Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 5 0 2012 02 07 69 69 Karori Mbugua University of Nairobi, Nairobi, Kenya. 2015 10 04 2021 01 31 In the last two decades, there have been numerous calls for a culturally sensitive bioethics. At the same time, bioethicists have become increasingly involved in empirical research, which is a sign of dissatisfaction with the analytic methods of traditional bioethics. In this article, I will argue that although these developments have broadened and enriched the field of bioethics, they can easily be construed to be an endorsement of ethical relativism, especially by those not well grounded in academic moral philosophy. I maintain that bioethicists must resist the temptation of moving too quickly from cultural relativism to ethical  relativism  and from empirical findings to normative conclusions. Indeed, anyone who reasons in this way is guilty of the naturalistic fallacy. I conclude by saying that properly conceptualized, empirical research and sensitivity to cultural diversity should give rise to objective rational discourse and criticism and not indiscriminate tolerance of every possible moral practice. Bioethics must remain a normative discipline that is characterized by rigorous argumentation. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/69 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/69/54

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 5 0 2012 03 01 70 70 Alireza Parsapoor Medical Ethics PhD Student, Medical Ethics and History of Medicine Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Kazem Mohammad Professor, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hussein Malek Afzali Professor, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Farshid Ala’eddini PhD in Biostatistics and Epidemiology. Bagher Larijani Professor, Endocrinology and Metabolism Research Institute, Medical Ethics and History of Medicine Research Centre Tehran University of Medical Sciences, Tehran, Iran. 2015 10 04 2021 02 03 Studying the situation of observance of patients’ rights and interaction of those individuals who provide and/or receive health services are regarded as the most significant and salient parameters of qualitative evaluation of health services. The main aim of this study is to compare the attitudes of patients as recipients of healthcare services with those of physicians and nurses as representatives of healthcare providers regarding the necessity of observance of various aspects of patients’ rights in three hospitals selected as representing the three models of providing medical service (teaching, private and public). This was a cross-sectional descriptive analytical study and the data were gathered using a questionnaire. Researchers helped the patients to fill in the questionnaire through interviewing and the physicians and nurses filled in their own questionnaires. The field consisted of three hospitals (a teaching general hospital, a private hospital and a public general one) all located in Tehran. The questionnaires included a set of general questions regarding demographic information and 21 questions about the necessity of observance of patients’ rights. They were filled in by the interviewer for 143 patients and, after being sent to other groups, 143 nurses (response rate = 61.3%) and 82 physicians (response rate = 27.5%) filled them in. The criterion for necessity of each right was measured according to the Likert Scale [from 0 (not necessary) to 10 (absolutely necessary]. The data were analyzed using SPSS 11.5 software. Given the abnormal distribution of the data, non-parametrical tests were used. The results of this study showed that all of the study groups agreed with the necessity of almost all aspects of patients’ rights and the highest level of disagreement between groups was related to patients’ right of access to information and right of choosing provision provider and deciding on treatment plan. However, these disagreements were not significant altogether. According to the results, it seems that healthcare providers, especially physicians, should be better familiarized with patients’ right of access to information and right of choosing and deciding. Based on the disagreement between the attitudes of the patients and physicians in this study, it seems that the patients had a higher level of expectations concerning their rights compared to physicians. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/70 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/70/55

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 5 0 2012 05 03 71 71 Seyed Mahmoud Tabatabaei Professor of Psychiatry, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mohammad Ali Tabatabaei Dentist, Yazd, Iran. Mohammad Mahdi Zamani Scientific Students of Pediatric Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Nastaran Sabetkish Master of Psychology, Mashhad, Iran. Farnaz Roshani Master of Psychology, Mashhad, Iran. 2015 10 04 2021 02 03 Gout, a medical condition of acute inflammatory joint disorders, has been recognized from the antiquity. However, the name of Rhazes, a Persian historic physician who has described the etiology, signs, symptoms, epidemiology, treatment and prevention of this malady more than a thousand year ago, hasn't been taken into consideration appropriately. In this article, we studied and reported several chapters of Alhawi which is considered the most important Rhazes's medical textbook, focussing on his hypotheses because he has described this disease more manifestly. His original manuscripts are originally written in Arabic and they hadn't been translated to Persian until 1998. We intend to compare Rhazes opinions about gout with those of the literature in the area of rheumatology. According to our findings, Rhazes documented the symptoms of gout and categorized them scientifically. His insights about the treatment of gout, side effects of pharmacotherapy and management of the patients are so interesting and wonderful. Generally most of Rhazes viewpoints about gout are correct and compatible with recent findings. More investigation on Rhazes' viewpoints can guide us to propose more reliable hypothesis and schematize cost effective studies by delving into past medical records. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/71 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/71/56

