Journal of Medical Ethics and History of Medicine

Metaparadigm concepts comprise the central issues in a discipline. Fawcett has named person, health, environment and nursing as the four main concepts of nursing that need to be comprehensively defined. The Human Caring Theory is significant because of its focus on the spiritual dimension of human beings. The aim of this study was to comparatively explain three of the main metaparadigm concepts of nursing in the Human Caring Theory and Persian mysticism, and find the similarities and differences that can help develop the theory and its application in societies with a theistic point of view...

Prescribing antibiotics to patients represents an ethical dilemma for physicians since the current health needs of the patients have to be balanced with concerns for long term containment of antimicrobial resistance in the community. Overuse of antibiotics is a major pathway for development of antimicrobial resistance. In resource-poor settings a complex social reality can influence antibiotic prescribing behavior among physicians which apparently violates the conventional biomedical ethics principles especially beneficence and justice...

Human dignity (HD) in patient care is an important concept in clinical ethics that has various definitions in existing literature. This study aimed at analyzing the concept of HD in patient care. To this end, Rodgers' evolutionary concept analysis was used. For this purpose, scientific databases PubMed, Elsevier, ScienceDirect, Scopus, OVID, Web of Science, CINHAL, IRANDOC, Google Scholar, Magiran, SID and IranMedex were searched fusing the words "human dignity", "patient care" and "ethics"...

Scientists and researchers have examined spiritual health from different angles and proposed various definitions, but a comprehensive definition does not exist for the term as of now. The present study aimed to offer the definition, components and indicators of spiritual health from experts' perspective. This qualitative study utilized conventional content analysis and individual in-depth interviews with 22 experts in the area of spiritual health in various fields selected through purposeful sampling. Member check, credibility, reliability, transferability and allocation of adequate time for data collection were measured to increase the validity and reliability of the results...

Moral distress is among the various types of distress that involves nurses and can lead to multiple complications. It is therefore rather important to identify the factors related to moral distress. The purpose of this study was to examine the relationship between futile care perception and moral distress among intensive care unit (ICU) nurses. This cross-sectional study used a descriptive-correlation method and was conducted on 117 ICU nurses of Qom hospitals in 2016. Data were collected using a 17-item futile care perception questionnaire, and Jameton's moral distress questionnaire containing 30 questions...

Privacy and confidentiality are among the inalienable rights of every human being that contribute to preservation of a sense of reverence and dignity. The present study was conducted to examine patients' awareness of their entitlement to these important rights. This cross-sectional study was conducted on 200 patients in Tehran, Iran during the year 2010. Collected data included patients' demographics (age, gender, marital status, place of residence, and educational level), type of hospital ward, frequency of hospitalization, duration of hospital stay, and patients' awareness of privacy and confidentiality...

In Iran, as in many Asian and Middle Eastern countries, a significant proportion of cancer patients are never informed of their illness. One solution that has been proposed to tackle this challenge is to develop a localized protocol on cancer diagnosis disclosure based on the culture and values of community members, and train healthcare team members to deliver the bad news using this protocol. This article introduces a localized protocol for disclosure of bad news to cancer patients in Iran. This protocol consists of six steps, including assessment, planning, preparation, disclosure, support and conclusion...

Nurses are continuously involved with ethical problems in their area of practice and need to possess a satisfactory level of moral sensitivity in order to be able to offer moral care. Additionally, they act as agents for proper management of ethical dilemmas and are therefore required to have high self-esteem. This study aimed to determine the correlation between moral sensitivity and self-esteem in nurses. In this descriptive-correlational research, sample study included 204 nursing personnel working in hospitals affiliated with Iran University of Medical Sciences...

Since patient safety is multidimensional and grounded in ethical and legal imperatives, both ethical and legal challenges should be taken into account. In this regard, a falling incident case of a 12-day-old newborn was raised in the monthly ethics round in the Children's Medical Center of Tehran University of Medical Sciences, Iran, and the ethical and legal dimensions of patient safety were discussed by experts in various fields. This report presents different aspects of patient safety in terms of root cause analysis (RCA) and risk management, the role of human resources, the role of professionalism, the necessity of informing the parents (disclosure of medical errors), and forensic medicine with focus on ethical aspects...

Disasters are sudden catastrophic events leading to decisions in health service provision that are not in compliance with the principles and frameworks used in normal circumstances. It is essential to develop guidelines in order to ensure the ethical performance of health service providers and to prevent and manage the adverse consequences. As the first step in guideline development, the present study investigated the underlying factors affecting the ethical performance of health service providers in disasters...

