Iranian Journal of Medical Ethics and History of Medicine

Virtue ethics is an agent-centered approach that is concerned with good and bad character rather than right or wrong action. It is based on the virtues and moral character of the agent. Morality of the physician is emphasized in medicine as well, which demonstrates its affinity with virtue ethics. Nevertheless, a theory of applied or medical ethics should provide a criterion for ethical decision making by instructing what should be done, something which, according to some philosophers, is incompatible with virtue ethics. This article aimed to demonstrate how virtue ethics can offer rules and guidelines by resorting to the moral agent and emphasizing virtues, and help physicians to make decisions when faced with dilemmas. For this purpose, examples about abortion and selling kidneys for transplantation were provided.Some of the most important advantages of virtue ethics include: context-dependence and attention to relevant realities the importance of emotions and the likely motivations of the people involved and finally emphasis on exemplar based on the sensitivity and practical wisdom of the virtuous agent. These advantages cause virtue ethics to be better positioned than other approaches to solving problems in medical ethics.

Nowadays, electronic communications technology propounds new forms of the patient-physician relationship in the field of medicine. Effective communication between the patient and the physician can play a crucial role in the process of treatment. This new form of communication greatly influences promotion of the health system by improving access to inexpensive and fast services regardless of geographic boundaries. In times of crisis, telemedicine plays an important role in delivering health services to deprived areas in a just manner. Usage of communications technology is inevitable, and due to the virtual nature of this kind of medical communication, recognition of certain ethical considerations seems essential. Successful examples of telemedicine are abundant throughout the world and usage of this technology is a helping solution for inadequacies in the healthcare system. In Iran, because of the geographical extent of the country, this technology can provide access to medical services in some cases.In order to achieve the best outcome in telemedicine, it is essential to respect confidentiality, privacy, informed consent and commitment to professionalism in this field.

In recent years, the general consensus is that medical education should comprise ethics courses focusing on clinical decision-making skills and professional ethics in order to institutionalize a set of values in physicians. The purpose of this study was to evaluate the internal and external qualities of the medical ethics curriculum from the perspective of students.This was a survey research on a study population of 157 medical students who were taking the medical ethics course. A sample of 113 students were selected by simple random sampling, and data collection tool consisted of two researcher-made questionnaires. In this research, the internal quality of the curriculum was evaluated according to the following 9 elements as proposed by Francis Klein: objectives, content, learning activities, learning strategies, instructional material, resources, grouping, time, location, and evaluation. The external quality of the curriculum was assessed based on Kirkpatrick’s model with attention to students' views on achievement of course objectives in terms of knowledge, skills and attitudes. Data analysis was performed using descriptive statistics (mean and standard deviation) and inferential statistics (one-sample t-test). Based on the findings, the students viewed the internal quality of the medical ethics curriculum as undesirable in terms of the above-mentioned nine elements. Students also believed that the external quality of the ethics curriculum was at an average level in the knowledge and attitudes components, and undesirable in the skills component. Overall, our findings indicate that from the perspective of students, the quality of the medical ethics curriculum is low and the course needs to be reviewed and redesigned.

Medical laboratory is one of the health service providers that intensely responsible for the life of patient / client. With an increase in the number and variety of laboratory tests in recent years, the role of laboratory science in identifying and assessing the cause of disease has been more recognized. Performing the laboratory tests with the utmost accuracy, precision and speed using up to date methods as well as protecting the rights, integrity and respecting human dignity and also the establishment of priorities and the requisites for quality management systems can have a significant impact on patient satisfaction and quality which are the characteristics of a good medical laboratory. The principle concept of doing good and not doing bad is the essence of every code of medical ethics. Therefore, in laboratory medicine like other areas of medical sciences, there are ethical questions that have become more complex with the development of diagnostic tests. Medical laboratory practitioners usually deal with issues of confidentiality of patient information, as well as issues related to research ethics, professional ethics and business ethics.This study has collected important and common topics of medical ethics in laboratory medicine which leads to increase readers’ and practitioners’ information in this field. It is hoped that such information could be effective and practical to improve the laboratorial services for patients.

Severe combined immunodeficiency (SCID) is an inherited primary immunodeficiency syndrome characterized by a profound deficiency in T-lymphocytes and variable defects in the B-lymphocyte number. The present study aimed to evaluate the ethical aspects of the clinical management of children with SCID. This report is based on the case of a 6-month-old male infant with SCID diagnosis presented during the Medical Ethics Grand Rounds in the Children's Medical Center in Tehran, Iran.