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 5 0 2012 03 29 72 72 Alireza Parsapoor PhD Student, Medical Ethics and History of Medicine Research Center, and Department of Medical Ethics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Kazem Mohammad Professor, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hussein Malek Afzali Professor, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Farshid Ala’eddini Epidemiologist, Tehran University of Medical Sciences Tehran, Iran. Bagher Larijani Professor, Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences and Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 04 2021 02 03 Neglecting patients' rights in a health care system can give rise to a challenging situation between health care providers and patients. The purpose of this study was to compare the views of patients as recipients of healthcare services and physicians and nurses, as healthcare providers, regarding the unsatisfied demands of different aspects of patients' rights in 3 hospitals representing three types of settings (teaching, private, and public). This was a cross-sectional descriptive analytical study. Data were gathered using a questionnaire which was filled out by an interviewer for the patients and self administered for nurses and physicians. The research venues were one general teaching hospital, one first class private hospital, and one non-teaching public hospital, and all 3 were in Tehran. The questionnaire consisted of some general questions about respondents' demographics, and 21 questions concerning the importance of patients' rights, and how well patients' rights were observed. Overall, 143 patients, 143 nurses (response rate: 61%) and 82 physicians (response rate: 27.5%) completed the questionnaire. The degrees of unsatisfied demands were different depending on the various views  within each group regarding the degree of importance and observance of each right, which was measured by the Likert's scale ranging from 0.0 (no importance, no observance) to 10.0 (absolutely important, full observance). Concerning the non-normal distribution, the collected data were analyzed by non-parametric tests using the SPSS software (ver. 11.5). Results showed that the studied groups had significantly different views. The most prominent issue concerned patients' to make an informed decision, which was particularly unsatisfactory in the teaching hospital. The results of this research indicate that healthcare providers, especially physicians, need to be informed to show more respect for patients' rights in terms of access to clinical information and making decisions. The results demonstrated that there was a significant difference between the opinions of patients and health care providers regarding the extent of unsatisfied demands of patients' rights. According to the patients, the level of unsatisfied demands of these rights is far higher than that expressed by physicians. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/72 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/72/57

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 5 0 2012 08 02 73 73 Alireza Parsapoor PhD Student, Medical Ethics and History of Medicine Research Center, and Department of Medical Ethics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Kazem Mohammad Professor, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hussein Malek Afzali Professor, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Farshid Ala’eddini Epidemiologist, Tehran University of Medical Sciences Tehran, Iran. Bagher Larijani Professor, Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences and Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 04 2021 02 03 Assessment of patients' views about the observance of patients' rights in the health system is of great importance for evaluation of such systems. Comparing views of patients (recipients of health services) and physicians and nurses (health care providers) regarding the observance of various aspects of patients' rights at three hospitals representing three models of medical service provision (teaching, private, and public) is the main objective of this study. This was a cross-sectional descriptive and analytical study, and the information needed was gathered through questionnaires. They were filled out by an interviewer for patients, but self administered by physicians and nurses. The field of study consisted of three hospitals including a general teaching hospital, a private hospital, and a public hospital, all located in Tehran. The questionnaires contained some general questions regarding demographic information and 21 questions concerning the necessity of observing patient's rights. The questionnaires were initially filled out by a total of 143 patients, and then consigned to 143 nurses (response rate = 61.3%) and 82 physicians (response rate = 27.5%) to be completed. The rate of observance of each right was measured on a Likert scale ranging from zero (non-observance) to 10 (full observance). Considering abnormal distribution of the information, it was analyzed with non-parametrical tests using SPSS 11.5 software package. The results of this study showed that the study groups had different views about how well different aspects of patients' rights were observed. The highest level of disagreement was related to the right of choosing and deciding by the patients, which was not satisfactory in the teaching hospital. According to the results, it seems that healthcare providers, especially physicians, should be better informed of patients' right of access to information and right of choosing and deciding. Based on the observed disagreement between the views of the patients and those of the physicians in the present study, it can be asserted that the patients thought that the level of observance of these rights was lower in comparison with what the physicians thought. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/73 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/73/58

