Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 03 08 1150 1150 EN Saleheh Tajalli Researcher, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Mansoureh Ashghali Farahani Professor, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Mazlome Hamzekhani Instructor, Department of Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran. Azam Shirinabadi Farahani Assistant Professor, Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Nima Pourgholam Amiji Researcher, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Martina Mavrinac Professor, Department of Medical Informatics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia. Roqayeh Aliyari Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran. 2021 11 08 2022 03 08 This study aims to assess the psychometric properties of the Persian version of the Attitudes Toward Plagiarism Questionnaire (ATPQ) among Iranian medical sciences postgraduate students and faculty members. In this study, the ATPQ developed by Mavrinac et al. in 2010 was translated into Persian. After assessment of face and content validity, we distributed the ATPQ draft among 286 Iranian medical science postgraduate students and faculty members. Explanatory and confirmatory factor analysis were applied, and Cronbach's alpha was used to measure the reliability of the ATPQ. All the items of our English version of the ATPQ were approved by the developer of the original ATPQ, and two were revised in the cognitive interview. Construct validity assessment showed that three items were not seriously involved in the extracted factors. The Persian version of the ATPQ had 26 items, five factors and a Cronbach's alpha of 0.81%, and the combined value explained 38.24% of the total variance of this scale. Two new factors of “perceived control” and “attitude toward self-plagiarism” were extracted and incorporated into the Persian version. To conclude, the ATPQ is a valid, reliable, and convenient instrument to determine attitudes toward plagiarism among Iranian medical science postgraduate students and faculty members. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1150 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1150/394

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 10 25 1193 1193 EN Negar Aghighi PhD candidate in Health Services Management, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Aidin Aryankhesal Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Science, Tehran, Iran. Pouran Raeissi Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. 2022 02 09 2022 10 25 Due to the high value of human life, the occurrence of even one error that leads to death or complications is of great consequence and requires serious attention. Although significant efforts have been made to ensure patient safety, serious medical errors continue to exist. This study aimed to identify the factors associated with the recurrence of medical errors and strategies to prevent them through a scoping review.Data were gathered through a scoping review of PubMed, Embase, Scopus, and Cochrane Library databases during August 2020. Articles related to factors influencing the recurrence of errors despite the available information, as well as articles related to measures taken worldwide to prevent them, were included in study. Overall, 32 articles were selected out of the 3422 primary papers. Two main categories of factors were identified as influential in error recurrence: human factors (fatigue, stress, inadequate knowledge) and environmental and organizational factors (ineffective management, distractions, poor teamwork).The six effective strategies for preventing error recurrence included the use of electronic systems, attention to human behaviors, proper workplace management, workplace culture, training, and teamwork.It was concluded that using a combination of methods related to health management, psychology, behavioral sciences and electronic systems can be effective in preventing the recurrence of errors. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1193 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1193/400

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 12 28 1255 1255 EN Mahshad Noroozi Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Fatemeh Bahmani Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Kazem Mousavizadeh Professor, Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Saeedeh Saeedi Tehrani Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Akram Hashemi Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Mina Forouzandeh Assistant Professor, Medical Ethics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2022 08 11 2022 12 28 Using genetic tests on deceased patients’ samples for diagnostic purposes affects the family members' health and lives but raises some ethical issues in today’s practice of medicine and research. In this paper, we address a common ethical dilemma of clinicians regarding whether to perform genetic tests on a deceased patient’s sample upon a request from first-degree relatives against the patient's wishes in the last days of life. In this paper, a real case scenario is presented that echoes the above-mentioned ethical challenge. Reviewing the genetic basis of the case, the ethical arguments for and against the reuse of genetic material in a clinical context are discussed. An ethico-legal analysis of the case is proposed based on Islamic medical ethics resources. As reusing stored samples of expired patients without their consent also challenges the researchers in the field of genetics, a debate is included on the post-mortem use of genetic data and samples for research.Finally, defining the special features of the presented case and positive benefit-risk ratio, it is concluded that reusing the patient's sample may be justified if the first-degree family members insist on genetic testing and are comprehensively informed about the benefits and harms. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1255 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1255/406

