Showing 97 results for Medical Ethics
Haleh Habibi, Mehrandokht Nekavand, Seyed Mohammad Akrami,
Volume 9, Issue 5 (1-2017)
Abstract
Errors in health care services may cause irreversible harm in some cases. Medical errors are a threat to the welfare and health of the patient and their family and should be prevented. The majority of medical errors have little impact on human health, but some of them cause huge losses. This report describes a case of laboratory error in amniocentesis during pregnancy in which uncertain test result caused anxiety and lots of concern for the family. Inappropriate approach to medical error causes more errors to happen. Studies have shown that appropriate reporting and shift from traditional to systematic approach are important factors in reducing the frequency of medical errors.
Mohammad Mohammadi, Mohammad Shamsoddin Dayani Tilaki, Professor Bagher Larijani,
Volume 9, Issue 6 (3-2017)
Abstract
Privacy and confidentiality are the inalienable rights of every human being to preserve his dignity. This issue should be considered in all levels of medical interventions. In the healthcare system, based on respect for privacy and confidentiality, patients decides what information to provide to their physicians. However, if a patient does not provide necessary information to his physician this may impact the diagnosis and treatment. This study aims to evaluate patients’ attitude regarding privacy and confidentiality in healthcare delivery. The result helps policy makers to establish appropriate relations between healthcare providers and patients by realizing its strengths and weaknesses.
This cross-sectional study was carried out on 200 patients, selected in a systematically random way, in Imam Khomeini and Shariati hospitals in Tehran the capital of Iran in 2010. The data were collected directly from patients by trained interviewers based on a questionnaire survey. In order to analyze the data based on the scores of the attitude, patients’ attitudes were classified into three groups of negative, slightly positive, and positive and were evaluated by using various statistical tests.
In result, 56.5% (113) of participants were females and 43.5% (87) were male. In this study, it was found 71 (35.5%) patients were “strongly agree” that male physician can examine female patients and 99 (49.5%) patients were “agree”. Fifty three patients were “strongly agree” that physician may consult with his assistant through training (without the patient's permission) and 103 patients were “agree”. Participants’ attitude about disclosing the patient’s information if a he has threaten self-harm or harm to another person was as follow, 45 (22.5%) patients were “strongly agree”, 82 (41.0%) patients were “agree” and 56 (28.0%) patients had “no comment”. In this study, in general 36 (18.0%) patients had “negative”, 162 (81.0%) patients “slightly positive”, and 2 (1.0%) patients had “positive attitude” towards privacy and confidentiality in healthcare settings.
In conclusion, the study population possessed a moderate attitude towards privacy and confidentiality. These results show that in addition to performing further studies, patients’ attitude towards privacy and confidentiality should be adequately improved.
Mojtaba Parsa, Bagher Larijani, Kiarash Aramesh, Saharnaz Nedjat, Akbar Fotouhi, Mir Saeid Yekaninejad, Nedjatollah Ebrahimian,
Volume 9, Issue 6 (3-2017)
Abstract
Informal payments in clinics raise ethical concerns in healthcare delivery. This cross-sectional questioner survey aims to evaluate the prevalence and related factors of informal payment in healthcare system in Iran.
The study was carried out in 2013, prior to the implementation of the government' Health System Reform among physicians with different specialties. The questionnaire were distributed among the participants during the congresses and continuing medical education programs.
In results; of the total specialist physicians, 276 returned the questionnaires. The response rate was 81.17%. and out of 276 returned questionnaires 257 fulfilled the inclusion criteria. The prevalence of informal payments, among the physicians who were susceptible to receiving informal payments, was relatively high (63.8%). The physicians who practiced in the private sector, as well as physicians who practiced in Tehran and those who had a positive attitude towards the informal payments, received more informal payments. From the viewpoint of the respondents, the main cause of informal payments was unrealistic/unfair tariffs and the main consequence of informal payments was the rising costs of patient care.
This study showed that, unfortunately, more than half of the participants did not believe or did not decisively consider informal payments as unethical. This confirms the importance of physicians’ education about the unethical practice of informal payments. However, compare to private sectors, more supervision in public sector may be the main cause of less prevalence of informal payments in public hospitals.
In conclusion: Developing ethical guidelines to prevent informal payments as well as more realistic and fair tariffs would help to decrease the incidence of informal payments.
