nurses of Vali-e-Asr Hospital in Shahr-e-Babak (Kerman province) in 2021. Samples were selected by consensus method. Lutzen Ethical Sensitivity Questionnaire and Work Environment Index Questionnaire were used to data collection. Data analysis was performed by determining the Pearson correlation coefficient and regression test using SPSS26. T-test and ANOVA were also used to examine the difference in mean scores based on demographic and occupational variables. Findings showed that the status of ethical sensitivity and work environment index of nurses participating in this study is at a moderate level and there is a significant correlation between nurses' ethical sensitivity and work environment index (P=0/049 R=0/212). Also, the mean score of work environment index showed a significant difference based on the variables of position (P=0/008) and shift work (P = 0/012). The existence of a significant relationship between nurses' ethical sensitivity and their work environment index confirms the importance of the work environment and its related consequences. According to the results of the present study, by optimizing the working environment of nurses, we can expect their ethical sensitivity to improve.
Mahshid Safaei, Maghsoud Farasatkhah, Ehsan Shamsi Gooshki,
Volume 15, Issue 1 (3-2022)
Abstract
In the health system, professional problems and organizational obstacles cause patient fatigue, physician exhaustion, and ultimately interpersonal issues between the patient and the physician, including lack of mutual understanding and erosion of trust. Therefore, trust, as the central core of social capital, plays a significant role in the quality of interpersonal and intergroup interactions. The trust between the patient and the doctor and its general expansion requires a set of organizational considerations and professional principles in the health system. The purpose of this qualitative research was to analyze organizational and professional factors affecting trust between the patient and the physician. The data were collected through semi-structured interviews in the health service centers located in Tehran. Using purposeful sampling and snowball, a total of 39 participants were interviewed until theoretical saturation was reached. Using the systematic approach of grounded theory (GT) and ATLAS.ti software, the data were categorized and analyzed in three stages of open, axial and selective coding. The findings show that the professional-organizational components effecting on trust between physicians and patients include three components of "adaptable professional management", "adaptable insurance" and "adaptable policy" and nine sub-components as described in the article. These components are the composing elements of the structure and infrastructure of professional development in health system, which can restore the relationship and interaction based on trust between the patient and the physician in health system. The other strategic researches are needed to develop strategies and executive policies to increase the trust between the patient and the physician.
Leila Razeghian Jahromi, Safoura Sadeghi Mazidi, Ali Farhangdoost,
Volume 15, Issue 1 (3-2022)
Abstract
An increase in the incidence of chronic and incurable diseases and the lack of facilities to care for patients raises the issue of prioritization in the allocation of facilities and the selection of patients to use the facilities and the choice between life and death. Discussion of termination of life and cessation of treatment is one of the challenges in the field of medicine and ethics. The demand for euthanasia has increased in recent years, and future physicians will face this issue. This cross-sectional study was performed on 200 interns and medical residents in 1400. All participants completed the Demographic Information Questionnaire, Beck Depression Questionnaire, and Attitude to Euthanasia Questionnaire. In the present study, 67.5% of participants agreed with euthanasia. The mean score of attitudes to euthanasia was higher in men than women (P = 0.023) and higher in single people (P = 0.045). As religious beliefs increased in individuals, the mean score of attitudes toward euthanasia decreased and opposition to it increased (P> 0.001). Positive attitudes toward euthanasia were associated with depression and its severity (P> 0.001). Depression and its severity are significantly associated with more physicians' desire for euthanasia. On the other hand, the stronger the religious beliefs, the greater the anti-euthanasia. Support for euthanasia in men and single people was also higher than in other groups.
Mohammad Hossein Eftekhari, Alireza Parsapour, Ayat Ahmadi, Bagher Larijani, Neda Yavari, Ehsan Shamsi Gooshki,
Volume 16, Issue 0 (11-2023)
Abstract
Defensive medicine is performing actions that have no medical indication and benefit for the patient (positive defensive medicine) or refraining from performing risky actions that have a medical indication and benefit for the patient (negative defensive medicine). These actions are carried out by the physicians with the sole motive of protecting themselves against complaints or tensions such as the protest of the patient or colleagues and usually cause physical, psychological, or economic harm to the patient or the institution that pays the treatment fee, such as insurance organizations. It can have consequences in terms of the quality of care and the efficient use of limited health resources. Factors such as the physician’s concerns about lawsuits and proceedings may lead to defensive behaviors. This study presented suggestions for the management and prevention of such behaviors, including three main categories related to the strategies for the reformation of the patient complaint handling system, social strategies for the management and prevention of defensive medicine, and managerial-organizational strategies. These strategies are based on the findings of a mixed-methods research including an unsystematic review of resources and a qualitative study conducted using semi-structured interviews. The results have been discussed by the Medical Ethics Committee of the Academy of Medical Sciences of Iran.
