mina mobasher

Patient’s privacy protection is a challenging ethical issue. The complex situation of the COVID-19 pandemic was a probable predictor of breaching confidentiality. This study aimed to assess the viewpoints of COVID-19-confirmed patients, who were hospitalized, and their healthcare providers about the compliance of different aspects of patient’s privacy. This cross-sectional study included 3433 COVID-19-confirmed patients who were hospitalized in Kerman, between 2020 and 2021, and about 1228 related physicians, nurses, and paraclinical staff. Two separate validated researcher-made questionnaires were developed, each including subscales for physical, informational, and spatial privacy, as well as a satisfaction rate of privacy protection. The data were analyzed using SPSS software version 26, with independent samples t test, Mann-Whitney-U, Kruskal Wallis, and Multiple Linear Regression tests at a 95% confidence interval. The mean percentages of the patients’ privacy scores in physical, spatial, and informational areas were significantly lower (P<0.001) than the average of the medical staff’s scores in all three areas (Difference: 10.27%, 14.83%, and 4.91%, respectively). Physical and spatial privacy scores could be predicted based on the participants’ classification, patients or medical staff, and sex. The mean patients’ satisfaction score was 9.25% lower than the medical staff’s (P<0.001). Moreover, only academic hospitals showed a statistically significant difference between the patient’s satisfaction with privacy protection and medical staff’s viewpoints (P<0.001). Although this study indicated the benefits of protecting patients’ privacy in the healthcare setting, patients’ privacy scores and satisfaction were lower than their healthcare providers. The pandemic conditions might have been an obstacle to preserving patients’ rights. These findings demonstrated the importance of sensitizing healthcare providers to manage these ethical challenges in a complicated critical state such as the COVID-19 pandemic.

Deciding on life-prolonging treatments for terminal patients is a major challenge in healthcare. The Advance Directive is a proposed solution. While morally justifiable and aligned with principlism, religious beliefs, particularly in Islam, where preserving life is paramount, heavily influence these decisions. Several juridical and legal rules can culminate in different decisions on the continuation or termination of life-prolonging treatments including the absolute legal power of the owner to exercise dominion[1] or control over property and permission of intervention in their body[2], the rules of prohibition on causing the death[3], the sanctity of human killing[4], the rule of prohibition of detriment[5], and paying attention to the concept of unstable life[6] in Article 372 of the Islamic Penal Code and the rules of preventing losses[7], and also paying attention to the rule of sanctity of idle[8]. In relation to the use of an Advance Directive, given various types of will in Islamic Jurisprudence and according to the contract of agreement[9], it is possible to enter the patient’s request regarding how to continue the treatment. This study indicated that applying Advance Directives in Iran’s health system requires a more accurate analysis of moral, legal and jurisprudential foundations

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.

Many medical schools are adopting varied teaching strategies to enhance students' understanding of the humanitarian aspects of their specialties. This study evaluated medical ethics education at Kerman University of Medical Sciences (Iran) from the students’ perspectives using the CIPP model.A cross-sectional study involving 136 clerkship medical students used convenience sampling and a validated, researcher-made questionnaire based on the CIPP model. The questionnaire, divided into context, input, process, and product sections, assessed the achievement of the program's goals, requirements, implementation, and outcomes of the medical ethics training program.The results revealed that the product domain scored the highest (79.17±21.82), while the input domain scored the lowest (54.30±29.00). The medical ethics program successfully communicated ethical concepts and enhanced students' understanding, excelling in the product domain. However, it requires improvements in the context, input, and process areas, such as aligning materials with cultural norms, and boosting students.It is hypothesized that the medical ethics program at Kerman University of Medical Sciences is robust and aligns well with the CIPP model standards. While the program excels in educational outcomes, there is room for improvement in the context, input, and process dimensions. This study offers pivotal insights for advancing and refining future medical ethics programs.

Effective educational strategies are crucial for developing moral sensitivity in nursing students. Traditional lecture-based methods may lack engagement, prompting the exploration of game-based approaches. This study compares the impacts of game-based and lecture-based teaching on nursing students' moral sensitivity.In this quasi-experimental study, 46 fourth-semester nursing students from Rafsanjan University of Medical Sciences participated. The control group received traditional lectures, while the intervention group engaged in game-based learning focused on moral scenarios in eight 90-minute sessions.Of the initial 46 students, 42 completed the study. Both groups had similar demographics. Post-intervention, the game-based group showed a statistically significant increase in total moral sensitivity scores (P = 0.017). Additionally, they scored higher in “experience of ethical problems and conflicts” (P = 0.044) and in “sincerity and benevolence” (P = 0.007) compared to the lecture group. It was concluded that game-based teaching methods significantly enhance moral sensitivity among nursing students compared to traditional lectures, particularly in areas related to ethical conflicts and benevolence. Future research should focus on the long-term effects and integration of game-based learning in nursing education.

