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Showing 11 results for Healthcare
Hannan Hajimahmoudi, Farzaneh Zahedi,
Volume 6, Issue 3 (8-2013)
Volume 6, Issue 3 (8-2013)
Abstract
Justice is one of the main principles of ethics in the healthcare system, and its establishment at macro level depends on formulation of appropriate policies by policy-makers and healthcare providers. Health care policies and payment and reimbursement systems have a significant impact on health systems’ efficiency and cost control. In this paper, payment and reimbursement policies and their impact on financial incentives will be reviewed moreover, financial policies in the national health care in Iran and related challenges will be mentioned in brief. There is no doubt that none of the payment and reimbursement policies is perfect and each of them has the potential to put caregivers or health care providers financially at risk. Therefore, policy-makers should select a combination of the best approaches, considering socioeconomic factors, in order to provide a maximum coverage of health services and ensure fairness in the health system. Efficient payment and reimbursement approaches should undoubtedly preserve the rights of all parties in a fair and logical manner. Current national policy shows that a high percent of health care expenditures are financed through out-of-pocket payments, and therefore appropriate policies should be adopted to lighten this burden. Considering the accelerated trend toward the Family Doctor Plan in big cities in Iran, the present paper would be helpful for many health care providers, physicians and other health care professionals.
Hamid Moghaddasi,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
The ethical use of patient medical records by healthcare providers is fundamentally guided by the patient's right to privacy and confidentiality, enshrined in patient rights charters. Users of patient medical records are categorized as authorized (e.g., clinicians directly involved in patient care) and unauthorized (e.g., administrative staff, external entities). This categorization informs both internal and external information disclosure policies. Authorized users access patient records based on the "need to know" principle, ensuring confidentiality while adhering to internal disclosure protocols. Unauthorized users have limited access, primarily governed by external disclosure policies that restrict access to personally identifiable information.
The transition from paper-based to electronic health records (EHRs) significantly alters the ethical landscape for healthcare providers. While paper records primarily raised concerns about physical security, EHRs present unique ethical challenges in three key areas:
1. Respect for Patient Information: Proper use of patient data requires a deep understanding of the ethical implications of accessing and utilizing sensitive information.
2. Privacy and Confidentiality: Maintaining patient privacy and confidentiality in the digital age requires robust security measures and a commitment to data protection best practices.
3. Data Integrity and Accessibility: Ensuring the accuracy, completeness, and accessibility of EHR data while maintaining patient privacy presents a complex challenge.
Healthcare providers, particularly physicians and nurses with extensive EHR access, must prioritize patient privacy and data confidentiality when utilizing information technology in patient care. This includes proactively mitigating threats to data security and adhering to strict ethical guidelines for data access and use.
The transition from paper-based to electronic health records (EHRs) significantly alters the ethical landscape for healthcare providers. While paper records primarily raised concerns about physical security, EHRs present unique ethical challenges in three key areas:
1. Respect for Patient Information: Proper use of patient data requires a deep understanding of the ethical implications of accessing and utilizing sensitive information.
2. Privacy and Confidentiality: Maintaining patient privacy and confidentiality in the digital age requires robust security measures and a commitment to data protection best practices.
3. Data Integrity and Accessibility: Ensuring the accuracy, completeness, and accessibility of EHR data while maintaining patient privacy presents a complex challenge.
Healthcare providers, particularly physicians and nurses with extensive EHR access, must prioritize patient privacy and data confidentiality when utilizing information technology in patient care. This includes proactively mitigating threats to data security and adhering to strict ethical guidelines for data access and use.
Mohammad Shojaeinia ,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
Artificial Intelligence (AI) represents a transformative and innovative approach in healthcare with the potential to revolutionize diagnostic, therapeutic, administrative, educational, research, and managerial processes. Given that AI systems influence reasoning, decision-making, and the delivery of care, their implementation faces challenges, particularly ethical considerations rooted in the unique nature of the healthcare system—where patient welfare, trust, and the autonomy of healthcare providers hold paramount importance. This study adopts a qualitative approach. Various information sources, including journals, articles, and publications, were reviewed. The applications of AI in clinical environments and its impact on individuals' interactions with healthcare systems, decision-making processes, and clinical workflows were analyzed, and relevant ethical considerations were extracted. The results indicate that the integration of AI in healthcare, despite its extensive benefits in prevention, diagnosis, treatment, prediction, decision-making, process automation, medication and therapeutic recommendations, surgical guidance, personalized medicine, telemedicine systems, and numerous other applications, is accompanied by a set of ethical considerations. Addressing these considerations is crucial to ensure the responsible and equitable use of these technologies. These include concerns related to patient privacy and data security, biases in AI systems, transparency, explainability, interpretability, accountability, informed consent, impacts on the relationships between healthcare providers and patients, equitable access to AI benefits, the appropriate and judicious use of technology, ethical use of automation, preservation of human dignity, effective oversight and regulation, legal and legislative issues, and long-term implications such as preventing misuse of predictive data by insurers or employers, among other patient rights-related issues. The utilization of AI in healthcare necessitates the development of ethical and legal frameworks that balance technological innovation with the humanistic principles underpinning healthcare systems. This ensures that while leveraging the advantages of AI, privacy, justice, equity, and human dignity are safeguarded. Emphasis on continuous monitoring and aligning AI-based systems with human values can foster trust in these technologies, ensuring that AI is used responsibly and adheres to ethical standards, ultimately serving to enhance public health outcomes responsibly and equitably.
