The Journal of Medical Ethics and History of Medicine is the official scientific publication of the Medical Ethics and History of Medicine of Tehran University of Medical Sciences. Physicians and health practitioners always deal with ethical issues in the treatment and management of diseases. The advent of new biomedical technologies further complicated the moral and societal issues of medical research and practice. Religious and cultural differences more emphasize the need for nationalizing this knowledge. The Journal of Medical Ethics and History of Medicine (J Med Ethics Hist Med) is an opportunity for healthcare professionals as well as theologians, philosophers, and sociologists to present and discuss their ideas from several aspects in relation to medical ethics and bioethics. In addition, this Journal traces its roots to several aspects of the History of Medicine which further emphasizes on Iranian and Islamic eras.

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Vol 17 (2024)

Original Article(s)

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    As a rule, physicians’ reputation significantly influences public confidence in the medical profession. Unfortunately, the societal perception of physicians in contemporary Iran appears to be negatively impacted. Therefore, the present study aimed to analyze and elucidate the fundamental causes of this phenomenon.This qualitative study employed content analysis of semi-structured interviews conducted in 2022. The study population consisted of 6 physicians, 6 nurses and 12 patients in the the affiliated hospitals in Kerman University of Medical Sciences selected through purposive sampling. Extraction of the main themes followed the Graneheim and Lundman approach, and data management was facilitated through MAXQDA 20. The study identified five themes encapsulating the causes for damage to physicians’ reputation: physicians' relationship with patients, physicians' relationship with the community, physicians' relationship with the medical profession, challenges within medical practice, and challenges related to medical education. Within these themes, a total of 38 subthemes emerged.The primary drivers that seem to damage physicians’ reputation include: non-effective communication, negative public attitudes toward certain physicians and medical centers due to malpractice, illegitimate relationships of physicians, gaps in physicians’ skills, insufficient education, and ethical lapses.It was concluded that several infrastructural elements negatively impact physicians' reputation. Consequently, it is recommended to monitor the professional behaviors, practices and relationships of physicians, while scrutinizing the medical education system.

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    In the Holy Quran, a strong emphasis has been placed on the dignity of human beings. There are two verses in the Quran that discuss the differences between humans and other creatures. In this article, we have tried to interpret these two verses using free selection of virtues and goodness as the criterion for human dignity that was obtained in our previous research. In the verse of trust, unlike other creatures, man accepts a trust that informs us about his cruelty and ignorance.  However, if we consider this trust as freedom of choice, it can also imply injustice and ignorance alongside justice and wisdom for humans. In the verse of succession, angels tell God that human as vicegerent on earth leads to corruption and bloodshed. God does not deny this, but reminds the angels of the existence of pure ones. If we consider freely choosing goodness the differentiating factor between humans and other creatures the angels accurately refer to the possibility of creating corruption and bloodshed. However, they did not see the value of voluntary goodness compared to their own compulsory goodness.Therefore, by considering freely choosing goodness as the criterion for human dignity, these two verses can be easily interpreted.

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    Research on human dignity is crucial for understanding the ethical foundations of human rights. Neglecting to address certain pitfalls in this area of research can lead to adverse effects, including the perpetuation of discrimination, the misrepresentation of dignity across different schools of thought, and the weakening of ethical standards in human rights discourse. The present study aims to identify such challenges by analytically examining outstanding research in this field. Our surveys have identified challenges and pitfalls that were categorized into two groups: challenges in the field of materials, and challenges in the field of methods. In terms of materials, researchers may fail to adequately consider the historical and cultural contexts that shape these views, while in terms of methods, they may overlook the diverse perspectives that contribute to a comprehensive understanding of dignity. Consequently, it is imperative for researchers to remain vigilant and avoid these pitfalls to ensure that their work upholds the true essence of human dignity and effectively advocates for the rights of all individuals, especially those from marginalized backgrounds.

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    Human dignity is discussed in fields such as law, theology and ethics. In human rights and law, dignity is fixed and equal for everyone, but in theology, it can be different based on human actions. The highest human position is obtained through voluntary selection of goodness. However, failure to achieve this does not indicate a complete loss of dignity from a religious point of view, as there are other characteristics that can bestow dignity. The existence of these dignifying factors creates minimum and maximum degrees of dignity, the maximum being discussed in theology, and the minimum in law and human rights. The laws on compensation for harm may lead to the false conclusion that dignity can be purchased, but we must remember that dignity has two dimensions: material and spiritual. While damage to the spiritual dimension cannot be undone, “Diya” has been provided in Islam to compensate for the material dimension. This explains the difference between male and female Diya in Islamic laws. Spiritual dignity is independent of gender, but to compensate for material dignity, higher Diya has been proposed for men as they have a more prominent role in financing the family. In the end, we will discuss that due to the role changes in the society nowadays, the laws will need to be modified.