As a rule, physicians’ reputation significantly influences public confidence in the medical profession. Unfortunately, the societal perception of physicians in contemporary Iran appears to be negatively impacted. Therefore, the present study aimed to analyze and elucidate the fundamental causes of this phenomenon.This qualitative study employed content analysis of semi-structured interviews conducted in 2022. The study population consisted of 6 physicians, 6 nurses and 12 patients in the the affiliated hospitals in Kerman University of Medical Sciences selected through purposive sampling. Extraction of the main themes followed the Graneheim and Lundman approach, and data management was facilitated through MAXQDA 20. The study identified five themes encapsulating the causes for damage to physicians’ reputation: physicians' relationship with patients, physicians' relationship with the community, physicians' relationship with the medical profession, challenges within medical practice, and challenges related to medical education. Within these themes, a total of 38 subthemes emerged.The primary drivers that seem to damage physicians’ reputation include: non-effective communication, negative public attitudes toward certain physicians and medical centers due to malpractice, illegitimate relationships of physicians, gaps in physicians’ skills, insufficient education, and ethical lapses.It was concluded that several infrastructural elements negatively impact physicians' reputation. Consequently, it is recommended to monitor the professional behaviors, practices and relationships of physicians, while scrutinizing the medical education system.

Although medical errors in the clinical system are a common cause of lawsuits against physicians, ethical violations have been reported at an alarming pace. We conducted this study to determine the frequency of ethical issues related to patientphysician relationships in registered complaints in three teaching hospitals in Kerman, Iran, from 2015 to 2018. In this cross-sectional study, we extracted data from all complaint cases registered in the complaints offices. The data were categorized according to ethical issues in the physicianpatient relationship including breaching confidentiality, not telling the truth to the patient, not obtaining informed consent, abandoning further treatment, causing unnecessary expenses, violating privacy, and not respecting the patient; then, we compared them according to our objectives using SPSS software. The results showed that 51.7% of the physicians who had been sued were male, and 30.2% of all of them were general surgeons. The most common ethical issues were related to not respecting the patient (49.7%), abandoning further treatment (25.5%), not telling the truth to the patient (14.1%), and not obtaining informed consent (5.4%). The complaints received in three teaching hospitals can reveal the disregard for ethical codes, and irresponsible behavior among healthcare providers may endanger the patients’ safety and increase the likelihood of injury in these hospitals. Further studies are recommended to determine the factors that influence ethical violation in the healthcare setting.

Academic faculty members play the most influential role in realizing the goals and ideals of higher education and community health. In the contemporary period, the cultural and educational role of professors, in the most crucial mission of higher education, has not received the required and necessary attention, and neglecting it has resulted in irreparable damages and adverse consequences. This study attempted to identify the prominent cultural roles of professors in relation to students (with an emphasis on higher health education), while explaining the necessity and importance, and effective solutions were examined and proposed. The present study was conducted using a descriptive-analytical method and a focus group discussion. Selected views of expert professors and data from authentic local scientific articles and related topics in upstream documents were utilized. The findings of the study were classified into five main themes and forty categories. “Cultural goals and ideals”; “general mission of professors for the cultural education of all students” and “special mission of professors of higher health education”; “authentic methods”; and “requirements for cultural education of students” were identified and recommended under the eight selected topics in each axis in order of priority. University Professors play a central role in the cultural and ideological education of students. It is appropriate to develop this responsibility in an objective manner and with suitable scientific methods and observe its excellence and realization in the education system.

Providing accurate information to patients is an important task of the medical staff that can help establish a relationship complying with current ethical principles. The present study aimed to clarify the current status of informing patients about their diseases by physicians.

This cross-sectional study was conducted in the internal medicine and surgery wards of a teaching hospital in Kerman University of Medical Sciences using a convenience sampling method. Participants answered 13 "yes" or "no" questions about the information given to them by their physicians based on Braddock’s study and the second part of the Patient's Rights Charter in Iran.

Totally 396 patients participated in this study. The results showed that less than half of the patients confirmed their physicians had given information to them and answered "yes" to related questions. There was a significant difference in participants’ answers about awareness of the drugs' names (P-value= 0.002), their side effects (P-value= 0.002), the results of para-clinical tests (P-value= 0.002), and patient's preferences and consent to have awareness of adverse outcomes of disease (P-value< 0.001) between internal medicine and surgery wards, and the frequency of “yes” answers was more in patients at internal medicine than in surgery wards.

