جستجوی مقالات مرتبط با کلیدواژه "medical ethics" در نشریات گروه "پزشکی"

Findings from ancient Persian literary texts indicate that the issue of professional medical ethics and the correct and logical relationship between a doctor and a patient has not been hidden from the eyes of writers and poets. In addition to the ethical advice of famous physicians, such as Ismail Jorjani, Ibn Sina, Razi, and other ancient Persian literary works have similarly addressed this issue and provided valuable ethical advice to physicians. The society of literature, using their creative and poetic nature, have recounted the relationship between a physician and a patient, sometimes in the form of stories and sometimes in explicit language. Although the field of medical knowledge and technology has made significant progress in recent decades and modern medical ethics has replaced traditional ethics, it seems that some acts and rights related to patients in the contemporary era are the moral heritage contained in ancient works, and in order to develop and complete ethical principles, we can return to this valuable heritage and support. Therefore, the aim of the present study was to determine and examine the components of medical ethics in ancient Persian literary texts and to compare them with modern medical ethics.

The present qualitative study was conducted in a descriptive-analytical manner with the aim of identifying, classifying, extracting and analyzing the components of professional medical ethics reflected in some ancient Persian literature texts up to the end of the eighth century AH and its conformity with the principles of modern medical ethics. The data collection tool in the present research was through library research and the research data was collected through the examination of primary and secondary sources, articles related to medical ethics, searching in databases and search engines. The works studied include the poetic works: Shahnameh by Ferdowsi, Nezami Ganjavi's works, Hadigheha al-Haqeha by Hakim Sana'i, Rumi's Masnavi, Saadi's Garden, Hafez's Divan and prose works including: Qabus Nameh, Chaharmakaleh, Kalileh va Demneh and Saadi's Golestan.

A number of medical laws and ethics, especially the human relations between doctors and patients in contemporary times, are consistent and in line with the moral heritage contained in ancient works, and in order to develop and complete the principles of professional ethics, we can return to this valuable heritage and support.

 The results of the present study indicated that ancient Iranian literature has a special place for medical ethics, and the ethical and cultural teachings reflected in ancient literary works are approved and recommended by medical ethics experts and are consistent with the principles of modern medical ethics.

Hope in infertile couples has increased with the introduction of assisted reproductive technologies including gamete donation to medical treatments and its significant progress. The purpose of this article was to review the ethical issues of gamete donation from the perspective of medical ethics.

This review study using the regular search of internet resources and information databases Magiran, Irandoc, SID, PubMed, Elsevier and Scholar google search engine between the years 2000 to 2023 with the keywords “Donor offspring, Embryo donation, Oocyte donation, Sperm donation, Gamete donation, Medical ethics”, have been done. A total of 42 articles were found. Including criteria were being related to the field of medical ethics and gamete and embryo donation, publication in Farsi and English and the availability of full text of articles and exclusion criteria were articles with letters to the editor and abstract articles, finally 15 articles were investigated

Issues such as confidentiality, consent of the parties, gamete buying and selling, and gender selection that arise in the process of gamete donation are important component for researchers and families. Infertile couples face the concerns of the social and cultural effects of this process on their society and family. According to the laws of each country, ethical issues are also variable in this case. In Iran, in addition to moral issues, attention is also paid to legal and jurisprudential issues.

Gamete donation is one of the big challenges of infertile couples, which requires the Medical team members to learn its ethical issues, and of course, proper training about the ethical issues related to gamete donation is also the responsibility of the medical team members. Increasing public awareness about the ethical issues and the rights of the parties in the gamete donation process can help the society to make more appropriate decisions with the support of scientific knowledge. In the decision-making process, ethical issues related to gamete donation should be carefully assessed and appropriate decisions should be considered to protect the rights and justice of all parties.

Medical ethics education is very vital to maintaining legality and maintain public trust in dentistry. Therefore, this study aimed to measure the knowledge, attitude, and practice of medical ethics of Birjand dental faculty students in 2021.