Mahmoud Motavassel Arani, Mohammad Hassan Alamolhoda, Nikzad Easazade, Gholamreza Noormohammadi,
Volume 10, Issue 0 (3-2017)
Abstract
Modern medical ethics, in particular the principle of Non-Maleficent, advises the medical staff to avoid any harm to the patient. Islamic jurists, using religious texts and sources, have introduced rules that are applicable in many areas of life. Among these rules, is the rule Non-Harm, that in this article to review this rule and its applications in medicine. In addition to discussions of the documents, a better understanding of the words "Darar" and "Dirar" and deny or forbid the word "La" at the beginning of the base document, is one of the major issues and disputes. Organ transplants, family planning and birth control, responsibility to protect the health, need to see a doctor for treatment, civil responsibility for doctors in the treatment, responsibility for custodians of society for the control of AIDS, are the problems affecting today's health systems that the rule of No Harm is flowing in them.
Sedigheh Ebrahimi , Nasrin Alinejad,
Volume 10, Issue 0 (3-2017)
Abstract
Today, due to the highlighted the importance of respect for the human dignity, and increasing awareness of patients, traditional methods of ethics training cannot meet the educational needs. In this cross-sectional study, the effect of medical ethics workshops on knowledge and attitudes of 40 fourth years medical students was studied. A pre-post questionnaire on the measurement of the importance of the medical ethics components, the self-assessment of ethical knowledge, behavior and professional ethics was presented. There was a significant difference between the mean score of the importance of the medical ethics components (questionnaire number 1) before and after the workshop (p = 0.002); but in the case of self-assessment of moral behavior (P = 0.64) and self-assessment of professional ethics compliance (p = 0.48), there was no significant difference between the mean score of students before and after the workshop. The analysis of log-books indicated that students understand, topics of confidentiality, informed consent, and breaking bad news; but issues such as empathy, respect for the patient's emotional state, interaction with a patient suffering from AIDS, informing the patient about the disease and the course of the treatment, accepting a mistake from the doctor, and apologizing to the patient were inadequately addressed by the students. Ethics training is not sufficient just at the beginning of the clinical course; it must also be trained actively in the hospital and on the patient's bedside.
Rasool Esmalipour, Mojtaba Parsa,
Volume 10, Issue 0 (3-2017)
Abstract
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
Amir Ahmad Shojaei ,
Volume 10, Issue 0 (3-2017)
Abstract
Medical ethics in a reductive look can be handed to physician’s ethics and then call a physician who adheres to medical ethics attributed to the moral virtues. Moral virtues are counted to be about 137 in the teachings of Shiite, most of which are not related to the practice of medicine but nearly eighty virtues are linked to the practice of medicine. This number is too much to be handled in a paper and analyzed by verses and hadiths. Therefore, we should take two steps: 1-Limit the virtues of physicians 2- Analyze the virtues of physicians. Believe and practice the virtues emphasized in the teachings of Shiite leads to a monotheistic look to the practice of medicine and provides physicians with a different and transcendental worldview. This insight that stood upon the teachings of the Qur'an and hadiths by Imams (AS) considers the practice of medicine a divine relation and then shows the communication between a physician and others. The current paper analyzes the divine relation of the physician and its impact to the practice of medicine. First literature review performed to find three most virtues. Then Factor analysis method was used and therapeutic virtues were limited to thirteen virtues. Then library study and focus group discussions were used to analyze the selected therapeutic virtues. The practical conclusions is that if we consider medical ethics practice based on virtue, and define and interpret virtues based on the teachings of Shiite, then we will get to a monotheistic view in the practice of medicine that distinguishes Shiite medical ethics monotheistic feature and the secular one, and helps to link between faith and morals.
Hossein Mahmoodian, Hamide Barzegar,
Volume 10, Issue 0 (3-2017)
Abstract
Patients have the right to make decision about their medical care. Thus, all the available information regarding decision-making should be provided for them. In surgical context, informed consent is essential for therapeutic relationship between patient and surgeon and sustains mutual trust and shared responsibility for decision making. Thus before surgery, the surgeon should describe available treatments, benefits and harms of them to the patients. So the patient can make a correct decision. In this cross-sectional study, 200 patients underwent gynecological surgery in a hospital in Shiraz during 2014 were recruited. The questionnaire which was used in this study had three parts. The validity and reliability of the questionnaires were evaluated using expert panel and SPSS software. In this study, there was no significant association between age, marriage status, job, home place, emergency or elective surgery and the amount of informed consent. There was significant difference between patients with primary school education and patients with higher education. Patients’ participation in decision making was 57%. Patients’ information about their rights in hospital and the amount of reading informed consent form were poor. This survey shows that the amount of informed consent obtained from patients is poor. So, we should consider some changes in content and obtaining informed consent.