Leila Jouybari, Zahra Talebi, Akram Sanagoo,
Volume 16, Issue 1 (3-2023)
Abstract
This Article has no Abstract .
Reza Shahrabadi, Roghayeh Javan, Roghayeh Zardosht, Mojgan Ansari, Mehdi Rabiei, Hamideh Yazdimoghaddam,
Volume 16, Issue 1 (3-2023)
Abstract
The health team, in their daily operations, are faced with many ethical issues they have to solve. Moral knowledge includes confronting with and resolving conflicts, values, norms, interests, or laws. Identifying the ethical challenges of the health system can contribute to the efficiency of educational and health programs of universities of medical sciences. The objective of this study was to explain the components of professional ethics in therapeutic and health interactions with patients. In this qualitative research, the Delphi method was used to determine the components of professional ethics. The participants were composed of three groups including faculty members, students, and clinical staff who were selected using purposive sampling. First, by reviewing the literature, a semi-structured questionnaire was developed to investigate different components of professional ethics. Then, using the Delphi method in four rounds, the ethical components were selected and by checking content validity indices (CVR and CVI), the final version of professional ethics components was explained based on therapeutic and health interactions with patients. The results of the qualitative research and the Delphi model led to the extraction of the 12 most common ethical components including disclosure of patients’ secrets, lack of justice in providing services, lack of respect for the patient’s discretion, medical and treatment staff errors, lack of compliance with regulations and standards of treatment and care, non-observance of legal regulations in telling bad news by the doctor, non-observance of dying patient’s rights, non-observance of patient’s privacy, lack of proper training of care principles and new and up-to-date treatment tips to students and staff, and finally, non-observance of professional communication. Accordingly, the final components were compiled as a questionnaire. Achieving ethical competence requires the identification of ethical components in educational, therapeutic, and care environments, especially in interaction with the patient. Therefore, it is necessary to identify, structure and formulate ethical components in regular and continuous training programs in the field of importance and observance of ethical principles in medical and health centers.
Nafiseh Momeni, Mojgan Alaeddini, Shahroo Etemad-Moghadam,
Volume 16, Issue 1 (3-2023)
Abstract
Various decision-making dilemmas arise for clinician in their practice, and one such dilemma involves dealing with medical or dental errors. Despite efforts to minimize errors and prevent harm to patients, complications arising from diagnostic or therapeutic mistakes can sometimes be irreversible. In such situations, it is crucial for dentists to engage in ethical encounters with their patients and investigate the root cause of the error. In this study, an approach was suggested for the management of detection of diagnostic error in pathology using the World Dental Federation ethical decision-making model.
Samireh Abedini, Elham Imani,
Volume 16, Issue 1 (3-2023)
Abstract
Face many ethical challenges during this course. Since ethics is an important factor in providing health services to clients, this study was designed to explain the ethical challenges in training in viewpoint of medical students. This qualitative study was conducted with content analysis approach. Purposeful sampling was performed and data were collected using in-depth, face-to-face and semi-structured individualized interviews. Data analysis was done simultaneously with qualitative content analysis using inductive approach according to Elo and Kingaz (2008). In this study, information was gathered after interviewing 40 students of Hormozgan University of Medical Sciences. The mean age of participants was 22/67±1/22 years. After analyzing the text of the interviews, two themes and seven categories were finally obtained. Themes were named under the headings: ethical challenges in clinical field and ethical challenges in clinical training supervisors. According to the results of interviews with different students, it is imperative that the faculty members pay special attention to the ethical challenges in hospitals and clinics and consider the necessary steps to familiarize students with ethical issues, how to deal with these issues and how to make decisions in ethical situations.