Offering appropriate training courses to physicians in order to further improve their relationship with patients to provide more informed decision-making is recommended.

Medical ethics courses play a pivotal role in medical education, aiming to enhance the moral decision-making capabilities of medical students. As such, the evaluation of medical ethics education programs within medical faculties is of paramount importance for the improvement of these initiatives.

This study aimed to appraise the psychometric properties of the Context, Input, Process, Product (CIPP) evaluation model in medical ethics education.

This cross-sectional study was conducted on 136 clerckship medical students, who were enrolled in a medical ethics course at Kerman University of Medical Sciences, Kerman, Iran. The participants completed a 40-item researcher-made questionnaire, which was designed based on the CIPP evaluation model. The questionnaire was divided into four distinct sections, each corresponding to the context, input, process, and product aspects of the model. The face and content validity of the instrument was established by an expert panel, consisting of 10 faculty members of medical education and medical ethics. The reliability of the questionnaire was also determined by calculating its internal consistency using Cronbach’s alpha coefficient. Moreover, the construct validity of the questionnaire was assessed via confirmatory factor analysis, using the goodness of fit indices. Data were analyzed in SPSS version 19 and Lisrel 8.8.

The content validity index and content validity ratio of the questionnaire were measured to be 0.97 and 0.89, respectively. The internal consistency of different sections of the questionnaire ranged between 0.71 and 0.87. In the confirmatory factor analysis, the model showed acceptable goodness of fit indices.

In this study, the psychometric properties of the CIPP evaluation model for medical ethics education were found to be acceptable and applicable.

 Emergency medicine physicians face major ethical challenges in their practices. Furthermore, they need to be aware of the principles of ethical analysis and clinical decision-making in order to provide quality care. This study aimed to propose professional ethics codes in the emergency medicine department.

 This is a qualitative study, which was performed using narrative review and expert panel, and was conducted in three steps, including: literature review and preparation of the initial draft of the ethical concepts, obtaining expert opinions on this initial draft and its validation, and finalizing main ethical components in emergency medicine. In this study, we received the opinions of an expert panel including 10 medical ethicists and 12 emergency medicine specialists using a survey form.

 The ethical guide to emergency medicine can be formulated in 34 key ethical concepts, 6 sub-components, and 5 main components including emergency physician-patient relationship, and emergency physicians’ relationships with other professionals, students, researchers, and community.

 Emergency care providers need to be familiar with ethical guidelines in order to improve quality of care in emergency departments. The findings of this study suggest that a guideline on patient-physician relationship as well as the emergency physicians’ ethical obligations for other professionals, students, researchers, and community should be developed in line with ethical norms.

Several research skills training courses are designed for both faculty members and students in educational and research institutions around the world.

The current study aimed to design, implement, and evaluate a short-term research skills training course for faculty members of Kerman University of Medical Sciences.

The current scholarship study was conducted in three stages, in 2017. The first stage comprised of a comparative study needs assessment, and course design. The training course was conducted with the participation of 30 faculty members and the teaching of 10 experienced professors. Participants were evaluated through practical work and homework. Instructors were evaluated by participants using survey forms. The course was evaluated through interviews with several participants and professors.

After eight months of research and holding 16 sessions (which each took between 2 to 4 hours), a course with three main modules was designed in 2017. Instructors used appropriate teaching methods, including interaction with participants, problem-solving, discussing, teamwork, and practicing at home. According to the results of the evaluation, the content of the course was appropriate for the research activities of participants. Besides, they believed that the instructors were among the strengths of the course.

Certainly, increasing research skills of faculty members will lead to better guidance of assistants and qualitative improvement of research conducted by students

A person’s appearance and his/her adherence to the dress code standards are essential in the medical profession.

This study aimed to investigate patients’ and physicians’ viewpoints on interns’ professional outfits.

This is a cross-sectional study, with the participation of patients and physicians of general departments in a teaching hospital of Kerman University of Medical Sciences in 2018. The patients and physicians were selected through convenience and census method, respectively. To examine the participants’ perspectives on the professional dressing, six schematic images, three for males (1, 2, 3) and three for females (A, B, C) were designed. Data were collected through a structured interview in this way, the schematic images were displayed to the participants and they were asked to express their perspective using a series of questions. Data analyzed using SPSS version20.

Totally, 381 patients and 34 physicians participated. The majority of the participants preferred the professional outfit A for female interns and the professional outfit 1 for male interns in response to questions regarding the knowledge, responsibility, patient-care, hygiene, reliability of diagnosis and treatment of diseases, giving emergency consultations, the possibility for discussing sexual and psychiatric problems, as well as life problems. The physicians and patients had the same perspective except for the item about knowledge. (p <0.05).

