Journal of Medical Ethics and History of Medicine http://jmehm.tums.ac.ir/index.php/jmehm en-US jmehm@tums.ac.ir (Dr. Bagher Larijani) journals@tums.ac.ir (TUMS Technical Support) Mon, 21 Jan 2019 12:51:34 +0330 OJS 3.1.1.0 http://blogs.law.harvard.edu/tech/rss 60 Adoption of Iran’s code of ethics for blood donation and transfusion as a public health policy http://jmehm.tums.ac.ir/index.php/jmehm/article/view/463 <p>Blood is a public resource of human origin and its transfusion process is essential to individual and public health. This study aimed to develop a national code of ethics for blood donation and transfusion (BDT).<br>This was a qualitative research with a multi methods approach in which a combination of methods including situational analysis, focus group discussion and expert panels were used. After situational analysis and orientation, the code of ethics for BDT was developed based on the findings of a content analysis within the framework of the four principles of biomedical ethics.<br>The results were categorized into two sections: situational analysis and underpinnings measures, and the clauses of the code. The Iranian Blood Transfusion Organization has carried out three essential supportive measures over the past decades: approval of insurance coverage of blood recipients against communicable diseases; inclusion of 14 blood services in the book of “Relative Value Units of Health Services”; and formation of the National Ethics Committee of Transfusion Medicine. After recognition and orientation, the national code of ethics for BDT was adopted and imparted to blood donation centers. The code consists of two sections: “Blood Transfusion Centers: Donors and Donation” in 19 clauses, and “Hospitals: Patients” in 8 clauses.<br>The national code of ethics for BDT establishes moral norms in order to protect the rights of blood donors and recipients. It could also serve as a basis for addressing the related ethical challenges and right decision-making in the area of BDT.</p> Abolfazl Asghari, Aliakbar Pourfathollah, Mahmoud Abbasi, Tooran Mohammadi, Forouzan Akrami ##submission.copyrightStatement## http://jmehm.tums.ac.ir/index.php/jmehm/article/view/463 Mon, 21 Jan 2019 00:00:00 +0330 A study of the validity and reliability of the questionnaire entitled “physicians' approach to and disclosure of medical errors and the related ethical issues” http://jmehm.tums.ac.ir/index.php/jmehm/article/view/464 <p>Medical errors are among the major challenges that threaten patients’ health worldwide. The aim of this study was to design a valid and reliable questionnaire to investigate the status of medical error disclosure by physicians.</p> <p>A preliminary questionnaire was developed based on the extracted results from 37 interviews with specialists. To test the validity of the questionnaire, 20 medical practitioners and medical ethics authorities were asked to evaluate the relevance and clarity of each item. To measure the instrument’s reliability (the intra-class correlation coefficient and Cronbach’s alpha), a test-retest study was conducted on 20 randomly selected physicians twice with a 2-week interval. Statistical analyses were performed using SPSS software version 20.&nbsp;</p> <p>The overall relevance and clarity of the instrument, with an average approach, were measured at 97.22 and 94.03 percent respectively. The Cronbach’s alpha, which presents the internal consistency was satisfactory (0.70 - 0.79) for various domains of the questionnaire. The range of intra-class correlation coefficients for the items in all domains of the questionnaire was 0.76 to 1.00.</p> <p>Regarding the validity and reliability of the questionnaire, it can be an appropriate instrument in the assessment and monitoring of the status of medical error disclosure by physicians.</p> Mohammad Mohammadi, Bagher Larijani, Seyed Mahmoud Tabatabaei, Saharnaz Nedjat, Masud Yunesian, Fatemeh Sadat Nayeri ##submission.copyrightStatement## http://jmehm.tums.ac.ir/index.php/jmehm/article/view/464 Wed, 06 Mar 2019 00:00:00 +0330 Medical ethics and the trolley problem http://jmehm.tums.ac.ir/index.php/jmehm/article/view/420 <p>The so-called Trolley Problem was first discussed by Philippa Foot in 1967 as a way to test moral intuitions regarding the doctrine of double effect, Kantian principles and utilitarianism. Ever since, a great number of philosophers and psychologists have come up with alternative scenarios to further test intuitions and the relevance of conventional moral doctrines. Given that physicians routinely face moral decisions regarding life and death, the Trolley Problem should be considered of great importance in medical ethics. In this article, five “classic” trolley scenarios are discussed: the driver diverting the trolley, a bystander pulling a lever to divert the trolley, a fat man being thrown from a bridge to stop the trolley, a bystander pulling a lever to divert a trolley so that a fat man may be run over, and a bystander pulling a lever so that a fat man falls off from a bridge to stop the trolley. As these scenarios are discussed, relevant moral differences amongst them are addressed, and some of the applications in medical ethics are discussed. The article concludes that Trolley scenarios are not the ultimate criterion to make ethical decisions in difficult ethical challenges in medicine cases but they do serve as an initial intuitive guide.</p> Gabriel Andrade ##submission.copyrightStatement## http://jmehm.tums.ac.ir/index.php/jmehm/article/view/420 Sun, 17 Mar 2019 13:56:47 +0330