Showing 272 results for Ethics
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.
Fariba Asadi, Maryam Donyaei , Mostafa Karimzadeh, Mahdi Heydari,
Volume 14, Issue 0 (3-2021)
Abstract
Applying the principles of professional ethics by nurses creates a suitable social and psychological environment for patients. The purpose of this study was to determine the level of nurses' awareness of the principles of professional ethics and barriers towards its observance in public hospitals in South Khorasan province in 2019.The present study was a cross-sectional study that was performed on 230 nurses in South Khorasan province by multi-stage sampling method. Data collection tools were a checklist of demographic information and a questionnaire about nurses' awareness and barriers of the principles of professional ethics. Data were analyzed by SPSS V.22 software using descriptive and inferential statistics. In this study, the mean ± SD age of participants was 32.34 ± 5.73 years. The mean score of participants' awareness was moderate level and the first obstacle to professional ethics from the perspective of nurses was the environmental domain. The most important obstacles to professional ethics were dissatisfaction from basic needs, unreasonable expectations of patients and their attendants from nursing staff and nursing staff shortages, respectively. Since nurses' awareness of the principles of professional ethics is moderate level, so holding professional ethics workshops, removing environmental barriers, and providing favorable conditions for nurses including improving the conditions of wards and increasing staff and meeting their expectations in the fields Various such as adequate rest, adequate income and planning appropriate shifts are recommended.
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.
Hosein Fasihi, Seyyed Mohammad Hoseini Souraki,
Volume 14, Issue 0 (3-2021)
Abstract
It is clear that technologies related to medicine and genetics, especially genetic engineering and eugenics, have grown significantly in recent decades. These advances have led to prevention of abnormalities and treatment of diseases. However, it seems the use of genetic engineering and eugenics and the possibility of irresponsible and profitable use of these technologies it's worrying. Hence, some moral philosophers say that to use eugenics’ methods it is morally wrong. Because the result of eugenics is injustice. In this study, while referring to the meaning and types of eugenics and related ethical issues, moral considerations to eugenics are explained and analyzed with emphasis and focus on the violation of justice and with analysis and explanation, it becomes clear that with some wise decisions, injustice caused to eugenic can be prevented or reduced.
Hadi Jalilvand, Mojtaba Abdi, Matineh Pourrahimi, Alireza Jalilvand , Dorsa Tanharo, Negin Vali, Hamed Abbasi Joshaty , Yaghoob Hassan , Somaye Norouzi , Mohaddeseh Alizadeh, Sahar Aghaee,
Volume 14, Issue 0 (3-2021)
Abstract
Human is spiritual dimensions that has legal status in health and disease. The purpose of this study was to evaluate the knowledge of nursing and midwifery students about patient rights in Iran Universities of Medical Sciences teaching hospitals’ in 2017. This study was a descriptive cross-sectional study in 2017 with convenience sampling method. Data was collected by a three-part questionnaire including demographic information, Knowledge about the Patient Rights Charter, and strategies for student information to deal with patient rights. Mann-Whitney and Spearman tests were used for data analysis. A total of 1219 undergraduate students participated in this study. The mean score of students' awareness of the Patient Rights Charter was 13.54±4.45 out of 29 points. 1007 students (82.61%) reported that education about patient right was sufficient. Direct correlation was between patient knowledge awareness score with pre-internship training (r = 0.461) and learning from instructor information (r = 0.512) and there was a negative correlation between self-education (r = -0.151) and other methods of information acquisition (r = -0.067). Given that most students did not consider the educational content taught in the field of patient rights to be effective, it can be concluded that these methods were ineffective and failed to convey the correct information. Therefore, revising of the Patient Rights Curriculum for Nursing and Midwifery students is recommended
Khadijeh Nasiriani, Mojghan Barati Kahrizsangi, Seyede Elham Fazljoo,
Volume 14, Issue 0 (3-2021)
Abstract
The ethical climate in hospitals can influence nurses' ethical decisions. In other words, in the hospital where the nurse cannot use his moral courage, the patient's rights and interests are gradually ignored. Therefore, the aim of this study was to determine the relationship between perception of ethical climate and moral courage of nurses working in hospitals affiliated to Shahid Sadoughi University of Yazd in 2019. This was a descriptive-analytical study. A total of 204 nurses working in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd were included in the study by census sampling. Data were collected using demographic questionnaire, Professional Moral Courage (PMC), and Hospital Ethical Climate Survey (HECS) and analyzed by SPSS 18 software. The results showed that the mean score of ethical climate (3.35 ± 0.62) of 5 and the mean score of moral courage was 56.37 ± 5.46 out of 75. There was no significant relationship between ethical climate and moral courage (P≥0.05). Of demographic characteristics, gender had a significant relationship with the mean score of ethical climate (<0.05), but other demographic characteristics did not have a significant relationship with ethical climate and moral courage (>0.05). Considering influence of environments supporting nurses’ moral courage on optimal care to patients, development of plans by managers to promote nurses’ moral courage can lead to beneficial effects.
