Iranian Journal of Medical Ethics and History of Medicine
Year:2012 | Volume:5 | Issue:5|Papers Count:11

Medicine is a branch of health science with the purpose of maintaining health and health promotion, diagnosis, treatment and prevention of diseases, and rehabilitation of patients. In addition to possessing academic qualifications and legal training, physicians and service providers should be familiar with moral and jurisprudential considerations in their profession, as is rationally and logically expected. Respect for moral values and legal principles is important since on the one hand it gives the service provider a feeling of fulfillment, and on the other hand it causes the patient to feel satisfied with the service offered. Islamic laws must be observed in all aspects of life in our country and medical practices are not an exception. Therefore it is necessary for all practices to be approved by jurists and to comply with the principles of Islamic jurisprudence and ethics. Consequently, practitioners need a thorough understanding of Islamic laws and ethics in order to be considered qualified. In this regard it should be remembered that Islamic jurisprudence, or Sharia refers to a set of laws and rules of life defined by the Quran and its interpretation and explanation by the great Prophet of Islam (SAW) and Imams (AS). In Islamic culture, law and medicine are closely related to each other. Many physicians are staunch followers of the Islamic jurisprudence and try to observe them in their diagnostic and therapeutic approaches, and in cases where they have dilemmas and are not certain what course of action to take, religious standpoint is what guides them to make the right decision. In recent decades, physicians have tried to apply Islamic laws in the context of medical or jurisprudential problems. This article investigates the realm of medical jurisprudence and medical ethics.

Narrative ethics is an approach that is well known for ethical education and moral development. In narrative ethics, by using a story, its components and characters, ethical knowledge and awareness can be achieved. This approach is very useful in medical ethics education and is helpful in dealing with ethical dilemmas. In fact, part of ethical development, in addition to moral judgment, is to reinforce the ethical sensitivity in which narrative ethics can play a significant role for this purpose. This approach has been widely used for teaching morality in Persian literature and history telling, such as Mathnavi. Narrative ethics can be applied by telling stories about patients' life and their experience of illness. It can also be used to criticize and analyze the clinical situation and explore ethical challenges that healthcare providers face in their daily practice. Thus, it can help to prevent ethical conflicts by establishing interaction between ethical principles and patients' values. This paper emphasizes the application of this method in medical ethics education and ethical decision-making.

By the late 1960s, there seems to be a growing number of articles in medical journals on the subject of the distress that many terminally ill patients declared they had gone through due to repeated resuscitations that only prolonged their suffering. This demonstrates that standard protocols of resuscitating any patient who is undergoing a cardiopulmonary arrest may bring about new problems. A review of studies shows that dealing with patients who are in the last days or hours of their life has been a major challenge for healthcare professionals, and making decisions on therapeutic approach is one of the most fundamental skills for healthcare staff. The scientific, ethical, religious and legal dilemmas in this field make decision-making difficult in some cases. In this paper, we reviewed articles published during the past 30 years, through which the views of health care providers including physicians and nurses on the issue of do not resuscitate (DNR) orders in different societies had been studied. The Islamic perspectives have also been discussed in brief. Moreover, DNR guidelines prepared by various countries such as America, Britain and Saudi Arabia have been assessed. For searching the related studies, we used authentic electronic databases and many reliable websites. Some articles were obtained through hand searching of the references of searched articles. The results showed that despite substantial studies, caring teams are still facing the challenge of DNR in different societies. In Iran, considering the religious values and beliefs, the matter needs more deliberation to help the caring teams to deal with the clinical issues. The religious and cultural background call for a national guideline to be adopted based on Iranian-Islamic culture. Education and awareness rising of different groups including patients, general public, healthcare staff, and health policy makers is crucial in all countries all over the world, and particularly in Iran.

