Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 06 12 1298 1298 Nematullah Shomoossi Associate Professor, Department of English, School of Medicine, Sabzevar University of Medical Sciences, Iran. Mostafa Rad Associate Professor, Department of Nursing, Nursing and Midwifery School, Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran 2023 01 20 2023 06 12 No Abstract No Abstract No Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1298 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1298/431

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 06 13 1282 1282 EN Shiva Khaleghparast Associate Professor, Cardiovascular Nursing Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. MSc Student in Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Majid Maleki Professor, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Maziyar Gholampour Dehaki Professor, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Setareh Homami Assistant Professor, Department of Health Education and Promotion, Damghan School of Health, Semnan University of Medical Sciences, Semnan, Iran. MSc Student in Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Afsaneh Sadooghiasl Assistant Professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. MSc Student in Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Saeideh Mazloomzadeh Professor, Cardiovascular Nursing Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Ehsan Shamsi Gooshki Associate 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. 2022 12 04 2023 06 13 No Abstract No Abstract No Abstract No Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1282 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1282/411

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 06 19 1254 1254 Ladannaz Zahedi PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Faculty Member of Iranian Academy 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. Mohsen Javadi Professor, Ethics Department, University of Qom, Qom, Iran. Shahin Aawani Associate Professor, Iranian Research Institute of Philosophy (IRIP), Tehran, Iran. Seyed Abdosaleh Jafari Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Kobra Joodaki PhD in Medical Ethics, Member of National Association of Iranian Obstetricians and Gynecologists (NAIGO), Tehran, Iran. Roya Rashidpouraie PhD in Medical Ethics, Head of Medical Error Committee, Shahriar Medical Council, Tehran, Iran. Saeedeh Saeedi Tehrani Assistant Professor, Ethics Department, Iran University of Medical Sciences, Tehran, Iran 2022 08 10 2023 06 19 The concept of common morality is fundamental in medical ethics, and lack of universal content and characteristics of common morality is a product of its multifaceted nature. This study aimed to identify the ideas and experiences of academic faculties regarding common morality in a pluralistic setting to promote conceptual knowledge and strengthen moral reasoning and ethical decision-making.The study was conducted using a qualitative method, employing semi-structured in-depth interviews with thirteen faculty members who were selected purposively. In order to assess their ideas and experiences, the transcripts of the interviews were analyzed using the content analysis method through directed and conventional approaches. The interviews were coded manually.Two themes were reflected in the interviews: ontology and epistemology of common morality.The study indicates that the debate about the subjective or objective dependence of common morality questions the coherence of Beauchamp and Childress' common morality (CM) theory, as common morality is the result of various individual and social factorthat influence moral thinking and decision-making in pluralistic environments. Additional studies are needed in order to investigate the effect of cultural, social, theoretical, ideological and individual factors on promoting clinical ethical reasoning and decision-making skills. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1254 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1254/412

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 07 29 1305 1305 Hanieh Sadat Ejtahed Assistant Professor, Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences 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. Bagher Larijani Professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2023 02 06 2023 07 29 No Abstract No Abstract No Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1305 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1305/414

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 07 18 1280 1280 Vahid Moazzen Visiting Professor, Department of Public and International Law, Law Faculty, Farabi Campus, University of Tehran, Tehran, Iran. Ehsan Shamsi Gooshki Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran;Associate Professor, Medical Ethics Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Lecturer, Monash Bioethics Center, Monash University, Melbourne, Australia. 2022 12 01 2023 07 18 The concept of individual freedom has complex and multifaceted dimensions that significantly affect the limits of permissible government interventions aimed at restricting such freedoms and maintaining public health. Therefore, the boundary between individual freedom and the social obligations of the government must be carefully clarified.  During the Covid-19 pandemic, the need for such clarifications clearly increased. This study intended to investigate the concept of freedom according to major theories and to observe their application in analyzing the relations between individuals and the government in the health system, particularly during public health emergencies.The findings revealed that “justice-based”, “development-based” and “accountability-based” conceptions of freedom provide a more appropriate rationale for implementation of public health restrictive measures by health authorities during infectious disease outbreaks including pandemics such as COVID-19. Even in minimal governments that are built upon a free-market system and unrestricted conception of individuals’ freedom, such public health interventions are justifiable in the light of the ‘Catastrophic Moral Horror’ where there is an extreme risk to the health of citizens. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1280 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1280/413