In this descriptive-analytical cross-sectional study, 117 dental students who passed or were passing the medical ethics unit participated. The data was collected using a questionnaire consisting of two sections (demographic information and questions related to the areas of knowledge, attitude and performance). The knowledge and attitude were measured through a questionnaire that was used in previous studies and its validity and reliability were confirmed. Performance was measured using a researcher-made questionnaire, the reliability of which was obtained by Cronbach's alpha method of 0.78. Data analysis was done using Independent Samples T-tests, One-way analysis of variance, Mann-Whitney and Kruskal-Wallis tests at the significance level of 0.05.

The mean score of students' knowledge, attitude, and practices was 34.11 ± 6.09, 47.07 ± 5.73, and 31.74 ± 6.02, respectively. There was a significant relationship between performance and attitude of students (r = 0.403, P < 0.05). Furthermore, there was a significant difference in the mean score of attitudes according to gender (p = 0.020), female students had a higher mean score of attitudes than males.

Based on the study's results, despite good knowledge, students' attitudes and performance are at an average level. Therefore, proper education on dental ethics among students, especially male students, seems necessary.

Treating patients whose lives are in danger or threatened by irreparable harm, is an obligatory act. However, sometimes, due to old age, the severity of the disease, or the lack of definitive treatment, the patient faces a situation where, according to the diagnosis of the medical staff, starting or continuing the treatment has no effect on patient recovery, or the effect is so insignificant that is ignored in medical practice. This study was conducted using a descriptive and analytical method based on library resources to compare “futile treatment” in medical ethics with “Israf” (extravagance) in Islamic jurisprudence so as to indicate the level of conceptual compatibility between these two concepts. Moreover, considering the illegitimacy of extravagance in jurisprudential teachings, it was attempted to explore whether it is illegitimate, according to Islamic rules, to perform futile treatment. To do so, first, futile treatment and its characteristics in medical texts were defined. Second, the ethical considerations of performing such treatment were explained based on the teachings of medical ethics. Third, extravagance was analyzed in terms of concept, topic, and sentence by referring to valid lexical, jurisprudential, narrative, and interpretative resources. Finally, based on a comparative study, the level of compatibility of futile treatment with extravagance was investigated. The findings of this study showed futile treatment is an example of extravagance as it causes the waste of personal or public property, lacks rational purpose, and does not lead to patient recovery or promotion of health status. Therefore, futile treatment is not considered an obligatory act but even an illegitimate one as it is a clear example of extravagance. In addition to punishment in the afterlife, it entails civil liability as it results in the loss of others’ property.

A part of the important missions of the higher medical education system is formed in the official curricula and an important part of it is formed through the hidden curriculum. Therefore, in order to fulfill its missions, the higher medical education system cannot ignore the part of the hidden medical curriculum. This study was conducted with the aim of predicting medical ethics through hidden medical curriculum components among students of medical sciences universities in Tabriz.

 In this cross-sectional study, the statistical population included all students of medical sciences universities in Tabriz. The statistical sample of this study was made up of 400 students from the fourth year and above of medical schools of the national and Azad universities of Tabriz based on Morgan's table. Due to the equality of the statistical population from each of the universities of medical sciences (only the faculty of medicine), 200 samples were selected by multi-stage (quota) sampling method. The tool of data collection was the hidden medical curriculum and medical ethics questionnaire. Pearson's correlation test and multiple regression were used to analyze the data.

The correlation between the medical ethics variable and the hidden medical curriculum components shows that the relationship between medical ethics and the curriculum (0.104), clinical/specialist education (0.144), educational content (0.133), physical space Social (0.195), incentive and punishment system (0.146), organizational structure (0.126), respect for rights (0.100), ethical behavior (0.104) and sense of responsibility (0.122) are positive and statistically significant. The relationship between medical ethics and personal/environmental background (-0.189) and perspective and career/financial pattern (-0.321) is negative and statistically significant. No significant relationship was found between medical ethics and evaluation and attitude and participation.

The components of the hidden medical curriculum have a positive relationship with the medical ethics of students, and some of the components of the hidden curriculum in line with the development of medical ethics should be given serious attention in medical sciences universities of Tabriz.