Seyed Ali Enjoo, Zahra Kavosi, Seyed Ziaadin Tabei, Abdolali Mohagheghzadeh,
Volume 10, Issue 0 (3-2017)
Abstract
Organizational culture affects the values, traditions, and norms of an organization. Therefore, the organizational behavior means how much an organization acts ethically. The cultural environment affects the formation of the organizational climate and, behavior. There are some deficiencies in the standards of organizational culture. This study aimed to review different aspects to accredit hospitals culturally in Shiraz University of Medical Sciences and consisted of two stages: First; the initial qualitative study was done by interviewing the experts who were selected purposely and held focused group discussion sessions to recognize the different aspects of cultural validation and develop an cultural accreditation manual for hospitals. Second stage was an evaluation of the hospitals in Shiraz University of Medical Sciences according to the cultural accreditation manual. Among 17 targeted hospitals, passed the training course of identifying indicators and volunteered to participate in the survey, 11 hospitals which had performed self-evaluation according to their manuals entered the survey. Seven main subjects and 17 sub-titles were derived from the first qualitative study. The subjects included considering religious laws demanded by patients and those patients’ accompaniers, patient satisfaction, staff satisfaction, consideration of ethical rules, dress codes, cultural activities of the hospital, and environmental neatness of the hospital. The evaluation of the above factors ranged from 0-1. The hospitals, total scores were from 0.68 to 0.78. Findings suggest capability of the indicators for hospital cultural evaluation. The qualitative study ranked the hospitals in every aspect.
Mohsen Rezaei Aderyani, Saeid Nazari Tavakkoli, Mehrzad Kiani, Mahmood Abbasi, Mohsen Javadi,
Volume 10, Issue 0 (3-2017)
Abstract
Medical ethics is an old science. Some of its issues have historical precedence, and others are modern challenges, and have emerged with advances in technology. One of such historic but newly emerging challenges is "bi’natijeghi-e-pezeshki (futile treatment)", which is defined as the treatment that cannot achieve its goal. This term entered medical literature as "medical futility" in late 1980s. Based on this investigation, it can be concluded that this term should only be used when the desired outcome following medical procedure and the outcome sought by the medical team and patient/family (patient's health) is unlikely to be realized. There are various equivalents for this term in our country (Islamic Republic of Iran), including "bi’fayedegi-e-pezeshki (medical uselessness)", "bi’houdeghi (frivolity) in medicine", and even "inappropriate treatment". The present article aimed to find a suitable Persian equivalent for this concept. The use of interpretations such as "frivolity" or "uselessness" may cause misunderstanding between patient/family and the medical team, and can ruin the trust between patient/family and the medical team. Thus, the best alternative to this English term appears to be "bi’natijeghi-e-pezeshki (futile treatment)".
Akbar Aqhayani Chavoshi,
Volume 11, Issue 0 (3-2018)
Abstract
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.
Amirhossein Mardani, Alireza Parsapour, Ehsan Shamsi Gooshki,
Volume 11, Issue 0 (3-2018)
Abstract
This research reviews the scientific productions of the field of biomedical ethics based on articles published in Iranian scientific journals in Farsi (Persian language). The findings showed that from 2003 to 2017, researchers have published 1238 Persian articles in this field. The average annual growth rate of published articles is 23.17 percent, but this growth has been declining since 2013. The citation rate of articles (0.4 per article) suggests a small impact. Shahid Beheshti University of Medical Sciences and Tehran University of Medical Sciences with the publication of 36% and 33% had the largest share in the publication of articles, respectively. Biomedical ethics research was interdisciplinary and researchers from the medical, nursing, and law sciences played a major role in compiling and publishing them. The topics such as medical ethics, medical education, and Islamic ethics were, repetitive subjects in articles, respectively. Only 22% of these articles referred
directly to funding provided by universities and research centers.
