مجله ایرانی اخلاق و تاریخ پزشکی
سال پنجم شماره 3 (خرداد 1391)

Al-Akawayni is considered one of the greatest and most reputable Iranian physicians of the fourth century AH whose medical works and expertise have been reliable and acceptable sources in most periods of the history of medicine. Unfortunately, old books do not reveal much about his life and works, and what we know about him is based on his own statements and evidence and inferences we have made from his famous work “Hidayat al-Mutaallimin fi-al-Tibb" (Learner's guide to medicine). He was a student of Abu Al Qasem Moqaneiy, who, in turn, was a student of Muhammad Zakaria Razi. His works, especially “Hidayat al-Mutaallimin fi-al-Tibb", are considered reliable medical texts along with other great medical textbooks of Iran. This book is important from several viewpoints. First, it is the oldest available medical text in Persian; second, it is rich in linguistic and literary technicalities; third, it is valuable from a medical and scientific point of view, especially traditional medicine; fourth, it is an important source to learn the names of a large number of medications, herbal medicines, and scholars in the history of Iranian medicine.

Recent advances in cloning have offered hopes for disease treatment and resolving some other difficulties related to health, but this technology comes with social, legal, ethical, religious and other questions, and has caused different reactions worldwide. While some countries have enacted legislations on cloning, other countries have no clear law. Many countries and organizations, for various reasons including ethical concerns, have taken strong stand against reproductive cloning, and some even against research cloning. Some refer to the positive results of cloning and are in favor. Overall, most are in favor of cell and tissue cloning for therapeutic reasons and against reproductive cloning.In general, cloning is an important development in genetics and biotechnology that can be both lifesaving and destructive. Therefore, decision makers should be aware of its positive aspects for human health and prevent potential social and ethical problems through appropriate legislation.In this paper, we present the opinions of opposers and supporters, and an overview of the position of countries and organizations regarding human cloning.

For some infertile couples, egg donation is the only option. In egg sharing programs, patients share half of their eggs with another couple in exchange for a discount on assisted reproductive technology. In many countries, using this method is legally discussed. Iran is the only Islamic country in which donation programs are practiced, so, we designed this study to compare egg sharing to ordinary egg donation from ethical, legal, and religious aspects. A complete review of ethical issues and debates about egg donation and sharing was done. For religious issues, we consulted clergies, Islamic texts, and current decrees (fatwas). Social issues and legal problems were examined by consulting expert opinion and jurists. Also a complete review of literature was done.Egg donation and egg sharing are both religiously accepted in Iran by the Shiite clergies as they are considered completely similar. Egg sharing has some religious (seeing and touching the female genitalia) and social (preventing repetitive donation) advantages to egg donation; as well as avoiding complications of fertility drugs and procedures, financial and trading issues, advertisement and brokers. However, there are some disadvantages with egg sharing, such as reduced likelihood of conception by donating half of the eggs, challenges related to donor health, and emotional stress of failure for the donor and success for the recipient, which can be prevented by careful case selection, psychology and genetics consultation, and practicing anonymity. As a result, egg sharing is ethically and religiously more acceptable than commercial egg donation.

Valuing human being is the foundation of nursing and the essence of care. Specified aspects of the health care are not compatible with the humanistic agenda. Thus, the challenge is to integrate a humanistic approach into nursing. Nursing scientists have tried to solve this problem by developing human centered theories. Internal evaluation of these theories helps decide about their applicability in solving this problem and enhancing a humanistic approach. The aim of this article is to investigate the applicability of some humanistic theories to nurses’ practice. The method is critical review of related literature. Data have been gathered by consulting books, searching some data bases, and using some guiding questions. Findings revealed that humanistic nursing theories, transpersonal care, and human development are becoming specifically expanded under the influence of humanism philosophy. In these theories, human being is free and prepared to grow in a mutual interaction with the environment. Nursing flows from its presence along side others and respect for people's potentials, and has a share in human growth. Emphasis on human interactions has increased the scope of applicability for these theories, but some characteristics of these theories, users, and different context necessitate modifying these theories and developing new ones.

Posthumous reproduction has recently emerged in line with the development of assisted reproduction technology (ART) methods. In this method, individuals take steps to freeze their gametes or embryos for posthumous insemination or reproduction. However, diverse moral and legal questions ensue, and it is important to preserve human dignity and protect the child's rights and interests. In this regard, from an ethical point of view, we discuss supporting and opposing arguments on autonomy, consent, and the child’s interests. We reason that any measure to be taken on the gamete after death has to be based on the autonomy of the deceased and his/her explicit or implicit consent as to the posthumous use of the gamete. On the legal aspects, we discuss proprietary rights over gametes, filiation of the child, and his/her inheritance. In our opinion, non-financial authority over one’s organs, tissues and cells, as well as parenthood and conditional inheritance are plausible answers in these regards. Evidently, the legal system cannot address these issues without taking into account the ART developments and contemporary expediencies. This in turn depends on taking a modern stance relying on justifiable moral and legal principles. Moreover, it will help identify shortcomings of the legal system in this regard.

Spiritual care includes assistance in performing religious rituals to support those seeking connection to the spiritual world. It forms an essential part of holistic care and helps finding answers to issues concerning life, pain, and death. This study was conducted to understand cancer patient's perception of spiritual care.A qualitative content analysis approach was applied to conduct the study. Semi-structured interviews were undertaken with convenience sampling of 17 cancer patients and their family members in oncology wards of a hospital in Tehran and Behnam Daheshpor Charity Organization. The recorded interviews were transcribed verbatim. For data reduction, data were labeled and coded before content analysis. The following themes were identified: characteristics and duties of nurses with a spiritual approach in religious and non religious domains, care with a spiritual approach in religious and non religious domains (emotional, communicational, functional), barriers to spiritual care.According to our findings, nurses do not satisfy all spiritual needs of the participants, because the characteristics and practices of nurses do not meet the expectations of patients and their family members, and ward environment does not support such care.

In recent years, a new manner has been common practice in emergency departments (EDs) of governmental hospitals in Iran, in which, of course illegally, patients are encouraged to self-discharge or refer to other EDs. This is done by giving incomplete or even false information and deceiving patients. The purpose of this study is to identify the underlying causes from the point of view of ED's personnel to clarify the root of this burden for authorities and pave the way for more studies.This is a cross-sectional descriptive-analytic study, gathering opinions via questionnaire and/or direct interview with open-ended questions. During November and December 2009, hospital managers, hospital heads, faculty members, residents in specialties involved with the ED, interns, ED nurses, and nurse supervisors were interviewed regarding the frequency of such instances in their hospital, the main violators, and its possible causes and determinants.In this study 114 persons from different groups took part. From participants’ point of view, the main violators in EDs are junior residents and interns; 48 (42.1%) participants pointed to junior residents and 29 (25.4%) participants found interns responsible. The estimated number of patients which were refused during a week was stated as 18.1 ± 15.6 (range between 0 to 90). Among participants remarks, the most important factors which lead staff to non-admission were high work load, overcrowding of EDs, lack of facilities, lack of any motivation or incentive for doing tough tasks, inappropriate patient transfer by city emergency system, bad policies and rules, lack of sufficient supervision from deputies, and improper work sharing between different levels.Patient non-admission and diversion through deception is a common practice among EDs of educational hospitals in Tehran. High work load and overcrowding of these centers should be considered a high priority target for interventions. Further studies are highly suggested to find appropriate solutions. In future studies, junior residents and interns should be considered as main target groups.