Iranian Journal of Medical Ethics and History of Medicine
Year:2016 | Volume:9 | Issue:3|Papers Count:12

Despite all recent advancements in medical sciences and the related technologies, the concept of death still remains obscure. It can be asserted that as death includes both physical and spiritual dimensions, medicine alone is not capable of fully illuminating its different features. Therefore, inter-disciplinary collaboration between different branches of science such as Quranic studies, humanities, and philosophy seems necessary in order to shed some light on this hitherto undiscovered subject. Through description of what the soul experiences before and during death, such collaborations may even enrich the knowledge and broaden the minds of physicians who are capable of the analysis of physical changes caused by death. This insight can promote the ethical decision-making process as well as the provision of end-of-life care and spiritual support in different stages of death. The current research, as a library literature review, endeavors to provide a descriptive view of death from a medical perspective, and then, a Quranic depiction of its different stages through an analysis of verses and quotations from the holy Quran and Islamic scriptures whose primary focus is the process of dying. The final discussion section presents some similarities and differences observed between viewpoints and raises questions which can be considered as being of great practical importance in terms of provision of necessary end-of-life spiritual support. We hope that further research in this field can better clarify the issues raised in this article so that practical measures aiming at the provision of Quran-based spiritual end-of-life care are designed and implemented.

Traditional and complementary medicine centers, as providers of health services, have a special responsibility towards patients and clients. With increase in the number of these centers, the role of traditional and complementary medicine has become more important in the analysis, diagnosis, and treatment of illnesses. The accurate and fast performance of medical approaches using evidence-based diagnostic and therapeutic procedures, with consideration of the rights, integrity, and dignity of clients are among the priorities and necessities that can have a significant impact on the satisfaction and acceptance of the scientific and legal institutions, parallel to the deployment of new services provision systems. Lack of sufficient scientific evidence of efficiency and effectiveness, lack of definition and determination of authorities to handle complaints, the legal process of ethical and legal aspects of medical errors has caused challenges for the field of complementary and alternative medicine. Thus, this legal void must be filled through formulation and revision of laws and regulations, defining of the practical and acceptable set of scientific resources, and determination of authorized service centers to resolve complaints and to punish. It is hoped that the results of this review study increase the information of the professionals in this field and attract the attention of authorities of medical ethics to this field.

Cryopreserved embryos are considered as abandoned embryos in two situations. The first situation is when the embryo’s owners have no definite domicile and no written guideline has been provided by the couple regarding the embryo’s status. The second one is when the owners of cryopreserved embryos explicitly state that they permit the freezing centers to decide about their embryos’ fate. The aim of the present study was to determine the best possible decisions about cryopreserved embryos in case of their abandonment by couples.This research was conducted through library and analytical research methods.As the cryopreservation of embryos is expensive, cryopreservation centers must be exempted from preserving embryos after unsuccessful attempts at communication with the owners and passing of reasonable time.Making decisions about the fate of abandoned cryopreserved embryos depends on the nature we attribute to them. If we consider abandoned cryopreserved embryos as humans, it is possible to destroy them according to the rule that necessities allow prohibitions. If we consider them as properties or quasi-properties, when there is no accessibility to their owners in order to determine their fate as properties, the governor is permitted to make decisions about their disposal or donation for researches.

Moral intelligence is the ability to utilize principal criteria that can lead to effectiveness of individual reactions. The aim of this study was to determine the relationship between moral intelligence and communication skills among bachelor’s students in nursing at Tehran University of Medical Sciences, Iran, in 2016-2017.This was a descriptive-correlational study. The study population consisted of all nursing students studying at the School of Nursing and Midwifery of Tehran University of Medical Sciences. Among the study population, 204 subjects were selected through convenience sampling method and based on the inclusion criteria (direct acceptance in the field of nursing, absence of any illness, and willingness to participate). The data collection tools consisted of a demographic characteristic questionnaire, the Moral Intelligence Scale (Lennick & Kiel), and the Communication Skills Inventory (Jerabek). The validity and reliability of both instruments had been approved in similar studies in the country using Cronbach’s alpha coefficient (a=0.88 and a=0.71, respectively). The reliability of the two questionnaires was calculated in the current research using Cronbach’s alpha (a=0.85 and a=0.81, respectively). Data were analyzed using descriptive (average and standard deviation) and inferential statistics (t-test, Pearson correlation coefficient, and ANOVA test) in SPSS software. The mean moral intelligence score was 71.98±7.12 and ranged from 20 to 100 and mean communication skills score was 114.9±9.67 and ranged from 34 to 170. Pearson correlation coefficient revealed a significant and positive relation between moral intelligence and communication skills of nursing students (r=0.54, P£0.001). Thus, the communication skills of students can be improved by strengthening their moral intelligence. Therefore, it is suggested that the grounds for the strengthening of moral intelligence among nursing students be provided.

