Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 94 94 EN Maliheh Kadivar Professor, Department of Pediatrics, Division of Neonatology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Ziba Mosayebi Associate Professor, Department of Pediatrics, Division of Neonatology- Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Fariba Asghari Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Pari Zarrini Neonatologist, Department of Pediatrics, Division of Neonatology- Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 2015 10 14 The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of Iran. In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians’ and nurses’ perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations. The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22. Respecting patients’ rights and interactions with parents were perceived as the most challenging aspects of neonatal care. There were significant differences between sexes in the domains of the perceived challenges. According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job. The results of our study showed that the most challenging issues were related to patients’ rights, interactions with parents, communication and cooperation, and end of life considerations respectively. It can be concluded, therefore, that more attention should be paid to these issues in educational programs and ethics committees of hospitals. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/94 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/94/77

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 100 100 EN Mohammadreza Ardalan Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Kazem Khodadoust Philosophy and History of Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Elmira Mostafidi Kidney Research Center, and Department of Pathology, Imamreza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 14 2015 10 14 T Ferdous al-Hekma (Paradise of Wisdom) is one of the oldest medical texts in the Islamic world written in Arabic in 850 AD by Ali ibn Raban Tabari. He was a Persian physician who moved from Tabaristan (Mazandaran province of modern day Iran) to Samarra during the reign of the Abbasid Caliph al-Mutawakkil (847-861 AD). We studied the book of Ferdous al-Hekma fil-Tibb, in an attempt to comprehend its general outlook on diseases of different organs, their classifications and the associated signs and symptoms. The book is one of the earliest medical pandects of the period of translation, adaptation and expansion of knowledge in the Islamic world during the 9 th  century AD. Tabari was mainly influenced by Hippocrates, Galen and Aristotle, as well as his contemporaries Johanna ibn Massavieh and Hunayn ibn Ishaq. The book is written in thirty chapters in a total number of 308 subtitles. In each part there is an introduction to the symptomatology, followed by organ specific diseases and therapeutic recommendations. Symptoms and physical signs of different diseases are vividly described in Ferdous al-Hekma, and some of them are even understandable for contemporary medical students.     https://jmehm.tums.ac.ir/index.php/jmehm/article/view/100 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/100/83

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 134 134 EN Omid Asemani Assistant Professor, Department of Medical Ethics and Philosophy of Health, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2015 11 03 2015 11 10 No Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/134 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/134/109

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 95 95 EN Fariba Borhani Associate Professor, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Somayeh Mohammadi MSc in Nursing, Shahrekord University of Medical Sciences, Shahrehkord, Ira. Mostafa Roshanzadeh Mentor, Surgical Care Research Centre, Birjand University of Medical Sciences, Birjand, Iran. 2015 10 14 2015 10 14 Special characteristics of care environments have always presented nurses with some challenges. One particular situation is futile care, which is frequently accompanied by countless moral and legal challenges. The dominant atmosphere in futile care may cause moral distress to nurses and lead to a sense of guilt, pain, suffering, job dissatisfaction, and eventually cause nurses to leave the job. This descriptive-analytical study attempted to investigate the relationship between futile care and moral distress in intensive care nurses. Study subjects were 300 nurses in intensive care units in Kerman, Iran and were selected by convenience sampling based on inclusion criteria. Study tools included Corley’s 21-item questionnaire on moral distress and a researcher-made 17-item questionnaire on futile care. Data analysis was performed using SPSS version 16 and suitable analytical and descriptive tests. The results showed a significantly positive relationship between moral distress and futile care ( P  = 0.03, r = 0.4). Based on the   obtained results, futile care can create conditions that may lead to moral distress in nurses and therefore strategies should be devised to prevent these conditions. Moreover, distress in nurses should be identified by periodical counseling so that it can be managed more efficiently.     https://jmehm.tums.ac.ir/index.php/jmehm/article/view/95 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/95/78

