DARU, Journal of Pharmaceutical Sciences
Volume:14 Issue: 1, Spring 2006

Abstract: Globally, there have been considerable debates on the ethical conduct and review of collaborative international researches. One of the great challenges is to conduct clinical trials in developing countries as Externally-Sponsored Researches (ESR). This descriptive survey has reviewed the status of this type of researches in Iran during 2002 to 2003. This study was carried out in 44 universities of medical sciences and 32 research centers. The questionnaires containing closed and open-ended questions were sent to their Ethics Review Committees (ECs). After collection of data and coding, they were analyzed by means of SPSS software version 11.5. Forty one universities and 25 research centers have been responded but only 35 ECs retrieved the questionnaire. According to the collected data, 26 and 54 studies have been carried out as a collaborative research or externally-sponsored researches in Iran in 2002 and 2003, respectively. Although more than half of ECs'' members have received necessary preliminary educations but there were professional educational courses in only 25% of ECs. About 17% of ESR projects have not been examined in ECs, although they have been evaluated in the Scientific Research Council. Only one of the evaluated ESR proposals has been rejected and the rest have been approved and conducted. Socio-cultural issues and religious beliefs, scientific validity, and national priorities were the most important factors for proposals evaluation. The ethical issues concerning international collaboration for clinical research in developing countries are complex. We should enhance educational programs for researchers and establish appropriate regulatory guidelines at national and international levels.

Abstract: Health statistics demonstrate remarkable progresses in the field of primary health care and academic education in Iran within recent decades. Iran has also had obvious progresses in the field of research and the International publication rate of Iranian scientists has been quadrupled over the past decade. Progresses in biomedical researches have been associated with considerable activities in bioethics education, research and legislation. Organ transplantation, stem cell research, assisted reproductive technologies and genetics are some important instances of ethical debates in our country. In this concise manuscript we intend to present some recent progresses in science and research in Iran. Considering importance of the bioethical issues, we will also review new legislations in the field of bioethics.

Abstract: Medical ethics has a long history worldwide, and the move towards a transcultural ethics must be based on an appreciation of the history that has produced the present relationships. It is often thought that medical ethics history has begun at the time of Hippocrates, however it is much older. It is clear that various cultures such as Babylonia, ancient Egypt, Greece, and the Persians have attempted to regulate medicine and to protect patients'' rights in the known ancient world. One of the earliest written provisions in this field that comes back to about 1750 BC is the code of Hammurabi. In medieval, great Iranian physicians had paid special attention to ethics in their practices, teachings and manuscripts.In this paper we aimed to explore the roots of medical ethics in Persian history, particularly after adherence of Iranians to Islam. History of medicine in Iran has begun at about fourth century BC. There was a gap between the ancient civilizations and the Renaissance era in Europe, commonly called the dark ages. The immense strides have been made by the Persians in that long interval which is briefly reviewed.

Abstract: It is the cherished goal of the health care providers to observe the patient rights. An official order to install the patient rights charter in all crowded places of hospitals motivated us to evaluate the patient rights both from the patients'' and resident points of view. This is a descriptive survey with cross-sectional method. The research was conducted to examine the patients and residents awareness of the contents of "Patients'' Rights Charter" in emergency department of Imam Khomeini hospital in Tehran and their views on the adherence of the cares to the articles of the charter. 140 patients and 70 residents were chosen by simple randomized method by Cochrane formula and the data was gathered by questionnaires. 57.9% of patients were not aware of this announcement. 78% of patients believed that patients'' rights is being carried out relatively. 88.6% of residents believed that they complied with the rights of patients. The patients were relatively satisfied with the nursing cares, medical services and hospital equipments (69% were satisfied with availability of physicians in necessary situations, 47% satisfied with the nursing cares and 93.6% satisfied with the hospital equipments).Two years after installation of the charter, patients and residents awareness of installation were low. According to the patient views, patients'' rights were relatively adhered. Unawareness of patients of their rights may limit their expectations from physicians and if they become aware of the contents of charter, their satisfaction from current situation may alter.

Abstract: In the recent years, new medical technologies and their probable misuses have emerged public concerns about medical ethics. Medical ethics is a practical discipline that provides a structured approach for identifying, analyzing, and resolving ethical issues in clinical medicine. In this study we reviewed some new methods of teaching medical ethics in other countries by searching in internet and literature. Two key features related to the teaching of medical ethics are active involvement of students in the learning process instead of merely lecturing about the ethical principles and assessing how students apply their knowledge of ethical principles in simulated and actual situations. In many countries such as Iran, medical schools attempted to address medical ethics issues in formal ethics classes. It is clear that the traditional method is no longer sufficient to meet the needs of practitioners and societies and new methods particularly those emphasize on active learning, individual participation, group interactions, and a process - based approach, should be developed and implemented. In addition, a concerted effort to improve education in medical ethics will benefit the medical profession and services to patients. Therefore, we recommend policy makers of medical ethics education to change the traditional methods to the modern methods; which are used now in the world.