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.
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.
Mojtaba Norouzi , Ali Akbar Haghdoost , Mina Mobasher,
Volume 16, Issue 1 (3-2023)
Abstract
Scientists now believe that precision medicine, which employs complicated technology and information derived from omics, can treat complex diseases and provide justice in health. Implementation of precision medicine will face new ethical challenges, considering the principles of medical ethics. With respect to philosophical principles, this study addressed the issue of justice and some ethical challenges of precision medicine. Because, in order to gain the benefits of precision medicine, a proper ethical framework must be developed while considering the challenges. The manner in which precision medicine information is shared and accessed can have an impact on people’s future careers, marriage choices, and type of health insurance. Furthermore, preserving people’s privacy and autonomy are important ethical concerns in precision medicine since there will be no perfect guarantee about data security and access. Although in the short and medium term, due to the design of studies and expensive and complex technologies, precision medicine will be limited to certain groups and will intensify the inequality in justice, in the long run, with the easy access and inexpensive cost of precision medicine technologies, the accumulation of medical expenses will decrease throughout life, and justice will be established between and within countries.
Arman Latifi, Seyyed Sadegh Hosseini, Sara Rahimi, Vahid Rahmani, Atefeh Esfandiari, Hedayat Salari,
Volume 16, Issue 1 (3-2023)
Abstract
Professional commitment is described as a set of attitudes, values, behaviors, and relationships that serve as the foundation of a health professional's contract with society. The present study was conducted with the aim of determining the attitude of medical students of Bushehr University of Medical Sciences towards professional commitment in 2022. The research population of this descriptive study included 254 students of the last 3 years of the Faculty of Medicine of Bushehr University of Medical Sciences who were included in the study by census. The standard questionnaire of attitude towards the professional commitment of doctors was used for data gathering. Data were analyzed using SPSS software version 25. Descriptive tests, Spearman's correlation test, linear regression and Mann-Whitney test were used to analyze the data. The mean and standard deviation of the age of the students participating in the study was 24.69±2.25 years. The mean and standard deviation of the attitude score towards professional commitment were 67.12±12.72 out of 100. There was a statistically significant relationship between the variables of age, academic semester and experience of participating in training courses related to professional ethics with the mean attitude score (p < 0.05), but there was no relationship between gender and the attitude score towards professional commitment. There was no statistical significance (p > 0.05). Educational centers and its professors, as the most influential force on the formation of students' morals, should revise and implement the educational program well in the field of medical professionalism, considering professional needs
Fatemeh Bahmani, Mahshad Noroozi, Narjes Kolahchi, Mostafa Ghanei,
Volume 16, Issue 1 (3-2023)
Abstract
Emerging biotechnologies contribute significantly to societal well-being by influencing social, economic, and health fields. Attitudes toward biotechnologies differ, in various situations and over time, based on new understanding and evidence. One issue always emphasized in the ethical evaluation of emerging technologies is their dangerous and problematic aspects for human life and well-being. Simultaneously, ethical assumptions can influence ethical decision-making toward employing these technologies, including liberty, technological optimism, determinism, the lifecycle, power, the form of life, technology neutrality, ambiguity, uncertainty, dual-use transformative potential, and the challenges that will be raised by them. For the ethical assessment of emerging technology, six principal methodologies are employed. The "principles-based approach" focuses on obtaining the intended goals rather than determining specific requirements, laws, standards, and obligations and avoids checklist design. The ethical principles raised by the principles-based approach are presented in this article, including risk-cost-benefit, adherence to individual rights, sustainability, naturalness, precautionary, trajectory, responsible stewardship, public beneficence, justice and fairness, democratic deliberation, and intellectual freedom.Finally, by presenting a conceptual model in applying the principles above in forming biotechnologies, eighteen operational recommendations are presented to facilitate the ethical evaluation and monitoring of emerging biotechnologies in the policy-making process in Iran.
