Health, Spirituality and Medical Ethics
Volume:6 Issue: 3, Sep 2019

Spirituality is recognized globally as an important aspect to respond to many  questions associated with health and happiness. The World Health Organization is also interested in pursuing the physical, psychological, and social dimensions of health (1).
There are several challenges regarding the definition of spiritual health and the advancement of research in this regard (2). In addition, due to the controversies, it is difficult to achieve a common definition of spirituality (3, 4).
However, it seems that the current definitions (5) on the concepts and indicators of spiritual health do not provide comprehensive coverage of all factors in societies; therefore, the results obtained from spiritual health research in one society are not generalizable to different societies.
Furthermore, due to the differences in people's attitudes towards religion and spirituality, it is difficult to evaluate these concepts independently or in combination. As we know, the cognition, actions, emotions, and personal effects of individuals are important indicators of spirituality.

Spirituality and the quality of communication with God with an emphasis on Islamic teachings can play an essential role in life, including marital relationships. On the other hand, the applicability of relationship with God quality in prohibition, activation, and verbal dialogue is important in this regard. Therefore, this study aimed to evaluate the model of marriage burnout associated with the relationship with God and verbal control. A total of 350 married students studying in Azad and Public universities were selected by multiple-stage sampling and modeling among them. Research tools included the questionnaires of marriage burnout, three-dimensional model of relationship with God, and verbal control designed by the researcher reliability and validity of which were assessed using factor analysis, Cronbach’s alpha coefficient, and structural equation modeling. In this study, the dimensional model of God-centered relationship with God predicted the decrease of “marital burnout” only indirectly by increasing verbal control (b=0.72). The value of God-centered trust and respect for God was obtained at 0.38. In addition, the path of “self-centered faith” triangle can affect the prediction of marital burnout increase directly (b=0.19) and indirectly (b=0.23) by a decrease of verbal control. God-centered relationship resulted in the reduction of marital burnout through the mediation of verbal control. On the other hand, the direct role of the self-centered human relationship with God in the increase of marital burnout was indicative of the importance of injury caused by this type of relationship.

Social anxiety disorder is one of the most important psychological disorders that has appeared concurrently with social changes. The present study aimed at evaluating the role of spiritual intelligence and personal beliefs in social anxiety among students at Azad University, Ferdows Branch, South Khorasan Province, Iran.
The study population of this analytical cross-sectional study was all students at the Faculty of Psychology and Educational Sciences affiliated to Azad University, Ferdows Branch, South Khorasan, Iran. In total, 300 students were selected through stratified random sampling in the 2017-2018 academic year. Data were collected using the social anxiety scale by Connor et al. (2000), King's spiritual intelligence scale (2008), and personal beliefs questionnaire by Ellis (1978). Moreover, data analysis was performed utilizing inferential statistics (Pearson correlation and multiple regression). The significance level was considered 0.01 in this study.
The results showed that spiritual intelligence correlated significantly with social anxiety (r=-0.651, P<0.001), and there was a remarkable association between personal beliefs and social anxiety (r=0.335, P<0.001). Moreover, according to the obtained results, spiritual intelligence (42.9) and irrational personal beliefs (11.2) predicted social anxiety (P<0.01).
According to the role of spiritual intelligence and personal beliefs in reducing social anxiety, it can be concluded that strengthening the components of these two factors can be effective in reducing the social anxiety among students which improve their mental health.

Abstract
Mother's general health, including spiritual well-being, is a prerequisite for neonatal health. This study aimed to investigate the relationship of maternal spiritual well-being with the nutritional behavior and psychological parameters of neonates.
In this cross-sectional study, a total of 101 women with non-emergency cesarean delivery were evaluated by convenience sampling method at Amiralmomenin Hospital in Grash, Iran. The study instruments consisted of demographic characteristic form, standard breastfeeding assessment tool, infant physiological parameters registration form, and spiritual well-being scale. Before delivery, the standard breastfeeding method was instructed to the mothers, and their mental health scores were recorded. After delivery, nutritional behavior was recorded by the relevant instrument. Furthermore, the physiological parameters of the newborns were recorded by a tympanic thermometer, pulse oximetry, and neonatal examination. The data were analyzed using descriptive and inferential statistics, as well as correlational tests.
The majority of pregnant women (78.2%) had a moderate level of spiritual well-being. Based on the Pearson correlation test, maternal spiritual well-being showed no significant relationship with mean nutritional behavior (e.g., readiness to feed, rooting, latching, and sucking) and neonatal physiological parameters (P≥0.05).
Maternal spiritual well-being did not significantly affect the nutritional behavior and physiological parameters of the neonates on the first days after birth. It is suggested that similar studies be performed in different hospitals to evaluate the correlation between these parameters.

