نشریه اخلاق پزشکی
پیاپی 49 (بهار 1403)

 Considering that university professors are one of the main groups of researchers and as students tend to be novices in this regard, it is of particular importance to examine their perspective and compliance with ethics in research. Therefore, this study was conducted with the aim of investigating the perspectives of the students and the faculty members of Gonabad University of Medical Sciences towards the inhibitors and the facilitators of ethical compliance in research in 2019.

 In this cross-sectional descriptive study, 66 faculty members and 144 students of Gonabad University of Medical Sciences were selected through census and stratified random sampling, respectively. The research tools included a demographic information form as well as the questionnaire of ethical codes and inhibitors and facilitators of ethical compliance in research. The data were analyzed through SPSS version 18, using descriptive and analytical statistics. The Kolmogorov-Smirnov test was used to investigate the compliance of the data with the normal distribution. The chi-square test was used in data analysis, with a P-value<0/05.

Ethical Considerations: 

In all the stages of writing the present research, while respecting the originality of the texts, honesty and trustworthiness has been observed.

 Sixty-six participants (31.5%) were faculty members and 144 of them (68.5%) were students.  The most important inhibitor of ethical compliance in research from the students' point of view (84%), in the stage of choosing the topic, was the researcher’s insufficient awareness of ethics in research. From the faculty members' point of view (50%), the most important inhibitor of ethical compliance in research in the stage of reviewing the existing documents was the lack of skill in reviewing the existing documents including search skills. The most important facilitator of ethical compliance in research was placing more emphasis on the issue of ethics in research while presenting the course of research methods, from the faculty members' point of view (68%) and holding educational workshops on professional and research ethics, from students' point of view (37.5%). The results regarding the agreement to use ethical codes in research from the perspectives of the students and the professors in the three stages of choosing the research topic and stating the problem, reviewing the available documents and analyzing and reporting and publishing the results of statistical differences, showed the significance levels of P<0.001, P=0.007 and P=0.01, respectively.

 Despite the good state of ethical compliance and the appropriate performance of the ethics committee in research, there are still obstacles on the way to reaching better ethical compliance. The need to hold periodic training workshops, monitor research projects closely and provide the necessary infrastructure is felt.

 With the beginning of the pandemic caused by the COVID-19 virus, the concept of social distancing received a lot of attention and was used in many public health announcements. However, this concept is vague and inexpressive and in the scientific literature, there is no consensus about what is called social distancing. Considering the multi-dimensional view and the ambiguity in different dimensions of social distancing, the need for further development and efforts to achieve a deep perception of this concept is felt. Therefore, this study was conducted with the aim of analyzing the concept of social distancing and determining its dimensions and characteristics.

 The analysis of the concept of social distancing, based on Walker and Avant's approach, was done in eight steps: Choosing a concept; determining the purpose of analysis; identifying the uses of the concept; defining attributes, antecedents and consequences; identifying model, borderline and contrary cases and finally, empirical referents. The articles within the time span of 2019-22 were searched in electronic databases PubMed, ProQuest, CINAHL, Irandoc, SID and Google Scholar search engine, using the keywords social distancing and social distance.

Ethical Considerations:

 In the current research, the ethical aspects of the review study have been observed, including the originality of the texts, honesty and trustworthiness.

 The result of the search was 480 articles, which were screened according to the research criteria and finally, 23 articles that had repeatedly been used to define or describe the antecedents, characteristics and consequences of the desired concept were analyzed. After analyzing the studies, the concept of social distancing was found to have certain qualities: Preventing the transmission of infectious diseases, recommending staying at home and being quarantined, being culture-oriented and the passage of time.

 In this study, a definition of social distancing was obtained, which is also supported by the literature. According to this definition, social distancing is a health protection and preventive measure, which prevents or reduces the transmission of contagious diseases through recommending keeping physical distance from others, staying at home and being quarantined during the outbreak of infectious diseases. Future studies can use this definition in designing preventive interventions related to the adverse consequences of this concept. Furthermore, this definition can be the basis for better teaching this phenomenon to students. Since concepts such as social distancing are always associated with issues like changing social relations and ethical challenges, the need for more reflection on the application of this concept is felt, due to the lack of respect for individuals’ independence.