Physician self-referral is the referral of a patient to a medical facility in which the referring physician has a financial interest. This can take two forms: internal referrals within the same office and external referrals, often involving joint ventures. Many claims, positive or negative, have been made regarding self-referral. Proponents claim that self referral causes, reduction of costs by fostering a competitive environment, encourage investment in health facilities particularly in underserved areas, financial benefits for both the doctor and the patient via cost reduction, and inhance the quality and accessibility of health services. Conversly, opponents, citing multiple studies, argue that self- referral may result in excessive and unnecessary utilization of healthcare services, leading to increased healthcare costs, low quality of services provided, and jeopardise patient safety. In certain countries, such as the United States and the Islamic Republic of Iran, ethical codes address self-referral. These guidelines either deem it unethical or require disclosure, accompnied by regulations to govern this practice.

Scientists now believe that precision medicine, which employs complicated technology and information derived from omics, can treat complex diseases and provide justice in health. Implementation of precision medicine will face new ethical challenges, considering the principles of medical ethics. With respect to philosophical principles, this study addressed the issue of justice and some ethical challenges of precision medicine. Because, in order to gain the benefits of precision medicine, a proper ethical framework must be developed while considering the challenges. The manner in which precision medicine information is shared and accessed can have an impact on people’s future careers, marriage choices, and type of health insurance. Furthermore, preserving people’s privacy and autonomy are important ethical concerns in precision medicine since there will be no perfect guarantee about data security and access. Although in the short and medium term, due to the design of studies and expensive and complex technologies, precision medicine will be limited to certain groups and will intensify the inequality in justice, in the long run, with the easy access and inexpensive cost of precision medicine technologies, the accumulation of medical expenses will decrease throughout life, and justice will be established between and within countries.

Ancient medical science is as old as human history and the history of science. Authentic documentation before Avesta is insignificant and there are few prominent scientific and civilizational institutions in the field of medicine before Jundishapur. This study endeavors to analyze the evolution of medicine and specifically Traditional Persian Medicine from the most prominent pre-Islamic civilizational institutions, namely Jundishapor, to the modern era, with an analytical approach, and to decipher the secrets of stagnation and transformation, and with the future research, to suggest the necessary and worthy developments of the present time and the next half century. Analytical historiography was used as the method to conduct this study.

Today, abortion treatment is performed legally for reasons such as preserving the health and life of the mother and fetus with disabilities. The aim of this study was to investigate the basic information and determine the main reasons for legal abortions in medical abortions referred from forensic medicine in Babol as a basis for designing and conducting studies in the future regarding the improvement of reproductive health among women of reproductive age.

This cross-sectional study was conducted via census sampling method among 104 cases of medical abortion referred from the forensic medicine of Babol to affiliated hospitals of Babol University of Medical Sciences in 2017-2020. Information related to individual and social factors and maternal and fetal causes leading to abortion was collected by a researcher-made checklist. Then, the data were reviewed and compared in terms of gestational age, termination of pregnancy, and maternal and fetal causes leading to abortion.

The mean gestational age at termination of pregnancy with fetal causes was 16.21±2.35 weeks and for maternal causes was 10.33±3.96 weeks. There was a statistically significant relationship between the history of underlying disease, gender at the time of abortion, gestational age, and the causes of termination of pregnancy (p<0.05). In maternal causes of abortion, the highest frequency (50%) was related to maternal cardiovascular causes, and in fetal causes of abortion, the highest frequency (51.08%) was related to genetic causes of the fetus. Misoprostol was used to terminate the pregnancy of 23.1% of mothers.

The results of the study showed that a large number of cases of medical abortions are related to the fetal cause.

Medical ethics is a field focused on studying the code of conduct and principles that healthcare practitioners are required to adhere to. The progress of medical knowledge and new methods of biological research have created various ethical conflicts, which necessitate the need to pay attention to medical ethics. Medical ethics in Iran and Islamic civilization have a long history. In the era of Islamic civilization, Rhazes and Qutb al-Din Shirazi, two of the greatest scientists of the Islamic world, pointed out important issues about medical ethics. The purpose of this research is to examine the basics of Rhazes and Qutb al-Din Shirazi's medical ethics.

This study was conducted based on a descriptive-analytical approach using library research to collect information from historical sources and texts.

In general, Rhazes was known for being a rationalist and Qutb al-Din Shirazi for being a Shariatist and having a God-oriented manner. The results show that Rhazes has paid attention to the topics of physician-patient communication, physician's scientific and practical competence, physician's confidentiality, and patient's beliefs. Qutb al-Din Shirazi has stated the moral requirements of a physician in ten principles.