Amirahmad Shojaee, Fazlollah Hasanvand, Hamidreza Namazi, Mojtaba Parsa, Kobra Rashidi,
Volume 16, Issue 1 (3-2023)
Abstract
Professional ethics is based on human values, tasks, rights and responsibilities and affects the professional and organizational conditions of nurses. In this regard, the aim of this study was identifying framework of the dimensions of nurses' professional ethics from the point of view their and physicians. This study was done with qualitative method, using semi-structured interview, with the participation of 26 physicians medical ethics specialist, clinical specialist, clinical assistant and intern and 20 nurses based on theoretical saturation with the purposeful sampling method and after obtaining informed consent from them. Content analysis method was used for data analysis, which was done in MAXQDA version 18 software. Findings showed professional ethics was based on a four-dimensional framework; The professional ethics of nurses in relation to the patient (six sub-components), in relation to colleagues in different job categories (four sub-components), in relation to the profession (three sub-components) and in relation to the hospital and medical organizations (two sub-components). The reliability of the coding of the components was obtained based on the Kappa index equal to 0.88. Therefore, it can be said. Framework of the dimensions professional ethics of the point of view of nurses found meaning in relation to themselves and others (patients, colleagues, organization and profession). The nurses, knowing and observing the details and nature of these communications, as well as the individual rights of these people from their own point of view; they can properly implement the principles of professional ethics in advancing the goals of the organization and increasing the quality of service provision and the satisfaction of others and raising the status of the profession.
Hossein Fasihi, Seyed Ahmad Fazeli,
Volume 16, Issue 1 (3-2023)
Abstract
This study analyzed the credibility perceptions from the perspective of Allameh Tabatabai, one of the prominent Iranian philosophers in the field of philosophy of ethics. Tabatabai emphasizes the significance of credibility based on fundamental values such as truth and justice, arguing that credibility should be rooted in these values. He also pays attention to the analysis of credibility perceptions and underscores their importance in human behaviors and decision-making. The study further delved into how individuals’ credibility perceptions are formed and highlighted the significance of grounding these perceptions on rational arguments, as well as religious and mystical experiences. Credibility perceptions play a crucial role in shaping ethical values and principles and have a direct impact on human ethical behaviors. Moreover, Tabatabai emphasizes the importance of willpower, faith, and piety in shaping human ethical behaviors, explaining that, for individuals to achieve their goals, they must possess knowledge and awareness and make decisions to perform actions based on precise knowledge. These credibility perceptions not only play a vital role in human interaction with the material world but also contribute to the formation of their ethical cognition. Finally, the study demonstrated that analyzing credibility perceptions and focusing on ethical principles and values can contribute to the establishment of suitable ethical environments required for the formation of ethical behaviors. In other words, this study considered credibility perceptions as a solution to addressing ethical challenges in societies and cultures
Mojtaba Parsa,
Volume 16, Issue 1 (3-2023)
Abstract
Physician self-referral is the referral of a patient to a medical facility in which the referring physician has a financial interest. This can take two forms: internal referrals within the same office and external referrals, often involving joint ventures. Many claims, positive or negative, have been made regarding self-referral. Proponents claim that self referral causes, reduction of costs by fostering a competitive environment, encourage investment in health facilities particularly in underserved areas, financial benefits for both the doctor and the patient via cost reduction, and inhance the quality and accessibility of health services. Conversly, opponents, citing multiple studies, argue that self- referral may result in excessive and unnecessary utilization of healthcare services, leading to increased healthcare costs, low quality of services provided, and jeopardise patient safety. In certain countries, such as the United States and the Islamic Republic of Iran, ethical codes address self-referral. These guidelines either deem it unethical or require disclosure, accompnied by regulations to govern this practice.