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 03 15 1186 1186 Mohammad Kiasalar PhD Candidate of 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. Younes Shokrkhah Assistant Professor, Department of European Studies, Faculty of World Studies, University of Tehran, Tehran, Iran. Saharnaz Nedjat Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hamidreza Namazi 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; Department of History of Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran. 2022 01 29 2022 03 15 Media is an opportunity for health professionals; however, it is not free of threats. Fixing the threats requires professional systematization through developing practical guidelines, which brings us to the goal this study was designed to achieve. The study was conducted qualitatively through literature review, semi-structured interviews, and a focus group discussion with health and media experts, as a result of which 486 codes were extracted and classified into 4 groups. The first group was addressed to media professionals and contained 126 codes in 5 categories: seeking and reporting the truth, harm minimization, integrity, independence, and respect for the rights of others. The second and third groups were addressed to health professionals, the former (150 codes) dealing with formal media, and the latter (190 codes) dealing with cyberspace. These groups were both categorized into 6 categories: scientific demeanor, beneficence, harm minimization,integrity, maintaining the dignity of the profession and professionals, and respect for the rights of others. The fourth group was addressed to the public audience and contained 20 codes categorized into 2 categories: ethics of belief, and ethics of (re-)publishing. Since the study was conducted during the pandemic/infodemic, the proposed codes can help reduce possible conflicts in similar future situations. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1186 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1186/395

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 12 28 1270 1270 Mamak Tahmasebi Palliative Medicine Fellowship; Cancer Institute of Iran; Imam Khomeini Hospital Complex; Tehran University of Medical Sciences; Tehran; Iran. 2022 11 07 2022 12 28 No AbstractNo AbstractNo AbstractNo Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1270 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1270/409

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 06 01 1205 1205 Arshia Zardoui Researcher, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mir Saeed Yekaninejad Associate Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Ali Kazemian Associate Professor, Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran. Mojtaba Parsa Assistant Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2022 03 09 2022 06 01 Breaking bad news to patients is an essential aspect of the physician-patient relationship, but in Iran, this relationship is often disrupted by patients’ families. This study investigates the views of patients' companions on breaking cancer news. In this descriptive-analytic cross-sectional study, we conducted research on 170 cancer patients’ companions and 170 non-cancer patients’ companions. We designed a questionnaire to investigate the subjects’ opinions and used CVI, CVR, Cronbach's alpha and ICC for evaluation. In order to compare groups, we used Mann Whitney, Kruskal-Wallis, Chi-square tests and Spearman’s correlation. Most participants believed that patients should be informed of their diagnosis. Cancer patients' companions were more willing to learn the bad news in case they were diagnosed with cancer and were less likely to choose “despair” as the reason for non-disclosure (71% vs. 44%).There was no difference between the two groups in willingness to break the cancer news to patients, choosing who should be informed first, and the reasons for non-disclosure. Most participants believed the family should be the first to know the diagnosis. In this study, most participants believed that patients should be informed of their diagnosis. However, they preferred to learn about the diagnosis before the patient, which confirms the importance of educating the families about autonomy. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1205 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1205/396

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 15 0 2022 08 10 1200 1200 Fatemeh Molaei Tavani Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran; Medical and Surgical Nursing, MSc Student Faculty of Nursing-Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. Mozhgan Behshid Assistant Professor, Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. Azad Rahmani Assistant Professor, Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran. Saeid Mousavi Assistant Professor, Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. Mehran Seif-Farshad Assistant Professor, Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. Parvin Rahmani Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran; Medical and Surgical Nursing, MSc Student Faculty of Nursing-Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. 2022 02 27 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranProfessor Reza Daryabeygi‐Khotbehsara Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Siamak Aghlmand Associate Professor Department of Public Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran. 2018 01 23 2018 06 17 Informal payments refer to sums that patients may pay to individual or organizational health care providers outside of the official payment channels or approved fee schedules. The aim of the current research was to investigate informal payments and related influential factors in Urmia city hospitals. The present study was a cross-sectional survey conducted among post-discharged patients from all Urmia city hospitals during one Iranian calendar month (January 21 to March 19, 2013). Simple random sampling was used to recruit 265 patients to undergo assessment via phone call interviews and complete a questionnaire. Data analysis was performed using SPSS software for descriptive reports, and EViews software for determination of factors affecting informal payments. Eleven percent of the patients had made informal payments to physicians (mean amount: 503,000 Tomans, equivalent of $412), 5% to nurses (mean amount: 20,000 Tomans, equivalent of $16), and 17% to other employees (mean amount: 16,000 Tomans, equivalent of $13). Hospital ownership, patients’ place of residence, education and income significantly influenced the payments. Most substantially, patients receiving surgical care were 100 times more likely to make informal payments compared to those who had received non-surgical inpatient care. The present study showed that although informal payment is illegal in Iran, it is a common practice among hospitalized patients, and has now become a challenge for the health system. Considering the high prevalence of informal payments and their severe impacts on equity and justice, policymakers have focused on this phenomenon to reduce and eliminate it. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/370 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/370/176

