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Showing 12 results for Conflict
Legal challenges in medical ethics
Alireza Milanifar ,
Volume 4, Issue 3 (5-2011)
Abstract
Illnesses and their treatment, pharmacy and pharmacology, medical equipment, hygiene and health related topics, health economics, preventative measures, lab equipment and supplies, human resource service delivery models, education and training of health care professional, and associated areas of law are collectively referred to as the health care system. At times it is even difficult to separate health care from social injuries and civil conditions, since these can pose direct or indirect threats to individuals’ health. As health policy makers, managers and professionals demand and encourage the observance of ethical considerations in providing health care, neglect of the legal aspect of the health care system can bring about unethical phenomena that necessitate legal measures. The present paper aimed to determine whether the general traditional legal classifications, that is, jurisdiction and sovereignty, apply to the health care system, and if so, which of the two it falls under. What further highlights the significance of answers to such questions is the fact that they are closely connected to regulations of the health care system. It could well be that some companies in the health industry have a negative effect on the ethical conduct of physicians and other health care professionals, as due to their commercial nature and structure, these companies are dominated by rules of business, and this exerts limitations on their observance of ethical considerations. This study investigated a number of such seemingly legitimate situations and the problems associated with them, hoping to eliminate legal conflicts and promote ethics in the process of providing health care in the society.
Assessing conflict of interest in Iran’s health legal system
Alireza Milanifar, Mohammad Mehdi Akhondi, Parvaneh Paykarzadeh, Bagher Larijani,
Volume 5, Issue 1 (12-2011)
Abstract

Conflict of interest is a real situation in which a person as a decision maker simultaneously has two positions, one in private and the other in the public. In public role he or she has to pay attention to the society`s best interests and follows his or her best ones as private role. Conflict of interest is a common challenge of health system among both real and legal persons in all courses such as education, treatment, and researches.
The most causes of conflict of interest are named as deferent goals, lack of resources, authorities malfunction, health marketing and etc.
We aimed at discussing conflict of interest and its relation to law, its management, conflict of interest in pharmacy and pharmaceutical companies and also Iranian legal system viewpoint. In conclusion it seems that conflict of interest should be included in the law and the provisions to achieve the least conflict of interests in health system should be revised.


Conceptual analysis of moral dilemmas
Mohsen Bahrami, Ahad Faramarz Gharamaleki ,
Volume 5, Issue 2 (4-2012)
Abstract
In this paper, different definitions of moral conflict and moral dilemma at two levels of recognition and observing moral duties are taken into consideration and some instances of usage of conflict in physiology (conflict of stimulant and goals) and sociology(conflict of roles and norms)are mentioned. Also concepts and constraints used in the moral dilemma, especially the concept of "ought to" and the concept of "Inescapable of wrongdoing" are surveyed in a logical analysis. If in definition of moral dilemma, the concept of “ought to” and “duties” being transformable to “commensurable reasons” and their justificatory values, many of apparent moral dilemmas will be solvable and only if the values contained in the duties, being incommensurable and non-infringement, moral wrongdoing will be inevitable. In this research, it will become clear that why and how proponents of the possibility of moral dilemmas under pressure of logical argument against the possibility of moral dilemmas and criticisms of opponents, in order to provide the necessary features for a genuine dilemma have suggested variety and supplementary definitions of moral dilemmas such as: natural, disjunctive, two shape and prohibition definitions. Natural definition of moral dilemma represents a situation in which the agent sees himself as both a moral duty, while he can't do it well. In disjunctive definition agent is required to perform either task. In two shape definition (consisting of the "ought to" and "ought not to"), on the one hand the agent ought to do and on the other hand ought not to do the same. In prohibition definition, the agent should not perform any of the two while he has no choice but to do one.
Effectiveness of the negotiating style on ICU nurses’ moral conflict in selected hospitals of Guilan University of Medical Sciences
Fatemeh Jahandar, Jamoleh Mohtashami, Foorozan Atashzadeh -Shorideh, Seyed Amir Hosein Pishgooie,
Volume 9, Issue 1 (5-2016)
Abstract

Nowadays nurses are faced with numerous complex moral conflicts. As a result, doing what one nurse considers as proper can prove contrary to the values and beliefs of other health care providers. The present study was performed to investigate the efficacy of the negotiating style for reducing the severity of moral conflicts in ICU nurses in selected hospitals of Guilan University of Medical Sciences.

This was a semi-experimental single group study with before and after design. For this purpose, 45 nurses working at ICU Wards of Guilan University of Medical Sciences were selected. Data were collected using the Ethical Conflict in Nursing Questionnaire by Falco-Pegueroles (2013). The questionnaire was first completed by each participant. Consequently, a negotiation style educational workshop was held for the nurses with an average or high score. After 8 weeks of intervention, the questionnaire was distributed among the participants one more time. The results were analyzed using SPSS software version 20, t-test and ANOVA to compare the severity of moral conflict in the samples before and after the intervention.