Amir Ahmad Shojaee, Mirsaeed Yekaninejad, Sima Amini,
Volume 12, Issue 0 (3-2019)
Abstract
The most important factor in interpersonal relationships is trust. Trust in the physician-patient relationship is key and essential. Understanding the factors that affect trust is a prerequisite for trust. These factors vary in different societies. So we need to identify these factors and provide a single criterion for measuring them. Therefore, because we need a tool to measure these different factors in the context of culture and society, the purpose of this study is to determine the factors that influence public confidence in physicians to provide the necessary evidence for making appropriate instruments in Iran. The first step was to investigate the factors affecting patients' confidence in physicians during a library study. Then, during interviews and numerous discussion sessions, nineteen factors influencing public confidence in physicians were provided. Then, to determine the content validity, twenty experts evaluated the transparency, relevance and importance of the factors. Content validity ratio (CVR) and content validity index (CVI) were measured. CVR value for each of nineteen factors was 0.42, therefore content validity of the tool was significant with P.value 0.05. CVI value was 0.944 and content validity of the tool was confirmed. Factors affecting public confidence in physicians in Iran include 19 factors extracted during this study and can be used as factors for assessment of public confidence in physicians. Factors affecting public confidence in physicians in Iran include 19 factors extracted during this study.
Mohammad Taqi Eslami, Hassan Boosaliki,
Volume 12, Issue 0 (3-2019)
Abstract
The concept of Islamic medicine, which differs from traditional medicine and even Muslims’ medicine, has become more and more popular in recent years in Iran, especially in religious cities. In the present article, we have addressed the extremist approach of the claimants of Islamic medicine (which considers itself a competitor of modern medicine and traditional medicine).Our theoretical basis for the ethical criticism of this approach has been the principlism of "Beauchamp and Childers". Thereby, we have attempted to challenge the clinical position and medical performances of extremists in the Islamic medicine on the basis of four principles of "justice, autonomy, beneficence, and non-maleficence". Then, we have concluded that the claim of the Islamic medicine cannot, in the present circumstances, satisfy the principle of distributive justice. It also violates patients' autonomy by making unfair judgments and fears about modern medicine. It is very prone to harm clients by refusing scientific evaluation of medicines and therapies and lacking a valid certification system. Accordingly, we particularly challenged the attribution of this process to Islam. This attribution may cause serious damage to the religious beliefs of the clients.
Hamid Reza Namazi, Nafiseh Momeni,
Volume 12, Issue 0 (3-2019)
Abstract
Over the past years in the literature of medical ethics about the doctor-patient relationship, patient's rights have been greatly considered, but the other side of this relationship is not concerned, and the physician’s obligations have been highlighted. The two meanings are understood from the concept of physicians’ rights; their rights in conflict with the patient rights’ and the right to self improvement. We want to review the causes of this neglect and its complications. The reasons for not paying attention to the physician’s rights include: traditional beliefs about the power imbalance in doctor-patient relationship, lack of emphasis in the four principles of medical ethics, lack of supportive structures, customer-orientation in medicine, and hyper medical professionalism. Continuing this neglect creates complications that include: physicians’ work-life imbalance, symbolic violence in their society, burnout of physicians, forgetting the principle of gratitude and ultimately, the lack of respect for patients' rights. Consequently, the discourse of medical ethics fails to achieve its primary goals.
Fatemeh Makkizadeh, Arezu Dehghan, Esmaeil Mostafavi,
Volume 13, Issue 0 (3-2020)
Abstract
The purpose of this research is to investigate association between social influence, productivity, and performance among researchers of medical ethics field. This research was done using common methods in scientometric studies with the method of co-author and network analysis. The statistical population of the study consists of all articles published in journals in the field of medical ethics, which were indexed in the database of web of science in the period of 1978-2017. A total of 14,231 articles and 20,845 researchers were surveyed. Data analysis was done using UciNet and SPSS softwares. Research findings based on the social influence that calculated for each researcher. The study of relationship between social influence and performance showed that there is positive correlation between performance and degree centrality. However, there is a negative correlation between performance and closeness and betweenness centrality. Also, the relation between social influence and productivity showed that there is a positive and significant correlation between social influence and productivity indices. The results showed that the researcher who have a good status in terms of performance, have a high social impact. In addition, researchers who have a high degree centrality are in a favorable position in terms of productivity and performance.