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 08 04 348 348 EN Akram Heidari Assistant Professor Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran. Masoomeh Razaghi Researcher Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran. Fariba Asghari Associate Professor Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2017 11 28 2018 07 24 Awareness of the occurrence of medical errors is the right of patients and duty of the health service providers. This study was conducted to evaluate to what extent people want to know the occurrence of an error in their medical care, what they expect to be disclosed about medical error, and what are the influential factors in filing a lawsuit against physicians in disclosed medical errors from their point of view.  In this cross-sectional survey, 1062 people residing in the city of Qom, Iran, were telephone interviewed using the random digit dialing method. The questionnaire used consisted of 4 demographic questions and 2 scenarios of major and minor medical error; the participants were asked if the physician should disclose the error in each scenario. The questionnaire also consisted of 16 questions about other issues related to error disclosure. Data were analyzed through descriptive and inferential statistics in SPSS software. About 99.1% of the study population believed that errors had to be disclosed to patients. They all wished to know that measures would be taken to prevent further errors. Moreover, 93.1% of the participants expected an explanation on the incident. As for the factors that decreased the likelihood of taking legal action against the physician from the viewpoint of the study population, treatment of the complications (96.1%) and honesty of the physician (95.8%) had the highest frequency. Based on the considerable preference of patients for error disclosure, it is recommended that physicians disclose all minor and major errors sympathetically and with transparency, honesty, and efforts to prevent future errors. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/348 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/348/179

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 09 09 384 384 EN Sajjad Azmand PhD Candidate of Medical Ethics Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, Iran Sedigheh Ebrahimi Associate Professor Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, Iran. Mohammadtaghi Iman Professor Department of Sociology, Shiraz University, Shiraz, Iran. Omid Asemani Assistant Professor Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, Iran. 2018 03 04 2018 06 12 Learning professionalism is a central topic in medical education. While many factors could affect the educational process of professionalism, hidden curriculum is considered one of the most important ones. As the working components of a hidden curriculum might be specific to the settings, this study explored its components in terms of professionalism and ethical conduct from the viewpoint of Iranian undergraduate medical trainees. Semi-structured and in-depth interviews were used to collect medical students' experiences and viewpoints, which were then analyzed through simple content analysis and the codes and categories were extracted. Finally, themes were derived as the central organizing concepts. Saturation occurred after 17 interviews. Seven main themes were extracted as the working components of hidden curriculum regarding professionalism in the setting: ‘convenient patients’, ‘evaluate me’, ‘trust as the base of team interactions’, ‘perceiving encouragement’, ‘relationship satisfaction and authenticity’, ‘workload and students’ well-being’ and ‘role modeling at the heart of professionalism’. Students' perception and experiences are a rich source of gaining a deeper understanding of the working hidden curriculum. In this study, two groups of human-related and environment-related elements were extracted. They were effective in the formation of the current 'ethical climate', which shaped the professional and ethical identity of medical trainees. Moreover, specific plans regarding the condition of the settings may provide opportunities for medical educators to enhance professionalism in their institutions. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/384 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/384/278

