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 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 History of Medicine which further emphasizes on Iranian and Islamic era.
Journal of Medical Ethics and History of Medicine is now Indexed in ISI Emerging Sources Citation Index(ESCI).
The ethical obligation to provide care to patients diagnosed with brain death until the end stages based on grounded theory
Nurses are faced with tremendous pressure when providing brain-dead patients with care. There is limited guidance for nurses on the care of these patients. The present study aimed to report the experiences of nurses regarding the care of patients diagnosed with brain death.Semi-structured interviews were conducted with 31 nurses and other stakeholders, and the observations and field notes were analyzed using continuous and comparative analysis based on grounded theory.The qualitative analysis of the data resulted in extraction of six final categories, including 'facing increased tensions and conflicts', 'organ donation: a distinct care element', 'inconsistency of care management', 'effective care requirements', 'challenges, rights and duty requirements', and 'moral obligation to provide holistic care until the last minute'. Data analysis identified 'Challenges, rights and duty requirements' as the main issue and showed that the nurses managed this issue using the strategy of 'moral obligation to provide holistic care until the last minute' as the core variable.According to the results, it is recommended that the healthcare system (especially hospital management) take supportive action for nurses in various fields of care of brain-dead patients to resolve educational, moral and legal challenges.
Nurses need to be resilient to be able to endure their working conditions, and their moral courage can affect their resilience. This work aimed at studying the relationship between resilience and professional moral courage among nurses working in hospitals.This descriptive cross-sectional study was conducted on 375 nurses working in teaching hospitals in the city of Ardabil in Iran in 2019. Data was collected using the following questionnaires: a demographic questionnaire, Sekerka et al. Moral Courage Scale and Davidson-Connor Resilience Scale. The reliability of the Davidson-Connor Resilience Scale, and Moral Courage Scale were found to be 89% and 85% using the test-retest method. The data were analyzed by Pearson correlation coefficient, t-test, variance analysis, and linear regression using the SPSS software version 24.In participating nurses, mean scores were 6.35±0.5 for total moral courage (favorable) and 79.35±0.35 (moderate) for resilience, respectively. A positive and significant relationship was observed between resilience and professional moral courage (P<0.05, r=0.1). Given the positive and significant relationship between resilience and professional moral courage, nurses require to have the high moral courage to enhance their resilience. Determining factors affecting moral courage and resilience, as well as finding strategies and creating an appropriate moral climate can increase nurses' morally courageous behaviors and resilience.
Nurses' attitudes toward caring for terminally ill neonates and their families in Iran: a cross-sectional study
Providing care for terminally ill neonates is an important issue in NICUs. This research aimed to determine nurses’ attitudes toward providing care for terminally ill neonates and their families. A total of 138 nurses working in neonatal intensive care units (NICUs) affiliated to Tehran University of Medical Sciences participated in this cross-sectional study via convenience sampling in 2019. The Data collection tool was the Frommelt attitudes toward caring for terminally ill persons and their families scale. The nurses in this study had the most positive attitudes toward the items “nursing care should include the family of the terminally ill patient, too” (4.2 ± 0.6) and “the care provider can prepare the patient or his/her family for death” (4.1 ± 0.7). The nurses had the least positive attitude toward the item “the time spent on caring for terminally ill patients creates a sense of frustration in me” (1.06 ± 1). The mean score of the attitudes of NICU nurses toward caring for terminally ill neonates and their families indicates the necessity of improving this attitude.