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 08 19 1306 1306 Mojgan Asadi Associate Professor, Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Farzaneh Zahedi Researcher, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Mahbube Ebrahimpur Associate Professor, Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Bagher Larijani TUMS 2023 02 06 2023 08 05 No Abstract No Abstract No Abstract https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1306 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1306/415

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 02 1313 1313 Maryam Mirahmad Researcher, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Sayed Mahmoud Sajjadi-Jazi Associate Professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Fariba Asghari Professor, Medical Ethics and History of Medicine Research Center, 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. 2023 02 25 2023 12 02 Osteoporosis has a significant economy, society, and health burden. The recent advancement of available therapies caused ethical questions regarding the use of placebo-controlled studies in osteoporosis. Some specialists believe it is not ethically to subject the study participants to any additional risk when there is already verified effective therapy for the disease and established therapies can significantly decrease the likelihood of osteoporotic fracture.  Accordingly, researchers have expressed ethical concerns over placebo-controlled trials. Here, we have briefly addressed ethical and methodological aspects regarding conducting placebo-control trials as well as potential alternatives. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1313 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1313/423

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 02 1349 1349 Cornelius Ewuoso Steve Biko Centre for Bioethics, University of Witwatersrand, Johannesburg, South Africa. 2023 07 19 2023 12 02 This article draws on the underexplored or novel accounts of inclusion and the moral accounts of decolonization in African health decolonial literature to increase our understanding of how ethics dumping manifests in health research partnerships, and what more ought to be done to eliminate this phenomenon. African decolonial health literature proposes “inclusion that matters” – conceptualized as substantial, respectful and deep engagement with African agency – as a solution to end domination or mitigate the “appearance” of inclusion. Based on this supposition, the harm of ethics dumping – and I demonstrate how – is that it fails to engage the agency of Africans, and listen to or echo their voices in health and health research collaborations on the continent, or research collaborations that have significant implications for them. This account of inclusion can usefully increase our thinking about ethics dumping, which is ultimately and in several ways a failure to practice responsible science. Research is required to increase our understanding of what could reasonably constitute responsible science from a variety of perspectives. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1349 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1349/430

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 02 1321 1321 Gita Shafiee Associated Professor, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Narges Zargar Balajam Researcher, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Ramin Heshmat Professor, Chronic Diseases Research Center, Endocrinology and Metabolism Population 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. 2023 04 16 2023 12 02 As the population ages, the number of older people with various geriatric diseases is increasing.  Sarcopenia is one of the important geriatric diseases with high mortality and morbidity. Some research needs to understand risk factors, diagnosis, and prevention, and develop treatment options with high safety and efficacy for sarcopenic people. To reduce the risks involved with sarcopenic people in clinical research, it is necessary to consider the ethical review of research on this issue. Therefore, this study aimed to guide on the ethical issues of sarcopenia research. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1321 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1321/417

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 02 1364 1364 Raheleh Amiri Researcher, Nursing department, Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran. Mina Gaeeni Associated Professor, Nursing department, Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran. Hoda Ahmari Tehran Assistant Professor, Spiritual Health Research Centre, Medical Education department, school of medicine, Qom University of Medical Sciences, Qom, Iran. 2023 08 15 2023 12 02 Moral reasoning is necessary to the nursing profession. Therefore, this study aimed to investigate the mediating role of moral reasoning in spiritual intelligence and caring behaviors among Iranian emergency nurses. In this descriptive-analytical study structural equation modeling (SEM) is employed for the data analysis. the minimum required sample size determined by the number of parameters of the model was 18. Considering that 5 to 15 samples were required for each of the parameters; the required sample size was 272. Nurses working in the emergency department of all hospitals in Qom, Iran, were selected by convenience sampling. Demographic characteristics inventory, King’s Spiritual Intelligence Self-Report Inventory, Crisham’s Nursing Dilemma Test, and Wolf’s Caring Behaviors Inventory used for data collection. SPSS (V20) and Mplus were used to analyze the data. The results showed that a significant direct relationship was observed between moral reasoning and caring behaviors. According to SEM results, direct and indirect effects were observed of spiritual intelligence on caring behavior It is therefore recommended managers and hospital officials pay meticulous attention to spiritual intelligence and the power of decision-making in nurses to improve their caring behaviors.  https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1364 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1364/427