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 09 09 309 309 EN Hamideh Moosapour Ph.D Candidate in Philosophy of Medicine and Medical Ethics Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Jannat Mashayekhi Ph.D 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. Farzaneh Zahedi Director of Medical Ethics Research Group Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Akbar Soltani Professor Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Bagher Larijani Professor Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2017 08 01 2018 07 15 Islamic and non-religious ethics discourses have similarities and differences at the levels of meta-, normative, and applied ethics (e.g. biomedical ethics). Mainstream biomedical ethics (MBME) uses the language of contemporary, non-religious, Western ethics. Significant effort has been dedicated to comparing Islamic biomedical ethics (IBME) and MBME in terms of meta- and normative ethical positions, and final decisions on practical ethical issues have been reached. However, less attention has been given to comparing the general approaches of the two aforementioned discourses to ethical reasoning. Furthermore, IBME uses different languages to approach ethical reasoning, but identification and conceptualization of these approaches are among the important gaps in the literature. The aim of this study was to conceptualize general approaches to ethical reasoning in IBME. Through review and content analysis of the existing literature and the comparison between the languages employed by IBME and MBME, an inductive distinction have been made. The languages used in conceptualized approaches include the followings: (i) a language in common with the one employed by MBME; (ii) MBME language adjusted to the basic, common beliefs of Muslims; (iii) a language based on fatwas; and (iv) a language based on IBME principles. In the authors’ opinion, major challenges of the above-mentioned four approaches include, respectively: identifying the lack of religious sensitivity or Islamic considerations regarding an issue; acknowledging specific beliefs as the basic, common beliefs of Muslims; diverse fatwas and relations between juridical soundness and ethical soundness; and agreement on the same principles and rules as well as who should apply them. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/309 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/309/280

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 09 24 406 406 EN Solmaz Sadat Naghavi Alhosseini Reseacher Department of Idea Development and Innovation Center, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Ata Pourabbasi Assistant Professor Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2018 05 05 2018 09 04 Professional commitment plays a significant role in all professions. Moreover, schools are valuable fields for teaching the principles of these concepts especially through novel methods such as gamification. "Earthquake in the city" was implemented in a school in Tehran, Iran, and its effectiveness on learning the concepts of professional commitment was evaluated. "Earthquake in the city" was built based upon a fantasy scenario occurring in an imaginary city. Each student took on a role in the city (citizen or healthcare provider). After finishing the game, participants were asked about the concept of professional commitment. Their definition was scored by a group of medical ethics experts separately in terms of compliance with the actual definitions and compared with their peers in the control group who did not participate in the game. A group of 16-year-old teenagers studying in the 11th grade participated in this intervention. The average score of conformity with the actual concept of professional commitment among the case group participants was significantly higher than the average value for the control group (P < 0.05). The results of this study could provide insights to planners and educators engaged in the education system so that gamification can be incorporated as an influential tool to teach the concepts of professional commitment. This experience can also be generalized to other concepts, but designing the appropriate scenario will be the most important component of the intervention in these cases. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/406 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/406/281

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 09 26 415 415 EN Alireza Nikbakht Nasrabadi Professor School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Mitra Khoobi PhD candidate of Nursing Education Medical-Surgical Group, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ali Cheraghi Professor School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Soodabeh Joolaei Professor School of Nursing & Midwifery, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran. Majid Ahmadi Hedayat MSc Research deputy of Applied Sciences University, Ibn Sina Hospital, Tehran, Iran. 2018 05 26 2018 09 26 Ethical management with minimum moral distress is one of the main duties of nurse managers. There is no doubt that a better understanding of the experiences of nurse managers in morally challenging situations could have an effective role in improving health care systems. The present study aimed to investigate the lived experiences of clinical nurse managers regarding moral distress. This hermeneutic phenomenological qualitative research involved the use of semi-structured interviews with nurse managers. The interviews were transcribed and analyzed by the Diekelman, Allen and Tanner approach. For this purpose, a total of 14 Iranian nurse managers with at least five years of experience in nursing management in hospitals were purposefully selected. The findings related to nurse managers’ experiences of moral distress contained two main themes (psycho-emotional trauma and professional desperation syndrome) and four sub-themes (shame, emotional dissociation, helplessness, impaired professional identity). The findings of the study indicated that in order to understand the phenomenon of moral distress among nurse managers, it is essential to investigate the moral distress experienced by them. We also found that although they experience moral distress in their daily decisions repeatedly, they are not fully aware of this phenomenon According to the results, for clinical nurse managers, moral distress is an ambiguous situation like suspension along with uncertainty, fear and so on. They believed that experiencing this kind of conscious mistake is the reason for the occurrence of professional desperation syndrome and psycho-emotional trauma. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/415 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/415/282