Abstract
Nowadays, the occurrence of issues, such as irresponsibility, the lack of moral beliefs, and disloyalty to the organization have led to elevated attention to ethical management, organizational spirituality, and effective factors, namely mental health. Therefore, the present study aimed to evaluate the mediatory role of mental health in the relationship between emotional intelligence (EI), commitment to ethical principles, and organizational spirituality.
This descriptive correlational study with applied approach was performed on the statistical population of the staff of Fars provincial government, Iran. A total of 316 study samples were selected through random sampling method using Morgan table. The data were collected utilizing a questionnaire filled out by the participants. Structural equation modeling and partial least squares method were applied with the SmartPLS software to assess the accuracy of the main model and test the hypotheses.
The findings of this study demonstrated that EI and commitment to ethical principles had a significant direct impact on the mental health of the investigated staff. Moreover, the direct effect of commitment to ethical principles and mental health on organizational spirituality was significant. On the other hand, EI was not shown to exert a significant direct influence on organizational spirituality. The analysis of the indirect effects of various factors indicated that mental health might play a mediatory role in the relationship between EI, commitment to ethical principles, and organizational spirituality.
Organizational spirituality is beneficial in organizations and society regarding the improvement of efficiency, innovation, occupational satisfaction, organizational commitment, and organizational citizenship behaviors. On the other hand, addressing EI uniquely is not sufficient for rising organizational spirituality in organizations. Consequently, the influential factors, such as mental health and commitment to ethical principles are required to be taken into consideration.

Considering the prominent and unique role of medical students as future makers of the health status of society, provision and identification of factors affecting their mental health and life satisfaction is obligatory. The present study investigated the relationship of religiosity with mental health and life satisfaction in the students of Arak University of Medical Sciences, Arak, Iran.
This descriptive-correlational study was conducted on 341 students in 2017-2018. The study population was selected with regard to gender through stratified random sampling method. The data were collected by standard questionnaires, including religiosity questionnaire by Glock and Stark, as well as mental health and life satisfaction by Diner et al. The data were analyzed using Pearson correlation, independent t-test, and multiple regression analysis.
Results of Pearson correlation test showed no significant relationship between religiosity and mental health(r=0.061; P=0.270). However, life satisfaction demonstrated a statistically positive relationship with religiosity and all its dimensions (e.g., theological, experiential, consequential, and ritual domains) (r=0.154;P=0.005). There was also a statistically negative relationship between life satisfaction and mental health (decrease in test score) (r=-0.501;P=0.000). Moreover, a significant difference was observed between male and female students in terms of mental health (P<0.05). In this regard, male students had higher mental health than female students.
Consideration of the role of religion and religious components in life satisfaction and educational emphasis on these issues can help to improve life satisfaction and mental health among students.

Competency-based medical education focuses on empowering the medical students with capabilities required to act effectively in their field work, in accordance with the needs and demands of the service sector. The remarkable rise in the interconnection between medicine and religious issues in recent years has intensified the need to addressing religious competencies in medical education. However, there is little evidence of such a tendency in the Iranian medical universities. We investigated the barriers and challenges faced by medical education system for the development of religious competencies.
This qualitative study was carried out by conventional content analysis method. The participants were 18 faculty members and instructors from 7 Iranian medical universities, selected through purposeful sampling. The experts' opinions were obtained through deep semi-structured interviews and analyzed by MaxQDA (version 10).
The results revealed the challenges of developing religious competencies in five main categories including conceptual challenges (lack of clarified concept of religious competencies,  and the predominance of secular approach), motivational challenges (lack of intrinsic/ extrinsic motivation), methodological challenges (lack of appropriate teaching/ learning methodology and inadequacy of assessment mechanisms), institutional challenges (the absence of supportive and facilitating organizational culture, lack of necessary infrastructures, discordant content and resources, and improper policies), and finally contextual challenges (sociocultural conflicts and macro social structures).
Religious competencies development in Iranian medical education is in need of close attention to multiple factors affecting it, some of which are outlined in this article. It seems that a multifaceted look is needed for a comprehensive plan in this regard.

Surrogacy is a challenging method of infertility treatment. In ethical domain, the value and dignity of a woman should be maintained despite the manipulative nature of surrogacy practice. The absence of strict letter of the law on surrogacy contracts has posed legal and ethical challenges to Iranian juridical and medical system. The purpose of the present study was to shed some lights on the challenges surrounding surrogacy contract termination.
This descriptive-analytical study utilized documentary method carried out through the assessment of books, articles, uniform judicial precedent votes, and valid judicial procedures.
Establishment and termination of surrogacy contract is legitimate and subjected to the public codes of contracts, according to article 10 of civil law and Faqihs’ verdicts. The absence of any written and consistent law code has resulted in myriad of challenges in juridical and ethical domains of contracts. Surrogate mother's economic need and a huge number of child applicant couples create a situation for contractors abuse and commercialization of agreement. Surrogacy contract allows for both automatic and non-automatic termination. In this regard, the juridical and ethical challenges usually increase in the latter when the surrogate mother, genetic parents, or treatment center change their minds and decide to give up the practice.
Technological innovations in medical science have opened up new horizons to human beings. Enactment of new law codes with ethical consideration can be an effective approach to infertility treatment through surrogacy and a powerful deterrent to ethical and juridical challenges arising from the termination of this kind of contract.