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    The fundamental topic in humanities is clearly the study of humans. Neglecting the understanding and recognition of humans can hinder us from achieving generalizable results and may lead us toward arbitrary and group-based decisions. Failure to distinguish between biological species up to the point of denying the objectivity of species, conflicts between nominalists and realists, and limitations of logical definitions are problems that will be addressed in this article.In this study, it is argued that there is no universal definition for human beings as a biological species. Therefore, from a philosophical perspective, the rights and characteristics that are associated with humans in humanities cannot be attributed to human beings as a mere biological species. In an attempt to settle this issue, a minimal shared definition of “human” (as a philosophical entity) that encompasses differences and exceptions has been accepted and recognized.It is evident that an attachment cannot stand on the same level as the essence, and discussions regarding their incorporation should be considered.In this article, it has been concluded that the criteria for the philosophical human are self-awareness and freedom of choice, and offering a definition for “human” will be founded on these two features.

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    Although human dignity has been the focus of many researchers, fundamental debates about its existence have often been ignored. Different views on human dignity and its existence can lead to divergent interpretations of human rights. In this study, we attempted to find an answer to the question of the nature of human dignity by examining and collecting the opinions of experts and analyzing and criticizing them. Our analysis showed that since dignity is linked to human existence and understanding, it has a subjective nature. Subjective existences have different types, including contractual and abstract. Contractual existence finds its way to objective entities through human thought, and it is changeable. An abstract existence, on the other hand, is created by perception of an objective entity in a constant way among human beings. Human dignity is consistent with the contractual type, because simply seeing a human does not bring to mind the existence of dignity and human rights. Once we accept the contractual nature of dignity, we must determine who bestowed this dignity on man. Through investigations, we came to the conclusion that God is the only one that can grant such privilege, and the existence of dignity for humans is a proof of God's existence.

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    The criteria for assigning human dignity have been a subject of debate among researchers for years. Regardless of what criteria are chosen for human dignity, each school of thought must provide a method to identify them in people. The authors of this article consider voluntarily in choosing goodness and virtues to be the criterion. The purpose of this article is to present a method for establishing the existence of this criterion in humans and to examine the various manifestations of acting freely on what is good and virtuous by citing philosophical Islamic sources, especially the Qur'an. In this article, we will first discuss the differences among people regarding the existence of dignity and its manifestations, and move on to investigate the special conditions that can be challenging for allocation of dignity across different schools of thought. Finally, we will examine various Islamic sources to evaluate the methods of identifying human dignity in people. Our investigations show that since concepts such as “right” and “good” are of a subjective nature, there is more than one manifestation for presence of criterion of human dignity, and in practice, no one can be deprived of their dignity.

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    Many medical schools are adopting varied teaching strategies to enhance students' understanding of the humanitarian aspects of their specialties. This study evaluated medical ethics education at Kerman University of Medical Sciences (Iran) from the students’ perspectives using the CIPP model.A cross-sectional study involving 136 clerkship medical students used convenience sampling and a validated, researcher-made questionnaire based on the CIPP model. The questionnaire, divided into context, input, process, and product sections, assessed the achievement of the program's goals, requirements, implementation, and outcomes of the medical ethics training program.The results revealed that the product domain scored the highest (79.17±21.82), while the input domain scored the lowest (54.30±29.00). The medical ethics program successfully communicated ethical concepts and enhanced students' understanding, excelling in the product domain. However, it requires improvements in the context, input, and process areas, such as aligning materials with cultural norms, and boosting students.It is hypothesized that the medical ethics program at Kerman University of Medical Sciences is robust and aligns well with the CIPP model standards. While the program excels in educational outcomes, there is room for improvement in the context, input, and process dimensions. This study offers pivotal insights for advancing and refining future medical ethics programs.

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    Professional ethics are important to support the ethical decision making of nurses and to respond to the current challenges in healthcare. This study was to explore professional ethical challenges and the strategies to address the ethical challenges in clinical in a Muslim country. This study used an exploratory descriptive qualitative approach. Two focus groups and semi-structured individual interviews were conducted, and data were analyzed using thematic analysis. Participants shared their experiences and perceptions of professional ethical challenges and suggested strategies. Nine ethical challenges were identified: 1) Less patient-centered care; 2) Giving bad news to the patient and family; 3) Ethical decision making about no treatment, no mechanical ventilation, and no resuscitation; 4) Not considering patients’ culture in nursing care; 5) New technologies and challenges related to overuse; 6) Health information as an ethical challenge for managing and using large patient datasets; 7) Nursing in disasters or crises and the challenge of respecting ethical principles; 8) Palliative care for patients; and 9) Fear created moral distress. Study findings highlight ethical challenges that nurses have in clinical practical and the strategies that can be used.moral distress. The findings underscore the ethical challenges faced by nurses in clinical practice and suggest strategies for addressing each challenge in Iran.

Review Article(s)

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