Jalal Saeidpour, Alireza Hajizadeh,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
As one of the countries with the fastest growing aging population, it is predicted that more than 20% of the Iran’s total population will be elderly in 2040. It is important to address ethical considerations in providing healthcare services to aged population. This study aimed to review the evidence related to ethical considerations in providing healthcare services to the elderly in Iran. This study was a scoping review conducted using the six-step protocol of Arksey and O’Malley. The English-language, Persian-language databases and Google Scholar, were searched without time limitation. After selecting studies and extraction the data, the narrative analysis was used to analyze the data. Providing comprehensive healthcare including, preventive, diagnostic, treatment, and rehabilitation services to the elderly needs to be based on humane-Islamic principles and values accepted by society. The most important ethical considerations required are: Maintaining the dignity and eminence of the elderly in all situations, considering ethics in communication with the elderly, ensuring autonomy and independence of the elderly in relevant decision-making, paying attention to the principles of justice and benefit in healthcare interventions, empathy and cheerfulness among healthcare providers, ensuring confidentiality and privacy and protecting information, paying attention to privacy, obtaining informed consent in healthcare centers, paying attention to religious and Islamic rules in caring for the elderly, the responsibility of government and non-government institutions in preventing stigma and discrimination against the elderly, carrying out timely and ethically-based care actions, healthcare providers' adherence to teamwork and scientific and professional behaviors, supporting the elderly as a vulnerable population group in prioritizing health services, preventing conflicts of interest in elderly care, and using safe, affordable, reliable, and evidence-based healthcare services for the elderly. It is necessary to pay attention to the ethical considerations identified in this study in providing healthcare services to the elderly. So, it is recommended that policymakers, managers, and healthcare providers take actions at the levels of the ministry of health, medical universities, and healthcare centers providing services to the elderly to promote humane-Islamic principles and values.
Reza Negarandeh ,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
Patient advocacy is a cornerstone of ethical healthcare practice, encompassing actions that protect patient rights, uphold their autonomy, and ensure they receive high-quality care. Nurses are often seen as being in the best position to play this vital role. This conference abstract aims to provide a comprehensive understanding of patient advocacy and identify strategies for enhancing advocacy practices in healthcare settings. In this comprehensive review, scientific literature, including peer-reviewed articles, professional guidelines, and relevant policies, was retrieved and reviewed. Data extracted from the literature were synthesized using quantitative content analysis to identify different forms of patient advocacy, including clinical advocacy and systemic or workplace advocacy, as well as strategies to improve the necessary skills for each. Clinical advocacy involves ensuring patient safety, supporting informed decision-making, and advocating for appropriate pain management. Improving clinical advocacy requires a multifaceted approach that prioritizes building trust and rapport with patients to foster effective communication and shared decision-making. Encouraging patient participation in their care, supporting self-management strategies, fostering effective communication within the healthcare team, and staying informed about relevant ethical, legal, and policy developments are essential components. Workplace or systemic advocacy, on the other hand, focuses on addressing broader issues within the healthcare system that impact patient care. Improving systemic advocacy involves identifying and analyzing systemic issues, such as healthcare disparities, resource limitations, and policy barriers, through data collection, stakeholder engagement, and thorough analysis. Strategies to address these issues include policy advocacy, improved resource allocation, and quality improvement initiatives. Building strong partnerships with other healthcare professionals, community organizations, and policymakers is key. Additionally, promoting education and awareness within both the healthcare workforce and the public is crucial. Leveraging technology to enhance data collection, communication, and mobilization efforts can further support systemic advocacy initiatives. By implementing these strategies, healthcare professionals can effectively advocate for systemic change, improve the quality of care for all patients, and create a more equitable healthcare system. Patient advocacy is a dynamic and multifaceted role that requires continuous learning and adaptation. By embracing the principles outlined in this synthesis, nurses can effectively champion patient rights, improve the quality of care, and contribute to a more equitable healthcare system.
