Showing 12 results for Icu
Ali Paya,
Volume 1, Issue 1 (7-2008)
Abstract
Philosophers of ethics and those who are involved in the debates concerning Medical Ethics have discussed the issue of human dignity and its cluster of meaning from different angles and have suggested many interesting points in this respect. However, a cursory glance at the published works in this field reveals that most of those writers who have contributed to this issue have either based their arguments on notions such as rights or justice, or have used theological doctrines, or have conducted their debates within the frameworks of pragmatic or particularistic ethics. In the present paper, I shall approach the issue from a new viewpoint which is mostly inspired and informed by the ideas of some analytic philosophers.
The main argument of the paper revolves around the pivotal notion of “value of life”. All those who take positions vis-à-vis stem-cell researches and the morality or otherwise of using embryos for such investigations, or those who form opinions concerning the ethicality or otherwise of abortion, or those who try to find satisfactory solutions for the vexing issue of the allocation of limited medical resources, maintain, at least in an intuitive way, that the life of a human organism, in whatever shape or form, has intrinsic value. The life of such an organism whether it is a newly conceived egg or an embryo ready to be implanted in the womb or a foetus whose neurological system has just emerged, or a morally fallen adult, is intrinsically valuable.
The idea that some things or events are valuable in themselves, namely, we respect them not because they serve our interests but because they are intrinsically valuable, is a familiar intuition. We have developed this ‘intuition’ through our long existential experiences. Now if we reflect upon this very intuition we will be able to discover further layers of meaning in it. For example, we realize that from the belief that ‘human’s life is intrinsically valuable’ one cannot conclude that one should multiply human life as much as possible. On the contrary, some of our other intuitions would inform us that at least some parts of the world would be better off if less populated than crowded. Thus the question arises that if the intrinsic value of human life does not mean its multiplication, then how the continuation of human life, once it has appeared, can have intrinsic value? In the present paper I shall try to use the apparatus of analytic philosophy to explore the ways of reconciliation between the two seemingly contradictory notions of ‘the intrinsic value of life’ and ‘the morality of sacrificing life under particular circumstances’.
Morteza Khaghanizadeh, Hasn Maleki, Mahmood Abbasi, Abbas Abbasi Pour, Mahdi Mesri,
Volume 5, Issue 2 (4-2012)
Abstract
Medical ethics is an interdisciplinary knowledge which increasingly developed during the last 30 years, and nowadays it becomes a part of medical student’s curriculum. Although, the quality of medical education has improved in Iran, but medical ethics teaching has not accomplished effective alteration yet. For deeper and more actual recognition of the challenges of medical ethics curriculum, we interviewed medical ethics instructors in a qualitative study. The data was collected by semi-structured interview with fourteen medical ethics instructors of Tehran University of Medical Sciences in 1389 and analyzed by Mairing content analyzing approach. Results of this study shows weaknesses and challenges in medical ethics curriculum which presented under five themes: comprehensiveness of goals, composing organization, proportion of content, active teaching method, and comprehensive system of evaluation. According to this the existing weaknesses and challenges of medical ethics curriculum can be considered as important obstacles in moral development of students. Considering those challenges, can develop medical ethics curriculum and introduce new models for medical ethics teaching.
Forozan Atashzadeh Shorideh, Tahereh Ashktorab, Farideh Yaghmaei, Hamid Alavimajd,
Volume 5, Issue 7 (2-2013)
Abstract
Moral distress is one of ICU nurses' major problems that can happen due to various reasons and may have several consequences. Considering that certain variables can be related to moral distress and turnover intention in nurses, this study was done to determine the correlation between ICU nurses' demographic characteristics and their moral distress and turnover. In this correlational study, 159 ICU nurses were selected from medical universities of Iran. Data collection instruments included a demographic questionnaire, ICU nurses' moral distress scale, and Hinshaw and Atwood's turnover scale. Data analysis was done by using SPSS 17. The findings showed high level of moral distress and turnover in ICU nurses. The results revealed a positive statistical correlation among ICU nurses' age, their work experience, the ratio of nurses to ICU beds and their moral distress. However, there was no correlation among sex, marital status, educational degree, work shift and moral distress. Similarly, moral distress and intent to turnover did not have a statistical correlation.The results showed that increasing recruitment of young nurses and nursing staff, and diminishing ICU nurses' moral distress and turnover intention are essential.
Manijeh Seresht, Ahmad Izadi,
Volume 6, Issue 4 (10-2013)
Abstract
Breaking bad news emotionally affects both health professionals and patients. Breaking bad news is a sensitive issue for both health care providers and patients. It is generally believed that the patient’s adjustment can be affected by either a positive or a negative experience in this respect. This study aims to determine health care providers’ attitudes toward breaking bad news to parents in NICU and labor wards.This cross-sectional study was conducted in Shahrecord in 2011 with a study sample of 70 health care providers drawn from neonatal intensive care units and labor wards and the department of nursing and midwifery who had had at least one year’s clinical experience. The sampling method was census. Data were collected through a self-administered questionnaire in two sections: demographic information and health care providers’ attitudes toward breaking bad news. Data were analyzed by SPSS software with descriptive and Chi-square and T-student test statistics.