In general, the examination of the views of Rhazes and Qutb al-Din Shirazi in the field of medical ethics from the perspective of traditional Iranian medicine shows that both Rhazes and Qutb al-Din Shirazi, similar to many doctors bound by ethical principles in the relationship between doctor and patient, consider compliance with ethical principles as a professional requirement.  They have paid attention to the issue of medical ethics in various areas, such as behavioral qualifications and specialized treatment issues.

Today, artificial intelligencetechnologies can provide incredible benefits to the health system. While artificial intelligence has a significant capacity to improve the performance of the health system, it is accompanied by challenges that sometimes lead to damages the health system. Therefore, the aim of the current research is to review the ethical and legal challenges associated with the use of artificial intelligence in the health system.

This research is a review study. To collect data, evidence wassearched in Web of Science, PubMed, Scopus and Google Scholar databases using the keywords artificial intelligence, medical ethics, health rights, health care and human dignity.

In all the stages of writing the present research, while respecting the originality of the texts, honesty and trustworthiness have been observed.

Based on the findings of the present research, several items can be mentioned regarding ethical challenges: trust in artificial intelligence, violation of human dignity in artificial intelligence, observing the principle of individual independence and its rules, artificial intelligence in diagnosing the completion of treatment, and artificial intelligence and emotional functioning. The legal challenges include the standardizationof artificial intelligence in medicine, artificial intelligence and civil liability, artificial intelligence and the physician’s warranty, artificial intelligence and the breach of data confidentiality, and artificial intelligence and cyber security.

While using artificial intelligence technologies to provide healthcare and medical services, decisions should be made based on respect for human dignity and observing ethical and legal principles, rules and regulations. Any AI-based technology which is considered for use in healthcare and the health system must be efficient, safe, standardized and regulated. Such technologies can only be efficient if they are implemented in healthcare and medical services along with monitoring and evaluation.

The right to access health services as a part of fundamental human rights, affected by the conditions and facilities of governments and the international status, has always faced challenges. Despite the clarity of the general policies and upstream documents in the Iranian health system regarding the need to provide immigrants and refugees with health services and Iran’s membership in the relevant conventions, the implementation of the provisions of these documents is not consistent and complete for various reasons, including the inadequacy of laws related to immigrants and refugees and the incorrect implementation of some existing laws. The first draft of the ethical guidelines for providing health services to immigrants was prepared by the research team using the results of a review of relevant documents as well as a qualitative study and finalized according to the opinions of the participants in a panel of experts. In this draft, after explaining the values and ethical principles governing the provision of services to Afghan immigrants, the suggested guidelines and assignments were presented to the main stakeholders involved, including the policymakers and macro planners of the health system, institutions and centers providing health services, professionals and health service providers, professional organizations, civil society activists, media and non-governmental organizations,  and medical research and education authorities and researchers.

Abortion has long been a complex and challenging issue in many societies. Abortion refers to the spontaneous or induced termination of a pregnancy before the fetus reaches a stage of viability. Women’s decisions regarding legal abortion are influenced by a range of factors, including their husbands, families, societies, cultures, and religious beliefs, which encompass various dimensions. Thus, the present study aimed to investigate the ethical aspects of legal abortion from the perspective of pregnant women attending Iran’s forensic medicine center.

This descriptive-analytical and cross sectional study was conducted in 2019. The research samples included pregnant women referring to the forensic medicine of Isfahan city to obtain a legal abortion license. A total of 229 participants were selected using convenience sampling method. The data collection tool was a researcher-developed questionnaire. The collected data were analyzed using descriptive and inferential statistical methods in the SPSS software.

In the present study, the highest and lowest mean scores of ethical aspects of legal abortion belonged to autonomy (36.20±3.01) and justice (17.24±2.45) respectively. The mean scores of ethical aspects of legal abortion did not show significant differences between women with wanted and unwanted pregnancies (P<0.05).

Women’s autonomy in doing a legal abortion had the highest score, while justice in legal abortion had the lowest score. Given the fact that a great percent of mothers agreed that their spouses should support their decisions, it is necessary to examine factors such as the role of spouses, family, doctors, and society in this regard. Determining the ethical aspects (positive or negative) of legal abortion and mothers’ viewpoint in this regard can hopefully lead to the design of an appropriate program to improve the conditions governing legal abortion.