Mahshad Noroozi, Ehsan Shamsi Gooshki, Saeedeh Saeedi Tehrani, Fatemeh Bahmani, Mina Forouzandeh, Saeed Biroudian, Nazila Nikravan Fard, Mahshad Goharimehr, Akram Hashemi,
Volume 16, Issue 1 (3-2023)
Abstract
The research activities of developing countries have increased over the last two decades. The expansion and decentralization of ethics committees necessitates appropriate performance evaluation. In 2023, a cross-sectional study was carried out on the Iranian research ethics Committees using the checklist called "Research Ethics Committee Self-Assessment Tool". The checklist was translated into Persian and revised based on the opinions of research ethics experts and the approved “regulation of establishment, grading, and description of duties for research ethics committees”. The electronic checklist was sent to the senior members of 269 research ethics committees. After gathering the data, it was analyzed using SPSS software. The response rate was 83%. The average overall score was 152.11 ± 25.173, or 69.14% of the maximum. The two sections (including continuing review (monitoring) and committee resources received less than 50% of the average score. The 138 research ethics committee scores were excellent and 85 committees were in the good range. The findings revealed that average scores are influenced by activity years, the number of monthly meetings, the presence of an approved annual budget, an approved quality improvement program, and having specific administrative staff. Completing the self-evaluation tool can raise the National Committee authorities' awareness about the adherence of the research ethics committees to the imperative standards. It can also lead to each committee's awareness of its strengths and challenges. Revision of national regulations governing the establishment, grading, and description of committee duties and then future self-evaluation can facilitate upgrading and improving the performance of ethics committees.
Masoud Amanzadeh, Mahnaz Hamedan,
Volume 17, Issue 0 (12-2024)
Abstract
Health chatbots, powered by artificial intelligence (AI), are revolutionizing healthcare by providing accessible, personalized, and efficient health-related assistance. These tools have found applications in symptom checking, mental health support, and even aiding in clinical decision-making. While their potential to enhance healthcare efficiency is significant, the use of medical chatbots raises significant ethical considerations that must be considered and addressed. The aim of this study is to investigate the ethical challenges and considerations of health chatbots. In this article, we reviewed the literature on the ethical considerations of health chatbots. PubMed, Scopus, Web of Science, and Google Scholar were searched using related keywords such as "Chatbot," "conversational agent," "ethics," "medical," and "healthcare." Relevant studies were selected and reviewed based on specified inclusion/exclusion criteria. The review identified several ethical concerns associated with health chatbots: 1) Privacy and Data Security: Patient data collected by chatbots are vulnerable to breaches, raising concerns about confidentiality and misuse. 2) Accuracy and Reliability: Errors in chatbot responses can lead to misdiagnoses or inappropriate advice, potentially harming patients. 3) Bias and Equity: AI algorithms may perpetuate biases present in training datasets, leading to unequal care for certain demographic groups. 4) Accountability and Responsibility: Unclear legal frameworks complicate the allocation of responsibility in cases of harm. 5) Autonomy and Trust: Overreliance on chatbots may diminish the human element of care, affecting trust and patient autonomy in decision-making. While health chatbots offer substantial benefits in accessibility and efficiency, addressing their ethical challenges is imperative. A robust ethical framework emphasizing privacy, transparency, fairness, and accountability is needed to mitigate risks. Continuous monitoring, user education, and adherence to evolving AI regulations can ensure safe and equitable integration of chatbots in healthcare.