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 02 1326 1326 Eti Muharremi Biomedical and Experimental Department, Faculty of Medicine, University of Medicine, Tirana 1005, Albania. Gentian Vyshka Biomedical and Experimental Department, Faculty of Medicine, University of Medicine, Tirana 1005, Albania. 2023 05 02 2023 12 02 The Yalta Conference of 1945 brought together three of the most influential leaders of the 20th century: Franklin D. Roosevelt, Joseph Stalin and Winston Churchill. Surprisingly, all three leaders would go on to suffer strokes after the conference. This manuscript examines the health status of these leaders during and after the Yalta Conference, the factors that contributed to their strokes (including the role of hypertension), and other modifiable risk factors present in each one of them, and the impact of their declining health on their countries and the world. Roosevelt's demise, prior to the conclusion of the war, triggered a leadership transition during a critical moment in history, while Churchill and Stalin's passing shaped the early Cold War era. A veil of secrecy shrouded the health conditions of these pivotal leaders. “The Big Three” made considerable efforts to hide their health conditions from both the press and the public at large.Understanding the health of political leaders is crucial as it can affect their decision-making abilities and the course of history. The fates of Roosevelt, Stalin and Churchill serve as important reminders of the potential consequences of poor health in the highest echelons of political power. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1326 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1326/425

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 02 1299 1299 EN Farzad Zakian Khoramabadi Ph.D. Candidate in Medical Ethics, Medical Ethics and History Research Center, Tehran University of Medical Sciences, Teharn, Iran. Vahid Moazzen Visiting Professor, Department of Public and International Law, Faculty of Law, Farabi campus, University of Tehran, Tehran, Iran. Alireza Parsapour Department of Medical Ethics and History Research, Tehran University of Medical Sciences, Tehran, Iran Amirhossein Takian Professor, Department of Global Health and Public Policy, School of Health, Tehran University of Medical Sciences, Teharn, Iran. Abbas Mirshekari Assistant Professor, Faculty of Law and Political Science, University of Tehran, Teharn, Iran. ‪Bagher Larijani . Professor, Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Teharn, Iran. Ehsan Shamsi Gooshki Associate Professor, Medical Ethics and History Research Center, Tehran University of Medical Sciences, Tehran, Iran; Lecturer, Monash Bioethics Center, Monash University, Melbourne, Australia. 2023 01 27 2023 12 02 The right to health is an internationally recognized and established human right with a long history of appreciation, indicating that governments should guarantee the highest possible level of access to health and provide health-care serivces with no discrimination based on nationality, race, gender, language or religion. The present study explored this topic using an analytic-descriptive approach. We reviewed related laws, policies and other available documents with the aim to investigate the ethico-legal aspects of Afghan refugees' and immigrants' access to health care and the challenges in in this regard within the Iranian health law system. According to the results of this study, the Iranian health law could be interpreted to include all Afghan immigrants in the country’s public health system as a legal commitment. In addition, while basic and primary health coverage is available for all Afghan immigrants in Iran, provision of other medical and rehabilitative health services to documented and undocumented immigrants follow different methods. In order to alleviate the current situation, we recommend strategies such as supporting policy changes intended to register undocumented immigrants, which naturally results in an increase in their access to health care. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1299 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1299/428

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 02 1290 1290 Soolmaz Moosavi Assistant Professor, Department of Medical Surgical, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Maryam Sadaat Mousavi Researcher, Medical Ethics Supervisor, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ayat Ahmadi Assistant Professor, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran. Amirhossein Mardani PhD in Information Science and Knowledge Study, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Alireza Parsapoor 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. Ehsan Shamsi Gooshki Associated 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 2022 12 18 2023 12 02 Considering the importance of respecting and observing patients’ rights, this study aimed to assess the level of observance of hospitalized patients’ rights from both patients’ and health-care workers' (HCWs) perspectives. This cross-sectional descriptive-analytic study reports the responses of 486 patients and 887 HCWs in a public referral university hospital. The study illustrates that patients and HCWs think patients’ rights are respected at a medium level; however, HCWs reported lower levels of respect for patients’ rights than patients, and senior HCWs reported even lower levels than their younger colleagues. Older patients and those hospitalized in internal medicine wards reported lower respect for autonomy and responsiveness, and patients’ companions reported lower levels of respect for patients’ rights than the patients themselves. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1290 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1290/429

