مجله ایرانی اخلاق و تاریخ پزشکی
سال چهاردهم شماره 1 (بهار 1400)

Failure to follow professional ethics in midwifery will lead to harmful risks, including an increase in maternal and infant mortality. The aim of this study was to investigate the barriers to professional ethics in midwifery clinical care from midwives ’viewpoints in hospitals specializing in obstetrics and gynecology in North Khorasan province in 2018. This cross-sectional descriptive study was performed with the participation of 141 midwives working in specialized obstetrics and gynecology hospitals in North Khorasan province, using classified sampling. The data collection tool was a questionnaire consisting of two parts: demographic information and barriers to professional ethics, in three areas: environmental and managerial and personal care. Data were analyzed using SPSS software version 22 and descriptive and inferential statistics. From the perspective of midwives, all three categories of environmental factors (73.94%), personal care (64.66%) and management (64.97%) were among the barriers to professional ethics. The most important barriers to professional ethics in the managerial dimension are staff shortages (80%), in the environmental dimension, biological changes in the body during work shifts (85.2%) and in the personal dimension, dissatisfaction with basic needs, such as insufficient income or adequate rest in midwifery (80.9%), was. Given the importance of observing professional ethics and the issues and problems arising from non-compliance, it is suggested that managers and officials make the necessary planning by hospitals to remove the barriers mentioned by midwives.

Applying the principles of professional ethics by nurses creates a suitable social and psychological environment for patients. The purpose of this study was to determine the level of nurses' awareness of the principles of professional ethics and barriers towards its observance in public hospitals in South Khorasan province in 2019.The present study was a cross-sectional study that was performed on 230 nurses in South Khorasan province by multi-stage sampling method. Data collection tools were a checklist of demographic information and a questionnaire about nurses' awareness and barriers of the principles of professional ethics. Data were analyzed by SPSS V.22 software using descriptive and inferential statistics. In this study, the mean ± SD age of participants was 32.34 ± 5.73 years. The mean score of participants' awareness was moderate level and the first obstacle to professional ethics from the perspective of nurses was the environmental domain. The most important obstacles to professional ethics were dissatisfaction from basic needs, unreasonable expectations of patients and their attendants from nursing staff and nursing staff shortages, respectively. Since nurses' awareness of the principles of professional ethics is moderate level, so holding professional ethics workshops, removing environmental barriers, and providing favorable conditions for nurses including improving the conditions of wards and increasing staff and meeting their expectations in the fields Various such as adequate rest, adequate income and planning appropriate shifts are recommended.

Common sense, according to rules such as no harm and no harm, the obligation to repel probable harm, the denial of embarrassment, the sanctity of induction in motion, the repulsion of harm from oneself is rationally and religiously obligatory, whether harmful or rationally possible; on the other hand in the teachings Islamic ethics embodies concepts such as self-sacrifice, compassion, cooperating, patience, benevolence, and the preservation of human dignity. The question that arises is whether physicians and caregivers are allowed to leave, according to the holy verse, "I should not leave until I die." Will their mission be to manage contagious diseases such as Corona virus infection? The present study, which has been organized by analytical and descriptive methods in order to combine the ethical principles of caring for infectious patients on the one hand and the rules related to protecting one's life from stagnation and eliminating self-harm, does not reflect the patient leaving in these conditions. Considers it against human dignity; therefore, it is appropriate for physicians and nurses, apart from their job duties, while strengthening the spirit of self-sacrifice and compassion in themselves, based on the rules of the medical system and the ethical principles governing the rules of jurisprudence, with strict and complete observance of health instructions. The rule of "Al-Misr Lightrak Bal-Masour" while protecting their health to care for and treat patients with coronary heart disease.