The average severity of the nurses’ moral conflict before the workshop was 53.22. The mean reduction of the severity of moral conflict was 17.66 after 8 weeks, and the difference was statistically significant (P < 0.05).  The results indicated a decrease in the severity of the nurses’ moral conflict following the intervention. Based on the findings of the research, the negotiating style is recommended for the purpose of reducing the severity of moral conflict in ICU nurses. 


The relationship between work-family conflict and work ethics with mediating role of job stress in nurses
Shahriar Dargah, Mojtaba Haghani Zemydani, Hossein Ghamari Givi, Mostafa Ghalavand,
Volume 10, Issue 0 (3-2017)
Abstract
Due to the great importance that the nurses health and job engagement have in the health of their, colleagues and patients, this study aimed to investigate the the relationship between work-family conflict and work ethics with mediating role of job stress in nurses. The design of this study was descriptive and correlation cross-sectional design. The study population included all male and female nurses working in hospitals and clinics in the Gachsaran city during 2016-2017 . To select participants, cluster sampling method was used. A total 150 nurses were selected. To collect information from the Carlson et al work - family conflict questionnaire, work ethics questionnaire of Gregory. C. Petty (1990) and revised French et al. nursing stress scale was used. The results showed that there is a negative significant correlation between job stress with work ethic (P<0.01). Also, there was a negative significant correlation between the work-family conflict with work ethics (P<0.05). In addition, this study showed that job stress plays mediating role between work-family conflict and work ethics in nurses. In general, the interaction between family and work issues influence nurces' performance. As family and work interactions and job stress are predictors of work ethics of nurses. Education about managing and improving quality of nurses' marital and family life and training the stress management can improve nurses' work ethics.
The Conflict of Interest in Pharmacy Practice
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
 

Conflict of Interest in Dentistry
Mojtaba Parsa, Azam Khorshidian,
Volume 10, Issue 0 (3-2017)
Abstract
The emergence of different types of economic relations and the desire of professionals to earn more income has led to new challenges such as conflicts of interest in the dental profession. The community expects dentists to prioritize the health and the interests of their patients in their professional activities. In this regard, one of the most important dilemmas is the confrontation between the professional duties of dentists and their profit. Business goals being preferred rather than providing specialized knowledge services by dentist is a major concern, which can lead to patients’ distrust. Fee splitting, Self-referral, receiving gifts from the patient and industrial companies are among the most significant type of conflicts of interest in the profession, which are discussed in this article in the form of four clinical cases.

Comparison of the Moral Conflict of Pre-Hospital Emergency Personnel with Nurses of ophthalmology departments in Isfahan Ophthalmology Hospitals in 2017
Morad Momivand, Arash Ghodousi, Neda Yavari,
Volume 11, Issue 0 (3-2018)
Abstract
Professional nurse should be familiar with the principles of biomedical ethics and how to deal with situations of moral conflict. Nurses encounter a variety of ethical conflicts in their work environments, which, if not properly educated for that, may be destructive. One of the first steps to recognize and help resolve moral conflicts seems to be a better understanding of the underlying causes of these conflicts. For this purpose, this study compared the exposure of pre-hospital emergency staff and nurses of the ophthalmologic departments in Isfahan with ethical conflicts in their careers. This descriptive-analytic study was performed on 44 pre-hospital emergency personnel and 42 nurses in ophthalmic and postgraduate degrees. Data were collected using Falco's moral conflict questionnaire. The results were analyzed using descriptive statistics such as frequency distribution tables, dispersion indexes, and mean and analytical statistics such as T test and ANOVA. Data were analyzed using SPSS software version 8. The results of this study showed that the prevalence of ethical conflicts among pre-hospital emergency personnel with a mean of 61.65 was higher than nurses in ophthalmic departments with an average of 40.23. Therefore, according to the results of this study, the degree of exposure to ethical conflict situations for pre-hospital emergency personnel more common in comparison with the staff of the elective hospital units in more stressful situations. The degree of exposure to ethical conflict situations is also more significant for pre-hospital emergency personnel than nurses in the ophthalmic departments.