Consanguineous marriage, which is common in many regions in the world, has absorbed much attention as a causative factor in raising the incidence of genetic diseases. The adverse effects may be attributed to the expression of the genes received from common ancestors and mortality and morbidity of the offspring. Iran has a high rate of consanguineous marriages. In recent years genetic counseling has come to be considered in health care services. This cross-sectional study was conducted in order to determine the prevalence and types of consanguineous marriages in the genetic clinics in Isfahan...

Past life regression therapy is used by some physicians in cases with some mental diseases. Anxiety disorders, mood disorders, and gender dysphoria have all been treated using life regression therapy by some doctors on the assumption that they reflect problems in past lives. Although it is not supported by psychiatric associations, few medical associations have actually condemned it as unethical. In this article, I argue that past life regression therapy is unethical for two basic reasons. First, it is not evidence-based...

One of the main issues in nursing education that teachers and students frequently encounter is uncivil behaviors. This type of behavior is destructive for the teaching and learning environment. As teachers play an important role in nursing students' education and are ultimately their role models, the identification of these behaviors in nursing teachers appears to be essential. This study was conducted to determine nursing students' perceptions of their teachers' uncivil behaviors. The present study was conducted using a qualitative approach and content analysis...

Doctor-patient interaction (DPI) includes different voices, of which the educator voice is of considerable importance. Physicians employ this voice to educate patients and their caregivers by providing them with information in order to change the patients' behavior and improve their health status. The subject has not yet been fully understood, and therefore the present study was conducted to explore the pattern of educator voice. For this purpose, conversation analysis (CA) of 33 recorded clinical consultations was performed in outpatient educational clinics in Shiraz, Iran between April 2014 and September 2014...

The central role of the virtue of compassion in the shaping of the professional character of healthcare providers is a well-emphasized fact. On the other hand, the utmost obligation of physicians is to alleviate or eliminate human suffering. Traditionally, according to the Aristotelian understanding of virtues and virtue ethics, human virtues have been associated with masculinity. In recent decades, the founders of the ethics of care have introduced a set of virtues with feminine nature. This paper analyzes the notion of compassion as a common virtue between the traditional/masculine and care/feminine sets of virtues and shows that compassion is a reunion and merging point of both sets of human virtues...

Air pollution is among the environmental problems that adversely affect people's health. There is a close relationship between medicine and environment, and as a consequence, there are ethical considerations surrounding the problem of air pollution. The present research aimed to determine physicians' attitude toward their ethical responsibility regarding air pollution, and their role in reducing it. This was a qualitative research using content analysis, conducted in Tehran University of Medical Sciences. The focus group included 21 physicians with specialties and subspecialties in pediatrics, infectious diseases, pulmonology, gynecology, and midwifery selected through predetermined sampling along with 13 personal in-depth interviews...

Ethical codes are instructions that shape ethical behavior and determine which values and beliefs should be accepted. These codes act as a practical guideline in the nursing profession. The present study aimed to compare adherence to ethical codes between the nursing students and working nurses of Valiasr Hospital, affiliated with Fasa University of Medical Sciences in Fars Province, Iran. In this descriptive-analytical study, the data collection tool was nurses' self-reporting questionnaire on adherence to ethical codes devised by Mahdavi Lenji and Ghaedi Heidari, who have also confirmed its validity and reliability...

Medication adherence is a behavior that is influenced by several factors, and maintaining patients' dignity is an important issue that needs to be considered in the course of treatment . The present study aimed to determine the relationship between human dignity and medication adherence in patients with heart failure. This was a cross-sectional study. A total number of 300 patients with heart failure admitted to the Mazandaran Heart Center, Iran, participated in this study by census. Samples were selected based on inclusion criteria such as an HF diagnosis by a cardiologist for a minimum of 6 months, and taking at least one cardiac medication...

Public health ethics is a field that covers both factual and ethical issues in health policy and science, and has positive obligations to improve the well-being of populations and reduce social inequalities. It is obvious that various philosophies and moral theories can differently shape the framework of public health ethics. For this reason, the present study reviewed theories of justice in order to analyze and criticize Iran's general health policies document, served in 14 Articles in 2014. Furthermore, it explored egalitarianism as the dominant theory in the political philosophy of the country's health care system...

During medical training, students obtain enough skills and knowledge. However, medical ethics accomplishes its goals when, together with training medical courses, it guides students behavior towards morality so that ethics-oriented medical practice is internalized. Medical ethics is a branch of applied ethics which tries to introduce ethics into physicians' practice and ethical decisions; thus, it necessitates the behavior to be ethical. Therefore, when students are being trained, they need to be supplied with those guidelines which turn ethical instructions into practice to the extent possible...