The purpose of this article is to investigate the role of faculty members in promoting ethical education in universities. This article has also attempted to provide the faculty members with ethical education (emotional, cognitive, and behavioral dimensions) in the form of practical solutions. This paper includes all available internal and external sources such as books and related articles. The method of data collection has been library. The findings of this study indicate that it is important for faculty members to strive to promote students' moral upbringing while also strengthening their religious beliefs. Therefore, it is concluded that the development of emotional, cognitive and behavioral dimensions promotes ethical training in faculty and students, and they can motivate themselves, develop appropriate jokes in the classroom, and maintain a sense of humor, extreme perfectionism, avoidance of pride and good ethics in the classroom to strive for emotional development. The cognitive dimension of ethical education teaches the effective and related components that the teacher's power of speech and clarity of speech, optimal classroom management, and effective interaction with students are presented as practical solutions. In the behavioral dimension, paying attention to moral freedom, patience and moral openness, and cultivating a spirit of criticism are the most important strategies for developing behavioral dimension.

One of the most important issues in medical law is the issue of physician responsibility. The aim of this study was to investigate the relationship between belief in each of the physician's responsibilities towards the patient and responsibility. The research method is library and descriptive-correlation. An examination of various sources shows that there are four perspectives on the physician's responsibility to the patient. The results show that there is a positive correlation between the components of responsibility and physician responsibility perspectives, which are significant at the level of 0.01. Findings indicate that views 1 and 3 are more correlated with physicians' responsibility than other views. The degree of correlation between the dimensions of responsibility with the views that consider more responsibility for physicians is greater.

Academic dishonesty is one of the important challenges of educational centers. In the present study, the role of moral disengagement mediators’ in the relationship between moral characters and academic dishonesty was investigated. The present study is a correlation study. The statistical population included all students of Shiraz University and the participants were 246 students selected by random cluster sampling. Moral disengagement and academic dishonesty scales and moral characters questionnaire were used to measure the research variables. Structural Equation Modeling was performed using AMOS software to analyze the research data. The results of the structural equation model showed that positive moral characters are directly related to academic dishonesty, also negative moral characters has a significant relationship with academic dishonesty directly and with mediating of moral disengagement. Moral disengagement has been directly predictor of academic dishonesty in students, too. According to the findings, it can be concluded that positive moral characters directly and negative moral characters directly and with mediating of moral disengagement can predict academic dishonesty. Moral disengagement was predictor of academic dishonesty in students, too.

It is clear that technologies related to medicine and genetics, especially genetic engineering and eugenics, have grown significantly in recent decades. These advances have led to prevention of abnormalities and treatment of diseases. However, it seems the use of genetic engineering and eugenics and the possibility of irresponsible and profitable use of these technologies it's worrying. Hence, some moral philosophers say that to use eugenics’ methods it is morally wrong. Because the result of eugenics is injustice. In this study, while referring to the meaning and types of eugenics and related ethical issues, moral considerations to eugenics are explained and analyzed with emphasis and focus on the violation of justice and with analysis and explanation, it becomes clear that with some wise decisions, injustice caused to eugenic can be prevented or reduced.

The present study seeks to find an answer to this question, “how effective was the religious and moral advice on environmental health situation of cities under the territory of Al-Buwayh dynasty”? Findings indicate that in the first half of the Al-Buwayh era, following the increase in population and expansion of some cities, the need for health measures in various areas was felt, of which is considered a responsibility of environmental health authorities nowadays. In addition to the instructions and recommendations being embodied in some verses of Quran and hadiths being the basis of health laws, a number of rulers of this dynasty, like Azd al-Dawlah intervened in the health affairs of cities in various fields such as providing drinking water, constructing of medical and service centers, and appointing Sheriffs (Darougheh). A part of the mentioned actions was involved with the community health in the field of food hygiene, roads and public places, water hygiene as well as sewage disposal. In the present study, first, narrative, historical, medical and geographical books were indexed by using descriptive-analytical method and relying on library resources; second, the data in the most important areas related to environmental health was classified; and then, a conclusion was reached.

The issue of disease in the context of history has always been one of the concerns of the wise man. In accordance with the intellectual system of each period of history, various diseases have been identified and prevention and treatment strategies have been presented. The identification of some diseases, including the flu, goes back to a new era. The use of the word "flu" first occurred in the Qajar era. Because it is new and unknown, the group of physicians, as the person in charge of health matters, needed to know about this disease and define and explain it. The purpose of this study as a historical-review study, in the first step is to study the history of the prevalence of this disease in Iran and the process of recognizing it through the available information sources in the Qajar era society. The medical approach of the press (publications) and the identification and introduction of " RESALE DAR MARAZ_E ANFLUENZA: GRIP" as the first treatise written about this disease, has been done at this stage. The second step of the present study is to investigate how the Spanish flu entered Iran and assesses its consequences in the affected areas.