Ethical Review of Physicians' Self Referral
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.
Defenders without a Defense: Factors Associated with Ethical Conflict in the Context of Nursing Care
Ebrahim Falahati, Mousa Alavi, Mohsen Shahriari,
Volume 17, Issue 0 (12-2024)
Abstract
While ethical conflict is an internal and individual experience, it is significantly influenced by environmental factors and variables. It describes a situation characterized by a discrepancy or conflict between the ethical values of caregivers, between caregivers and patients, or within the individual caregiver regarding the morally right course of action, often leading to ambiguity regarding duties and obligations. This research aimed to elucidate the factors associated with ethical conflict within the nursing context. This qualitative study employed conventional content analysis. Participants included 27 nurses working in various clinical departments, including emergency, intensive care, internal medicine, and surgery. Data were collected through in-depth semi-structured individual interviews conducted after obtaining written informed consent. Data analysis was performed using MAXQDA version 20 software, adhering to Granheim and Lundman's approach. To enhance the rigor of the study, the criteria of credibility, confirmability, dependability, and transferability proposed by Lincoln and Guba were applied. Decision-making challenges within the context of care emerged as a central theme. Several factors were identified as contributing to ethical conflict in nursing care, including disrupted relationships, inefficient management systems, physician prioritization, conflicts of interest, legal constraints, a negative ethical climate, and insufficient resources. Nurses, as primary patient advocates, are consistently exposed to various ethical conflicts within their practice. This study highlights the critical importance of addressing decision-making challenges within the context of care for policymakers within the healthcare system. Reducing these conflicts is crucial for improving the quality of nursing care.

Financial Relationships and Conflicts of Interest Between Physicians and Patients: Guideline to Professional Ethics for Medical Practitioners, Medical Council of Islamic Republic of Iran
Saeed Biroudian,
Volume 17, Issue 0 (12-2024)
Abstract
Conflicts of interest, particularly financial ones, pose a significant ethical challenge in the medical field. They can compromise clinical decision-making, erode patient trust, and ultimately diminish the quality of healthcare. This study reviewed ethical documents and guidelines published by the Medical Council of the Islamic Republic of Iran, including the Charter of Rights for the Medical Community. A comprehensive review of relevant scientific literature on conflicts of interest in healthcare was also conducted. The analysis revealed that financial relationships between physicians and external entities, such as pharmaceutical companies, can create conflicts of interest that negatively impact patient care. These conflicts can erode patient trust and lead to suboptimal clinical decisions. The Medical Council's ethical guidelines address these concerns by emphasizing the importance of transparency regarding financial ties and relationships. They advocate for the disclosure of such relationships to patients and the implementation of educational programs to enhance physician awareness of ethical principles and conflict-of-interest management strategies. Adherence to the ethical guidelines established by the Medical Council of Iran is crucial for effectively managing conflicts of interest in the physician-patient relationship. By prioritizing transparency, disclosure, and ongoing education, healthcare professionals can mitigate potential conflicts and maintain the highest standards of ethical conduct in patient care.

Conflict of Interest in Research
Shiva Khaleghparast, Samaneh Karimian,
Volume 17, Issue 0 (12-2024)
Abstract
Conflict of interest refers to situations in which professional judgment or actions related to a primary interest are unduly influenced by secondary interests. In scientific communication, such conflicts can compromise professional decision-making and threaten the integrity of research outcomes. As educational, research, and clinical activities in the medical field expand, the prevalence of conflicts of interest across healthcare domains has increased. Despite the efforts of organizations such as the International Committee of Medical Journal Editors and the Committee on Publication Ethics, which have established guidelines for conflict of interest disclosure, there remains a significant gap in awareness and understanding among researchers. This highlights the urgent need for increased attention to this issue. The UK National Research Ethics Advisory Panel defines conflict of interest as situations where professional judgment concerning a primary interest, such as patient welfare or the credibility of research, is improperly influenced by a secondary interest, such as financial gain. In clinical research, therapeutic studies primarily aim to validate the safety and efficacy of new drugs or devices. This goal should take precedence over secondary concerns, such as economic benefits derived from pharmaceutical production. Good Clinical Practice (GCP) guidelines and the International Conference on Harmonization (ICH) stress that researchers have primary responsibility for the health and medical care of participants. Therefore, any conflict of interest represents a significant risk to participants, potentially compromising their welfare. To safeguard scientific integrity, institutions must enforce policies that uphold ethical principles, require researchers to disclose conflicts of interest to ethics committees, and implement measures to mitigate associated risks. Identifying and managing conflicts of interest based on their potential impact is crucial to preserving the credibility of clinical research. Members of ethics committees, like researchers, must disclose their conflicts of interest, as they significantly influence study processes. Transparency in research funding is essential to minimizing bias and managing conflicts of interest. Effective strategies for addressing conflicts of interest include the development of comprehensive policies and guidelines, the maintenance of an electronic database for conflict disclosure, and the promotion of regular training for ethics committee members and researchers on managing such conflicts. Collaborative learning initiatives and the ongoing refinement of institutional policies further enhance the management of conflicts of interest, ensuring the integrity of scientific research.

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