The patient had a positive history of recurrent infections and frequent hospitalization. His parents were consanguineous and came from a low socioeconomic level of the community. He was the fourth child of the family. The first and second children were healthy girls, while the third child was a boy with a history of numerous problems post vaccination who had eventually died of widespread infections. The physician had recommended bone marrow transplant, but the parents had been directed by a neighbor to visit a religious healer.

Timely management of severe combined immunodeficiency can reduce complications and improve the patients’ quality of life. The need for early screening tests is therefore ethically justified, although ethical issues surrounding the subject should not be overlooked. Instances of these issues include: neglecting the scientific criteria necessary to conduct the tests the economic burden imposed on the family of the child failure to provide sufficient information to parents and ignoring their consent to conduct testing and treatment lack of equitable access to diagnostic and treatment facilities and lack of attention to the child’s autonomy. It should, however, be noted that in certain cases, healthcare providers could perform their management activities with an ethical and supportive approach, taking into account all physical and psychological needs of infants with severe combined immunodeficiency, as well as those of their families

Ethics is important in all professions, particularly in nursing, since morality and commitment in nurses can play a significant role in improving patients’ health and recovery. The nursing profession is therefore rooted in ethics, and the observance of nursing ethics is more important than other aspects of health care. This study aimed to determine patient's views on standards of professional ethics in nursing practice in Imam Hussain Hospital during 2015.

This was a cross-sectional study conducted on 575 patients in different wards of Imam Hussein Hospital in Shahroud. Research instrument was a 22-item questionnaire designed by the researchers to evaluate nurses’ observance of professional ethics in the three dimensions of accountability, improvement of care quality, and respect for patients. Data analysis was performed using SPSS 20 software.

The mean age of participants in this study was 51.32 (± 19.03), and 299 participants (52%) were male. The mean total score of professionalism was 18.38 (± 2.74), and the relationship between age and observance of professional ethics was statistically significant (P = 0.006).

According to the subjects of this study, the nurses’ observance of professional ethics was relatively good and at a desirable level. It is recommended to utilize a variety of learning styles and employ the services of professors of nursing ethics in order to enhance the quality of nursing education with respect to professional ethics.

Introduction and Problem Statement:  Attitude Prophet Muhammad (Peace be upon him and his family) treatment, has several dimensions as follows: ontological, ethical, Juridical and medical. This article studies the mystical and moral attitude of the Prophet Muhammad's treatment of prophetic mysticism a nd moral to explain the nature of treatment.

Methods: this study, used the Quran and prophetic traditions as well as Shia and Sunni interpretations used and documentary - library.

Results: The results show that the Prophet (PBUH and prophet) said treatment is only with God's command. The Prophet of Islam only God knew therapist. Prophet knew doctors who serve with tolerance to the patient. Of course, the prophet  did not know doctors dismiss the treatment but he, presented the doctor through the grace of God. He has said his companions to follow the recommended treatment processes According to this attitude. He believed that God has landed the drug. Also, according to the moral teachings of the Prophet (PBUH and prophet) central task of the treating physician is as follows: the need for specialized doctors, trying to detect treatment, avoid seeking treatment from unlawful activities.

Applications: mystical prophetic teaching about the treatment that "God is revealed for each analgesic drug" is a very important idea that can be used as a methodology proposition, medicine paradigm of the crisis related to the rescue Which can be used as a methodology proposition, fever that save crises related paradigm.

As well as other mystical vision of his heart, can be explain the moral principles of treatment in the healing process with integrated color. Ethical principles in relation to medicine and treatment can also introduce the responsibility of the medical profession as divine responsibility and thus enhance the physician's professional responsibility.

Abstract

Community genetics is an applied research area that explores the role of genetic variables on the interactions and community structure determinism affecting species. Community genetics covers a spectrum from services, genetic and congenital disorders, genetic counseling, prevention and screening to macro policies. The focal point of community genetics is the society, and community-oriented physicians make priorities on medical genetics based on the specific characteristics of each society. The present study aimed to investigate the prioritization process of community genetics in the Iranian society.

According to previous studies, priorities of community genetics services in Iran can be evaluated from several aspects, including severity and type of illness, diagnosis, prevention and treatment, epidemiology, attitudes toward illness, and domestic, social, cultural, ethical and economical challenges. In order to promote community genetics activities, the above-mentioned priorities must be taken into consideration, while special attention should be paid to the four ethical principles of medical genetics, that is, autonomy, beneficence, non-maleficence, and justice.