The widespread and increasing number of deaths due to the Corona virus has caused many psychological injuries, including stress. Therefore, the aim of this study was to study the relationship between perceived stress and coping strategies of the family members of patients with Corona virus admitted to the Intensive Care Unit (ICU) of Ardabil medical centers. The present study is a descriptive-analytical study. Sampling was done by available method among the companions of patients with Corona virus infection admitted to the ICU (between May and September 2020). The number of research samples according to the results of a pilot study was estimated at 462 people. Available sampling method was used for sampling. Data collected included patient demographics, Cohen's Perceived Stress Questionnaire, and the Blinges-Moss Coping Styles Questionnaire. The collected data were analyzed using independent t-test, Mann-Whitney, Spearman and Chi-square tests and one-way analysis of variance by SPSS software version 24. The results showed that the mean and standard deviation of perceived stress were 44.80 ± 5.92 and emotion-oriented and problem-oriented coping styles were 19.08 ± 3.02 and 32.35 ± 5.54, respectively. Spearman correlation coefficient test showed a significant relationship between perceived stress with problem-oriented coping style (r = 0.321) and emotion-oriented coping style (r = 0.113) (p <0.05). This study showed that the companions of coronary patients admitted to the intensive care unit use more emotional coping methods, which results in increased emotional behaviors. Therefore, in order to help the psychological health of coronary patients, it is possible to strengthen the application of problem-oriented coping style by designing and implementing educational and supportive-care programs.

The purpose of this study was to perform a narrative review and documentary research in the history of community medicine specialty formation and the needs for its existence in health systems. We searched and reviewed related literature and documents in English and or Farsi (printed or online). Data was extracted and findings were categorized, summarized, and reported. About a century ago community medicine specialty was formed to respond to major health challenges of that time such as neglecting the effects of social determinants on populations’ health and total separation between clinical care and public health. Community medicine professionals are able to address many of the current health problems such as inequalities in health, fair financing problems, increasing demands and costs and disease-based health system approaches. They can be the leading advocates to emphasize the importance of social determinants in health of populations. They can promote communications with influencing institutions outside the health system to improve the health of the communities. This discipline can pave the way for the health systems to tackle the most important contemporary health challenges. Lack of attention to this discipline may hinder the achievement of sustainable development goals and health promotion of the communities. More support from officials and utilizing the skills of community medicine specialists can help health systems not only to better respond to the health needs of the society but also to facilitate the achievement of their main goals.

The rapid spread of COVID-19, lack of standard treatment, time constraints, and lack of resources are challenges around the world. Considering the importance of ethics in providing care to patients with emerging diseases, this study was conducted to explain the ethical challenges in care and treatment for patients with COVID-19. The present study was conducted by qualitative content analysis during 2019. Participants were 22 infectious disease physicians and nurses of COVID-19 care wards with at least five years of experience in hospitals of Mazandaran province. Data were collected through semi-structured interviews based on the purpose and method of snowball after obtaining informed consent from participants and continued until data saturation. Data analysis was performed using Granheim Lundman method. Guba and Lincoln proposed criteria were used for the accuracy and robustness of the study. In the present study, five main themes and 18 sub-themes were extracted. Respect for patients' rights, maintaining patient independence, preventing the effects of stigma and discrimination against patients, lack of comprehensive support, and lack of support and accountability of the authorities were the main ethical challenges in caring for patients during the admission period. According to the findings of the study, solutions to address ethical challenges, protect patients' rights and provide quality care through informed and ethical decision-making to increase patient satisfaction and improve their health are recommended.