Ethics of care are the central core of nursing values and a fundamental concept in the nursing profession. Since the outlook of nurses on ethics can affect the quality of care, the present study was conducted to investigate the attitude of nursing students to codes of ethics for nurses, their commitment to ethics of care, and academic dishonesty in Abadan School of Medical Sciences.This descriptive analytical study was performed among 150 nursing students of Abadan School of Medical Sciences by census sampling in 2016. After giving their informed consent, the students completed the questionnaire designed by McCrink in 3 sections: 1) demographic information, 2) attitude to ethics codes, commitment to ethics of care and neutralization behaviors, and 3) outlook on academic dishonesty. Data were analyzed using descriptive statics, chi-square test and Pearson’s correlation coefficient in SPSS version 21.The results showed that the students had the most positive attitude to ethics codes and commitment to ethics of care, and the most negative attitude to neutralization behaviors. Less than half of the participants had a negative outlook on academic dishonesty. Moreover, about 40 percent of the students reported academic dishonesty among their classmates. Ethics codes are moral values in academic and clinical settings and should therefore be considered as major components of initial nursing education programs. Additionally, it seems necessary to make efforts in order to change nursing students’ attitude toward academic dishonesty.

Ethics is elemental in all lines of work, but more so in the nursing profession, since the ethical and responsible conduct of nurses can have an important role in promoting patient recovery. As members of a large group in the field of medical science, nurses need to be equipped with sound professional ethics in their interactions with others.The present study was a descriptive survey of the relationship between professional ethics and the efficiency of nurses. Study population consisted of the nurses employed in Imam Hospital and Mostafa Khomeini Hospital in Ilam. Sample size was determined at 134 using the Cochran formula, and 126 completed the professional ethics and efficiency questionnaire. The validity of the questionnaire was confirmed by experts, and its reliability was established by Cronbach's alpha test. Subsequently, the main hypothesis and the eight sub-hypotheses were examined.The subjects consisted of 89 males and 37 females, of which 50 percent were aged between 20 and 35, 42% between 36 and 50, and 6% between 51 and 60 years. In terms of education level, 7 subjects had high school diplomas, 18 associate degrees, 42 were undergraduate and 59 graduate students and higher. The findings showed a significant correlation (0.002) between professional ethics and the efficiency of nurses. Results of the Pearson’s correlation test confirmed the relationship between accountability, honesty, fairness, loyalty, respect for others, and the efficiency of the nurses employed in Imam and Mostafa Khomeini Hospitals, Ilam. No significant correlation was found, however, between the components of superiority and sympathy in nurses and their efficiency.Considering the relationship between professional ethics and the efficiency of the nurses in these two hospitals, it is recommended to improve their performance through continuous training and promotion of nursing ethics.

The Declaration of Helsinki is one of the most important international documents in medical research ethics on human subjects which has been revised 7 times and the last revision was in 2013. Researchers must be informed of the principle of Helsinki declaration and the latest changes in order to respect the rights of participants in medical research. In this study, the last version of the declaration are compared with the previous version (2008). The evaluation of the changes and challenges of the final revision can be helpful in modification of the ethical codes of our country. The 2013 version included a number of important changes; it has been categorized into more clear and detailed sections. So this version has a better structure and more practical as well. The 2013 version places more emphasis on vulnerable groups and includes a separate section on the compensation and treatment of injuries due to research. The revised version of the Declaration of Helsinki also emphasizes obtaining of the informed consent (even in researches on material or data contained in biobanks) and post-trial access.

Protecting patient’s secrets and private information such as disease name and diagnosis can play an important role in establishing trust in the treatment team. The present study aimed to investigate the issues surrounding the confidentiality of patients’ disease names and diagnoses in hospitals affiliated with Mazandaran University of Medical Sciences.This was a cross-sectional study conducted on 216 patients in internal, surgical and women’s wards who had been hospitalized for at least 24 hours. Research tool was a questionnaire consisting of two parts: demographic data, and questions on the disclosure or confidentiality of information such as disease names. Patients' views were investigated through simple sampling method, and data were analyzed using SPSS software and chi-square test. Of the 216 patients entered in the study, 122 (56.5%) were male and 94 (43.5 %) were female. Participants were aged between 16 and 80, and their mean age was 47±18.6 years. The results showed that 49 (22.7 %) of the patients did not approve of an open display of their disease names and diagnoses above their beds, while a difference was observed between male and female patients in this regard (P<0.50). Moreover, there was no relationship between patients’ educational levels and their perspective on other patients’ caregivers finding out about their disease names or diagnoses (P<0.578).In this study, a significant percentage of patients were found to be opposed to the disclosure of their diagnoses and disease names. Considering that this phenomenon may prevail among special disease or emergency room patients, it is recommended that authorities take measures against disclosure of patients’ disease names and diagnoses.