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 96 96 EN Tannaz Ahadi Assistant Professor, Department of Physical Medicine and Rehabilitation, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran. Elaheh Mianehsaz Clinical Research Unit, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran. Gholamreza Raissi Associate Professor, Department of Physical Medicine and Rehabilitation, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran. SeyedAlireza Moraveji Associate Professor, Department of Community Medicine, Kashan University of Medical Sciences, Kashan, Iran; 5Medical Student, Iran University of Medical Sciences, Tehran, Iran. Vahid Sharifi Medical Student, Iran University of Medical Sciences, Tehran, Iran. 2015 10 14 2015 10 14 Professionalism is the foundation of trust on which the doctor-patient relationship is built. This study was performed to measure professionalism in Iranian physical medicine and rehabilitation residents as a baseline assessment tool for future studies. This was a descriptive study. The Persian version of the American Board of Internal Medicine (ABIM) questionnaire was distributed among all the second and third-year residents of the medical state universities of Iran (n=43). Data were summarized as mean (SD), and independent samples t-test was used for comparison of means between genders, and also between the second and third-year residents. Forty questionnaires were analyzed. The mean (± SD) age of respondents was 29.95 (± 2.37) years. The mean score (SD) for the overall score was 115.15 (± 17.36) out of 150, and the mean score (± SD) for all items was 7.67 (± 1.15) out of 10. The respondents averaged 5.88 (± 1.69) for items forming the ‘excellence’ factor, 7.98 (± 1.48) for items in ‘altruism/respect’ and 8.92 (± 1.26) for items in the ‘honor/integrity’ subscale. These data may serve as a baseline for future research in this field. The lowest score pertained to excellence, which needs more focus in future studies. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/96 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/96/79

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 97 97 EN Fariba Borhani Associate Professor, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Keshtgar MSc in Nursing, Nursing Department, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Abbas Abbaszadeh Professor, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences; and Academy of Medical Sciences, Tehran, Iran. 2015 10 14 2015 10 14 Nurses are often faced with serious situations that require high levels of legal and ethical knowledge, and should therefore be sensitive to the moral issues in their profession in the decision making process. Some studies have investigated nurses’ moral self-concept as an effective factor in moral sensitivity, but there is not sufficient evidence to support this. The purpose of this study was to determine the correlation between moral sensitivity and moral self-concept in nurses employed in the teaching hospitals in Zahedan, Iran. This cross-sectional descriptive study aimed to study the relationship between moral self-concept and moral sensitivity in nurses employed in the teaching hospitals affiliated with Zahedan University of Medical Sciences. Chang’s Moral Self-Concept Questionnaire and Lutzen’s Moral Sensitivity Questionnaire were used for data collection. Data analysis was performed using SPSS software version 17. A total of 188 nurses participated in this study. The results showed that there was a positive and significant relationship between moral self-concept and moral sensitivity ( P  < 0.05). Based on our findings, an individual's attention to moral issues can lead to greater sensitivity and result in morally responsible behavior at the time of decision making. Consequently, promotion of moral self-concept through personal effort or education can increase moral sensitivity, which in turn leads to behavioral manifestations of ethical knowledge.     https://jmehm.tums.ac.ir/index.php/jmehm/article/view/97 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/97/80