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 30 1371 1371 Seyed Abdosaleh Jafari Researcher, University of Religions and Denominations, Research Center for Religions and Denominations; Researcher, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Behin Araminia Researcher, Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran. Hanieh Tavasoli Resident of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Nafiseh Tavasoli Researcher, Endocrine and Metabolism Research Institute, Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Soheil Abedi PhD Candidate in Medical ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Fayaz Bakhsh Researcher, Sina Trauma & Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2023 09 01 2023 12 30 One of the critical aspects in discussing human dignity is the establishment of its criterion, a standard unique to humans. This criterion should effectively create a fundamental and structural distinction from other creatures. Initially, our focus was on the endeavors of biologists to differentiate the human species from others, emphasizing the physical aspects. However, physical and genetic differences lack the necessary characteristics to serve as a criterion for dignity. Subsequently, we explored the notion of this criterion in human behavior. Yet, given that behavior stems from human thought, it proves unsuitable as a criterion for dignity. Thus, our quest led us to explore human wisdom. However, since wisdom, like other abilities, serves as a tool for improved living and is present to some extent in other animals, it proves inadequate as a criterion. We have determined that the distinguishing characteristic lies in the power of choice or free will, setting humans apart from other living beings whose behavior is solely instinctual or driven by needs. Consequently, free choice forms the foundation of dignity, assigning value to the chooser based on the choices made. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1371 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1371/438

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 30 1341 1341 Mahsa Khedmatizare BSc Student of Nursing, Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran. Maedeh Moosavipour BSc Student of Nursing, Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran. Nastaran Saeedi BSc Student of Nursing, Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran. Maryam Aghabarary Assistant Professor, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran. 2023 07 01 2023 12 30 Compliance with patients’ rights by medical sciences students requires an understanding of the patients’ rights charter. This study aimed to assess the awareness of medical sciences students regarding the patients’ rights charter. A descriptive cross-sectional study was conducted, involving all final-year medical sciences students at Alborz University of Medical Sciences, Iran (n=370). Samples were selected using convenience sampling, and data were collected through a questionnaire designed to evaluate awareness of the patients’ rights charter. The study included 269 students. The results indicated that over half of the students possessed a moderate level of awareness about the patients’ rights charter. Analysis of specific domains revealed that the right to access services had the highest percentage, while the right to personal autonomy had the lowest percentage of awareness. Furthermore, analysis of variance revealed that medical students exhibited the highest level of awareness. Given the moderate level of awareness among medical sciences students regarding the patients’ rights charter, it is essential to design and implement plans to enhance their understanding of patients’ rights. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1341 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1341/435

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 30 1342 1342 Seyed Alireza Hasani Assistant Professor, Department of Nursing, School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran. Roghieh Nazari Assistant Professor, Department of Nursing, School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran. Hooman Shahsavari Professor, Department of Medical-Surgical Nursing and Basic Sciences, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Tayeb Ramim PhD Candidate in Medical Informatics, Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Kurosh Jodaki Assistant Professor, School of Nursing and Midwifery, Shohadaye Haft-e Tir Hospital, Iran University of Medical Sciences, Tehran, Iran. 2023 07 01 2023 12 30 Conscience is defined as the cornerstone of ethics and is considered a valuable asset. There is, however, little evidence about how Iranian nurses perceive conscience. The purpose of this study was to psychometrically evaluate the Persian version of the Perception of Conscience Questionnaire (PCQ) in Iranian nurses. In this cross-sectional and descriptive study, a psychometric evaluation of the PCQ was conducted on Iranian nurses in 2022. A total of 300 nurses participated in this study to validate the PCQ. At first, the initial translation and determination of face validity was done, and content validity was assessed using the Content Validity Index and Content Validity Ratio. Reliability was determined by intra-class correlation coefficient and Cronbach's alpha coefficient.The construct validity of the PCQ was determined by exploratory factor analysis, which led to the extraction of five factors of warning signal, valuable asset, spiritual power, burden and conscience outcomes from the initial 14 factors of the questionnaire. Reliability of the whole questionnaire was calculated to be 0.80 using Cronbach's alpha. While an intra-class correlation coefficient of 0.58 indicated average stability, the five-factor construct of the PCQ showed good validity and reliability. Therefore, our findings proved that this tool is suitable for assessing Iranian nurses’ perception of conscience. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1342 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1342/434

