فصلنامه اخلاق پزشکی
پیاپی 7 (بهار 1388)

We can study medical ethics based on three main subjects of ethics in education, ethics in research and clinical ethics at the beginning, during and at the end of life, and after death. Medical Ethics deals with all aspects of medical sciences, however, in contrast with the medical ethics in previous centuries which were exclusively concerned with the physician-patient relationship, since 1970s with the rapidly developing biomedical technology, there appeared new challenges in medical practice that are the subjects of medical ethics today. As a main sub discipline of medical ethics, clinical ethics deals with the ethical rules of the physician-patient relationship and the new problems such as clinical trials, genetics, organ transplantation, euthanasia, physical examination, fair allocation of scarce health resources, expensive surgeries, medically-assisted fertilizations and access of the patient to the necessary information regarding the diagnosis and treatment. In this article, the author tries to study parameters of clinical ethics, the development of clinical ethics, strategic planning for teaching clinical ethics, care- based ethics and the role of ethical counseling in health care system as the main subjects in medical ethics.

Bioethics is a newly-arisen and inter-disciplinary field in practical ethics. It deals with the analysis, challenges, ethical, philosophical, religious and legal problems arisen from the emergence and development of novel biotechnologies. International organizations encoded and enacted declarations and conventions, specified general principles and guidance for countries to cooperate to compile comprehensive Acts due to following reasons:Certain or possible results and consequences arisen from the applying technologies such as human cloning, genetic manipulations and biomedical tests on human subjects. NNESCO declarations, the efforts and declarations of UN general assembly and in regional level, the conventions of European Council can be referred to.

The DNA molecule has an essential role in physiology, phenotypic characteristics and disease in humans. The information related to physical attributes such as height, hair color, eye color,… inherited from parents are kept in DNA molecule and in recent Genetic studies it has been shown that genes not only have a role in shaping physical characteristics but also have a decisive role in behaviors such as: Sudden excitability, adventurous behavior, excitement, desire for new initiatives and psychological diseases such as: schizophrenia, manic depression and autism. Recently, in social, philosophical and psychological studies the role of genes in regulating brain as the only center which control human behavior has been widely discussed. The long standing hypothesis in human history under the name of "tabula rasa" has served as a model providing a mechanism describing human behavior. However, this hypothesis is no longer acceptable to many. As the understanding of the complex human brain has increased, researchers have been trying to discover mechanisms and hypotheses to explain the human brain.The presence of many cultures on earth and the existence of similarities among all cultures demonstrate that genetics has a major role in creation and growth of different cultures. The present article attempts to briefly describe the role of genetics in the field of human behavior and culture.

Meaning in life is a multi- faceted that has been construct that has conceptualized in diverse ways. It refers broadly to the value and purpose of life, important life goals, and for some, spirituality. We developed a measure of meaning in life derived from this conceptualization and designed to be a synthesis of relevant theorical and empirical traditions. Two samples, all cancer patients, provided data for scale development and psychometric study. From exploratory and confirmatory factor analyses the meaning in life Scale (Mils) emerged, and includes four aspects: Harmony and peace, Life Perspective, purpose and Goals, Confusion and Lessened Meaning and Benefits of Spirituality. Supporting data for reliability (internal consistency, test- rest) and construct validity (convergent, discriminant, individual differences) are provided. The MiLS offers a theorically based and psychometrically sound assessment of meaning in life suitable for use with cancer patients.

Several studies have indicated that compared to non-familial marriage, familial marriage would increase the incidence of congenital abnormalities. Since the rate of consanguinity marriage is high in our country, this study was performed to determine the prevalence of congenital anomalies between familial and non-familial marriage. For this analytic descriptive study, 928 couples were participated as the population of this investigation. Of them, 358 were familial-marriage couples and 570 were non-familial-marriage couples. We evaluated the variables such as parent's age, familial and non-familial marriage rate and rates of congenital abnormalities between both groups. Both the questionnaire and face to face interview technique were applied in this study. Congenital anomalies were identified in 26 (7.26%) children of familial marriage group and 11 (1.92%) ones in non-familial marriage group. The average rate consanguineous marriage in this study was found to be 38.57%. considering that the rate of congenital anomalies in familial marriage was more than that of non-familial marriage, it seems that it is essential to consult and teach families and young couples about the risks of familial marriage.

Introduction and The emphasize that is on religious values in our country is the basis of activities that are considered to protect the level and value of human beings and the medical ethics has a great place among them. Medicine is unique among all the sciences, as it is related directly with the lives of humans, so ethics is an inseparable part of it and ethical advices act as guides during the medical professional activities. Teaching the medical ethics has been an important issue in medical curriculum during past two decades in Iran. The aim of this study was to gain the opinions and insights of medical students and also graduates of Jundishapur University of medical sciences on the course of medical ethics during 1385-86. The findings and results of this study may help in solving possible problems and be beneficial in adjusting the curriculum.Methods and Materials: this is a cross-sectional descriptive epidemiologic study and all the medical students and graduates of Jundishapur University of medical sciences in educational year 1385-86 who had had medical ethics in their curriculum before participated in this study. In this study 457 paper questionnaires including demographic and 8 questions about the insight and opinion on the course of medical ethics were distributed among the medical students and graduates, but only 398 answered questionnaires were gathered due to non-cooperation. The data were analyzed with SPSS software and P<0.05‌ considered to be significant. Among all the participates, 332 were medical students (83.4%), 66 were medical graduates (16.5%). In addition, 235 were female (59%) and 163 were male (41%). Overall, the graduates were less satisfied with the content of the medical ethics course and the ways it is taught and they simultaneouslyealized the importance of that course much more than the students. Most of the students (53.0%) considered the internship the appropriate time for the course and the same was considered by the graduates with a greater percentage (93.9%). according to the results of this study, a serious revision and change in the contents and the references of this course to more applied references and also an increase in the hours related to the course is suggested. In addition, the course should be taught in late steps of the medical education (last year for example) in order to be considered with more attention and interest by the students.

Medical profession has always been considered as holy knowledge and job in the job in the Old Iranian and Islamic texts. Specially, it was regarded as worship in Islamic and religious teachincs. Observing professional and ethical principles has always been rendered as the most important characteristics for Iranian and Islamic physicians. Accordingly, in Iranian and Islamic texts and literature, some characteristics such as relation and keeping God in mind, confidence to God, faithfulness to a secret, good humour, giving hope, having proper relation and treatment with the patient and good belief, all have been considered as the culture of ethics in medicine. Hence, a positive measure can be taken to enforce and organize medical ethics in healthcare of Iranian an Islamic society.

Until the end of nineteenth century infertility of each couple was an impossible matter and was considered as cessation of generation. After the birth of the first child by laboratory fertilization, the knowledge of people of the new healings of fertilization was increased and then new methods of fertilization developed fast. Every year many children are born through the donation of gamete. There are several questions about these children one of the most important of which is about the revealing or hiding of gamete donation or identification of the child from this gamete, which is studied in this research. Chapter one: In this chapter we consider infertility and its treatment. Fertility is divided into two groups: natural and artificial. Chapter two: In this chapter we consider reasons about revealed or hidden donation, its benefits and damages, the theories about it and personal independence. First, infertile couples should be spoken to separately in counseling sessions, and know the process of treatment and its outcomes before the treatment. Second, children from gamete have the right to be informed of their genetic origin. Third, non-genetic parents should have the legal responsibility of these children. Fourth, the right to inform the children about its genetic origin is the right of his non-genetic parents.