Most participants (63.2%) had a positive attitude toward disclosing bad news to parents. 77.6% of caregivers faced difficulties in delivering bad news to parents, 92.6% of them believed that training workshops in this field are necessary. There was a significant statistical relationship between the attitudes of the health care providers and their education level and work place (P < 0.0001). Health professionals with higher education levels and nursing and midwifery staff had more positive attitudes.There was no significant statistical relationship between the attitudes of the health care providers and their history of difficulties in transferring bad news, workshop trainings, work experience, gender, age and marital status (P > 0.05). The majority of health professionals had a negative attitude toward immediate disclosure of bad news to parents, mothers holding and seeing their deceased babies, dedicating a special room to perinatal loss mothers with similar problems, and preventing other patients and their families from contacting them.Based on the findings of this study, teaching bad news communication skills to personnel of NICU and labor wards should receive prioritization in future continuing medical education programs in order to best prepare the staff for disclosure of bad news to parents.
Sakineh Mohebbi Amin, Mehdi Rabiei, Amir Hossein Keizoori,
Volume 8, Issue 3 (9-2015)
Abstract
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.
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.
Saeid Nazari Tavakkoli, Mohammadreza Hajiesmaeili , Omidvar Rezaei Mirghaed , Saeedeh Nateghinia,
Volume 12, Issue 0 (3-2019)
Abstract
A study on the adaptability of the patient's admission process with ethical standards has a significant role in reducing the misconduct of the medical staff and increasing the satisfaction of patients. Hence, by the study of the patient's admission process in the Neurosurgery ICU and the identification of its personnel faults; we are going to provide a platform for excellent service to patients. This study is a qualitative study. It had done with the In-depth interviewing with 28 staff of the Neurosurgery ICU of Loghman Hospital during the winter of 1396 (December2017- March 2018). The data is collected and analyzed with triple coding: open, selective, and axial. "The lack of ethical sensitivity to nursing profession and its importance" is a general tag for seven categories of functional status of ICU staff: the use of staff with insufficient professional competence, the impact of staff tastes in professional relationships, irrational expectations, lack of communication skills, the inability to admission new patients and work in other health centers. Accordingly, "the lack of moral sensitivity to the profession and its importance" in the ICU staff is a central phenomenon that results from neglect of the importance of developing transparent processes for various activities in the ICU, as well as the lack of professional training. This will make the ICU staff ignore the implementation of the defined standards, and subsequently the decline in the quality of health care services in ICU.
Seyyed Abdol Rahim Hosseini, Davoud Zareian,
Volume 13, Issue 0 (3-2020)
Abstract
Perhaps, the most appropriate translation proposed for euthanasia is the painless and piteous killing. According to the existence of effective components in committing a crime, it is considered as complicity in murder and the consent of victim does not affect the nature of criminal act and the criminal liability of person depriving the life. One of issues related to this killing which is disagreed is the edict that person who is obliged to save life related to passive type of euthanasia does not perform this killing and there must be difference among its different types and conditions. The primary reasoning of the edicts indicate that duties whether difficulty or not must be done but, according to the rule of negation of difficulty and hardship, obligation to these edicts in cases of hardship is cancelled. The articles of this rule include obligatory duties to disuse. However, from the view of jurists, it is not general that euthanasia corresponds to some juridical sub-principles indicating the permission of suicide in some conditions, although this is criticized and rejected. Two rules of hardship and beneficence are those believed to help prove the hypothesis by attaching to the rule of negation of hardship and difficulty. But, it is clear that it is not so. In feasibility study of this rule with the rule of no harm, they are proved by the murder illegality and the mentioned rules cannot govern the primary reasoning of depriving the life Therefore, euthanasia is not allowed at all.
Masoumeh Jorjani, Mitra Amini, Noushin Kohan, Seyyed Samad Sajjadi, Nikzad Isazadeh, Amin Habibi, Maryam Sohanaki, Pouria Kanani, Reza Mortazavi,
Volume 16, Issue 0 (11-2023)
Abstract
General courses can effectively empower students and enhance their professional and social personality, and it is essential to continuously evaluate the effectiveness, status, and updating of these courses. Accordingly, the present study aimed to investigate the factors influencing the effectiveness of teaching general courses in the medical curriculum in Iran. The study involved both qualitative and quantitative phases. After conducting semi-structured interviews with experts, medical students, and professors of general courses, and using Braun and Clarke’s thematic analysis method, 528 codes were extracted and classified into 4 themes, 11 categories, and 33 subcategories. The main themes included updating the curriculum, focusing on effective and purposeful learning, collaboration and needs assessment of the stakeholders, and linking general courses with practical skills. Based on the results of the qualitative phase, a model for the effective teaching of general courses was developed using Delphi method with subject matter experts, and the validity of the model was confirmed with a two-round validation process. Removing unnecessary courses or those with repetitive content, designing needs-oriented content, involving experts in course revisions, using skill-based education methods, increasing skill-based and practical courses, flexibility in evaluation, and utilizing new educational technologies indicated the highest mean and consensus index. The results showed the necessity of evolving the traditional education system, rethinking, revising the topics and content, focusing on skills based on new needs, promoting evaluation models, and utilizing modern tools and technologies in teaching general courses.
