Iranian Journal of Medical Ethics and History of Medicine
Year:2016 | Volume:9 | Issue:1|Papers Count:8

The pharmaceutical industry plays an important role in every economy. Although the pharmaceutical sector has distinctive financial features, principles of competition law must be applied to the production and distribution of pharmaceuticals as in all other areas of the economy.Regulations regarding unilateral anticompetitive conduct such as discriminatory pricing, aggressive price setting, abuse of a dominant position, hoarding and refusal to enter into transactions as well as collective anticompetitive practices such as collusion are important competition rules which are applicable in the pharmaceutical industry.Although competition law and regulations are indispensable to the pharmaceutical industry, professional ethics can play an effective role as a deterrent factor and prevent anticompetitive conduct. This article reviews the application of competition law in the pharmaceutical industry and identifies anticompetitive behaviors in this sector. It also focuses on the role of the competition council in monitoring the pharmaceutical industry and the impact of professional ethics in preventing violations of competition law in this sector.

Moral dilemmas are among the most important challenges in medical ethics. Dilemmas can occur frequently during a physician’s career and if physicians lack the ability and skills to solve them, they may be pushed to unethical behavior. Bioethics experts have always been concerned with solving ethical dilemmas in the medical profession and facilitating physicians’ decision-making process. Therefore, they often try to find useful and practical solutions by combining the views of different schools of ethics. Designing decision-making models is part of their effort to apply ethics in medicine. It is impossible to solve dilemmas without acquiring the necessary skills, and the ability to apply a decision-making model can be part of the training process.These models aim to facilitate ethical decision-making in the field of health care by providing various frameworks. This article aims to introduce and evaluate the popular models of ethical decision-making in medicine in the hope of helping physicians choose appropriate solutions when faced with moral challenges. By presenting the advantages of applying the model approach and offering a brief introduction to popular models, the article recommends applying the approach in analyzing and resolving ethical dilemmas. Although the models each have their advantages and disadvantages, becoming proficient in their application will facilitate ethical decision-making for physicians.

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

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.

Observation of patients’ rights as a major component in defining the standards of clinical services can increase patient satisfaction and is an important indicator of health care quality. Since most hospital patients are admitted through the emergency department, this study was conducted to investigate the observance of patients’ rights in the emergency department of Nemazee Hospital during 2015.This cross-sectional study was performed on 100 patients over a period of one month. Data were collected by a questionnaire and analyzed using SPSS version 21 and statistical tests including descriptive statistics and inferential analysis.The mean of the patients’ age in this study was 54.4±19.35. Based on our findings, the overall level of observing patients’ rights was 51%, while patients’ expectations were 93%. Moreover, there was a meaningful difference between observance of the patients’ rights and their expectations in all aspects based on the paired sample t-test (P<0.05). It was also established that age was one of the factors affecting observance of patients’ rights (P<0.05).In this study, observation of patients’ rights in the emergency department was at the intermediate level, while patients’ expectations were higher in comparison.In order to promote patient satisfaction, it seems necessary to educate the personnel and medical students on patients’ rights by holding workshops, reducing the waiting time for receiving services, and establishing an order in the system based on the patient’s condition.

It is an undeniable fact that nurses have an important role in the provision of health services. The psychological well-being of nurses is associated with an improvement in their job performance. The aim of this research was to survey the relationship between spiritual and moral intelligence and the psychological well-being of nurses.This was a descriptive-correlational study conducted on 128 nurses working in hospitals of Bojnourd during 2013. The subjects were selected through availability sampling and responded to King’s Spiritual Intelligence Self-Report Inventory, Lennick and Kiel’s Moral Competency Inventory and Ryff’s Scales of Psychological Well-being. The collected data were analyzed by Pearson’s correlation coefficient and regression analysis using SPSS software version 18.The results indicated a positive and significant relationship between spiritual and moral intelligence and psychological well-being (P<0.01). The regression analysis showed that spiritual and moral intelligence could significantly predict 26 percent of the variance of psychological well-being (P<0.01).Based on the positive relationship between spiritual and moral intelligence and the psychological well-being of nurses, it is recommended that these factors be taken into consideration in programs designed to promote nurses’ mental health.

Organizational spirituality is a modern topic of discussion in the field of organizational behavior. Iran compared to the world has more spirituality level so the responsibility of the management researchers for using this value tools to solve organizational problems has decreased. Providing peace of mind alongside comfort and convenience for hospital staff greatly affects their competence and will naturally influence the quality of service. The purpose of this study was to investigate the relationship between spirituality and professional burnout among the hospital staff in Ardebil. This descriptive-analytical study was conducted on the staff of Ardebil hospitals (3 public hospitals, 1 private hospital and 1 veterans’ hospital) selected by sampling. Data were collected using the Maslach Burnout Inventory (MBI) and a Spiritual Leadership Questionnaire. The reliability of the questionnaire was confirmed through Cronbach’s Alpha coefficient at 0.95. Finally, data were analyzed using the SPSS 20 software, t-test, ANOVA, Mann-Whitney and Kruskal-Wallis statistical tests.The results showed the mean of spiritual leadership among the staff of public, private and veterans’ hospitals to be 3.51 out of a possible 5, indicating a good spiritual condition. Spearman’s Rho test results showed a significant negative relationship between spiritual leadership and professional burnout of the staff (P<0.05). Moreover, professional burnout among the subjects was calculated at 43.2%, indicating a medium level.In conclusion, spiritual leadership and its dimensions were found to be above average, thus indicating favorable conditions. Considering the importance of spiritual leadership and its relationship with burnout, managers should strengthen all dimensions of spiritual leadership in hospitals to create an environment without conflict and reduce burnout to improve efficiency.