Iranian Journal of Medical Ethics and History of Medicine
Year:2017 | Volume:9 | Issue:6|Papers Count:8

Privacy and confidentiality are the inalienable rights of every human being to preserve his dignity. This issue should be considered in all levels of medical interventions. In the healthcare system, based on respect for privacy and confidentiality, patients decides what information to provide to their physicians. However, if a patient does not provide necessary information to his physician this may impact the diagnosis and treatment.This study aims to evaluate patients’ attitude regarding privacy and confidentiality in healthcare delivery.The result helps policy makers to establish appropriate relations between healthcare providers and patients by realizing its strengths and weaknesses.This cross-sectional study was carried out on 200 patients, selected in a systematically random way, in Imam Khomeini and Shariati hospitals in Tehran the capital of Iran in 2010. The data were collected directly from patients by trained interviewers based on a questionnaire survey. In order to analyze the data based on the scores of the attitude, patients’ attitudes were classified into three groups of negative, slightly positive, and positive and were evaluated by using various statistical tests.In result, 56.5% (113) of participants were females and 43.5% (87) were male. In this study, it was found 71 (35.5%) patients were “strongly agree” that male physician can examine female patients and99 (49.5%) patients were “agree”. Fifty three patients were “strongly agree” that physician may consult with his assistant through training (without the patient's permission) and 103 patients were “agree”. Participants’ attitude about disclosing the patient’s information if a he has threaten self-harm or harm to another person was as follow, 45 (22.5%) patients were “strongly agree”, 82 (41.0%) patients were “agree” and 56 (28.0%) patients had “no comment”. In this study, in general 36 (18.0%) patients had “negative”, 162 (81.0%) patients “slightly positive”, and 2 (1.0%) patients had “positive attitude” towards privacy and confidentiality in healthcare settings.In conclusion, the study population possessed a moderate attitude towards privacy and confidentiality. These results show that in addition to performing further studies, patients’ attitude towards privacy and confidentiality should be adequately improved.

One of the major challenges in healthcare system is to train staff with strong commitment to the organizational mission. The key variables that have a significant impact on the performance of the organization is communication satisfaction. In fact, organizational communication has influential affect on different aspects of the organization including, professional commitment. This study was conducted to determine the relationship between communication satisfaction and organizational commitment among nurses.In a descriptive-correlation study, 300 nursing staff in hospitals from Tehran University of Medical Sciences were selected through random cluster sampling in 2015. Data were collected by organizational communication “Downs and Hazen” and organizational commitment of “Allen and Meyer” questionnaires.Data were analyzed using chi square test and SPSS 16 software. In Result, 7.2% of nurses were satisfied with their organizational communication and 1.7% of nurses had organizational commitment. There was a significant correlation between organizational communication satisfaction and organizational commitment (p<0.001). The mean and standard deviation of organizational communication Satisfaction (91.396±2.39) and for Organizational Commitment respectively (47.488±9.33) was. Also there was a significant correlation between organizational commitment and age, education and shift, but it was not correlated with sex, marriage status and organizational post. Likewise, communication satisfaction had significant correlation with job position and job experience, but hadn’t significant correlation with other demographic variables. Also, the regression model showed that with one point increase of organizational communication satisfaction are added. /189 to the score of organizational commitment.In conclusion, considering the existence of significant positive relationship and also linear regression result, satisfaction of organizational communication is as predictive variable for organizational commitment.Therefore it seems that the optimization of organizational communication managers and officials could increase the commitment of nurses in hospitals and to increase their effectiveness.

Informal payments in clinics raise ethical concerns in healthcare delivery. This cross-sectional questioner survey aims to evaluate the prevalence and related factors of informal payment in healthcare system in Iran.The study was carried out in 2013, prior to the implementation of the government' Health System Reform among physicians with different specialties. The questionnaire were distributed among the participants during the congresses and continuing medical education programs.In results; of the total specialist physicians, 276 returned the questionnaires. The response rate was 81.17%. and out of 276 returned questionnaires 257 fulfilled the inclusion criteria. The prevalence of informal payments, among the physicians who were susceptible to receiving informal payments, was relatively high (63.8%). The physicians who practiced in the private sector, as well as physicians who practiced in Tehran and those who had a positive attitude towards the informal payments, received more informal payments. From the viewpoint of the respondents, the main cause of informal payments was unrealistic/unfair tariffs and the main consequence of informal payments was the rising costs of patient care. This study showed that, unfortunately, more than half of the participants did not believe or did not decisively consider informal payments as unethical. This confirms the importance of physicians’ education about the unethical practice of informal payments. However, compare to private sectors, more supervision in public sector may be the main cause of less prevalence of informal payments in public hospitals. In conclusion: Developing ethical guidelines to prevent informal payments as well as more realistic and fair tariffs would help to decrease the incidence of informal payments.

Nursing role development was created to response to the challenge of balancing supply and demand in healthcare system. The aim of this study is to examine the evolution in nursing role development and subsequent experience in dealing with the challenges in the world. In this study, electronic resources were searched till to 2015 by English keywords contain ' Role development' and ' Nursing role' in combination and individually. Data were extracted from articles that were more relevant. This study found two approaches regarding nursing role development. First, the role extension that relates to progressing in the field of medicine and the traditional functions of physicians, and the role expansion that implies any enlargement of the nurse's role within the boundaries of nursing education, theory and practice. In many countries that seek to expansion/extension of the nurses’ role. However, despite the shortage that exist in nursing and also because of the increased workload of nurses, caused employment of workers with lower skills and in result multiple significantly challenges have been experienced In our country, nursing role development has not considerable progress. The current situation does not provide enough infrastructures such as the licensing professional qualification and data-based decision-making from monitoring the effect of changes on the quality of care. Therefore, decision-making about the implementation of any changes in the nursing profession and its role development, must be accomplished very prudential with regard to all aspects of the professional Ethics.

Currently, in Iran, some difficulties in the application of conventional medicine, has caused more public interest in using Persian traditional medicine for their health problems.In terms of terminology, Persian traditional medicine, Islamic medicine and traditional medicine have been used interchangeably.Although, proponents of traditional medicine claim a strong basis for its application, at least in scholarly available literature it has not been proved, specially based on evidence-based sciences.In search for Islamic medicine’s definition and its foundations a non-systemic literature review with saturation based in authors’ opinion, with attention to relationship between science and religion was conducted.Medical issues in Qur’an andhadith as well as conventional medicine were searched and based on the relationship between science and religion; there are six perspectives about Islamic medicine. It includes approval, denial, prioritization, or a combination of these opinions.The article, describing the so-called Islamic medicine from the perspective of Allameh Javadi Amoli and definition suggested by Mehdi Esfahani about Islamic medicine.

Although, physicians have a duty to treat their patients, sometimes the cure is not possible in medicine and there is no result in attempt to cure patient. In this situation, we face with two types of patients: first, patients who are conscious but suffering with advanced disease and will survive only for a short time. The second group, are patients who are unconscious and may not be cured with the standard treatment based on physician experience.The latter are the subject of the present article. So what a Hospital should do in dealing with these patients.How the hospital, should develop a community-based policy on providing care for these patients. Finally, how should inform the public to adhere to these policies.