Iranian Journal of Medical Ethics and History of Medicine
Year:2016 | Volume:8 | Issue:5|Papers Count:8

Community genetics is an applied research area that explores the role of genetic variables on the interactions and community structure determinism affecting species. Community genetics covers a spectrum from services, genetic and congenital disorders, genetic counseling, prevention and screening to macro policies. The focal point of community genetics is the society, and community-oriented physicians make priorities on medical genetics based on the specific characteristics of each society. The present study aimed to investigate the prioritization process of community genetics in the Iranian society.According to previous studies, priorities of community genetics services in Iran can be evaluated from several aspects, including severity and type of illness, diagnosis, prevention and treatment, epidemiology, attitudes toward illness, and domestic, social, cultural, ethical and economical challenges. In order to promote community genetics activities, the above-mentioned priorities must be taken into consideration, while special attention should be paid to the four ethical principles of medical genetics, that is, autonomy, beneficence, non-maleficence, and justice.

Chronic renal failure in infants is a life-threatening condition that can also severely affect their families. Patients and their families are under great physical, mental and social pressure, and therefore require medical, palliative and supportive care. Moreover, ethics has an important role in care for these infants and their families. The purpose of this study was to identify an ethical approach to providing medical, supportive and palliative services for infants with chronic renal failure and their families. The study was based on a case report in the Medical Ethics Grand Rounds of the Children's Medical Center in Tehran, Iran. The case pertained to a male newborn infant with diagnosis of renal failure. Assessments indicated severe bilateral hydronephrosis and multicystic dysplastic kidneys accompanied by high creatinine levels. The patient underwent surgery but further evaluations revealed a low glomerular filtration rate accompanied by elevated blood pressure. The physicians suggested insertion of a catheter for CAPD (continuous ambulatory peritoneal dialysis) after the initial peritoneal dialysis until a kidney transplant was performed. The proposal, however, was rejected by the parents and the patient was discharged by their consent. A few weeks later, the infant expired at home. It seems that health professionals need effective ethical strategies to offer medical, supportive and palliative services for infants with chronic renal failure and their families.

In the Iranian Civil Code, article 190 and the following articles specify a series of conditions that each party of a contract should possess in order to be able to enter into the contract. The above-mentioned article states that in order for a contract to be valid, both parties must be of age, must be in full possession of their senses, and must have reached puberty. In addition to these conditions, the intended parents must meet a number of other criteria as well; for instance, they should be infertile and must be physically and mentally healthy. As regards the surrogate mother, she needs to be married and in good physical and mental health, and she should have previously conceived a child. She must also be of an age suitable for pregnancy, and it needs to be ascertained that she will come to no harm due to pregnancy. These terms, however, are not ordained by the Iranian law and are only observed by some institutions at the moment. Therefore it is recommended that legislators focus on the issue of surrogacy and oversee the observance of the above-mentioned terms by institutions that are involved in the process.

Aromatherapy is a form of alternative medicine that is now widely practiced throughout the world. Medical history studies indicate the popularity of aromatherapy in ancient civilizations such as Persia as a method of decontamination and treatment.The present study uses religious texts, ancient Persian manuscripts in the Pahlavi language, and the history of Persia to confirm the status and application of aromatherapy as a method of treatment in ancient Persian medicine.In ancient Persia, illness was perceived as a product of evil. Ahriman and Ganak Mainyu were the main causes of diseases, often associated with foul odors and filth. Thus, ancient Persians tried to cure illnesses by using herbs and applying certain principles of hygiene.Evil, foul odors and stale air were believed to transmit diseases, while ahuric divinities were associated with sweet smells. Therefore, fragrances were used in keeping with the divine forces, and aromatic substances, herbs and woods were employed as a means of prevention to eliminate the causes of illnesses, and as a cure for certain mental and physical diseases.