Afsaneh Saadati, Mohsen Mohamadi,
Volume 13, Issue 0 (3-2020)
Abstract
In human communication, the relationship between the patient and the physician is one of the most challenging issues. This relationship is of critical importance in the medical ethics and forms the base of medical measures. Relationship between the physician and the patient brings about mutual trust between them to the extent that it overshadows physician’s skills. A physician needs to have the art of communication with the patients as well as his information in medical sciences. Damaging this communication leads to lack of efficiency, trust and satisfaction in the treatment of the patient. The authors of this article seek to analyze the major issues of medical ethics in the medical texts based on Mathnawi. Rumi has also made special mention of physicians' responsibilities and ethical duties in the stories of pulmonology, physiology, herbal therapy, routine treatment, and etc. In The story of “King and Handmaiden”, Confidentiality, Compassion, Kindness, and the expertise of saint against Handmaiden are issues that they are discussing in medical ethics. At the end of the story, audiences unbelievably are evaluating the performance of saint as opposed to the spirit of Hippocratic oath. In the story of “the old man and the physician”; deficiency of the communication between physician and patient is very definite. Not building trust and emotional communication in the relationship between the physician and the patient, specifically at the very first time which has happened without semiology has provided the context in which the patient distrust his physician and is not pleased with the treatment process. In the story of “Man who was desperately ill”, the physician has hidden the secret and also he has not given a clear and enough explanation for the prescription, therefore the patient's life is endangered.
Mostafa Moallemi, Morteza Darabinia,
Volume 13, Issue 0 (3-2020)
Abstract
This study seeks to identify one of the pioneers of traditional clinical medicine named Abdullah Azdi and his medical dictionary. This research is an analytical study. The focus of the search was on two keywords, Abdullah Azdi and Kitab al-Ma'ma, but the scope of the search included all appropriate terms such as: medicine, Bu Ali Sina, traditional medicine, medical dictionary, ethics, and medical law. Data were collected and analyzed using comprehensive library software (version one), Islamic History Library, Islamic Iran History and reputable national and international centers. The main purpose of the forthcoming research, on the one hand, is to identify and introduce points about life and beliefs, as well as Abdullah Azdi's specialized knowledge in the field of medicine, and on the other hand, to introduce his book, which is in fact a dictionary called "Kitab al-Ma'a". The researches of this research show that Abdullah Azdi was one of the students of Ibn Sina and the companion of Abu Rihan al-Biruni. In addition of being expert in clinical medicine, he was an ethical and professional physician and in every part of his book, he observes the Shari'a. The use of specialized medical terms indicates that he was surrounded by medical knowledge.
Mohammad Kiasalar, Hamidreza Namazi,
Volume 13, Issue 0 (3-2020)
Abstract
The National Medical Ethics Film & Photo Festival was held in February 2020 and ended with the registration of 487 works which 80 films and 36 photographs of them were finally selected and peer reviewed. The present article focuses on the films of this festival and tries to explain the experience of attracting, selecting, and judging films through the design and holding a festival by using action research method. The article, also, tries to analyze the selected films (50 documentaries, 20 short films, and 10 unspecified films) from medical ethics point of view. In this way, the thematic adaptation of the selected films with 16 topics declared by the festival has been used. One of the obvious findings of this study is the difference between the views of filmmakers and experts on medical ethics. This difference becomes more significant when we see that the number of films related to the 16 topics declared by the experts is one less than the number of the films that the filmmakers made and submitted to the festival on the 7 topics neglected in the text of the call. It seems that the camera of filmmakers in the field of medical ethics mainly focuses on the commitment of professionals and the vulnerability of patients. On the other hand, considering the number and variety of films in the festival, another finding of this study can be considered as the possibility of using short and documentary films to teach some concepts of medical ethics to medical students.
Farzad Zakian Khoramabadi, Alireza Parsapour, Bagher Larijani, Amirhossein Takian, Ehsan Shamsi Gooshki,
Volume 16, Issue 0 (11-2023)
Abstract
The right to access health services as a part of fundamental human rights, affected by the conditions and facilities of governments and the international status, has always faced challenges. Despite the clarity of the general policies and upstream documents in the Iranian health system regarding the need to provide immigrants and refugees with health services and Iran’s membership in the relevant conventions, the implementation of the provisions of these documents is not consistent and complete for various reasons, including the inadequacy of laws related to immigrants and refugees and the incorrect implementation of some existing laws. The first draft of the ethical guidelines for providing health services to immigrants was prepared by the research team using the results of a review of relevant documents as well as a qualitative study and finalized according to the opinions of the participants in a panel of experts. In this draft, after explaining the values and ethical principles governing the provision of services to Afghan immigrants, the suggested guidelines and assignments were presented to the main stakeholders involved, including the policymakers and macro planners of the health system, institutions and centers providing health services, professionals and health service providers, professional organizations, civil society activists, media and non-governmental organizations, and medical research and education authorities and researchers.