Telemedicine or remote medicine refers to provision of medical services using information and communication technology, where the provider and recipient of the health service are geographically far from each other. In this study, the clinical, ethical, legal, as well as security and confidentiality aspects of health information in telemedicine have been discussed.

The present article is a narrative review paper that has been prepared based on the authors' experiences and a review of relevant literature.

Physician training on patient safety in telemedicine, preparing patients to accept this kind of technology, and building medical equipment related to remote clinical examinations are very important issues that must be addressed for the successful implementation of telemedicine. Creating medical information infrastructure, including legal infrastructure and obtaining necessary licenses and obligations, can provide a suitable platform for legal and ethical issues in telemedicine and play a significant role in its successful implementation and increased acceptance.

Telemedicine is proposed as a potent solution for improving healthcare access in remote regions, reducing expenses, and addressing challenges related to patient travel. To promote adoption of telemedicine, it is crucial to focus on creating well-defined regulations, implementing quality control systems, fostering interactive platforms, considering ethical and legal aspects, providing comprehensive training, and formulating policies to facilitate the integration of telemedicine services.

The position of the principle of confidentiality in the health sector in the current era, which is known as the information age, requires the existence of legal mechanisms as guarantees to respect it and to uphold the ethical principles and determine its boundaries in the health sector. The fact that the access to patients' information can lead to intentional and unintentional disclosure of their data reveals the necessity of the current research.

This study was conducted using a doctrinal approach. Library-based research and books and articles have been used to collect information. To organize this research, honesty and fidelity have been observed alongside authenticity.

Investigations show that there are deficiencies in Iran's subject laws; because the law must respect the rights of citizens and have the ability to guide its subordinates, while in Article 19 of the Law on Preventing Sexually Transmitted Diseases and Infectious Diseases approved in 1941, despite the counting of diseases in an exclusive manner and remaining silent the consequences of breach of confidentiality in emerging diseases such as AIDS, hepatitis and covid-19 are not seen in such guidelines. Also, considering the principle of openness and taking it into consideration when enacting the law, it should be said that such a thing has not been done in Article 648 of the Islamic Penal Code (Penalties) regarding the distinction between intentional and unintentional disclosure of a secret in the relevant matter, and in both cases, the behavior of the perpetrator is the same as the answer.

By making amendments to the above laws and taking into account the principles of medical professional ethics as well as comparative law, including the set of laws related to the responsibility of health insurance in the United States of America in this case, an important step can be taken in the direction of protecting the rights of patients.

 The basics of ethics and medical law, always in medical ethics books or its implied works in Islamic civilization. It has been the focus of attention and discussion with different approaches. Explaining the data of these works and the approach of doctors and the dos and don'ts of medical ethics and law, it is important for the creation of a new Islamic civilization. The purpose of this article is to investigate two rationalistic and Sharia-based approaches in the implied works of some doctors in the basics of ethics and medical law.

 This is an original fundamental research, with a descriptive-analytical method, focused on the texts of ethics and medical law in the period of Islamic civilization, especially the "Kitāb ul mā" written by Abu Muhammad Azdī. By directly searching the keywords of "Adab al-Tabib", medical ethics, patient rights, Abu Muhammad Azdī and repeated reading of "Kitab al-Ma'a", concepts related to the purpose of research extraction, classification, analysis and then it was written. To present the background of the research, keywords in the databases Magiran, Noormags, SID, Scopus, PubMed were searched.

Ethical Considerations: 

In this research, all ethical and trustworthiness principles have been fully observed in referring to documents.

 Two rationalistic and Shariat-based approaches, looking at ethics, law and medical ethics two rationalistic and Shariat-based approaches, looking at ethics, rights and medical etiquette among doctors in the periods of Islamic civilization who also have a great reputation in the history and ethics of medicine, is visible. each of these two approaches has representatives. Razi, relying on reason and Muhammad Azdī and Quṭb ad-Dīn ash-Shīrāzī, with special attention to Sharia, are the representatives of two rationalist and Sharia-based approaches.

 These two approaches from the perspective of contemporary researchers or they have been neglected or they have passed through it with a homogenization. The idea of creating a new Islamic civilization makes it inevitable to pay attention to the two mentioned approaches.