Our study shows that the outfits of physicians were considered by the participants in forming an effective relationship between the doctor and the patient, and the amount of patients' trust. Therefore, training interns for dressing professionally and complying with the necessary standards should be considered.

The attitudes to the professional dress code as well as the level of adherence to this code are of utmost importance in clinical settings. This study aimed to investigate the students' attitudes and adherence regarding the professional dress code at Kerman University of Medical Sciences, Kerman, Iran.

This descriptive analytical study was conducted on 368 students of medical sciences at Kerman University of Medical Sciences, Kerman, Iran. The data were collected using two researcher-made questionnaires asking for students' attitudes and adherence regarding the professional dress code. The data analysis was performed in SPSS software (version 18) through descriptive statistics and analytic tests.

According to the results of this study, the mean scores of female and male students' attitudes and adherence regarding professional dress code were obtained at 74.04±13.49 and 74.12±10.77, respectively. Moreover, this result indicates that students have positive attitudes toward professional dress code. In addition, the participants believed that 75% of the other students dress professionally.

Given the positive attitudes of participants regarding professional attire, and the fact that 75% of the other students adhere to this issue, it is necessary to maintain and reinforce the positive attitudes of the students to encourage the professional attire values and impress the views of patients who refer to the health care centers.

Using animals in science have had major contributions in progression of human knowledge. However, this contribution has been always accompanied with varying degrees of pain and suffering for these sentient creatures, whom they are completely unable to defend their rights. In a humane and ethical point of view, we humans are responsible for protecting them. One of the most important means for protecting laboratory animals (LA) is to educate researchers according to the highest available ethical and scientific standards, thus developing the concept of “responsible researching” among the scientific community. The aim of the current study was to develop a comprehensive guide for the care and use of LA in the country. This guide is also aimed to provide a basis for the activity of the animals’ ethics committees in the country. The current qualitative study was based on a Health System Research platform and is formed according to the structured communication technique of experts’ panels based on the Delphi method. Primarily any available ethical codes of LA research in the country were collected and integrated. Then, they were compared with the ethical codes of the selected countries and any necessary modification or update of the primary codes were performed to prepare a draft of the comprehensive guide. The draft was evaluated by a selected panel of experts in several rounds to achieve the maximum convergence between the experts. Results are presented narratively. The final version of the guide is presented along with this paper.

Recent advances in life-sustaining treatments and technologies, have given rise to newly emerged, critical and sometimes, controversial questions regarding different aspects of end-of-life decision making and care. Since religious values are among the most influential factors in these decisions, the present study aimed to examine the Islamic scholars’ views on end-of-life care. A structured interview based on six main questions on ethical decision-making in end-of life care was conducted with eight Shiite experts in Islamic studies, and was analyzed through deductive content analysis. Analysis revealed certain points in Islamic views on the definition of death and the persons making decisions about end-of-life care. According to the participants, in addition to conventional criteria (‘urf) such as absence of heartbeat and respiration, the irreversible cessation of human voluntary acts (as a sign that the soul has control over the body and the faculty of thinking) are considered to be the criteria in establishing death. The participants also recognized physicians as the main authorities in verifying signs of death. Furthermore, it was emphasized that life preservation and continuation of care must be sensible, and the patient can request not to have death-prolonging procedures started or continued. In the view of participants, patient’s autonomy cannot be the sole basis for all measures, but Islamic ethical and jurisprudential principles should be relied upon to make correct and sensible decisions whether to continue or stop terminal patients’ care. Final decisions should be made by a team of experts, and physicians must be at the center of such a team. Finally, we suggest that a guideline in keeping with Islamic norms on human life and death, purpose of life, God’s will, boundaries of man’s authority, and the physician’s ethical duties and obligations should be developed.

It is universally acknowledged that death is a complex concept and different factors such as complicated philosophical ideas، contradictory descriptive approaches، and diversity in interpretations add to this complexity. Although a thorough understanding of the notion of death is important for everyone، this concept is of crucial importance to health care providers as they face enormous ethical challenges in the course of their careers. A few instances are controversial issues such as brain death، euthanasia and end-of-life care، where it seems essential to define a set of robust criteria for death. On the other hand، it can be argued that death is not a scientific concept and only different branches of medicine can provide a framework to clarify the subject of death. Therefore، it could be argued that theological approaches may shed some light on this concept. In this article، we aim to extract ontologic components of death mentioned in the Holy Quran، and will move on to propose a set of 12 criteria for death. This may help provide a clear understanding of the concept from the point of view of the Holy Quran، although more research is warranted to further illuminate this complex subject.