The Attitude Prophet Muhammad (Peace be upon him and his family) to treatment comprises ontological, ethical, jurisprudential and, medical dimensions among others. This article studies Prophet Muhammad's mysticism and moral attitude toward medical treatment to investigate them from a mystical point of view and to examine physician’s moral behavior throughout the healing process.The study is based on the Quran and prophetic traditions as well as Shia and Sunni interpretations, and used documentary and library research. The results show that Prophet Muhammad perceives medical treatment to depend solely on God's command, and even refers to God as “the Healer”, whom he believes to be the only provider of cures. The prophet considers doctors as compassionate souls who serve patients with tolerance and are not detached from the process of treatment, but are vessels for the grace of God, and He therefore advises his companions to follow the recommended procedures. He believes medicines to be a gift from God and maintains that there is a cure for each ailment. According to the moral teaching of Prophet Muhammad, physicians must possess the necessary expertise, try to find proper treatments, and avoid seeking cures through forbidden activities.The mystical prophetic teaching asserting that God has revealed a cure for every ailment is an important notion that can be used as a methodology proposition to deliver medicine from related paradigmatic crises. Furthermore, other mystical views held by Prophet Muhammad can provide a monotheistic backdrop to the healing process and define the moral principles of treatment. Ethical principles of medicine and treatment can also promote professional commitment as a sort divine responsibility and thus enhance the physician’s professional accountability.

Long-standing concerns about the feeding needs of infants and the search for a viable alternative to the formula prompted the World Health Organization to propose the concept of breast milk banks in 1909. A year later, the first donor milk bank was founded in Boston, Massachusetts to be followed by similar institutions in various countries in Europe and Asia. Multiple births and mothers’ inability to produce adequate breast milk, premature births resulting in mothers’ insufficient milk supply, babies’ reaction to the chemical composition of their mothers’ milk and several other reasons have triggered an increase in the demand for breast milk banks. An examination of the arguments related to Rada or milk-kinship in Shitte and Sunni jurisprudential and narrative sources demonstrates that there is no judiciary challenge or obstacle to establishing breast milk banks in Iran and other Muslim countries. This descriptive-analytic study uses library sources to investigate the evidence and confirming principles of milk-kinship in order to support the above-mentioned concept.

In the nursing profession, ethical practice is contingent upon the nurses’ ability to determine the ethical issues in their vocation, and their sensitivity to these issues in the nurse-patient relationship. In order for the health system to have a strong and solid foundation, this sensitivity must be formed in nursing students during the early stages of their education. Educational environment and clinical experience each affect ethical sensitivity in their own way. The purpose of this study was to determine and compare the ethical sensitivity of third and fourth year nursing students and nurses in Islamic Azad University, Mashhad branch during 2014.In this cross-sectional study Lutzen’s Moral Sensitivity Questionnaire was used, and its validity and reliability was confirmed. According to the formula for sample size, 110 persons were sampled in each group. Sampling was performed randomly among the third and fourth year students, and in two stages among the nurses: first cluster, and then randomly. Data were analyzed using descriptive and analytical statistics by SPSS software.The mean and standard deviation of moral sensitivity was 3.33±0.36 in nursing students, and 3.27±0.35 in nurses, and the independent t-test showed no significant difference between the two groups (df=218, t=-1.06, P>0.05). Moreover, there was no statistically significant difference between the mean scores of moral sensitivity based on demographic characteristics.It was concluded that the ethical sensitivity of nurses and nursing students of Islamic Azad University, Mashhad branch was satisfactory, which can be considered as a point of strength for policy makers of the health system.

Pharmacists serve as members of both the society and the health care team, which may involve them in activities that could be the subject of ethical query. They can face issues and problems in the workplace that may raise questions as to whether their acts are appropriate, right, just or legal.This study aims to explore ethical issues from the perspective of pharmacists and to examine their reasoning processes regarding social phenomena such as ethical challenges. Moreover, it explores the ethical decision-making strategies that pharmacists employ when dealing with such problems in pharmacies and in their interactions with people.This was a qualitative content analysis study. The participants were chosen using purposeful sampling from community pharmacists and the academic staff of the School of Pharmacy at Shiraz University of Medical Sciences. The data were obtained through semi-structured interviews with 20 individuals and analyzed using content analysis approach.Analysis of the interviews led to extraction of the following six categories: pharmacists' understanding of key ethical concepts; pharmacists' experiences and duties; relationship with other health professionals; the pharmacy as a commercial setting; the difference between the practice of ethics in pharmacy, medicine and nursing from the perspective of pharmacists; and the actual response of pharmacists in confronting ethical problems. Each of the above-mentioned categories were further divided into sub-classifications describing specific ethical challenges in pharmacy practice.Awareness of ethical issues and professional guidelines is a fundamental part of the education of health care professionals and provides a structure that will enable them to assess ethical problems and make appropriate, justifiable decisions. The findings of this study indicate the need for implementation of professional guidelines and codes of ethics in pharmacy practice to cover all ethical issues.