Abstract: During recent decades, the third person intervention in human artificial insemination has created new hopes for infertile couples. However these new progresses have propounded new ethical and legal concerns for families. One of them is confidentiality regarding gamete donor''s identity, and its disclosure to the future child and others. Of course, negligence to this ethical issue would produce a big barrier for efficient health care services.For compiling this article we searched different websites including Pubmed, Ovid, Elsevier, Google and etc and the resulting articles were investigated carefully. In this article, the history of gamete donation in different countries is reviewed initially and the mentioned reasons for anonymity with that of disclosure are compared. Because of the different cultures and values of various societies, it is not justifiable to propose a unique method regarding this issue; however, there have to be clear rules in this regard, in each country. In order to facilitate this process, pretreatment counseling courses should be established to explain different aspects of this issue for the recipients.

Abstract: All schools of Islamic jurisprudence regard abortion as wrong and forbidden and allow abortion only before the stage of ensoulment, if the continuation of pregnancy would endanger the mother''s life or put her into intolerable difficulties. In this article we describe and assess the viewpoint of Shiite jurisprudence toward abortion. Using a selected collection of related references, and discussion describes with experts, this article the abortion in Shiite jurisprudence.In the Shiite jurisprudence, the ensoulment occurs after about 4 months. Before this stage, all Shiite authorities regard abortion as forbidden (Hiram) unless if continuing the pregnancy would put the mother''s life in real danger or will be intolerable for her. But after that, they regard abortion as Hiram, unless in conditions in which continuing the pregnancy results in dying of both mother and fetus, but abortion will save the life of mother. However, the Shiite authorities have not accepted to legitimate abortion in unwanted pregnancies and even in pregnancies resulted from adultery (Zina) or rape.The debate over abortion is still controversial as ever. There are some important and notable related Fatwas that make jurisprudical basis for some new and problem solving legal acts, showing the inherent and valuable flexibility of the Shiite jurisprudence in dealing with such important issues. Some related issues, such as the priority of saving the life of mother after ensoulment can be referred to jurisprudical authorities for more assessment.

Abstract: One of the fundamental issues in the ethics of medical researches is cost-benefit assessment which consists a main part of related codes. This article is aimed to propose a model for ethical assessment of researches with judgment about their costs and benefits.After reviewing related materials and our experiences and discussions with experts, we proposed a model for ethical assessment of costs and benefits of medical researches. It seems that there can be a complex table that shows the potential influenced groups such as patients, researchers, their families, society, and. .., and in the other side of the table, we can see the aspects of such influences, including physical, economical, psychological, social, spiritual, political, and so on. So, the authors designed a table showing the above mentioned types of influences, for using in ethical assessments of the costs and benefits of medical researches.Because of the complexity that exists in various aspects of the costs and benefits of a research, the researcher can not accomplish this analysis alone. It reveals the philosophy of the composition of the research ethics committees. The proposed table of this article will help the researchers and ethical committees for implementation of the above mentioned principles in research activities.

Abstract: During the last decades, gamete donation has been known as an assisted reproductive treatment for infertile couples. This method has raised many ethical issues; one of the dilemmas is the payment between the donor and recipient. In this article we discuss the payment issues in gamete donation. For compiling this article, we searched keywords of "gamete donation, monetary relationship and ethics" in Pubmed and Ovid. After reviewing the history of gamete donation, the risks and benefits of gamete donation, the motivations of donation and the financial incentives were reviewed. Then the ethical debates were discussed; the possibility of undue inducements, coercion and exploitation, the quality of informed consent, commodification of donation, compensating the risks and troubles, the results of not paying the donors and other ethical aspects were also explained.Payment is one of the inevitable problems in gamete donation. Considering the scarce supply of gametes compared to its demand, the current policies of gamete donation without any payment leads to increasing numbers of infertile couples and also the longer waiting times for treatment. Moreover, the essential and immediate needs of couples for gamete leads to significant expenditures in illegal outlines. It is necessary to compile an arranged schedule to organize the financial relationship between the donor and recipient in a legal outline.

Abstract: The rapid progress of science and technology, including genetic research and technology has been led to new hopes in the treatment of some genetic conditions and diseases. But these developments have also raised ethical and societal concerns in different communities. Certainly, medical genetics knowledge should be applied so, we have to maximize its benefits and minimize any harm. In recent decades, many attempts have been performed by scientists, ethicists, jurisprudents and lawyers for compiling international and national guidelines for regulation and legislation in this field. For compilation of this article, we searched some comprehensive electronic databases and some valid English and Farsi books and journals. In this intensive review, we intend to provide a basic knowledge about genetic ethics for health care professionals in order to facilitate their decision-making in clinical practice.There are various ethical issues related to medical genetics that we reviewed in this paper in brief. These key issues do need attention and urgent resolution universally. We also reviewed Islamic view of points in this regards and finally we addressed the status of genetic ethics in our country, containing new national guidelines in this field.