Azam Khorshidian,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
Nurses are committed to protecting the rights of their patients. However, significant challenges often arise in their communication with physicians and patients. In some situations, nurses feel that patient autonomy is not respected, and sufficient, appropriate information is not provided to patients and their families. These challenges are particularly pronounced in pediatric nursing, as children often cannot fully express their needs. Pediatric nurses must be especially sensitive to the vulnerability of children and their families, actively supporting their welfare and best interests. When a child is suffering from a serious illness or nearing the end of life, the ethical challenges become even more complex. Some of these challenges include:
- How should healthcare decisions be made for these children?
- Who should make these decisions?
- How is the best interest of these children determined?
- Who can best advocate for children's rights?
- When treatment involves life-sustaining therapies (LST), is preserving life more important than ensuring quality of life?
- Who has the authority to transition from therapeutic or life-sustaining interventions to palliative care?
To address these challenges, nursing associations in various countries have developed ethical charters. However, no universal consensus or definitive solutions exist for navigating these complex clinical situations. Consulting experts across different fields and developing comprehensive professional ethics codes can serve as valuable guidance for pediatric nurses making ethical decisions in cases of serious illness.
Hanieh Karimi, Ali Farahmand Asil, Saeedeh Saeedi Tehrani,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
Trust between doctors and patients is a cornerstone of improved health outcomes and quality medical care. However, this trust has eroded in recent decades due to various factors. The global crisis of the COVID-19 pandemic presents a unique opportunity to examine and analyze changes in public trust towards the healthcare system. This narrative review explores the state of public trust in healthcare before and after the COVID-19 pandemic, analyzing the factors influencing this trust and proposing strategies for its maintenance and rebuilding. A narrative review was conducted, with information gathered from searches in reputable national and international scientific databases like PubMed, ScienceDirect, Springer, and Scopus. Relevant articles from Iranian databases such as Magiran and IranMedex were also included. The review focused on the components of trust, factors affecting it, and challenges faced by the healthcare system during the pandemic. The review revealed significant changes in the components of trust in doctor-patient relationships due to the COVID-19 pandemic. Prior to the pandemic, public trust in physicians had been declining due to factors such as perceived inequities in treatment, medical errors, and unprofessional behavior by some healthcare professionals. For example, surveys indicate a decline in public trust in healthcare professionals in the United States, dropping from 73% in 1966 to 34% in 2012. The COVID-19 pandemic significantly exacerbated this decline, with many people distrusting governmental institutions, pharmaceutical companies, and media outlets perceived to be providing misleading information. A study in Poland found that 31% of respondents viewed the pandemic as an exaggerated threat, while 3% considered it entirely fictional. However, the dedicated service and transparent communication of some institutions and healthcare personnel during the COVID-19 crisis partially restored public trust. This led to the emergence of a concept known as "dual trust," where people not only trust individual physicians but also pay closer attention to the overall performance of the healthcare system and governments. Dual trust has implications not only for the quality of healthcare services but also for the success of prevention and treatment programs. The COVID-19 crisis has had a profound impact on public trust in the healthcare system. To maintain and rebuild this trust, effective measures are essential. These measures should focus on enhancing service quality, fostering scientifically informed citizens, ensuring transparent communication, and promoting positive interactions between doctors and patients.
Mehran Saadatmand, Abolfazl Ghani Honar,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
Promoting an ethical culture is crucial for ensuring job commitment and competent clinical care among nurses. Ethical culture encompasses shared understandings and perceptions that guide ethical conduct within an organization. Job commitment reflects an individual's psychological and emotional attachment to their job. This study aimed to investigate the relationship between ethical culture and job commitment among nurses working in educational and medical centers affiliated with Hamadan University of Medical Sciences. This descriptive correlational study included 170 nurses selected from teaching hospitals in Hamadan using the Morgan table and based on inclusion criteria. Data were collected using demographic questionnaires, the Gobel et al. Ethical Culture Questionnaire, and the Schaufeli Job Commitment Questionnaire. Data analysis was performed using SPSS version 22 software. A significant and positive correlation was found between ethical culture and nurses' job commitment (r=0.42, p<0.05). Ethical culture was significantly higher among nurses with more work experience and female nurses compared to their counterparts. Additionally, job commitment was significantly higher among male nurses and those with formal employment status. The findings demonstrate a strong positive correlation between ethical culture and job commitment among nurses. Enhancing ethical culture within healthcare settings through effective leadership, clear ethical guidelines, and open communication channels can significantly improve job satisfaction and, ultimately, patient care. Further research is needed to explore the specific factors that contribute to ethical culture within different healthcare contexts.