The emerging and pervasive disease of COVID 19 (coronavirus disease), which has gone from an epidemic to a global pandemic, has created many challenges for the international community. Since this disease has certain characteristics such as the unknown and complexity of its origin, high extent and speed of its spread and transmission, high mutability, lack of definitive treatment so far for it, existence of incubation period and latency of the disease and many other features, it requires a comprehensive study and development of a comprehensive plan in all dimensions to be controlled and managed. Due to the high rate of transmission of this disease and lack of care by carriers and patients, COVID-19 has increased exponentially, and on the other hand, the long duration of the disease has caused people to neglect following health protocols, which itself causes other people to get sick. And while imposing a legal and moral burden in non-compliance with the rights of society, it threatens people’s security, physical and mental health. On the other hand, one of the goals of the jurisprudential rules and customary laws is to protect the life and health of individuals. The requirements and guarantees of the supervision of care and prevention against COVID-19 and the responsibility imposed on people who do not comply with health protocols will be the subject of this article. Accordingly, people who do not consider the minimum health standards against this virus have a responsibility if they are carriers, and if negligence or fault and attribution of harm or damage to other people is confirmed, they should be able to compensate the damage while being punished. There will also punishments if people are aware of being a carrier.

Since the release of COVID-19 epidemic in late December 2020, recommendations issued for personal protection by the World Health Organization and National Health Organizations around the world. The most prominent of which has the use of masks to prevent the spread of the virus. Despite the importance of this solution, many people still resist using the mask. Therefore, this study, by emphasizing the effect of individual beliefs and norms on consumer behavior, predicts the rate of wearing of mask by people with 4 factors: systemic thinking, individual-social responsibility, moral obligations and individualism. The statistical population of this research consists of citizens of Kashan city. A questionnaire has been used to collect data. The results of the mean tests indicate that women use masks more than men. Also, with increasing age and education, the use of masks has increased. The results of regression analysis test show that 4 predictors had predictive power. The rate of mask use has a positive and significant relationship with the variables of systems thinking, individual-social responsibility, moral obligations and a negative and significant relationship with individualism. Also, moral obligations (β=0.694; p-value<0.05) and systemic thinking (β=0.107; p-value<0.1) had the most and least effect on the criterion variable (mask wearing), respectively. According to the findings of this study, it seems necessary to create and develop a systemic thinking, pay attention to individual and social responsibilities, strengthen moral obligations and avoid individualism in relation to desirable collective behaviors to manage a pandemic crisis. As a result, implementing strategies to enhance these individual characteristics can help can help to strengthen and form desirable collective behaviors such as wearing a mask in the time of COVID-19.

With the onset of the COVID-19 pandemics, a huge flood of people rushed to medical centers, which severely affected working conditions of the medical staff. In this article, we are going to evaluate the reaction of health care workers to the rise of traffic, social gatherings, non-observance of mask use protocols and physical distance which lead to an increasing number of infected persons and death rate. Here, we address the impact of community’s indifference on medical staff which seems to decrease the quality of medical staff practice gradually

In recent decades, on the one hand, we have faced atmospheric phenomena and environmental changes, and on the other hand, with the emergence of new diseases called emerging diseases. Managing emerging diseases requires an ethical approach to control and care for them. Ethical problems raising from new diagnostic and therapeutic advances in medical science have increased the need to address medical ethics. One of these emerging diseases of the present century, which is faced by almost the whole world and its problems, is coronavirus (COVID-19). The present study was conducted with the aim of assessing attention of medical staff towards ethical considerations in the care of patients with COVID-19. In this study, in addition to the use of articles published in English related to this disease from late 2019 to early 2020, as well as using national researches by different research groups, different dimensions of the disease is reviewed; Interviews were conducted with the COVID-19 recovered patients who were hospitalized in Shahid Sadoughi Hospital in Yazd Province from the beginning of February 2020 to the end of October 2020. Studies showed the need to put ethical considerations in the care of patients with COVID-19 by training health care providers about professional ethics and medical ethics in the pandemic of the virus in order to optimally manage the disease

One of the most important and influential events in the interaction between Islamic civilization and the West was the Crusades, which lasted for nearly two centuries and extended from Europe to the Levant and Egypt. The main reasons for these wars, apparently, were the religious zeal of the Christians to seize Jerusalem from the Muslims and, in fact, the territorial expansion and influx of the surplus population of Europe to the east. The present study aims to explore the role of the Crusades in the transfer of medicine to Europe. The present research uses a descriptive-analytical method and library resources to explain the process of transferring Islamic and Eastern medical science to the world, affected by religious wars. Referring to texts, honesty and trustworthiness, citation of used texts, avoidance of bias in inference from texts or analyzes have been observed. The results of the research show that during the Crusades, Europeans, observing the scientific progress of Muslims, decided to translate the works of Islamic physicians and transfer them to Europe. This led to the advancement of medical knowledge and the development of health in Europe's Renaissance. Thus, he most important consequence of the Crusades was facilitation of the transfer of the cultural and civilizational foundations of the Islamic world, including the reserves of Islamic and Persian medicine to Europe