Stem cell research holds outstanding promise for both understanding fundamental mechanisms of human development and differentiation, and for developing new therapies for diseases such as diabetes, spinal cord injury, Parkinson's disease, and myocardial infarction. Stem cell research continues to be seen as a potential alternative to conventional medications. The rapid advancements in biotechnology have brought to light numerous pressing ethical and policy concerns related to stem cell research. The most significant ethical considerations surrounding stem cell and stem cell-derived product therapies are similar to those arising in other emerging biotechnologies. Given the scientific promise and ethical dilemmas of stem cell research, it is crucial to carefully consider the ethical controversies as this rapidly expanding field progresses. This essay provides an overview of the most important issues that the stem cell research community needs to address

 Awareness of the therapist's interventions includes informing the patient of the nature of the medical decision, treatment methods, the risks and benefits of the proposed treatment and the possible side effects of each treatment method. Failure to understand these elements distorts the consent and acquittal obtained from the patient; it is considered a violation of medical ethics and causes civil and criminal liability for the therapist. In medical emergencies, it is either impossible or difficult and time-consuming to inform the patient or his/her legal representative of the complications and risks of treatment, necessitating the modification of the legal standards of emergency medical interventions in Iranian health law, especially in the case of patients with mental disorders.

 The present study is a narrative review with a Critical Legal Studies (CLS) approach. To this purpose, relevant books and articles were extracted using Farsi databases such as SID and Magiran and international databases including Science Direct, PubMed, and Google Scholar motor engine. The search was conducted without the limitation of   until June 2024, using the keywords criminal law, EMS, mental disorders, patient rights, victimization. The present study is conducted after reviewing 25 references out of a total of 61 Farsi and English books and articles, focusing on presenting a critical legal analysis and not limited to reviewing the mentioned studies.

Ethical Considerations: 

Throughout all the stages of conducting this research, authenticity of sources, honesty and integrity have been observed.

 The "Executive Regulations on the Maintenance and Treatment of Individuals with Mental Health Conditions" (approved in 2019) and the "Bill for the Protection of the Rights of Individuals with Mental Disorders" (drafted in 2020) have not addressed issues related to healthcare providers’ consent and acquittal of the patients, as outlined in the Islamic Penal Code and the Criminal Procedure Code. The challenge of criminality/victimization of patients with mental disorders during the transfer to the emergency department is still not adequately regulated.

 The regulations governing the practice of medical professions and related occupations do not adhere to a coordinated and consistent criminal policy, especially regarding the conditions, scope, legal enforcement guarantees for medical acquittal and consent. Between article 492 of the Islamic Penal Code (approved in 2013) and Note 1 of Article 496 of the same Code contain contradictions regarding the nature of medical consent and acquittal, the related legal burden of proof and the concurrence of causation and agency in cases of medical malpractice (involving the physician and other members of the medical staff). Furthermore, it is necessary to amend the Bill of Rights of Individuals with Mental Disorders, before it is approved by the Islamic Consultative Assembly (Iranian Parliament), especially regarding the need to clarify the provisions of this bill concerning hospitalization orders for patients with psychological disorders. It is also essential to determine the duration and manner of its implementation, since it has been overlooked by the legislator thus far.

 Research ethics effectively influences the quality of research. Since a significant portion of research is conducted by faculty members and students, it is essential that academic institutions uphold scientific and ethical research standards. This study aimed to assess the extent to which research ethics is adhered to by medical faculty members and students.

 This descriptive-analytical study was carried out during the 2022-23 academic year on 130 medical students and 98 faculty members at Abadan University of Medical Sciences. Students were selected through simple random sampling, while faculty members were included through the census method. Data were collected using demographic and research ethics questionnaires and then analyzed using SPSS 18. Statistical tests, including the independent t-test, one-way ANOVA and Pearson correlation, were applied at a significance level of Lees than P<0.05.

Ethical Considerations: 

The study was conducted and published in full compliance with ethical principles.