Farzaneh Mokhtary, Fatemeh Talebian, Akram Sanagoo, Leila Jouybari ,
Volume 17, Issue 0 (12-2024)
Abstract
Infantilization is a behavioral pattern where an autonomous individual is treated as a child. This behavior manifests in various forms, such as the use of inappropriate or exaggerated vocabulary, thereby disregarding the social status and dignity of the elderly. Ethics, as a branch of philosophy, guides values related to appropriate and inappropriate human behavior. This article aims to enhance our understanding of elder infantilization and consequently facilitate the avoidance of such behaviors through a thorough analysis of the concept. This concept analysis study employed Walker and Avant's eight-step approach. A comprehensive literature search was conducted, encompassing both Persian and English databases, including Magiran, SID, PubMed, Scopus, Web of Science, and Google Scholar, with no time limitations. Keywords used for evidence retrieval included "infantilization," "elderspeak," "elderly," and "older people" in both Persian and English. A total of seven selected articles were reviewed in full text, and attributes, antecedents, and consequences related to the concept of elder infantilization were extracted. Antecedents of elder infantilization include functional impairment and observable disabilities, cognitive impairment, age over 70 years, and non-age-related factors such as lower education, less credible professional backgrounds, and care provided by younger caregivers. Infantilization is more prevalent in patients with delirium and those experiencing prolonged hospital stays. Environmental factors contributing to infantilization include the use of childish decorations in elderly care facilities. Activity-related manifestations encompass the lack of elderly participation in decision-making, inappropriate grooming of elderly women, loss of privacy and independence, reprimands, punishments, confinement, suppression of sexual expression, engagement in childish games, and the use of nicknames without the elderly person's consent.Linguistic manifestations include the use of childish terms and phrases, short sentences, simplified language, slow or exaggerated speech, and addressing elderly individuals by diminutive names without their permission. Consequences of elder infantilization encompass negative impacts on behavior, well-being, personal identity, relationship formation, social interaction, diminished abstract thinking abilities, limited problem-solving skills, decreased self-esteem, and increased resistance to care in individuals with cognitive impairment. Fostering autonomy is an ethical imperative in the care of the elderly across all service-providing settings. The occurrence of infantilizing behaviors towards the elderly stems from a failure to adopt a person-centered approach to care. It is crucial to prevent such behaviors by ensuring the provision of age-appropriate services for the elderly, even when they experience physical or cognitive disabilities.
Mamak Tahmasebi,
Volume 17, Issue 0 (12-2024)
Abstract
Avoidable suffering at the end of life refers to the unnecessary pain and distress experienced by individuals with terminal illnesses—pain that can often be alleviated through effective palliative care practices. Addressing this issue is critical for improving the quality of life for both patients and their families during this challenging period. The recognition of holistic care, which considers physical, emotional, spiritual, and social needs, has fueled efforts to enhance end-of-life care to reduce suffering and uphold patients' autonomy. Numerous studies indicate that many terminally ill patients endure avoidable physical and emotional pain as they approach death, highlighting gaps in healthcare delivery. For instance, research from the National Center for Health Statistics reveals that a significant number of hospice patients report unmanaged pain despite the availability of effective interventions. Psychological distress, including anxiety and depression, is also prevalent among terminally ill patients, underscoring the need for comprehensive care that integrates mental health support. Furthermore, neglecting spiritual and social needs can leave patients feeling isolated and despairing, exacerbating their suffering. Ethical considerations in pain management at the end of life remain a subject of debate, particularly concerning the principles of beneficence and non-maleficence. The principle of double effect, which permits actions to relieve suffering even if they may unintentionally hasten death, continues to spark controversy among healthcare providers, patients, and families. Additionally, ethical dilemmas arise in advanced care planning, particularly in respecting patient autonomy while navigating complex end-of-life decisions. Addressing avoidable suffering at the end of life requires a multidisciplinary approach that honors patients' values and preferences while striving to minimize unnecessary distress. As research and clinical practices advance, healthcare systems must prioritize strategies to reduce avoidable suffering and ensure patients' dignity during their final days.
