مجله ایرانی اخلاق و تاریخ پزشکی
سال شانزدهم شماره 1 (بهار 1402)

Malaria is one of the most common infectious diseases, the growth and prevalence of which depends on the environmental and climatic conditions of each region. The Pahlavi government took measures to prevent the spread of this disease in order to ensure public health in the society. In 1334 to 1347A.H, the seventh province of Fars, which included a large part of the coastal and post-coastal areas of the Persian Gulf, was considered one of the vulnerable areas to this disease due to its geographical location. Therefore, the main goal of this research is to investigate and analyze the actions of the Pahlavi government to control and prevent the spread of malaria in Fars province during the years 1334 to 1347A.H. The research method in this article is descriptive-analytical and data collection was done by referring to historical first-hand sources and unpublished local (Persian) documents. The findings of the research show that the Pahlavi government, within the framework of the second and third seven-year construction plans, has implemented solutions to treat and eradicate this disease, such as spraying operations, sending health teams, allocating special funds and implementing programs. He did training for this purpose. Statistical analysis shows that these measures were relatively successful and effective in preventing the spread and control of malaria in Fars. However, the implementation of this plan in Fars was not without challenges.

Drug title is one of the important tools for recognizing and evaluating a combination drug and also analyzing its content. However, sometimes due to the existence of problems that is considered a kind of pathology in this field, is tarnished. The present study tries to identify the problems of nomenclature of compounded drugs. The names of combination drugs available in this research have been collected from three books in traditional pharmacy, namely Gharabadin-e-Salehi, Gharabadin-e- Kabeer, and Gharabadin-e- Azam, related to 18th and 19th centuries. The results showed that there are 5 major problems in nomenclature of compounded drugs: (1) several names for one drug with various formulations, (2) one name for drugs with various formulations, (3) a great deal of variation in unnamed drugs, (4) some unknown pharmaceutical dosage forms, and (5) being dosage forms at one with route of administration and mechanism of action. The study exposes combination drugs in Persian medicine have named concerning various patterns. For this reason, there is non-cooperation that feels a need to special investigation

Emerging biotechnologies contribute significantly to societal well-being by influencing social, economic, and health fields. Attitudes toward biotechnologies differ, in various situations and over time, based on new understanding and evidence. One issue always emphasized in the ethical evaluation of emerging technologies is their dangerous and problematic aspects for human life and well-being. Simultaneously, ethical assumptions can influence ethical decision-making toward employing these technologies, including liberty, technological optimism, determinism, the lifecycle, power, the form of life, technology neutrality, ambiguity, uncertainty, dual-use transformative potential, and the challenges that will be raised by them. For the ethical assessment of emerging technology, six principal methodologies are employed. The "principles-based approach" focuses on obtaining the intended goals rather than determining specific requirements, laws, standards, and obligations and avoids checklist design. The ethical principles raised by the principles-based approach are presented in this article, including risk-cost-benefit, adherence to individual rights, sustainability, naturalness, precautionary, trajectory, responsible stewardship, public beneficence, justice and fairness, democratic deliberation, and intellectual freedom.Finally, by presenting a conceptual model in applying the principles above in forming biotechnologies, eighteen operational recommendations are presented to facilitate the ethical evaluation and monitoring of emerging biotechnologies in the policy-making process in Iran.

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.

One of the most important patient rights is to respect the patients’ autonomy and their participation in the process of treatment decision-making. This is of particular importance for the patients in the emergency department, who require due care in differential diagnosis leading to illness and death. However, the problem arises when this right is negligently ignored and despite the fact that it seems a simple matter, it is difficult to manage and control. Accordingly, this study aimed to investigate this issue through the case report of a patient diagnosed with acute abdomen. Moreover, an attempt was made to briefly review how negligence occurs, its causes and consequences, as well as its management strategies. In this report, the results highlighted the importance of patient participation, obtaining informed consent from the patient in the entire treatment process (diagnosis, treatment, rehabilitation, and prevention), and maintaining privacy and confidentiality regarding all medical and non-medical information of patients that are provided to the treatment staff in verbal, written, partial, and even electronic forms, especially in sensitive and stigmatizing cases. It seems that there are certain strategies to manage such negligence including timely detection, investigation of the causes and consequences, compensation for the damage, enhancing the cultural competence of the treatment staff, developing relevant local guidelines and instructions, having an efficient system with the support of the organization for handling it, and strengthening communication skills and teamwork.

