مجله ایرانی اخلاق و تاریخ پزشکی
سال نهم شماره 2 (امرداد 1395)

One major problem that continued to threaten the Iranian society well into early twentieth century was the spread of epidemics and infectious diseases. Even though the Iranian civilization had been around for centuries, deaths resulting from such diseases caused the population to stay at approximately six million. Qajar kings and rulers were the first to attempt to control epidemic diseases by utilizing modern methods such as vaccination.
In 1919, Prince Firuz Mirza Nusrat al-Dawla was elected as head of the Iranian delegation to the Paris Peace Conference. A member of this delegation and the ruler's personal physician was Dr. Mohammad Khan, who introduced Firuz Mirza to the Pasteur Institute upon arriving in Paris. Firuz Mirza was impressed by the activities of the Institute and decided to establish a similar institution in Iran.
Findings of the present study show that the establishment of this institution resulted in measures that, along with other activities initiated by the government in the field of public health, controlled the spread of many infectious diseases in Iran.

Disasters and accidents usually occur unexpectedly and without warning, and frequently cause the deaths of millions of people all over the world. In addition to general and specialized medical staff, volunteers, many of whom lack the necessary training for providing care to victims, enter the scene. In recent years, there has been rising concern about prosecution of volunteers who participate in relief operations due to the possibility of harm to victims. The aim of this study was to investigate the application of the "Ihsan rule" to liabilities resulting from unintentional and uninformed actions of volunteers who operate during disaster relief.
This was a review study conducted through examination of related articles on SID, Magiran, Google Scholar and Pubmed. The results showed that the Ihsan rule cannot absolutely and ubiquitously eliminate the liability of volunteers who participate in relief operations after disasters and accidents. The reason is that although the rule recognizes benevolent motives, good intentions and non-anticipation of monetary compensation, volunteer aid should be approved by experts, and the possibility of harming the injured should not exceed the expected benefits. Consequently, volunteer acts in disasters and accidents are acceptable if:1.Basic training and education is provided to all employees of the medical profession who may volunteer for relief operations after disasters and accidents.
2.Volunteer deployment is executed in the form of committees or specific scientific groups that will organize and train members so that they will perform relief operations according to the guidelines of these institutions.

Genetic research was initially limited to the screening and diagnosis of known hereditary diseases. After the completion of the Human Genome Project (HGP), studies became concerned with the diagnosis and treatment of many non-communicable diseases threatening the public health. Aside from this, genetic engineering, in its new form, is also concerned with the development of recombinant medications, genetic enhancement, and genetically modified organisms and their applications. The climax of these achievements is the advent of transgenic creatures. These are organisms with a genetic makeup different from their natural one created through biotechnology. Transgenic products have become more popular in recent years, especially in agriculture and livestock sectors. At the same time, genetics and biotechnology are trying to keep pace with modern advancements. Genetic modifications have resulted in larger yields in agriculture and livestock as well as the development of new medications and vaccines. Despite the large profits that genetic engineering and transgenic organisms can bring for us, they may pose dangers in certain fields. Furthermore, there are ethical concerns about the application of these technologies.
The present study attempted to address the ethical issues in new genetic technologies and analyze them with regard to the four principles of bioethics. For this purpose, keywords were first looked up in scientific sources and the data were classified; ethical considerations were then analyzed in the light of the four principles of bioethics.
In the results section first the merits of such products for humanity and their contributions to saving the limited available resources are pointed out; subsequently, potential threats in some fields are addressed, along with considerations about the mass production and consumption of genetically engineered products, autonomy of individuals, the importance of raising awareness about the pros and cons of genetically modified organisms (GMOs), and their labeling. Finally, equity is addressed, and general benefits and harms, costs and effectiveness are discussed.

Replacement of missing teeth with dental implants has received growing popularity in recent years. In order to select the proper treatment plan the clinician should provide a list of all applicable options. Decisions on the treatment of the edentulous area should be performed in consultation with the patient while taking into account the four principles of bioethics, that is, respect for autonomy, non-maleficence, beneficence, and justice. The dentist must inform the patient of all available treatment options and point out the advantages and disadvantages of each modality. Rendering dental services should not be based on wrong principles, so dentists’ knowledge and professional skills must be up-to-date. Informed consent is crucial, and when obtained prior to implant placement, typically will bring about better results and prevent many ethical and legal issues and conflicts. Understanding and approval are two important components of informed consent that can hasten the process of patient recovery. Moreover, patient requests and expectations should not lead to incorrect and unethical decisions on the part of the dentist. Implant dentistry may be a suitable option in replacing missing teeth, but it does not license tooth extraction in any way, as natural teeth should not be extracted in the hope of dental implants. Dental implants are not permanent, are not resistant to infection and disease, are not without risks and complications, and more importantly, require comprehensive care.