In the recent years, advances in medical technologies for end stage cancer patients’ care have affected the end-of-life decision-making in clinical practice and exposed oncologists to serious ethical dilemmas. But little is known about oncologist's viewpoints in our country regarding their ethical problems in this mention. We aimed to clarify the ethical dilemmas which Iranian oncologists may face in our health care setting and to determine factors influencing decision-making process. In this qualitative study, a phenomenological approach was used. We interviewed 8 cancer specialists in teaching hospitals in Iran and used content analysis to identify codes and categorize themes in the data. During the process of analysis, three main themes emerged about ethical dilemmas in end of life care for advanced cancer patients: illness factors, socio-cultural context and patient-physician relationship. Cancer specialists identified ethical problems on several main issues, the most important of which were telling the truth in Iranian cultural context, uncertainty in end stage definition, multidisciplinary team working and cost consideration in Iranian health care system. Health care and insurance system in Iran face to end of life care challenges; therefore, health care providers and policy makers need to allocate appropriate resources and programs to improve quality of care in terminal stages. Appropriate physicians’ communication skills training, multidisciplinary team working and supplementary insurance services that provide essential health care can improve the quality of care of patients with end stages of cancer. The findings of this study can help us to provide ethical policies for decision-making in end-of-life care.

The importance of pediatric research especially in the ethically proven trials resulted in considerable legislative attempts in association with compiling ethical guidelines. Because of children’s vulnerability conducting pediatric research raises different ethical issues; the two most important of which are informed consent and risk-benefit assessment. Differences in ethical standards and socio-cultural issues limit application of ethical standards. At the aim of finding a solution we critically reviewed guidelines, and literatures as well as Islamic points in addition to comparing different viewpoints in application of ethical standards in pediatric research The literature review showed that pediatric research guidelines and authors viewpoints have the same basic ethical core, but there are some variations; depend on cultural, religious, and social differences. Furthermore, these standards have some limitations in defining informed consent according to child’s age and capacity upon application In this regard Islamic approach and definition about growth development and puberty shed light and clarifies a clearer and more rational address to the issue

Dracocephalum polychaetum bornum is exclusively found in a limited geographical area in the Kerman province; It is used by the local people for treatment of abdominal pain, meteorism and musculoskeletal pain. No study has been performed on the effects of D. polychaetum bornum, so the aim of this work was to assess the role of the extract and essential oil of this plant on pain and anxiety assessed by formalin test and elevated plus-maze (EPM), respectively, in male rats. Analgesic effects: One hundred twelve NMRI male rats were divided into 14 groups. Aqueous extract and essential oil were administered to 8 groups at doses of 25, 50, 100 and 200 mg/kg i.p., while 2 groups were treated with normal saline, and the last 4 groups (sham positive) received ASA (300 mg/kg) and morphine (2.5 mg/kg). Anxiolytic effect: Forty-two NMRI male rats were divided into 7 groups. Four groups were injected intraperitoneally with 25, 50, 100 and 200 mg/kg of the extract of the plant and 2 groups were injected with normal saline (control group) and 1 mg/kg diazepam (positive sham). Anxiolytic effect was evaluated by EPM. The results showed that the extract but not the essential oil at the dose of 200 mg/kg had a significant analgesic effect 25, 30 and 35 minutes after administration. The findings on the anxiolytic effect revealed that there was no significant difference between groups treated with different doses. This study showed that D. polychaetum bornum had analgesic effects.

The number of research misconduct cases seems to be increasing so the need for developing a disciplinary charter of research misconduct is felt more than ever. This study was aimed to propose and develop a charter to determine types of research misconduct and dealing with them.

In this qualitative study, three consensus rounds were conducted. Each round consisted of five to six qualified experts with related specialties. They included one member of academic staff with sufficient experience in research management, two experts in professional ethics, and two experts in legal affairs. Each session lasted for 1.5 to 2 hours. Based on an extensive literature review and personal experiences, the different types of research misconduct were extracted in the first two sessions and in the third round, agreement on classification of research misconduct was made

In general, 49 types of research misconduct were explored and defined including 17 mild, 22 moderate and 10 severe ones. Based on the severity of each type, an appropriate penalty like "verbal warnings and summons" to "early retirement with reduced payment base" was determined. Finally the expert panel made some comments.

The results of this study revealed different types of research misconduct and dealing with them. Such an understanding can lead to a better design of national charters compatible with Iranian culture and it can also be as a base for preventive interventions