Atefe Salimi Akinabadi, Maryam Jahangiri, Mitra Zandi,
Volume 17, Issue 0 (12-2024)
Abstract
The intensive care unit (ICU) is a complex environment where diverse healthcare professionals collaborate to care for critically ill patients. Evidence suggests that ethical issues or conflicts are prevalent and can negatively impact ICU care. This research aimed to investigate the ethical challenges encountered by critical care nurses in clinical practice. Using the PRISMA guideline, relevant studies were identified through searches of the PubMed, Scopus, and Web of Science databases from 2015-2024 using the following MeSH terms: "ethics," "ethical challenges," "nursing," and "intensive care unit." Only English-language manuscripts were included. Ethical challenges in the ICU were categorized as follows:
1. Internal Constraints: Lack of self-confidence, fear, maladaptive coping mechanisms, religious conflicts, and spiritual conflicts.
2. External Constraints: Lack of collegiality, hierarchical structures, poor communication, inadequate staffing, restrictive policies, shortages of full-time critical care physicians and nurses, and working with incompetent staff.
3. Clinical Situations: Futile treatment, inappropriate care, inadequate pain relief, hastening death, providing false hope, end-of-life care decisions, decisions about life-sustaining treatments, and the use of physical restraints.
Recognizing ethical challenges in the ICU is crucial. It enables the implementation of measures to minimize ethical conflict, design effective strategies for preventing ethical dilemmas, and improve the nursing work environment.
Ali Akbari, Alireza Arman, Alireza Nikbakht Nasrabadi,
Volume 17, Issue 0 (12-2024)
Abstract
Moral courage is essential for intensive care unit (ICU) nurses to navigate complex ethical dilemmas and advocate for patient rights. Despite its importance, the factors that influence the expression of moral courage remain poorly understood. This review aims to identify key predictors of moral courage in ICU nurses, offering valuable insights to enhance ethical decision-making and improve patient care in critical care settings. This review followed the Cochrane systematic review principles and adhered to PRISMA guidelines. A comprehensive literature search was conducted using both English and Persian keywords related to "moral courage," "ICU nurses," and "predictors." International databases such as PubMed, Scopus, and Web of Science were searched, along with grey literature from Google Scholar. No time frame restrictions were applied. Inclusion criteria included observational studies that focused on predictors of moral courage in ICU nurses, while studies such as clinical trials, reviews, opinion pieces, and those lacking primary data were excluded. Two authors independently screened and extracted data, resolving discrepancies through consensus with a third author. The Newcastle-Ottawa Scale (NOS) was used to assess study quality, and relevant data were systematically organized into an extraction table. A total of 136 articles were initially identified, with 24 observational studies included after screening. The final selection consisted of 4 cross-sectional studies and 8 cohort studies. Key predictors of moral courage in ICU nurses were identified, including age, gender, professional experience, ethical training, and workplace support. Older and female nurses were more likely to demonstrate moral courage, while nurses with more years of experience and formal ethical training exhibited a stronger ability to confront ethical challenges. Additionally, a supportive work environment and personal ethical beliefs were found to significantly influence the likelihood of nurses advocating for patients and addressing unethical practices. These findings emphasize the importance of both individual and organizational factors in fostering moral courage. This review identifies age, gender, professional experience, ethical training, and workplace support as significant predictors of moral courage in ICU nurses. These findings highlight the critical role of individual characteristics and organizational support in promoting ethical behavior and moral courage in critical care settings.
Parsa Farmahin Farahany, Zahra Torkashvand,
Volume 18, Issue 1 (3-2025)
Abstract
One of the key ethical-legal concerns in the medical profession is patients’ trust in the quality of care and adherence to professional standards. This viewpoint explored the ethical-legal dimensions of using surveillance cameras in Intensive Care Units (ICUs), focusing on a specific legal-ethical case. In this scenario, the patients’ family caregivers express doubt about the quality of care and request access to recorded footage. From an ethical-legal perspective, documenting events by the medical team—provided that privacy, data protection regulations, and visual monitoring standards are respected—can help safeguard patients’ rights, clarify staff performance, and prevent legal misunderstandings. While acknowledging the potential benefits, this study also outlined legal considerations, such as patient notification, access limitations, and data management protocols. The key conclusion is that the use of cameras in ICUs, if aligned with legal and institutional requirements, can enhance trust, demonstrate ethical compliance, and reduce legal complaints.