The prevalence of academic cheating in educational centers and institutions leads to inefficiency and incapacity of graduates. Accordingly, the current study aimed to design a structural model for academic cheating in medical students based on moral metacognition, moral identity, and moral potency. This correlational study was done using structural equation modeling. The statistical population of the study included the students of Tabriz University of Medical Sciences in 2022, and 350 students were selected for the study using simple random sampling method. Data were collected through the Academic Cheating Scale (ACS) (Parks-Leduc, Guay and Mulligan, 2022), Moral Metacognition Scale (McMahon and Good, 2016), Moral Identity Questionnaire (MIQ) (Black & Reynolds, 2016), and Moral Potency Questionnaire (Hannah and Avolio, 2010). Data were analyzed using Bootstrap, Sobel, and Pearson’s correlation coefficient tests via SPSS and AMOS, version 24. The results indicated that the direct effect of moral potency (-0.34), moral identity (-0.25), and moral metacognition (-0.29) was significant on estimating academic cheating in students. The indirect effect of moral identity (-1.97) and moral metacognition (-2.06) with the mediating role of moral potency on students’ academic cheating was significant. Considering the mediating effect of moral potency in the academic cheating model, it seems that moral potency plays a role in increasing the effects of moral metacognition and moral identity on reducing academic cheating.

The health team, in their daily operations, are faced with many ethical issues they have to solve. Moral knowledge includes confronting with and resolving conflicts, values, norms, interests, or laws. Identifying the ethical challenges of the health system can contribute to the efficiency of educational and health programs of universities of medical sciences. The objective of this study was to explain the components of professional ethics in therapeutic and health interactions with patients. In this qualitative research, the Delphi method was used to determine the components of professional ethics. The participants were composed of three groups including faculty members, students, and clinical staff who were selected using purposive sampling. First, by reviewing the literature, a semi-structured questionnaire was developed to investigate different components of professional ethics. Then, using the Delphi method in four rounds, the ethical components were selected and by checking content validity indices (CVR and CVI), the final version of professional ethics components was explained based on therapeutic and health interactions with patients. The results of the qualitative research and the Delphi model led to the extraction of the 12 most common ethical components including disclosure of patients’ secrets, lack of justice in providing services, lack of respect for the patient’s discretion, medical and treatment staff errors, lack of compliance with regulations and standards of treatment and care, non-observance of legal regulations in telling bad news by the doctor, non-observance of dying patient’s rights, non-observance of patient’s privacy, lack of proper training of care principles and new and up-to-date treatment tips to students and staff, and finally, non-observance of professional communication. Accordingly, the final components were compiled as a questionnaire. Achieving ethical competence requires the identification of ethical components in educational, therapeutic, and care environments, especially in interaction with the patient. Therefore, it is necessary to identify, structure and formulate ethical components in regular and continuous training programs in the field of importance and observance of ethical principles in medical and health centers.

This study analyzed the credibility perceptions from the perspective of Allameh Tabatabai, one of the prominent Iranian philosophers in the field of philosophy of ethics. Tabatabai emphasizes the significance of credibility based on fundamental values such as truth and justice, arguing that credibility should be rooted in these values. He also pays attention to the analysis of credibility perceptions and underscores their importance in human behaviors and decision-making. The study further delved into how individuals’ credibility perceptions are formed and highlighted the significance of grounding these perceptions on rational arguments, as well as religious and mystical experiences. Credibility perceptions play a crucial role in shaping ethical values and principles and have a direct impact on human ethical behaviors. Moreover, Tabatabai emphasizes the importance of willpower, faith, and piety in shaping human ethical behaviors, explaining that, for individuals to achieve their goals, they must possess knowledge and awareness and make decisions to perform actions based on precise knowledge. These credibility perceptions not only play a vital role in human interaction with the material world but also contribute to the formation of their ethical cognition. Finally, the study demonstrated that analyzing credibility perceptions and focusing on ethical principles and values can contribute to the establishment of suitable ethical environments required for the formation of ethical behaviors. In other words, this study considered credibility perceptions as a solution to addressing ethical challenges in societies and cultures

A professional and educated midwifery workforce is essential to provide high-quality maternal and newborn care. Midwives’ awareness and knowledge of professional rules and regulations would be necessary for correct practice. Accordingly, this study aimed to investigate midwives’ awareness and knowledge of the professional rules and regulations in Iran. In this systematic review study, the PICO guidelines were used to find the relevant articles through searching MeSH terms in Irandoc, SID, Scopus, EMBASE, Cochrane, Magiran, and PubMed databases up to September 7, 2023. The JBI checklist was used to assess the quality of the articles. This systematic review investigated 14 cross-sectional studies with a total of 2161 participants. The results demonstrated that midwives in Iran do not have a satisfactory level of awareness and knowledge about the professional rules and regulations. Based on the results, much more focus is required to enhance the awareness and knowledge of midwives about the professional rules and regulations. The results of this study can be used for developing educational programs on midwifery professional rules and regulations as a necessity for providing high-quality maternal and newborn care

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.