From the beginning of the COVID-19 pandemic, researchers aspired to produce an effective vaccine with appropriate efficacy and low side effects to mitigate the pandemic. It seems that vaccination is the only mean to save the world from this pandemic. In this article, we will review the ethical challenges of mass vaccination (focusing on the vaccine distribution and uptake), referring to the main principles of bioethics. Safe and standard manufacturing and passing scientific and ethical stages, as well as evaluation of efficacy and safety monitoring, are the main considerations in the production of vaccines. Justice requires that vulnerable and high-risk individuals be vaccinated sooner. Public vaccination must therefore be ethically prioritized. Individuals may for some reason resist vaccination. For example due to, the confusion caused by mass media information, public’s distrust of the medical profession, the proposed relationship between vaccination and development of certain diseases, and finally low death rate due to covid 19 in some groups, especially young and healthy individuals. However, as the disease is highly contagious and if it spreads, the death rate and hospitalization due to the disease rises sharply, and the consequences of the disease mainly affect vulnerable people, in moral decision-making, the benefits and harms of the vaccine for each person should be considered against the benefits for and harms to the society. In addition, to respect the individuals’ autonomy, cultural modalities and persuasive programs shall be considered. This article is aimed to address the ethical issues of the COVID-19 vaccine rollout while proposing practical solutions to handle them.

Drug crimes, regardless of the economic consequences, have threatened public and individual health and determined the international community to combat them effectively. Therefore, in the laws in question, confiscation of property is considered as a punishment for criminals of drug crimes; while from a jurisprudential point of view, this punishment has faced challenges. The findings of the present study performed using descriptive-analytical method and based on library sources show that the legislator has accepted the confiscation of property as a punishment for some drug crimes in article 18 of the Law on Medical and Pharmaceutical and Food and Beverage Regulations. According to jurisprudence, although man has the right of ownership over his property and assets, it does not mean he is absolute owner. According to special circumstances and assuming the existence of public interests, this right can be ignored in the form of confiscation of property provided that other deterrents to committing drug offenses are not applicable.

The relationship between physicians and operating room staff includes interaction between them in caring for the patient to achieve a common therapeutic goal and condition improvement. Present cross-sectional descriptive-analytical study aimed to examine viewpoints of physicians and operating room staff about their relationship in Ahvaz at 2019. The research samples were operating room staff and physicians working in three educational hospitals affiliated to Ahwaz Jundishapur University of Medical Sciences. Consecutive samples were icluded in the study. The research tool was a two-part questionnaire including socio-demographic information and questions about the professional relationship between the doctors and the operating room staff. Results showed that viewpoints of physicians and operating room staff about respecting ethics in their communications are good. In the group of physicians, 18.1% had a moderate viewpoint and 81.9% had a good viewpoint about communication with operating room staff. Among the operating room staff group, 4.8 percent had a bad viewpoint, 27.3 percent had a moderate viewpoint, and 67.9 percent had a good view point about their communication with physicians. Until reaching highest level of respecting professional ethics, any attempt to improve communication between physicians and operating room staff will result in positive outcomes for physicians and staff, and promote quality of their care for patients.