Moral distress has been identified in nursing literature as a major dilemma affecting nurses in all healthcare systems. It is viewed as an important factor threatening the integrity of nurses and ultimately the quality of patient care. The present study attempted to determine levels of moral distress among the nursing staff employed in hospitals across the city of Malayer. This was a descriptive and cross-sectional study conducted on 195 nurses of Malayer hospitals during 2015. Data were collected using a demographic questionnaire and the standard moral distress scale (MDS). Data analysis was performed by descriptive and analytical statistics using SPSS software version 18.
In this study, 88 nurses (45.1%) were found to be suffering from severe moral distress. The most important factors causing moral distress pertained to substandard care and treatment due to a shortage of health professionals and care providers (6.6±0.21), physician orders for unnecessary tests, treatments and care (6±0.12), and measures taken by staff who lacked clinical competency (5.9±0.22). Among the nurses’ demographic data, gender (P=0.001), job experience (P=0.001) and nursing ward (P=0.01) were significantly related to the level of moral distress experienced by the nursing staff. The results imply that in nursing, moral distress is a highly important and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators.

The increasing use of infertility treatments has given rise to the issue of filiation of the children conceived through such methods and created serious theoretical challenges. In this regard, it seems necessary to scrutinise the concept of filiation and understand its nature. The main question here would be whether filiation is a biological and natural concept, or a legal and normative one. The present study attempted to explain and criticize both the natural and normative outlooks, and it seems that strong arguments may be put forth in criticism of the former and in defence of the latter.
This study employed an explanatory/analytical method whereby the claims related to the issue were studied, explained, and analysed in a theoretical and philosophical manner. The results showed that with the recent developments in assisted reproductive technologies, the current outlook, which considers filiation to be a biological concept, might give rise to various theoretical as well as moral and legal problems that the biological theory cannot solve. It can be concluded that filiation, as it seems prima facie, is not a purely biological concept and may be established on normative and upbringing bases.

Job stress is rather common in the nursing profession and affects many areas of nurses’ personal lives such as physical, psychological, social and family aspects. Considering the important role of nurses in the society, it is necessary to identify factors that influence their professional and domestic life, and take preventive measures. The aim of this study was to investigate the impact of job stress on marital stress and subjective well-being of nurses.
This was a descriptive correlation research. Study population consisted of 120 nurses employed in the city of Ardabil during 2013 and 2014 selected through available sampling. To collect data, Job Stress Questionnaire (Tufts and Gary Anderson), a subjective well-being questionnaire, and Stockholm-Tehran Marital Stress Scale (STMSS) were used. Data analysis was performed by Pearson’s correlation coefficient and regression analysis.
The results of Pearson’s correlation coefficient demonstrated a negative correlation between job stress and subjective well-being in nurses. Moreover, a positive correlation was discovered between job stress and marital stress. Additionally, regression analysis showed that nursing job stress could predict 25 percent of variance of subjective well-being, 27 percent of variance of marital stress and 29 percent of variance of empathy.
It can be concluded that due to the nature of the nursing profession, nurses’ physical, mental and personal lives are influenced by the stress of the workplace. This will in turn lead to increased marital stress and reduced subjective well-being, which may intensify the risk of developing psychological problems and marital issues in the long run.

Nurses comprise the largest group of service providers in the health system and have a significant impact on health care quality; therefore, ethical practice is of greater importance in the nursing profession compared to other fields of care. The present study was conducted to evaluate patients’ views on nurses’ observance of professional ethics in training hospitals of Bushehr during 2015.
This was a descriptive cross-sectional study performed on 208 patients hospitalized in teaching hospitals of Bushehr selected by convenience sampling. The research instrument was a questionnaire including demographic characteristics and questions about ethics of the nursing profession. Validity and reliability of the data collection tool were approved. Data were analyzed through descriptive statistics, t-test, ANOVA and Pearson’s correlation coefficient using SPSS version 18.
The results showed that 94.6 percent of the patients evaluated the nurses’ observance of professional ethics as good, 4.4 percent as moderate and 1 percent as poor. Moreover, no significant relationship was found between the independent variables of age, gender, marital status, education level and history of hospitalization ward in the patients, and their views on nurses’ observance of professional ethics.