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 5 0 2012 10 08 74 74 Fariba Borhani Assistant Professor, Kerman University of Medical Sciences, Kerman, Iran. Tayebeh Jalali Nursing Student in Master degrees, Kerman University of Medical Sciences, Kerman, Iran. Abbas Abbaszadeh Associate Professor, Kerman University of Medical Sciences, Kerman, Iran. Ali Akbar Haghdoost Associate Professor, Kerman University of Medical Sciences, Kerman, Iran. Mohammadreza Amiresmaili Assistant Professor, Kerman University of Medical Sciences, Kerman, Iran. 2015 10 04 2021 02 03 The high turnover of nurses has become a universal issue. The manner in which nurses view their organization's ethical climate has direct bearing on their job satisfaction. There is little empirical evidence confirming a relationship between different sorts of ethical climate within organizations and job satisfaction in Iran. The aim of this study was to determine the correlation between nurses' perception of ethical climate and job satisfaction in the Teaching Hospital of Kerman University of Medical Sciences. A descriptive analytical design was used in this study. The sample consisted of 275 nurses working in 4 hospitals affiliated with the Kerman University of Medical Sciences. The instruments used in this study included a demographic questionnaire, Ethical Climate Questionnaire (ECQ), and Job Satisfaction Scale (JS). Data analysis was carried out using Pearson's correlation, one-way ANOVA, T-test and descriptive statistic through Statistical Package for Social Science (SPSS), version 16. Across the five dimensions of ECQ the highest mean score pertained to professionalism (mean = 13.45±3.68), followed by rules climate (mean = 13.41±4.01), caring climate (mean = 12.92±3.95), independence climate (mean = 11.35±3.88), and instrumental climate (mean = 8.93±2.95). The results showed a positive correlation among ethical climate type of: professionalism (p=0.001), rules (p=0.045), caring (p=0.000), independence (p=0.000) with job satisfaction, and no correlation was found between instrumental climate and job satisfaction. The result of this research indicated a positive correlation among professionalism, caring, rules, independence climate and job satisfaction. Therefore managers of hospitals can prome Medical Council Organization and the data obtained were analyzed after classification. During a 3-year period, 832 complaints were lodged against physicians and dentists. The complaints against physicians in the years ending on 20 March 1997 and 20 March 2002 were 70% more than that in the year ending on 20 March 1992. 83.1% of the physicians and dentists of Tehran that were sued had not been convicted until the date of the performance of the study, on the basis of the contents of the files, and had no malpractice from the vantage point of the Medical Council Organization. The most common causes of complaints from the viewpoint of complainers were therapeutic errors (38%), neglect (30.2%), financial affairs (25.4%) and the physicians' lack of skill (17.7%). On the basis of this study, with the increase of the doctor's practice track record and experience more than 15-20 years, the number of the complaints decreases and most of the complaints are against the middle-aged doctors/dentists with 10-20 years of experience. Most physicians and dentists of Tehran having been sued have not committed any wrong from the vantage point of the Medical Council Organization experts and a large part of the complaints are a consequence of doctor-patient inconvenient interactions. A behavior based on professional commitment of the physician/dentist vis-à-vis the patient can hinder a major part of complaints. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/38 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/38/23

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 2 0 2009 06 09 39 39 Marjan Laal Specialist of General Surgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences. 2015 10 04 2021 01 11 Environmental ethics has emerged during the early 1970s, when environmentalists started urging philosophers to consider the philosophical aspects of environmental problems. Environmental ethics considers the ethical relationships between humanity and non-human world. The Union of Concerned Scientists, a group of over two thousands scientists, has concluded that climatic change is beyond dispute, and already changing our environment. Environmental instability portend ill for public health and well-being. This paper attempts to apply ethical theories to support environmental concerns and provides moral grounds to preserve the earth's environment. This article documents consensus among environmental philosophers as given by synthesis data provided via survey among articles, websites, and books by the keywords: environment, ethics, health and crises. The field has come to exert significant influence over a large number of human science disciplines in relation to environmental sustainability and human wellbeing. Environmental ethics focuses on the possibility of the identification of human ego with nature, means the larger ecological self deserves respect, too. Environmental ethics expands the boundaries of ethics to include the nature and considers its sustainability to ensure human wellbeing. This study emphasizes mainly on a brief history of environmental ethics and its protection against damage. Environmental changes and extreme weather events in plus to species distinction and a growth of diseases are impossible to hide and ought to be impossible to ignore. The health decline associated with various forms of these changes is continuing. It raises crucial issues about environmental justice. https://jmehm.tums.ac.ir/index.php/jmehm/article/view/39 https://jmehm.tums.ac.ir/index.php/jmehm/article/download/39/24

Tehran University of Medical Sciences Journal of Medical Ethics and History of Medicine 2008-0387 2 0 2009 07 13 40 40 Ali Ardekani Reproductive Biotechnology Research Center, Avicenna Research Institute, Shahid Beheshti University, 2015 10 04 2021 01 12 In the past decade, the human genome has been completely sequenced and the knowledge from it has begun to influence the fields of biological and social sciences in fundamental ways. Identification of about 25000 genes in the human genome is expected to create great benefits in diagnosis and treatment of diseases in the coming years. However, Genetic technologies have also created many interesting and difficult ethical issues which can affect the human societies now and in the future. Application of genetic technologies in the areas of stem cells, cloning, gene therapy, genetic manipulation, gene selection, sex selection and preimplantation diagnosis  has created a great potential for the human race to influence and change human life on earth as we know it today. Therefore, it is important for leaders of societies in the modern world to pay attention to the advances in genetic technologies and prepare themselves and those institutions und