In medical centers, compliance of personal and social behaviors with ethics and religious standards is very important and requires constant evaluations. Therefore, the present study was conducted to determine the compliance of medical affairs with the standards of the Holy Sharia from the perspective of patients and interns in the teaching hospitals of Jundishapur University of Medical Sciences in Ahvaz in 2020. This was a descriptive cross-sectional study and the statistical population consisted of 204 interns and 385 patients referred to the teaching hospitals of Jundishapur University of Medical Sciences in Ahvaz. Sampling was done randomly. Data were collected by data collection form and questionnaire from patients and interns which was collected by the researcher including 17 questions. Data were analyzed by SPSS version20 software and descriptive and inferential statistics. From the interns' point of view, there was a significant difference (P <0.05) between the compliance of medical affairs with the standards of holy sharia in different hospitals and gender, but there was no significant difference in different ages and marital status (P> 0.05). From the patients' point of view; There was no significant difference (P >0.05) between the compliance of medical affairs with the standards of the Holy Sharia based on gender, age, education, marital status, and hospital. From interns and patients point of view, compliance with Holy Sharia standards were 45.1% and 40.5%, respectively. According to the results of the present study, physical space and more medical staff in both genders are required to fully comply medical affairs with the standards of the Holy Sharia in all the examined hospitals.

The ethical climate in hospitals can influence nurses' ethical decisions. In other words, in the hospital where the nurse cannot use his moral courage, the patient's rights and interests are gradually ignored. Therefore, the aim of this study was to determine the relationship between perception of ethical climate and moral courage of nurses working in hospitals affiliated to Shahid Sadoughi University of Yazd in 2019. This was a descriptive-analytical study. A total of 204 nurses working in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd were included in the study by census sampling. Data were collected using demographic questionnaire, Professional Moral Courage (PMC), and Hospital Ethical Climate Survey (HECS) and analyzed by SPSS 18 software. The results showed that the mean score of ethical climate (3.35 ± 0.62) of 5 and the mean score of moral courage was 56.37 ± 5.46 out of 75. There was no significant relationship between ethical climate and moral courage (P≥0.05). Of demographic characteristics, gender had a significant relationship with the mean score of ethical climate (<0.05), but other demographic characteristics did not have a significant relationship with ethical climate and moral courage (>0.05). Considering influence of environments supporting nurses’ moral courage on optimal care to patients, development of plans by managers to promote nurses’ moral courage can lead to beneficial effects.

Medicine is a profession in which emotional and moral intelligence play an effective role in improving the quality of medical care for patients, mental health, and increasing job satisfaction. The aim of the present study was to investigate emotional and moral intelligence among different physicians. This study was conducted as a descriptive study. The statistical population consisted of all physicians in Mashhad in 2019. Among them, 213 physicians were selected by convenience sampling method and completed questionnaires. The data collection tools were the Bar-On Emotional Quotient Inventory (EQ-i) and the Moral Intelligent Questionnaire. Data were analyzed by Analysis of Variance (ANOVA) and independent t-test. The results showed that among physicians, female physicians, married, over 60 years old, and with a work experience of 30 years and more had more emotional intelligence. The results also showed that physicians over 60 years and a work experience of 30 years and more had higher moral intelligence. Therefore, it can be concluded that educating and selecting medical students and physicians based on measuring emotional and moral intelligence can give them better ability to solve problems and be more resilient when exposing to crises and difficult situations

Human is spiritual dimensions that has legal status in health and disease. The purpose of this study was to evaluate the knowledge of nursing and midwifery students about patient rights in Iran Universities of Medical Sciences teaching hospitals’ in 2017. This study was a descriptive cross-sectional study in 2017 with convenience sampling method. Data was collected by a three-part questionnaire including demographic information, Knowledge about the Patient Rights Charter, and strategies for student information to deal with patient rights. Mann-Whitney and Spearman tests were used for data analysis. A total of 1219 undergraduate students participated in this study. The mean score of students' awareness of the Patient Rights Charter was 13.54±4.45 out of 29 points. 1007 students (82.61%) reported that education about patient right was sufficient. Direct correlation was between patient knowledge awareness score with pre-internship training (r = 0.461) and learning from instructor information (r = 0.512) and there was a negative correlation between self-education (r = -0.151) and other methods of information acquisition (r = -0.067). Given that most students did not consider the educational content taught in the field of patient rights to be effective, it can be concluded that these methods were ineffective and failed to convey the correct information. Therefore, revising of the Patient Rights Curriculum for Nursing and Midwifery students is recommended