In the nursing profession, ethical practice is contingent upon the nurses’ ability to determine the ethical issues in their vocation, and their sensitivity to these issues in the nurse-patient relationship. In order for the health system to have a strong and solid foundation, this sensitivity must be formed in nursing students during the early stages of their education. Educational environment and clinical experience each affect ethical sensitivity in their own way. The purpose of this study was to determine and compare the ethical sensitivity of third and fourth year nursing students and nurses in Islamic Azad University, Mashhad branch during 2014.

In this cross-sectional study Lutzen’s Moral Sensitivity Questionnaire was used, and its validity and reliability was confirmed. According to the formula for sample size, 110 persons were sampled in each group. Sampling was performed randomly among the third and fourth year students, and in two stages among the nurses: first cluster, and then randomly. Data were analyzed using descriptive and analytical statistics by SPSS software.

The mean and standard deviation of moral sensitivity was 3.33 ± 0.36 in nursing students, and 3.27 ± 0.35 in nurses, and the independent t-test showed no significant difference between the two groups (df = 218, t = -1.06, P > 0.05). Moreover, there was no statistically significant difference between the mean scores of moral sensitivity based on demographic characteristics.

It was concluded that the ethical sensitivity of nurses and nursing students of Islamic Azad University, Mashhad branch was satisfactory, which can be considered as a point of strength for policy makers of the health system.

The present study tests a model of the relationship between Islamic work ethics and job satisfaction and organizational commitment with mediation of intrinsic motivation. Research design was correlation through structural equation modeling (SEM) and the sample consisted of 203 employees of Sabzevar University of Medical Sciences selected by census sampling method. Participants in this study completed questionnaires on Islamic work ethics, job satisfaction, organizational commitment and intrinsic motivation. Reliability and validity of all questionnaires were reported to be at an acceptable level. Data were analyzed through structural equation modeling (SEM) using AMOS-21 and SPSS-19 software packages. In addition, Preacher and Hayes’ SPSS macro program was used for testing mediation. The results showed that the proposed model fit the data properly, and that Islamic work ethics directly affected job satisfaction and organizational commitment. Moreover, the mediating effect of intrinsic motivation on the relationship between Islamic work ethics and job satisfaction and organizational commitment was confirmed. Employers can therefore rely on Islamic work ethics and training the employees and supervisors to reinforce intrinsic motivation, and thus promote job satisfaction and organizational commitment

The pharmaceutical industry plays an important role in every economy. Although pharmaceutical sector has distinctive economic features, like every other sector of the economy, the production and distribution of pharmaceuticals must obey competition law rules.

The provisions regarding unilateral anticompetitive conduct such as discriminatory pricing, aggressive price setting, abusing a dominate position and hoarding and refusal to inter into transactions as well as collective anticompetitive conducts such as collusion are some important competition rules which are applicable in the pharmaceutical industry.

Although the existence of competition law and regulation is necessary for working in pharmaceutical industry but pharmaceutical ethics can prevent committing the anticompetitive conducts and plays an effective role as a deterrent factor. This Article while reviewing the application of competition law rules in pharmaceutical industry introduces the anticompetitive behaviors in this sector.We also focus on the competition council’s function in monitoring the pharmaceutical industry and the role of professional ethics in preventing theviolation of competition law in this sector.

As a result of the changes made in health care systems, nurses nowadays are faced with more complicated ethical dilemmas. Therefore, they need to be familiar with ethical decision-making procedures and have the ability to perform ethical reasoning. The present study aimed to evaluate this ability in nurses and investigate its relationship with demographic characteristics in a subspecialized hospital in Tehran during 2015. This was a descriptive-analytical study, and the research population consisted of 245 qualified nurses selected by census. A demographic questionnaire and Crisham’s Nursing Dilemma Test were used to collect the data. Descriptive-analytical tests and SPSS software version 22 were used for data analysis. Based on the, the mean value of the nurses’ ethical reasoning was 40.81 ± 6.72, which is lower than the average score of the test. Furthermore, increased work experience led to a reduction in the mean value of ethical reasoning (P ≤ 0.05). Overall, single subjects scored higher in the mean ethical reasoning than those who were married (P ≤ 0.05), but no significant relationship was observed between other demographic characteristics and the mean of ethical reasoning. Due to the nurses’ low ability to perform ethical reasoning, further studies will need to be conducted on proper training methods to promote ethical decision-making in nurses. As regards the reduced ethical reasoning ability in nurses with more work experience, it is necessary to identify the reasons and devise appropriate solutions with the help of nursing managers and hospital ethics committees.