The reproductive right, in its positive or negative form, has been raised in all religions and sects as well as in international documents and human rights, as an important principle and a supported and demanded right. However, the negative population growth rate in recent years in Iran, despite religious documents and laws and jurisprudential and theological support, shows the importance of the government’s attention to the causes of negative population growth and the necessity of taking measures to resolve this problem. Even though the population increase is of paramount importance and governments have the right to recommend and encourage population growth according to their visions, it is the right of every family to freely make their own decision regarding fertility or non-fertility. Although the reproductive right requires the freedom of decision, we should not ignore the positive and negative consequences of legislation regarding the population increase under any title and for any purpose. Informing people of these consequences is the responsibility of the governments and it is the right of the citizens to be fully aware of them and then make a decision freely; the freedom of action which has been neglected by the legislators in the Youthful Population and Protection of the Family Law and needs to be revised. This study attempted to investigate different viewpoints and domestic and foreign scientific and legal texts, to first prove the freedom of individuals in the implementation of reproductive rights, and then, explain the merits and demerits of Article 51 of the Youthful Population and Protection of the Family Law. Finally, certain suggestions were proposed to change this article as well as the legislators’ point of view regarding the strategies to increase the population growth rate.

Face many ethical challenges during this course. Since ethics is an important factor in providing health services to clients, this study was designed to explain the ethical challenges in training in viewpoint of medical students. This qualitative study was conducted with content analysis approach. Purposeful sampling was performed and data were collected using in-depth, face-to-face and semi-structured individualized interviews. Data analysis was done simultaneously with qualitative content analysis using inductive approach according to Elo and Kingaz (2008). In this study, information was gathered after interviewing 40 students of Hormozgan University of Medical Sciences. The mean age of participants was 22/67±1/22 years. After analyzing the text of the interviews, two themes and seven categories were finally obtained. Themes were named under the headings: ethical challenges in clinical field and ethical challenges in clinical training supervisors. According to the results of interviews with different students, it is imperative that the faculty members pay special attention to the ethical challenges in hospitals and clinics and consider the necessary steps to familiarize students with ethical issues, how to deal with these issues and how to make decisions in ethical situations.

Quarantine has a long history in Iran. The spread of epidemic diseases led to the creation of quarantine establishments in Iran. During the Qajar period, quarantine was taken into consideration, and at the end of the 19th century, quarantine establishments were developed in the borders of Iran. Accordingly, in recent years, much research has been conducted on quarantine. The present study aimed to introduce and criticize the paper entitled, “Quarantines of Iran in the End of Ghajar and the Beginning of Pahlavi Era” by Kasiri and Dehghannejad. This analytical-critical study was conducted using library resources to introduce and evaluate the aforementioned paper. The text of the article is coherent and integrated and indicates the authors’ efforts to identify the problems and obstacles to implementing quarantine in Iran. Concerning the structure of the article, there are instances of inappropriate referencing, writing errors, and ambiguity in the scope and limits. Moreover, the failure to mention the effects of World War I on the severity of communicable diseases and quarantine and the vagueness of the prevalence of infectious diseases can be among the criticisms of the content and methodology. Although the abovementioned paper could present a new approach to the history of Quarantine in Iran in the Qajar and Pahlavi eras for the scholars of the history of medicine, it suffers from several structural, content, and methodological flaws. Therefore, given the importance of criticism in scientific studies and according to the analysis of this paper, the results could help enhance the quality of studies and scientific productions in this field.

Professional commitment is described as a set of attitudes, values, behaviors, and relationships that serve as the foundation of a health professional's contract with society. The present study was conducted with the aim of determining the attitude of medical students of Bushehr University of Medical Sciences towards professional commitment in 2022. The research population of this descriptive study included 254 students of the last 3 years of the Faculty of Medicine of Bushehr University of Medical Sciences who were included in the study by census. The standard questionnaire of attitude towards the professional commitment of doctors was used for data gathering. Data were analyzed using SPSS software version 25. Descriptive tests, Spearman's correlation test, linear regression and Mann-Whitney test were used to analyze the data. The mean and standard deviation of the age of the students participating in the study was 24.69±2.25 years. The mean and standard deviation of the attitude score towards professional commitment were 67.12±12.72 out of 100. There was a statistically significant relationship between the variables of age, academic semester and experience of participating in training courses related to professional ethics with the mean attitude score (p < 0.05), but there was no relationship between gender and the attitude score towards professional commitment. There was no statistical significance (p > 0.05). Educational centers and its professors, as the most influential force on the formation of students' morals, should revise and implement the educational program well in the field of medical professionalism, considering professional needs