Nurses are among the members of the treatment team who have the most contact with Corona Virus Disease- 2019 (COVID-19) patients and their ethical decision-making is inevitable during patient care. On the other hand, nurses' motivation to implement end-of-life care is influenced by their attitude, awareness, and moral reasoning. The aim of this study was to investigate the level of ethical decision making of nurses and its relationship with the attitudes of end-of-life care of patients with COVID-19 in hospitals affiliated to Hamadan University of Medical Sciences in 2021. In this study, 180 nurses working in hospitals affiliated to Hamadan University of Medical Sciences were selected by convenience sampling method. Data collection tools included: demographic Information questionnaire, Nursing Dilemma Test (NDT) questionnaire, and Frommelt Attitudes towards End-of-Life Care questionnaire. According to the results, there is a direct relationship between nurses' ethical decisions and the attitude of end-of-life care (<0.05, r=0.819). The mean score of nurses' ethical decision-making indicates the low level of ethical decision-making (39.19 (5.3)) and the mean score of nurses' practical considerations (20.62(4.2)) showed that the process of nurses' ethical decision-making is relatively influenced by environmental factors. Also, the average score of nurses' exposure to moral challenges indicates that nurses are familiar with similar situations. The mean score of nurses' attitudes toward end-of-life care was reported at an undesirable level (81.58(7.8)). According to the results, by identifying the factors affecting nurses' ethical decision-making and educational planning to improve their decision-making level, it is possible to improve the quality of patients care while improving nurses' attitudes toward end-of-life care.

The medical terms currently used are derived from a variety of sources. These terms are often derived from an eponym. Eponyms are a long-standing tradition in medicine. Eponyms usually involve honoring a prominent physician-scientist who played a significant role in identifying the disease or the person who first reported the disease or the area where a disease first broke out in there. Eponyms are sometimes associated with myth, literature, and art. Of course, the mythological, literary, and artistic figures used in medicine as eponyms are mostly related to Greek and Roman mythology and English and German literature. However, without knowing the ancient records of a disease such as Sarsam (delirium), Barsam (pleurisy), Da'alfil (elephantiasis), Da'al-Raqs (chorea), Pisi (Vitiligo), Degg (languish), Zat-ul- reyeh (Pneumonia), and Zat-ul-Janb (pleurisy), one can specialize in medicine, but, recalling of literary and mythological letters, even those that have no practical application today or have been forgotten somewhere in the history of medicine, can soften medical science and allow us to link science and art. In this article, eponyms that are related to the sciences of anatomy and biochemistry are studied based on myth.

Spanish flu was one of the harshest historical pandemics in the northeastern Iran, which killed many local people. Its first outbreak in Mashhad dates back to August 3 and 4, 1918. This disease continued until 1920 in successive waves. The death toll of this disease in Mashhad (with a population of 100,000 people at the time) was possibly as high as 3,500. Moreover, this disease caused outbreak of other diseases. In fact, it killed five percent of this city’s population and resulted in huge deaths in this city. This paper takes the importance of Mashhad’s medical history into consideration and at the same time investigates the outstanding role of Spanish influenza, World War I, and the presence of Russians who were the main cause of this outbreak in Mashhad, and the reaction of Iranian and foreign physicians to this disease and the medicine they prescribed, as well as the significant role of British in fake Persian Famine, opium addiction, and food poverty.

The aim of this study was to investigate the effect of knowledge strategies on organizational performance with the mediating role of ethical leadership. The present research is a correlational-analytical study in terms of applied purpose. The statistical sample size is 196 people. Data analysis was performed using structural equations through smartpls3 software. Findings showed that knowledge strategies have an effect on organizational performance with the mediating role of ethical leadership. According to the software output, the probability statistic for the ethical leadership mediator variable is 8.475, which is greater than the critical value of the absolute value of 1.96. System-based strategies affect organizational performance by mediating the role of ethical leadership. According to the software output, the probability statistic for the mediating variable of moral leadership is 7.729. Human-centered strategies affect organizational performance by mediating the role of ethical leadership. According to the software output, the probability statistics for the ethical leadership mediator variable is equal to 9.075. In the health system as a knowledge-based organization, managers must plan to implement a system to evaluate the desired knowledge performance. On the other hand, ethical leaders use their potential capacities and abilities through the application of knowledge among employees to achieve organizational goals by establishing two-way communication with employees, and motivating them and placing rewards and punishments for employees in performing organizational tasks and activities.