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 30 1365 1365 Ali Mohammadpour Professor, Department of Medical Surgical Nursing, School of Nursing, Nursing Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. Hoda Salehi MSc of Medical Surgical Nursing, Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran. Mahdi Basiri Moghaddam Assistant Professor, Department of Medical Surgical Nursing, School of Nursing, Nursing Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. 2023 08 15 2023 12 30 Moral disengagement is a set of cognitive mechanisms through which a person violates his/her moral standards without losing his/her dignity. Therefore, a tool has been designed to measure moral disengagement in nurses. This study aims to determine the psychometric properties of the Nursing Moral Disengagement scale. In this methodological study, 440 nurses working in hospitals of Mashhad were selected by the availability sampling method. The translation was carried out using the forward-backward method. The final version of the tool was psychometrically tested for validity (exploratory and confirmatory factor analysis) and reliability (internal consistency and relative stability). Four factors were extracted in the exploratory factor analysis, and since the factor loadings of all the tool items were higher than 0.3,they were all retained. The tool's general fit indices indicated the model's confirmation and optimal fit. Cronbach's alpha and relative stability coefficients for the whole questionnaire were 0.90 and 0.89, respectively. The study results showed that this tool has good validity and reliability and can therefore measure behaviors related to moral disengagement in nurses, so that appropriate interventions can be designed to reduce these harmful behaviors. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1365 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1365/433

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 30 1289 1289 Soolmaz Moosavi Assistant Professor, Department of Medical Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Zandpoor Researcher, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Masood Motasadi Zarandi Professor, Department of Otolaryngology, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Amir-A'lam Hospital, Tehran University of Medical Sciences, Tehran, Iran. AmirAhmad Shojaei 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. Alireza Parsapoor 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. 2022 12 18 2023 12 30 To deliver effective medical services and establish trust and psychological security in patients, care providers must prioritize ethical principles. Developing a comprehensive clinical education program for learners, along with specific ethical guidelines, and implementing managerial and executive interventions necessitates a thorough understanding of the ethical challenges within this field. This qualitative study aimed to elucidate the ethical issues faced by otolaryngologists. Sixteen otolaryngologists participated in the study, selected through purposive sampling. Data were gathered through semi-structured interviews, and the analysis, conducted through conventional content analysis, revealed eight main categories and 38 subcategories encapsulating the identified ethical issues.The primary categories encompassed ethical issues faced by otolaryngologists concerning patients and companions, education, communication with the treatment team, physicians' rights, medical tourism, medical advertising, cultural considerations, and managerial challenges. resources and treatment approaches in alignment with Iranian cultural norms, address conflicts between treatment and education, and implement sound management plans to uphold rights of the treatment team. Additionally, the study suggests the necessity of ethical advertising programs and the strategic promotion of therapeutic tourism. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1289 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1289/439

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 16 0 2023 12 30 1348 1348 Layth Hthelee MSc in Nursing, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Afsaneh Sadooghiasl Assistant Professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Sima Kermanshahi Associate Professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. 2023 07 19 2023 12 30 In the years following its outbreak in 2019, COVID-19 changed the health-care system structures, the context of professional activity, and nurses’ moral performance. The present study aimed to examine the moral distress and moral courage of Iraqi nurses during the COVID-19 pandemic. This cross-sectional and correlational study was conducted in 2021 on 168 nurses selected by convenience sampling methods. Data were collected by self-reported instruments including a demographic questionnaire, the Professional Moral Courage (PMC), and the Moral Distress Scale (MDS). Data were analysed using descriptive statistics, the Spearman, Mann-Whitney and Kruskal-Wallis tests, and SPSS version 22. Most nurses showed a moderate level of moral distress (98.80%) and a high level of moral courage (99.40%).The dimension of multiple values had the highest mean (12.45 ± 1.47) and endurance of threats had the lowest mean (9.15 ± 1.79). There was a statistically significant correlation between moral distress and moral courage (P = 0.007, r = - 0.2), and moral distress and the dimensions of endurance of threat (P < 0.001, r = - 0.26), going beyond compliance (P < 0.001, r = - 0.037), and moral goals (P < 0.001, r = - 0.173). A statistically significant relationship was also found between moral distress and work shift, position and gender (P < 0.05), and between moral courage and position (P < 0.05). We concluded that nurses need more organizational support in terms of protective facilities, job security and organizational incentives to be able to show ethical behaviors. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/1348 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/1348/437