فصلنامه اخلاق پزشکی
پیاپی 17 (پاییز 1390)

The patients’ rights charter has been codified for the purpose that on one hand the patients become acquainted with their rights and on the other hand this charter is principally observed by the hospitals. In our country, despite the approval of the patients’ rights charter by the Ministry of Health, Treatment and Medical Education in 2002, it has not yet been recognized and accepted correctly. This descriptive study has been performed in a cross-sectional manner. In this study, 150 patients with more than 24 hours of hospitalization records in gynecology, obstetrics, internal medicine I, internal medicine II, and surgery and cancer wards of Shahid Sadoughi Hospital of Yazd were chosen by an easy random sampling method. Most awareness was of the paragraph 1 related with the due treatment and/or respecting without noting racial, cultural and religious factors and the least awareness was related with the paragraph 9 i.e. the patients’ awareness of the types of educational and research activities. Therefore, considering the results of this research and other studies, the researchers provide proposals for the increase of the patients’ awareness of their rights that include: supply of the patients’ rights charter to the patients upon reception at the hospital and explanation of its contents by the hospital staff, execution of educational programs (pamphlet, brochure, poster, etc) for the patients.

An ethical work climate refers to individual perception of their organizations. Since the ethical climate is related to many factors such as performance, job satisfaction, organizational commitment, therefore this study is designed to assess nurses attitudes about ethical climate of educational hospitals in Kerman.Questionnaires were distributed to 275 nurses. The data were collected by ethical climate questionnaire.The findings of study which show the prevailing ethical climate of Kerman hospitals in order of priority include: professionalism, rules, and caring. Independence, instrumental. Although the professionalism is a suitable climate, but it is recommended that planning is implemented in order to create interest.

Rights of a patient include his/her legitimate and reasonable physical, mental and social needs when he/she is under medical treatment. The aim of this study is to determine the relationship between disciplines and educational levels of students and their knowledge about the patient rights. In this cross-sectional study data was collected by a questionnaire with two sections containing 40 questions that are in accordance with the patients’ charter of Rights. Samples included 192 medical sciences students. There was a significant relationship between disciplines and educational levels of students and their knowledge about patient rights so that Anesthesiology students (P=0/03) and undergraduate students (P =0/02) had more knowledge than other people. The findings of this study can be used as an appropriate criterion to assess different universities in respect of patient rights.

There is a growing need for nurse managers to increase their knowledge about patient's rights, legislations and ethical codes concerning these rights. Because they have key role to improve clinical researches and nursing staff interactions in researches. The purpose of this study was determination of nurse manager's perceptions of patient's rights as the research subjects and their extents of participation in research activities. All nurse managers in four educational hospitals of Kerman, Iran were the research sample (n=107).A researcher made questionnaire was used for gathering data. Total mean perception score for the sample was 13.22(44.1%).The highest score was related to obtaining informed consent from competent elderly and the lowest score was related to compensation research subject's medical treatment expenses. The most research activities of nurse managers were participations as the research subjects (73.8 %). The least activities were participations in the research ethics and bioethics conferences (1.9 %).Only 17 out of 255 analyses were done for each scenarios according to managers individual characteristics and their research activities were significantly different (P≤ 0.05). Achieved total mean score less than 50% about the perceptions of research subject's rights in this study shows that nurse managers must participate in formal and systematic training in research method and ethics. Also they need to have close relationship with researcher to avoid potential violations of patient's rights when clinical researches are conducted in their field.

Relationship between doctor and patient not only has effect on patient satisfaction from treatment process, but also it has effect on information recall orders, abeyance blood pressure scale and blood sugar. Effective relationship can reduce complaints about wrong actions of physicians. In this descriptive research, relationship function of 39 student´s of medical science selected by statistics method has been evaluated on 200 pregnant women bedridden in labour section of five chosen hospitals Tehran city, these persons entered the study by available sampling method. Research tools were demographic questionnaires of pregnant women and students of medical science school and one check list observation made by the researcher. Descriptive statistics and Spss software version 17 were used to analyze the datas. establishing appropriate relationship has an important role in making trust to caregivers, diagnosing speed and more effective treatment; it shows that professor and educational planning should pay attention to teach relationship skills to medical science students. Average scores that students got in relationship with patient 24/45, that in this research this number shows relationship function is middle.