Birth of a poor prognosis neonate (premature and/or congenitally affected) may potentially burden the family and/or society with many ethical, social, legal, etc challenges. Most of the decision making criteria used in handling the care of these neonates, such as disability, quality of life, etc., are multidimensional and heavily ethical bearing. In this study, we have tried to explore and present a perfect view on the existing challenges and different dimensions of the discussed criteria. In the end, the prominent standpoint of the Islamic school in confronting a severely disabled newborn has been introduced and analyzed. Most related discussions boil down to some fundamental and unanswered questions, for instance whether human beings should be permitted to make decisions about the life of severely diseased neonates, the decision making criteria themselves and their appropriateness, etc. Even though many scientists have theorized on the subject, a multilateral explanation of life and death criterion has not been presented yet. One thing is for certain and that is, in answering the basic questions of the subject, our present knowledge and experience is limited and insufficient. The authors have tried to show that despite many western views, decision making about the life of a neonate has no place in Islamic teachings, since it could be considered an unauthorized human action. Instead, it is proposed that any attempt to provide an ethical rationale, while utilizing today's science and technology, be in compliance with God's commandments.

Providing sufficient information for patients and other healthcare clients is necessary to protect their rights in health systems. In this realm, medical librarians, especially in hospital libraries, can play an important role in supporting patients' rights. Professional national and international associations have compiled and promulgated some codes and guidelines in some countries however, there are many shortcomings in this area in our country. This paper aims to review the status of patients' and other healthcare clients' rights in professional codes of ethics of library and information sciences and professional standards of hospital libraries. We hope the results can provide us with an approach for a more strict observance of patients' rights in our country. This paper reviews professional codes of ethics of library and information sciences and professional standards of hospital libraries. We will contemplate on the articles related to patients' and other healthcare receivers' rights. The findings show that providing patients with information is a pivotal element in professional codes of ethics of library and information sciences and professional standards of hospital libraries. Interactive and knowledge-based information (KBI) that is based on improvement of performance and finding clinical solutions (not just education without practical impact) have aided clinical librarians in protection of patients' rights in some countries. Considering the roles of libraries and information centers in collecting, organizing and making accessible the information for their users, librarians and information scientist should make effective utilization of information possible for healthcare clients, while taking into account their specific needs. Therefore, it is essential to compile professional codes of ethics containing the appropriate approach to disseminate information to patients and other healthcare clients, and to define specific roles for clinical librarians in hospitals and medical clinics.

Avicenna wrote many great books and articles such as Canon of Medicine which is his most important medical work. This study has been conducted in order to provide the necessary information on Avicenna's adherence to ethical principles and ethical norms in Canon. Three aspects including his medical practice, researches and philosophical attitude have been studied. Avicenna offers some valuable guidelines on the ethics in medicine in Canon. The first necessary condition for the practice of medicine is to comprehend medicine. Congruently, Avicenna emphasizes in his book that the doctor must be masterful. The use of scientific resources and valid information with citation to the references is one of the ethical subjects that are highlighted in this book. Avicenna has put much emphasis on ethical principles as a religious issue in medical practice. He believed in Islam and Islamic ethics and felt responsible toward God and his creations including humans Although in Canon there is no chapter specifically devoted to medical ethics, there are numerous ethical references that focus on humans as the main target of medical activities. It offers recommendations regarding ethical issues such as how to treat patients and minimize hazards. In brief, the book of Canon represents many humanistic ideas.

The most important element in physician-patient relationship is trust which has a major effect on treatment and satisfaction of both patient and physician. To be able to realize the trust between patients and physicians, at first we should find an appropriate definition of trust so in this article we study the criteria of trust and it's realization to be adapted between patient and physician. We reviewed the literatures investigating the perspective of scientists of sociology and ethics. Afterwards the issue was discussed in focus groups, and the contents were analyzed to reach to a proposed model including several criteria. We believe that trust has two sides, the trust (patients) and the trustee (physicians) and for trust fulfillment both sides should be involved. So some criteria are related to the individual patients, such as patient's needs and desire to trust. Some are related to patients and are considered as respect to patients, awareness of physicians characters, such as his/her knowledge and experiences of physician. The other two criteria are related to physician's characteristics, such as his/her commitment and appearance, and physician-patient relationship, such as communication skills of physician.