Hooman Heydary, Shakila Belkafeh, Mohammadreza Dinmohammadi,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
Telehealth has emerged as a rapidly expanding method for delivering healthcare services, especially during the COVID-19 pandemic. This approach has opened new avenues for accessing medical care and contributed to reducing healthcare costs. However, the growth of telehealth has introduced significant legal and ethical challenges that warrant thorough investigation. This review study employed keywords such as "telemedicine," "telehealth," "ethical challenges," "legal challenges," and "healthcare system" to search scientific databases including PubMed, Scopus, CINAHL, and Google Scholar. Articles published in English and Persian between 2010 and 2024 were reviewed. Eligible sources included research articles, systematic reviews, and case reports focusing on legal and ethical issues related to telehealth. Following an initial screening, articles were assessed based on quality and scientific credibility, and the selected works were analyzed for the final synthesis. Telehealth presents several critical challenges that must be addressed to ensure safe and equitable care delivery. One of the foremost concerns is patient privacy and data protection; the exchange of sensitive health information necessitates robust security protocols and adherence to data protection regulations to uphold patient confidentiality and trust. Another key issue is informed consent, which must be adapted to the virtual context to ensure patients are adequately informed of both the benefits and potential risks associated with telehealth services. While telehealth enhances healthcare accessibility, it may also deepen existing health disparities due to unequal access to digital technologies. Therefore, investments in communication infrastructure and digital literacy are essential to promote inclusivity and equal access to care. Although telehealth offers substantial benefits—including improved access, convenience, and enhanced coordination of care—its legal and ethical implications must not be overlooked. To fully realize its potential, stakeholders must collaborate in developing comprehensive regulations and ethical frameworks. Addressing these challenges is imperative to advancing telehealth in a manner that ensures patient safety, protects rights, and promotes health equity.
Peyman Parvizrad,
Volume 17, Issue 0 (12-2024)
Volume 17, Issue 0 (12-2024)
Abstract
Healthcare policy-making and national planning are complex processes that require the integration of ethical principles to ensure fairness, effectiveness, and public trust. This qualitative study explores the key ethical considerations that should guide the development and implementation of healthcare policies and plans. A qualitative research design was utilized, incorporating semi-structured interviews with key stakeholders in the healthcare sector, including policymakers, healthcare providers, and patient representatives. A total of 15 interviews were conducted until data saturation was achieved. The interviews were transcribed verbatim and analyzed using thematic analysis. Thematic analysis identified seven key ethical considerations in healthcare policy-making and planning: (1) Equity and Justice – ensuring equitable access to healthcare regardless of socioeconomic status, race, or other demographic factors; (2) Autonomy and Informed Consent – respecting individual autonomy and ensuring informed decision-making in healthcare interventions; (3) Beneficence – prioritizing actions that maximize benefits and minimize harm; (4) Non-Maleficence – preventing harm to patients and communities; (5) Confidentiality and Privacy – safeguarding patient information and ensuring data protection; (6) Resource Allocation – making fair and justifiable decisions regarding the distribution of limited healthcare resources; and (7) Transparency and Accountability – promoting openness in policy decisions and ensuring accountability for outcomes. Ethical considerations play a critical role in shaping healthcare policies and national planning efforts. By integrating ethical principles into decision-making, policymakers and healthcare providers can foster policies that enhance public well-being, equity, and trust in the healthcare system. A structured ethical framework can help ensure that healthcare policies align with societal values and promote justice in health service delivery.
Sooreh Khaki, Masoud Fallahi -Khoshknab, Farahnaz Mohammadi-Shahboulaghi, Gülbeyaz Can, Mohammad Ali Hosseini,
Volume 17, Issue 1 (3-2024)
Volume 17, Issue 1 (3-2024)
Abstract
Conveying bad news to patients and their families is a process that requires team collaboration. Different countries have taken into consideration providing suitable solutions. This study aimed to develop an practical guideline, according to the experiences of patients, families, and healthcare providers in intensive care units across three phases. In the first phase, in-depth interviews were conducted with 31 participants selected through purposive sampling, and the initial draft of the practical guideline was created. In the second phase, the initial draft was discussed and reviewed by experts in two focus group meetings, and a secondary draft was developed. In the third phase, the practical guideline compiled by the Delphi method was validated by 43 experts in policymaking and decision-making. Finally, an practical guideline to deliver bad news to patients and their families was developed with 8 main steps and 43 sub-steps. The main steps included before delivering bad news (assessment, planning and preparation, coordination), during delivering bad news (announcing bad news, emotional support, summary and documentation), and after delivering bad news (referral, follow-up). This practical guideline is intended to facilitate the process of delivering bad news in intensive care units to achieve the desired outcomes and reduce the resulting consequences and harms. Accordingly, healthcare providers are recommended to consider the importance of patient and family preferences, adhering to scientific and standard methods for delivering bad news, and upholding the principles of professional ethics.
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