Observation of patient's rights is the most important ethical characteristic in a hospital which should be noticed to bring more peace and cure for hospitalized patients. They should be aware of all stages of treatment as well as their rights and duties. The present study aims to determine views of nurses and patients on patient's rights. Through a descriptive cross-sectional study in 2011, all nurses and patients available at the internal and surgical wards of educational hospitals affiliated to the Ilam University of Medical Sciences were recruited using a census sampling method. A validated and reliable questionnaire including 29 questions for patients and 25 self-completed questions for nurses were used for data gathering. Demographic and particular questions about patient's rights were asked by questionnaires. Content validity and re-test methods were used to approve the validity and reliability of the questionnaires respectively (r = 0/90 – 0/92). SPSS version 16 was used for all analysis. Almost half of the nurses (48.3%) were aware of patient's rights, while majority of the patients (82.5%) were not aware of the patient's rights. Overall, 70% of nurses and 45% of patients had an agreement on patient's rights being observed at the hospitals. Both nurses and patients agreed that “the patient's education level” is the most significant individual factor on observation of patient's rights. The views of nurses and patients in particular on the patients’ Rights Charter as well as patient rights observation were different significantly. The concepts of patient's rights are still unknown and controversial in Iran and therefore need to be discussed and studied more. Taking any step and clarification toward the concept of patient's rights can help patients to receive enhanced cares based on human and emotional legislations.

Organizations in today's world need high productivity for their promotion and continuous improvement. The most important and valuable organization capital is human resource. Relationship between the organizational justice and employee's productivity was the aim of this research. A descriptive and analytical study was performed on Zabol's hospitals staff in 2010. A questionnaire was used that was scored Five- item Likert scale. Findings showed that there was a significant relationship(r=0/15 and p=0/008) among dimensions of equity, justice with employees productivity (r=0/1 and p=0/005). There was a direction and significant relationship between organizational justice and employee's productivity. Consequently managers can create a justice atmosphere for enhancing the staff and the whole productivity of the hospital.

Increasingly accelerated progress in biomedical technologies in recent decades, has been associated with an increased tendency to ethical issues. The nurses as health staff are constantly in situations which require them to make decisions. They face, every day during the struggle in their working environment with a variety of psychological stresses. The moral distress affects on all aspects their personal and professional lives. The purpose of this study is to determine the moral distress of nurses in health centers of Bam in 1390.

This study was a descriptive cross-sectional study on 140 nurses working in the medical centers the city of Bam. Data were collected from the moral distress questionnaire, the reliability and validity of which were measured in other studies as measured, were collected. Data analysis was performed by using descriptive statistics and one-way ANOVA.

The findings show that the intensity of moral distress among nurses is 5/04. Significant relationships between age (p =0/ 00), work (p =0/ 01), the amount of interaction and collaboration between physicians and nurses (p =0/ 00), decision-making in leave the job and resigning (p =0/ 00), job promotion opportunities (p =0/ 03), feeling of job security (p =0/ 00), the amount of support from hospital administrators (p =0/ 00) with the moral distress of nurses have been observed.

Nothing that the moral distress of nurses participating in the study is too high membership of courses of action to reduce it Seems necessary including: nurses at the hospital ethics committees making preparations to consult and express stressing ethical situations and teaching confrontational strategies with moral distress may be helpful in this regard.

The quality of care presentation is the most important and major concern in care centers, and target search in the nurses working may be effective on the quality of patients care. Yet, there are few studies about the effect of nurse's spirituality on the degree of patients’ satisfaction. Accordingly, the objective of present research is to determine the relationship between nursing staff spirituality and patient satisfaction from the cares. This is a correlation –descriptive study. 100 nurses and 100 patients hospitalized in selected hospitals of Ardabil Medical Sciences were randomly selected. Data were collected through using the spiritual wellbeing scale (swbs) and patient satisfaction instruments from nursing care. The findings showed that mean and standard deviation of satisfaction degree in hospitalized patients participating in this research was 157.2±19.5. Mean and standard deviation of spiritual wellbeing of nurses participated in this study is 101.3 ±9.3 and there is a significant relationship between the levels of nurse's spirituality and the degree of patient's satisfaction in selected hospitals of Ardebil Medical Sciences(p <0.05).the assessment of nurse's spiritual well being indicated that most nurses studied, had high and positive spiritual wellbeing scores, but they had received no professional training to provide the spiritual assistances to the patients. Considering that patient satisfaction is concerned with this aspect of care more than anything, so the patient's satisfaction at care centers may be increased through using the professional training in nursing, in order to develop the spiritual assistance to patients and to evaluate their spiritual needs.

Nowadays, the subject of embryonic stem cells has engaged In addition to biologists and physicians other specialists including medical ethicists, politicians, statesmen, lawyers.There is a wide range of ethical and legal issues about producing and using of these exclusive cells in research. Clearly legislation of stem cell researches guarantees and prevents from probable unfavorable sideffects and instrumental using of the embryo; in addition it preserves the position and value of the embryo.The gradual process of legislation in embryonic cell using in comparison to accelerate using of these cells in medicine will make a legal gap that will impair human dignity and the right to life and their compensations will be very difficult.Therefore, it is necessary to legislate about these cells before development of these researches.One of the first countries that have achieved technology of stem cell is Iran but yet we dont have ethical guideline and codified law about stem cells.In other countries that have had acceleration in this scientific field from beginning of stem cells research even before beginning of research.They have spent a long time on legislation and experimental activity.In this article, we talk about different sides of these technologies. We review briefly legislations status in international communities and some developed countries and finally we state key points in these laws and remind necessity of legislation of stem cell research in Iran.