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 98 98 EN Akram Hashemi PhD candidate, Department of Medical Education, Iran University of Medical Sciences, Tehran, Iran. Habibeh Yeketaz MD, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fariba Asghari Associate professor,Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 2015 10 14 Clinical education is an essential part of medical trainees’ education process, and curriculum planners agree that it should be based on ethical standards and principles in the medical field. Nevertheless, no explained and codified criteria have been developed for ethics in clinical teaching. This study was aimed to develop an ethical guideline for medical students and teachers as the first and most important step in respecting patients' rights in educational centers. The initial draft included the codes of ethics in clinical education and was developed based on library studies. Subsequently, it was improved through a qualitative study using semi-structured interviews and focus group sessions with medical students, patients, and medical teachers in educational hospitals affiliated to Tehran University of Medical Sciences. The improved draft was reviewed and validated by a medical expert panel to prepare the final draft. The codes derived from this study included patients’ choices and rights in purely educational procedures, and special considerations for a) obtaining informed consent for educational procedures; b) performing procedures on deceased persons, patients under anesthesia and those lacking decision making capacity; c) educational visual recordings of the patients; and d) safety monitoring in clinical education. The guideline developed in this study incorporates codes of ethics into clinical training. Therefore, in addition to providing efficient education, the interests of patients and their rights are respected, and the ethical sensitivity of learners in primacy of patients’ best interests will be preserved and enhanced. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/98 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/98/81

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 8 0 2016 02 28 99 99 EN MohammadAli Cheraghi Associate Professor, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Arpi Manookian Assistant professor, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Alireza nt of Medical Education, School of Medicine, Saveh University of Medical Sciences, Saveh, Iran. Nayereh Baghcheghi Assistant professor, School of Nursing, Saveh University of Medical Sciences, Saveh, Iran. Mahmood Karimy Associate Professor, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran. Morteza Hemmat Assistant professor, Department of Health Information Management, School of Medicine, Saveh University of Medical Sciences, Saveh, Iran. Morteza Shamsizadeh Instructor, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. 2018 06 23 2019 04 29 The field of education has experienced a profound change following the introduction of mobile technology over the last decades, and nursing education is not an exception. This study explored the experiences of nursing students about the ethical concerns regarding the use of mobile devices for learning purposes, that is, mobile learning, in educational and clinical contexts. A qualitative phenomenological study was carried out on nursing students (n = 19) in Saveh University of Medical Sciences of Iran between December 2017 and April 2018. Data were collected through semi-structured interviews with openended questions. Data analysis was done using Colaizzi’s 7-step method, revealing four the mes and nine sub-themes including: 1) preserving professional dignity (in front of the patient, and the teacher, and preserving academic virtual identity); 2) securing informed consent and respecting personal (the patient’s and teachers) autonomy; 3) proper and efficient use (observing the regulations and codes, and making educational use); and 4) avoiding harm (responsible use of class and patient data). It was revealed that using mobile technology in education could raise ethical concerns for nursing students, and this should be emphasized in nursing educational programs. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/425 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/425/296

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 12 0 2019 11 12 562 562 Stefane Kabene Faculty of Communication, Arts and Sciences (FCAS), Canadian University Dubai, Dubai, UAE. Said Baadel Faculty of Communication, Arts and Sciences (FCAS), Canadian University Dubai, Dubai, UAE. 2019 04 21 2019 11 12 Using animals for cosmetics and medical tests has contributed towards a debate based on conflicting interests. Despite the efforts in justifying the value of animals in conducting analyses, this study seeks to elaborate whether or not it is rational to use animals as test subjects in medical and cosmetics fields. The value of animal life is at the core of the emotional conflicts that arise when animals become experimental subjects in medical and cosmetics fields. The aim of this study is to determine if there are ethical differences in the use of animal testing in medicine versus cosmetics. The research, through review and content analysis of the existing literature, compares and provides the outcomes of using animals in medical and cosmetics tests by examining studies conducted in the UK. The findings of this research indicated that animal testing is considered acceptable in the medical field only if there are no other alternatives, but is completely unacceptable in the cosmetics field. The study also provides recommendations in the form of alternatives that protect animals from cruelty and may benefit the different stakeholders and the society at large. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/562 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/562/317

