Iranian Journal of Public Health
Year:2008 | Volume:37 | Issue:1(SUPPLEMENTARY ISSUE ON BIOETHICS)|Papers Count:10

Ever-increasing advances in the field of bioethics have been encouraged by recent developments of biomedical technologies. Stem cell research and therapy are among the most promising approaches in medicine of which are raised some ethical challenges. Likewise, the therapeutic potential of stem cell-based therapies created new policy concerns for health care systems, particularly the issue of equity, priority in resource allocation and justice. There are arguments against and in favor of funding for stem cell research. Governments have also diverse policies in encouraging private sector sponsorship to support researches. Iran is one of the pioneers in the field of human embryonic stem cell research in the region. The religious decrees permitting therapeutic purposes have paved the way for wide-ranging researches. Indeed, the researchers have an obligation to observe moral values. Therefore, the national specific guideline for gamete and embryo research, compiled in 2005, is followed in this issue. In this paper, we will discuss the major ethical concerns relating to the issue of equity and justice, and will review the regulatory policies for stem cell research and therapy. On the whole, stem cell research is a global enterprise about which there is a need to think in the context of globalisation and also from the perspective of the developing countries. Stem cell based therapies are expensive and technologically demanding, the low-resource healthcare systems need to consider a specific national policy and to weigh up costs and benefits to consider making such treatments available. We must ensure that rights, values and welfare of the donor, recipient and the community are respected.

Nanotechnology is considered as an industrial revolution of the third millennium. Advances have a remarkable impact on different fields such as medicine, engineering, economy and even politics. However, a wide range of ethical issues has been raised by this innovative science. Many authorities believe that these advancements could lead to irreversible disasters if not limited by ethical guidelines. Involvement of developing countries in new fields of science could be associated with substantial advantages. In this paper, we intend to review main ethical issues of nanotechnology, taking into account the surge of interests in this field and the ever-increasing advances of nanotechnology in Iran. The issue of safety, considering environmental and ecological impacts of nanoparticles (smart dust), and standards of customer awareness are important debates. The 'Grey-goo' scenario and the concerns about 'post-humanism' are also discussed by bioethicists. There are further concerns about justice, intellectual property rights, accountability, and the probability of military and security misuse.

Recent advances in organ transplantation have promised certain benefits to humankind. Consequently, it is necessary to take into consideration all aspects of these new approaches and provide specific ethical guidelines for research in this field. Considering the ever-increasing advancements of transplantation in Iran and noting the necessity of scientific researches in this field, and to observe ethical principles in such researches, compilation of the "National Ethical Guidelines for Transplantation Researches", as one topic of the "Specific National Ethical Guidelines for Biomedical Research" were considered in our country. We stated some points of this guideline in this article.

Nursing is a universal health care necessity. Nursing profession, similar to the other medical professions, is responsible to maintain public health promotion, prevent diseases, and also care and rehabilitate client, family and the society. The inherent nature of nursing is respect for moral values and human rights. However, clinical ethical dilemmas occur for nurses at all levels, not always concerning patients. Although this is the primary area of concern, it is relevant to all areas of nursing practice and every aspect of their professional roles including research activity, education and management. The ethical codes of nursing, which set out the ethical behaviors expected of registered nurses, are considered indisputable with regard to nursing practice. There are some national codes in the world but the international code of ethics for nurses was first adopted by the International Council of Nurses. The current paper gives an overview of nursing ethics history, which will be followed by the study on the promotion and dissemination of the nursing ethical codes and guidelines. The concepts, topics and strategies of some codes will be stated in this paper. The present study also aims to emphasize nursing ethics in Iran. Despite the compiling of general and specific guidelines of biomedical research in Iran during recent decade, there have been limited activities on the issue of nursing codes of ethics. Iranian nurses should be educated and fully prepared to engage with ethical issues in the field of nursing. Given the importance of sociocultural issues, it is necessary to compile nursing codes of ethics according to Islamic culture of Iran.

My main question in this article is as follows: "to which extent cultural diversity should be permitted to influence bioethical judgments?" There are cultural heritages, values and traditions which are acceptable and respectable and there are ones which are not so. In this article I concluded that our reasoning based on common ethical sense can guide us through such differentiations. Human dignity as a common notion among most alive cultures and religions thorough the world, can be relied for sketching a plan for further dialogues in this regard.

Principlism, in general and Four Principles Approach in particular is largely discussed in current medical ethics. According to principlism, the ethical relationship between physician and patient has to be categorized based on some principles, the principles which are general, action-guiding and could help both the patient and the physician to arrange their ethical behavior. Four Principles Approach which is a principlistic view, has formulated the principles which have to be considered in medical ethics in the light of Rossian ethical framework as follows: respect for autonomy, nonmaleficience, beneficence and justice. Ethical Particularism, on the other hand, strongly criticizes principlism and repudiates the very idea of generalizability in the realm of ethics. According to particularists, the way in which a morally relevant feature like fidelity and justice behave in different ethical occasions is fully context-dependent so that they cannot be patternable in advance. It follows from this that fidelity, for instance, is not a good-making feature, generally speaking.In this paper, firstly, the Rossian ethics is discussed in order to make Four Principles Approach intelligible. Secondly, the main particularists' argument against principlism is formulated. Finally, Particularists' argument is evaluated and its plausibility is discussed.

Background: One of the domains of scientific activities is working on animals. Performing experiments on animals is permissible only with the purpose of obtaining necessary information for saving and improving life of human beings or animals. Principally, all religions believe that human life is more valuable than animal life and humans have a God-given authority over animals, but they should not be cruel to animals and cause their pain or suffering. Based on Islamic view points, although Allah has put the Man as the lord of all creatures, he has not the right to use other creatures for any conditions and does not respect their real statues. Because of the widespread use of experimental animals in our country, special ethical codes should be redefined for living conditions of experimental animals based on the present regulations in Iran and also other countries. Therefore, all our researchers should have enough information about ethical codes of treating experimental animals as well as Islamic principles in this regard. Methods: All Islamic and international sources related to treating animals and also valid international ethical guidelines were collected and classified in order to extract the aimed points. Then all extracted points were reviewed by experts familiar with Islamic and ethical rules of treating animals. Results: Finally the strategies for appropriate and complete implementation of the national ethical guidelines of animal research in Iran were suggested.Conclusion: It is obvious that the suggested principles are applicable only with appropriate planning of training courses based on the facilities and needs of our country.

Pharmacy, being a profession which its activities are directly related to the health and wellbeing of the people and society has been described an ethical profession from earliest time. In the recent decades there has been a shift in the pharmacist role from dispensing to relationship with patients and health care providers and interfere the therapeutic process. Other branches of pharmacy such as producers, distributors and etc. will certainly have the same responsibilities. In this respect, student of pharmacy, besides his professional education needs learning social, behavioral, communicational sciences as well as the principles code of pharmaceutical ethics. Therefore, teaching and learning principles code of ethics seems as an obligation. These principles are a guide to the standards of conduct. Furthermore, rapid progress of biotechnology, nanotechnology and increase cost of new drugs are factors presented the importance of the study of ethics in pharmacy. Therefore, setting syllabus in pharmacy law and ethics is a need for undergraduate and even postgraduate students. The code, therefore attempts to define principles to be born in mind. It is the pharmacist who must interpret them in the light of pharmacy practice.