Moral distress has been identified in nursing literature as a major dilemma affecting nurses in all healthcare systems. It is viewed as an important factor threatening the integrity of nurses and ultimately the quality of patient care. The present study attempted to determine levels of moral distress among the nursing staff employed in hospitals across the city of Malayer. This was a descriptive and cross-sectional study conducted on 195 nurses of Malayer hospitals during 2015. Data were collected using a demographic questionnaire and the standard moral distress scale (MDS). Data analysis was performed by descriptive and analytical statistics using SPSS software version 18.

In this study, 88 nurses (45.1%) were found to be suffering from severe moral distress. The most important factors causing moral distress pertained to substandard care and treatment due to a shortage of health professionals and care providers (6.6±0.21), physician orders for unnecessary tests, treatments and care (6±0.12), and measures taken by staff who lacked clinical competency (5.9±0.22). Among the nurses’ demographic data, gender (P=0.001), job experience (P=0.001) and nursing ward (P=0.01) were significantly related to the level of moral distress experienced by the nursing staff. The results imply that in nursing, moral distress is a highly important and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators.

Genetic research was initially limited to the screening and diagnosis of known hereditary diseases. After the completion of the Human Genome Project (HGP), studies became concerned with the diagnosis and treatment of many non-communicable diseases threatening the public health. Aside from this, genetic engineering, in its new form, is also concerned with the development of recombinant medications, genetic enhancement, and genetically modified organisms and their applications. The climax of these achievements is the advent of transgenic creatures. These are organisms with a genetic makeup different from their natural one created through biotechnology. Transgenic products have become more popular in recent years, especially in agriculture and livestock sectors. At the same time, genetics and biotechnology are trying to keep pace with modern advancements. Genetic modifications have resulted in larger yields in agriculture and livestock as well as the development of new medications and vaccines. Despite the large profits that genetic engineering and transgenic organisms can bring for us, they may pose dangers in certain fields. Furthermore, there are ethical concerns about the application of these technologies.

The present study attempted to address the ethical issues in new genetic technologies and analyze them with regard to the four principles of bioethics. For this purpose, keywords were first looked up in scientific sources and the data were classified; ethical considerations were then analyzed in the light of the four principles of bioethics.

In the results section first the merits of such products for humanity and their contributions to saving the limited available resources are pointed out; subsequently, potential threats in some fields are addressed, along with considerations about the mass production and consumption of genetically engineered products, autonomy of individuals, the importance of raising awareness about the pros and cons of genetically modified organisms (GMOs), and their labeling. Finally, equity is addressed, and general benefits and harms, costs and effectiveness are discussed.

Nurses comprise the largest group of service providers in the health system and have a significant impact on health care quality; therefore, ethical practice is of greater importance in the nursing profession compared to other fields of care. The present study was conducted to evaluate patients’ views on nurses’ observance of professional ethics in training hospitals of Bushehr during 2015.

This was a descriptive cross-sectional study performed on 208 patients hospitalized in teaching hospitals of Bushehr selected by convenience sampling. The research instrument was a questionnaire including demographic characteristics and questions about ethics of the nursing profession. Validity and reliability of the data collection tool were approved. Data were analyzed through descriptive statistics, t-test, ANOVA and Pearson’s correlation coefficient using SPSS version 18.

The results showed that 94.6 percent of the patients evaluated the nurses’ observance of professional ethics as good, 4.4 percent as moderate and 1 percent as poor. Moreover, no significant relationship was found between the independent variables of age, gender, marital status, education level and history of hospitalization ward in the patients, and their views on nurses’ observance of professional ethics.

Cryopreserved embryos are considered as abandoned embryos in two situations. The first situation is when the embryo`s owners have no definite domicile and no written guideline has been provided by the couple regarding the embryo`s status. The second one is when the owners of cryopreserved embryos explicitly state that they permit the freezing centers to decide about their embryos` fate. The aim of the present study was to determine the best possible decisions about cryopreserved embryos in case of their abandonment by couples.

This research was conducted through library and analytical research methods.

As the cryopreservation of embryos is expensive, cryopreservation centers must be exempted from preserving embryos after unsuccessful attempts at communication with the owners and passing of reasonable time.