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 12 0 2019 04 16 442 442 EN Amirhossein Mardani PhD Student in Information Science & Knowledge Study, Department of Information Science & Knowledge Studies, Faculty of Management, University of Tehran, Tehran, Iran. Maryam Nakhoda Assistant Professor, Department of Information Science & Knowledge Studies, Faculty of Management, University of Tehran, Tehran, Iran. Alireza Noruzi Associate Professor, Department of Information Science & Knowledge Studies, Faculty of Management, University of Tehran, Tehran, Iran. Ehsan Shamsi Gooshki Assistant Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2018 07 21 2019 04 13 The national guidelines for biomedical research ethics are approved by the “National Committee for Ethics in Biomedical Research” at the Iranian Ministry of Health and Medical Education as the regulatory body for biomedical research in the country. The focus of these guidelines should be on the ethical issues related to different stages of the research process, which would lead to increased research integrity and better supervision of research activities. The present study analyzed the contents of these national guidelines to clarify the ethical considerations connected to the five stages of a research process including 1) proposing, 2) approval, 3) operation, 4) documentation and 5) publishing. The findings showed that the assessed guidelines laid more emphasis on the ethical considerations related to the research operation stage rather than the proposal stage. In other words, activities such as identification of the research problem, formulation of hypotheses and questions, financial evaluation, data analysis and data interpretation did not receive adequate attention in these guidelines. Most of the guidelines presented subject categories such as the rights of participants and supervisory considerations in the “research operation stage”, ethical considerations in the “evaluation and approval procedure stage”, and editorial responsibilities in the “research review and publication stage”. In general, despite noticeable content for guiding researchers for ethical conduction of research the national guidelines are not adequately developed to cover comprehensive and sufficient ethical considerations regarding all the activities of research. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/442 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/442/295

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 12 0 2019 12 21 633 633 Gabriel Andrade Assistant Professor, College of Medicine, Ajman University, United Arab Emirates. 2019 09 02 2019 12 21 In continuation with the New Thought movement that arose in the United States in the 19th Century, there is now a massive self-help industry that markets books and seminars. This industry has also extended to healthcare in the form of positive thinking, i.e., the idea that happy thoughts are essential for health. While some of these claims may seem reasonable and commonsensical, they are not free of problems. This article posits that positive thinking has some ethical underpinnings. Extreme positive thinking may promote alternative forms of medicine that ultimately substitute effective treatment, and this is unethical. The emphasis on positive thinking for cancer patients may be too burdensome for them. Likewise, unrestricted positive thinking is not necessarily good for mental health. After considering the ethics of positive thinking, this article proposes a more realistic approach. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/633 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/633/322

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 12 0 2019 03 06 464 464 EN Mohammad Mohammadi PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Ethics, School of Medicine, Tehran, University of Medical Sciences, Tehran, Iran; Faculty of Medicine, Department of Medical Ethics, Mashhad University of Medical Sciences, Mashhad, Iran. Bagher Larijani Professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mahmoud Tabatabaei Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Saharnaz Nedjat Professor, Knowledge Utilization Research Center, Tehran University of Medical Science, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Masud Yunesian Professor, Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical sciences, Tehran, Iran; Department of Environmental Heath, School of Public Health, Tehran University of Medical sciences, Tehran, Iran. Fatemeh Sadat Nayeri Professor, Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2018 09 02 2019 03 06 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. 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.  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. 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. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/464 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/464/293

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 12 0 2020 01 01 624 624 Boleslav Lichterman Professor, Department of Humanities, The IM Sechenov First Moscow State Medical University, Moscow, Russia 2019 08 20 2020 01 01 The aim of this paper is to compare “Zapiski Vracha” (“Confessions of a Physician”, first published in 1901) by Vikenty Veresaev to “Aerztliche Ethik” (“Doctors’ Ethics”, first published in 1902; two Russian editions were published in 1903 and 1904) by Albert Moll. It starts with an overview of medical ethics in Russia at the turn of the 20th century in relation to zemstvo medicine, followed by reception of Veresaev’s “Confessions of a Physician” by Russian and German physicians, and of Moll’s “Doctors’ Ethics” in Russia. Comparison of these two books may serve as a good example of a search for common philosophical