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 12 16 424 424 EN Nazafarin Ghasemzadeh PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research 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. Mandana Shirazi Associate Professor, Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Faramarzi Razini Mentor Jurisprudence and Islamic Law Department, Urmia University, Urmia, Iran. Bagher Larijani Professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran, Iran; Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2018 06 20 2018 08 13 End-of-life care and protection of the patient in the near-death moments are part of a patient’s rights and the duties of the medical staff. As the beginning and end of human life are most sensitive moments, there are various religious rules associated with them. The ethical issues regarding practicing medical procedures on nearly dead patients are of particular complexity and are consistent with invaluable and profoundly religious recommendations. In addition, the purpose of medical training is to provide physicians with the knowledge and skills necessary to practice appropriately and within legal and ethical frameworks. Therefore, respecting patients’ cultural and religious beliefs is an ethically accepted principle in the health systems of different countries and is the basis of respect for human dignity. The present study used a qualitative content analysis to explain how to practice medical procedures on a dying or nearly dead patient in accordance with Islamic jurisprudential rules. It was finally concluded that according to the Islamic jurisprudential rules of “authority”, “no harm”, “necessity”, and “public interest”, procedures performed on a dying patient could be used for training purposes under certain circumstances. Nevertheless, such activities should only be done with the patient’s permission and provided they cause no unnecessary harassment, and they may take place in the absence of alternative methods. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/424 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/424/285

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 12 25 499 499 Nazafarin Ghasemzadeh PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research 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. Mandana Shirazi Associate Professor, Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Faramarzi Razini Mentor, Department of Jurisprudence and Islamic Law, Urmia University, Urmia, Iran. Bagher Larijani Professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran, Iran; Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2018 10 20 2018 10 20 Part one of the present study presented practical Islamic jurisprudential rules and investigated their application to performing medical procedures on nearly dead patients. It was contended that a dying patient could be used in medical education in cases where there is no alternative method, provided the patient voluntarily consents and is not offended. Part two of the present study addresses the issue by referring to the opinions of Islamic jurisprudents to find an appropriate solution to a challenging question in medicine, namely, whether clinical training of medical students on the dying person is permissible. For this purpose, istiftas (petitions or requests for a fatwa) were sent to prominent contemporary Shiite jurisprudents to solicit their opinions on the use of dying patients for medical education. After exploring the existing views, it was finally concluded that the majority of the jurisprudents allowed the practice in cases of “necessity” and provided that the principles of “no harm” and “consent” were strictly observed. All these terms are found in jurisprudential rules, and we reached the conclusion that Shiite jurisprudents considered this type of training permissible under certain circumstances and in accordance with jurisprudential rules. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/499 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/499/286

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 12 30 341 341 EN Alireza Ebrahimi Student of Medicine, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. Sedigheh Ebrahimi Associate Professor, Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, Iran. 2017 10 13 2018 12 29 One issue that has received less attention in present health care protocols is pediatric palliative care (PPC), which is an approach to care starting with the diagnosis of life-threatening diseases in children. It embraces physical, emotional and spiritual elements. Ethical issues are major concerns in today’s pediatric health care guidelines and must be considered by residents and attending physicians in this field. The present study was conducted in Namazi Teaching Hospital, Shiraz, Iran. Forty-eight out of 92 pediatricians were enrolled in this research, including 8 attendings, 6 fellows, and 34 residents. The study questionnaire consisted of 66 items. It was built based on previous reliable and validated questionnaire; also the calculated Cranach’s alpha was 0.815. Data were analyzed and presented by mean ± SD and percentage. While seventy-five percent of the participants reported involvement in pediatric palliative care, fifty-six percent did not acknowledge any information about the subject. More than half of the participants perceived the pediatric palliative care services in Namazi Hospital as somewhat or completely satisfactory. Furthermore, thirty-five percent of the applicants stated that they encounter an ethical problem with regard to PPC once a week. There are many challenges to providing decent palliative care for children, including symptom controlling, shifting to end of life care, background dissimilarities of patients, financial restrictions, and acceptance of death. Our applicants believed that offering psycho-spiritual support was the most important challenge in PPC. However, further investigations are needed to determine other requirements for providing a comprehensive guideline on PPC. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/341 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/341/289

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 11 0 2018 09 09 423 423 EN Fateme Alipour Associate Professor Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Fariba Asghari Associate Professor Medical Ethics and History of Medicine Research Center, Tehran Univers