 The overall research ethics score and all of its dimensions, except for the justice dimension, were higher among faculty members (148) compared to students (101). There was a significant and direct correlation between the research ethics scores of faculty members and students, observed across all evaluated dimensions (P<0.001). Additionally, significant correlations were found between faculty members and students in the dimensions of professional competence (r=0.762, P<0.001), commitment to truth-seeking (r=0.767, P<0.001), benefit (r=0.786, P<0.001), respect for respondents (r=0.769, P<0.004), research activities (r=0.803, P<0.001), justice (r=0.730, P<0.001) and the overall research ethics score (r=0.804, P<0.001).

 The adherence to research ethics was higher among faculty members compared to students; however, the score among faculty members was still average. Hence, it is recommended that greater emphasis be placed on adhering to research ethics principles as a vital and essential component of research, with the aim of enhancing the quality of knowledge production and dissemination.

Ethical principle trainingcan lead to changes in nurses’ behavioral patterns, including anger control. Given the high workload of nurses, more emphasis should be put on virtual and remote approaches to ethical training. Therefore, the present study was conducted with the aim of determining the effect of virtual training of professional ethics on anger control among operating room nurses working in the teaching hospital of Shahrekord University of Medical Sciences.

The present study was a Quasi-experimental study with single-group before-after design conducted in 2019 on 35 operating room personnel who were selected by convenience sampling. Demographic information and standard anger control questionnaires were used to collect data. Data analysis was performed using SPSS version 16, with descriptive statistics such as percentage, mean, and frequency, and inferential tests including Independent TTest, ANOVA and Pearson correlation test at a significance level less than 0.05.

Ethical Considerations: 

Written informed consent was obtained from the participants. They were also assured of data confidentiality and their right to withdraw during the research.

Based on the results the mean age of the participants was 30.77±8.17 years. Results showed a significant difference between the mean score of anger control after the intervention (49.54±7.97) and before the intervention stage (104.43±21.37, p <0.001). No significant relationship was reported between anger control and the variables of age (P=0.62), service history (P=0.92) and number of working hours (P=0.74). Also, the mean of anger control was not significantly different according to gender (P=0.12).

The research findings showed that virtual training on professional ethics can enhance anger control. It is recommended that managers and authorities provide virtual courses on professional ethics so that operating room staff can improve interpersonal relations and anger control by increasing their awareness of professional ethics principles.

 Awareness of patient rights and respecting them are both an important and a fundamental duty of healthcare staff. This study aimed to assess nurses' awareness of the patient bill of rights and their adherence to it from the perspective of hospitalized patients.

 This cross-sectional descriptive study was conducted in 2022 on 168 nurses and 383 patients admitted to Qa’em Hospital, in the city of Asadabad, Hamadan. The participants were selected using convenience sampling. The questionnaires "The Awareness of the Patient Bill of Rights" by Ruintan et al and "The Level of Compliance with Patient Bill of Rights" by Basiri Moghadam were used in this study. Data analysis was done using SPSS 18, considering a significance level of less than 0.05.

Ethical Considerations: 

In all the stages of this study, ethical principles and data confidentiality were observed and the questionnaires were completed after obtaining informed consent and explaining the research objectives to the participants.

A positive but non-significant correlation was observed between the nurses' awareness of the patient bill of rights and the level of compliance with it from the patients' perspective at a significance level of 0.05 (r=0.04, p=0.61). The mean and standard deviation of nurses' awareness of the patient bill of rights were 9.44±4.34, indicating an average level. The mean and standard deviation of compliance with the patient bill of rights in the hospital from patients' perspective were 32.90±7.73, which was considered optimal. The mean score of nurses' awareness of the patient bill of rights was higher in nurses aged 31-40 years, and this difference was statistically significant (p=0.01). There was a significant difference in the mean score of compliance with the patient bill of rights in the hospital from the perspective of patients across different age groups; the highest mean score was reported by patients over 40 years of age and the lowest, by patients aged 20-30 years (p=0.005).

 The results of the study showed a correlation between nurses' awareness of the patient bill of rights and the level of compliance with it from patients' perspective. It is necessary for the healthcare planners and policymakers to consider interventions in developing and implementing in-service training programs, providing incentives to motivate employees, and establishing strict rules to improve compliance with the patient bill of rights in hospitals. To examine the impact of factors, other than awareness, on the level of compliance with the patient bill of rights in hospitals, it is recommended that interventional and qualitative studies be conducted in the futur.