جستجوی مقالات مرتبط با کلیدواژه « medical ethics » در نشریات گروه « پزشکی »

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.

 Medical ethics is one of the important subjects in medical knowledge and profession, which plays an important role in systematization and scientific improvement of this profession and consequently in the lives of people in the society. In the Abbasid era (132-656 AH), at the same time as the scientific progress in the field of Islamic civilization, great efforts were made to realize the principles of medical ethics and structure it by sages and rulers. Paying attention to the status and importance of doctors in this era had prepared the ground for the increase of fraudsters in this profession who were endangering the health and lives of patients. Therefore, the institution of the Abbasid caliphate dealt with the delinquent people entering this profession by providing several measures and measures and provided a platform for the improvement of ethics in the medical profession.

 The present research is a descriptive-analytical study. In order to collect information, first-hand sources in the Abbasid period have been examined. In this regard, first the books of general history and chronicles have been examined, then the medical sources of this era have been studied. New sources have also been used to complete the information.

Ethical Considerations: 

Throughout the present study, scientific integrity and fidelity have been fully observed.

 The results of the research showed that paying attention to medical ethics training, expanding medical service centers, paying attention to the importance and status of doctors' science and knowledge, and strengthening the social position of those whose knowledge was proven, testing and monitoring their work through devices Competent supervision was one of the functions of the caliphate institution of the Abbasid era, which provided the ground for the moral education of doctors.

 In the Abbasid era, in addition to the attention of the caliphate to realize ethics in the medical profession, trained doctors also tried to treat all patients ethically without considering the apparent differences. They were not indifferent even to the patients who were in a more sensitive situation in terms of mental and social conditions and they tried to treat them decently like other patients and take measures to reduce pain and Do their pains.

One of the most basic rights of patients is the right to consent to accept a treatment method. Informed consent is the foundation of medical ethics. Compliance with the standard process of obtaining informed consent from the patient in the fields of therapeutic and research activities, while directly affecting the patient's satisfaction, will lead to a reduction in complaints and legal and disciplinary interventions from the medical staff. For this purpose, the present study was conducted.

The current research is a descriptive-analytical and cross-sectional study. The data collection tool was the standard questionnaire of knowledge and attitude towards informed consent and its legal aspects. For data analysis, appropriate descriptive and analytical tests were used and the significant level was considered less than 0.05.

The average attitude score of assistants was 3.14±0.93 and interns was 2.80±1.23. Also, the average knowledge score of assistants was 15.23±3.79 and interns was 14.64±3.79. Among the demographic variables evaluated, there was only a significant relationship between the attitude and the field of study of the assistants, as well as between the attitude and the marital status of the interns.

The results of this research showed that the knowledge and attitude of assistants and interns about informed consent and its legal aspects is average. Considering the importance of this issue, it is necessary to make changes in the educational process of the university in order to plan an educational program in this regard.

Medical ethics is a long-lasting and deep-rooted heritage, and its foundations have all human knowledge and the teachings of divine prophets and the lives of sages and physicians, dating back as far as human history. The purpose of the study is to process the historical developments of medical ethics and to take instructive lessons from them. This review study was conducted by referring to a selection of valid and relevant articles. Analyzing the findings, establishing coherence and coordination between them, inferring ethical concepts and clarifying ambiguous cases, has been done with an analytical historiography approach. The severe limitation of resources is one of the factors affecting any type of study in the history of ancient medicine. In the subject of the study, two time periods "Ancient times before the appearance of Zoroaster and writing the Avesta"; and "the rise and fall of the Sassanids until the rise of Islam", has been reviewed. In practice, the desired findings and evidence from the ancient times to the founding period of Jundishapour University, including the activity period of this great civilizational institution to the period before the advent of Islam, were reviewed; and highlights related to moral values and developments, were gathered and, based on the historical periods are presented. Ethics is at the heart of the holy profession of medicine and its cognate and companion, as an ancient knowledge, throughout time and current and as a soul in the body of time, it is always life-giving and still alive and dynamic and playing a role.

Professional behavior of residents plays an important role in improving hospital performance and patient satisfaction. In this study, we investigated the rate of changes in residents' adherence to protocols and patient satisfaction by changing the method of evaluation of residents' professional behavior.

In this observational study, this was designed and implemented by before and after, 384 specialized residents in Imam Hossein Hospital were included in the study. In two consecutive 5-month periods, residents' performance was evaluated first based on "Residents' Professional Behavior Evaluation Questionnaire Communicated by the Ministry of Health" and then on "New Protocol of Residents' Professional Ethics". Data were analyzed by SPSS software. To describe the data, mean and median indices were used. Wilcoxon and McNemar tests were used to analyze the data.

Attendance of assistants in hospital conferences during the same period increased from 1038 people to 1669 people in the second round of the study (p < 0.001). Observance of religious and ethical standards in examination and treatment measures in outpatients increased from 79.6% to 90.7%, which was significant. (P = 0/016) Before the implementation of the new protocol, 81.51% of non-emergency consultations were performed in less than 24 hours, which increased to 90.84% after the implementation of the plan (p < 0.032). The rate of patient assignment index in the emergency department improved to an acceptable level. Indicators related to emergency outpatients, such as physician's attitude, adequate patient attention, and appropriate coverage, improved Also. In hospitalized patients, indicators such as observance of sharia rules in examination and treatment were improved, but these improvements were not significant.

It seems that the changed style sheet would improve the ethics and professional character of the assistants. It is recommended to conduct similar research at other universities. In this regard, it seems that changes in evaluation indicators as well as assigning part of the evaluations to the deputy of hospital education, can be effective in improving patient satisfaction level and more adherence of residents to ethical standards.