Making decisions about the fate of abandoned cryopreserved embryos depends on the nature we attribute to them. If we consider abandoned cryopreserved embryos as humans, it is possible to destroy them according to the rule that necessities allow prohibitions. If we consider them as properties or quasi-properties, when there is no accessibility to their owners in order to determine their fate as properties, the governor is permitted to make decisions about their disposal or donation for researches.

Despite all recent advancements in medical sciences and the related technologies, the concept of death still remains obscure. It can be asserted that as death includes both physical and spiritual dimensions, medicine alone is not capable of fully illuminating its different features. Therefore, inter-disciplinary collaboration between different branches of science such as Quranic studies, humanities, and philosophy seems necessary in order to shed some light on this hitherto undiscovered subject. Through description of what the soul experiences before and during death, such collaborations may even enrich the knowledge and broaden the minds of physicians who are capable of the analysis of physical changes caused by death. This insight can promote the ethical decision-making process as well as the provision of end-of-life care and spiritual support in different stages of death. The current research, as a library literature review, endeavors to provide a descriptive view of death from a medical perspective, and then, a Quranic depiction of its different stages through an analysis of verses and quotations from the holy Quran and Islamic scriptures whose primary focus is the process of dying. The final discussion section presents some similarities and differences observed between viewpoints and raises questions which can be considered as being of great practical importance in terms of provision of necessary end-of-life spiritual support. We hope that further research in this field can better clarify the issues raised in this article so that practical measures aiming at the provision of Quran-based spiritual end-of-life care are designed and implemented.

The Declaration of Helsinki is one of the most important international documents in medical research ethics on human subjects which has been revised 7 times and the last revision was in 2013. Researchers must be informed of the principle of Helsinki declaration and the latest changes in order to respect the rights of participants in medical research. In this study, the last version of the declaration are compared with the previous version (2008). The evaluation of the changes and challenges of the final revision can be helpful in modification of the ethical codes of our country. The 2013 version included a number of important changes; it has been categorized into more clear and detailed sections. So this version has a better structure and more practical as well. The 2013 version places more emphasis on vulnerable groups and includes a separate section on the compensation and treatment of injuries due to research. The revised version of the Declaration of Helsinki also emphasizes obtaining of the informed consent (even in researches on material or data contained in biobanks) and post-trial access.

Traditional and complementary medicine centers, as providers of health services, have a special responsibility towards patients and clients. With increase in the number of these centers, the role of traditional and complementary medicine has become more important in the analysis, diagnosis, and treatment of illnesses. The accurate and fast performance of medical approaches using evidence-based diagnostic and therapeutic procedures, with consideration of the rights, integrity, and dignity of clients are among the priorities and necessities that can have a significant impact on the satisfaction and acceptance of the scientific and legal institutions, parallel to the deployment of new services provision systems. Lack of sufficient scientific evidence of efficiency and effectiveness, lack of definition and determination of authorities to handle complaints, the legal process of ethical and legal aspects of medical errors has caused challenges for the field of complementary and alternative medicine. Thus, this legal void must be filled through formulation and revision of laws and regulations, defining of the practical and acceptable set of scientific resources, and determination of authorized service centers to resolve complaints and to punish. It is hoped that the results of this review study increase the information of the professionals in this field and attract the attention of authorities of medical ethics to this field.

Ethics of care are the central core of nursing values and a fundamental concept in the nursing profession. Since the outlook of nurses on ethics can affect the quality of care, the present study was conducted to investigate the attitude of nursing students to codes of ethics for nurses, their commitment to ethics of care, and academic dishonesty in Abadan School of Medical Sciences. 

This descriptive analytical study was performed among 150 nursing students of Abadan School of Medical Sciences by census sampling in 2016. After giving their informed consent, the students completed the questionnaire designed by McCrink in 3 sections: 1) demographic information, 2) attitude to ethics codes, commitment to ethics of care and neutralization behaviors, and 3) outlook on academic dishonesty. Data were analyzed using descriptive statics, chi-square test and Pearson’s correlation coefficient in SPSS version 21.

The results showed that the students had the most positive attitude to ethics codes and commitment to ethics of care, and the most negative attitude to neutralization behaviors. Less than half of the participants had a negative outlook on academic dishonesty. Moreover, about 40 percent of the students reported academic dishonesty among their classmates. Ethics codes are moral values in academic and clinical settings and should therefore be considered as major components of initial nursing education programs. Additionally, it seems necessary to make efforts in order to change nursing students’ attitude toward academic dishonesty.