The research activities of developing countries have increased over the last two decades. The expansion and decentralization of ethics committees necessitates appropriate performance evaluation. In 2023, a cross-sectional study was carried out on the Iranian research ethics Committees using the checklist called "Research Ethics Committee Self-Assessment Tool". The checklist was translated into Persian and revised based on the opinions of research ethics experts and the approved “regulation of establishment, grading, and description of duties for research ethics committees”. The electronic checklist was sent to the senior members of 269 research ethics committees. After gathering the data, it was analyzed using SPSS software. The response rate was 83%. The average overall score was 152.11 ± 25.173, or 69.14% of the maximum. The two sections (including continuing review (monitoring) and committee resources received less than 50% of the average score. The 138 research ethics committee scores were excellent and 85 committees were in the good range. The findings revealed that average scores are influenced by activity years, the number of monthly meetings, the presence of an approved annual budget, an approved quality improvement program, and having specific administrative staff. Completing the self-evaluation tool can raise the National Committee authorities' awareness about the adherence of the research ethics committees to the imperative standards. It can also lead to each committee's awareness of its strengths and challenges. Revision of national regulations governing the establishment, grading, and description of committee duties and then future self-evaluation can facilitate upgrading and improving the performance of ethics committees.

Considering the importance of learning ethical intelligence in nursing students as the future builders of this field and the valuable role that teaching ethical principles in the narrative way, as well as considering the practicality of virtual education in all disciplines, especially medical sciences, the study aimed at determining the effectiveness of virtual teaching of ethical principles in the narrative way on the moral intelligence of nursing students. the present study was of a semi-experimental type, with 40 nursing students entering the study in the available method. Before the intervention, immediately, after and two months after the intervention, participants completed the Lennick and Kiel's moral intelligence scale. Virtual training was held in 16 training sessions. The data was analyzed with the SPSS version 18 software. The Findings showed the present study involved 40 nursing students with an age range of 18-23 years. Comparison of the average overall score of moral intelligence before intervention (155/45±17/81) immediately after intervention (161/50±17/89) and two months after intervention (162/97±15/41) indicates an increase in this score during the study, which was statistically significant(P=0/02).the present study showed that the average overall score of moral intelligence in students increased immediately after and two months after the intervention, and differed from before the intervention, which is statistically significant. Studies show that optimal moral intelligence can portray a good perspective on people's success and progress. Therefore, it is necessary for university administrators to pay special attention to ethical education with new methods, along with clinical education.

Professional ethics is based on human values, tasks, rights and responsibilities and affects the professional and organizational conditions of nurses. In this regard, the aim of this study was identifying framework of the dimensions of nurses' professional ethics from the point of view their and physicians. This study was done with qualitative method, using semi-structured interview, with the participation of 26 physicians medical ethics specialist, clinical specialist, clinical assistant and intern and 20 nurses based on theoretical saturation with the purposeful sampling method and after obtaining informed consent from them. Content analysis method was used for data analysis, which was done in MAXQDA version 18 software. Findings showed professional ethics was based on a four-dimensional framework; The professional ethics of nurses in relation to the patient (six sub-components), in relation to colleagues in different job categories (four sub-components), in relation to the profession (three sub-components) and in relation to the hospital and medical organizations (two sub-components). The reliability of the coding of the components was obtained based on the Kappa index equal to 0.88. Therefore, it can be said. Framework of the dimensions professional ethics of the point of view of nurses found meaning in relation to themselves and others (patients, colleagues, organization and profession). The nurses, knowing and observing the details and nature of these communications, as well as the individual rights of these people from their own point of view; they can properly implement the principles of professional ethics in advancing the goals of the organization and increasing the quality of service provision and the satisfaction of others and raising the status of the profession.

Various decision-making dilemmas arise for clinician in their practice, and one such dilemma involves dealing with medical or dental errors. Despite efforts to minimize errors and prevent harm to patients, complications arising from diagnostic or therapeutic mistakes can sometimes be irreversible. In such situations, it is crucial for dentists to engage in ethical encounters with their patients and investigate the root cause of the error. In this study, an approach was suggested for the management of detection of diagnostic error in pathology using the World Dental Federation ethical decision-making model.

The spread of epidemic diseases has always been one of the important issues in the scope of Islamic civilization The history of the plague epidemic dates back to ancient times So that the outbreak of the plague known as Justinian Plague in the late ancient period and its transfer to the Islamic period Muslims in the conquered lands Facing new issues Therefore, plague is one of the deadliest infectious diseases In the geographical scope Islamic civilization has been that in the early Islamic centuries It has caused damage to the social, economic and even intellectual and cultural structure of the Islamic society The land of sham has been one of the most plague-prone regions of Islamic civilization that repeatedly and consecutively And it happened with many injuries. This research aims to investigate the plague in the Sham region during the Umayyad period (661-749AD) Also, examine the reasons for its occurrence and the beliefs surrounding the plague in this region. The investigations of this research show The geographical location of the sham, its Mediterranean climate, and the location of the sham on the trade routes And the resulting changes It has been influential in the occurrence and spread of the plagueThe occurrence of the plague has also had important and interesting effects on the world view of Muslims. So that the plague was not considered an epidemic but as a result of divine mercy or divine punishment.