فصلنامه اخلاق پزشکی
پیاپی 18 (زمستان 1390)

Reading and deliberating on the scholarly paper by Mr Dr MohagheghDamad, reflecting the view of the jurists and the legislator on an issue called the suicide caused that we consider also the opinions of a philosopher and a mystic on this human issue. For this purpose, we chose Plotinus from among the philosophers and Ibn Arabi from among the mystics. In this occasion, however we do not have an opportunity for a comparative study and only deal with the expression of each view briefly.

Today, despite the scientific improvements in the field of neonatal care in the world due to encountering with some awful medical situations many newborns are still suffering from very bad conditions for survival. Some Health-care providers and even some parents believe that the best choice for helping them is terminating their lives.Perhaps the heavy costs of neonatal intensive care wards, parental duties in comparison with other parents or the pity of parents for infants which cannot tolerate pain, determines their decisions.One of the topics that were considered by opponents of euthanasia is slippery slope theory; which means whatever that is provided seen by legal resolutions in modern countries. In the Netherlands in 1980 and 1990, euthanasia was widely discussed and in 2001, killing a patient by a doctor for getting rid of incurable pains was approved.Nowadays, there are valid documents indicating that at present in countries such as Holland, USA, UK and Australia providing that some physicians are being trained for voluntary euthanasia and some of the professors have accepted that the involuntary euthanasia for babies is a necessary action to help humanity.While in the present era all the religions have clearly expressed their disagreement with, euthanasia the question is that how the humans who claim for the human ethics and rights, in last few decades have descended from legalization abortion to the euthanasia of disabled children and neonatal and try to defend the newborns euthanasia by approving the Groningen protocol? This paper deals with the eroticization and discussion of the protocol by relying on the reliable books and papers of the world. So it’s better to train neonatologist and supporting poor families instead of euthanasia.

This review study explains health and reproductive health consequences of female genital mutilation, legal dimensions and interventional strategies for its elimination. Female genital mutilation includes all procedures involving partial or total removal of the external female genitalia. Female genital cutting is classified into three major types. Type I, Clitoridectomy (partial or total removal of the clitoris); Type II, Excision (partial or total excision of the clitoris and the labia minora, with or without removal of labia majora) and TypeIII, Infibulation (tightening of vaginal orifice by cutting and appositioning the labia minora and/or the labia majora). According to global statistics, around 135 million women worldwide have been circumcised. Every year 3 million African girls are circumcised. There is no clear data on FGM prevalence in Iran. But according to a research in Minab the prevalence of circumcision is 70%. There are cultural, social and religion-based reasons behind FGM. Female genital mutilation is also rooted in severe gender discrimination against women. Female genital cutting is considered to be a means to conserve a girl’s virginity and to make them clean and beautiful.Female genital mutilation has many harmful consequences. Short-term complications such as pain, infection, urinary problems, septicemia and some long-term consequences are chronic pain and pelvic infections, dysparonia and increased prevalence of infertility. Genital mutilation of women has negative effects on delivery process and increases the risk of maternal and neonatal mortality.Female genital mutilation is a violation against women and children rights and violation of human rights. As it was mentioned, girls and women are being circumcised in some parts of Iran. To stop FGM in our country we could use media, schools and religious groups to raise people awareness and pass acts against this practice. We must consider that there is a long road ahead of the people who are trying to end this practice.

The first step in observing patient rights is to inform him of all things which cause the patient and his family to be confident and comfortable during their care and treatment at the hospital. This study has tried to follow this direction by providing a framework for the preparation of patients and their family’s handbook. This is a descriptive analytical study. In This study reviews the available resources in the field of effective factors patients’ satisfaction and reviews 20 patients’ handbooks, so a proper pattern based on indexes such as being understandable, alignment with Islamic and Iranian culture and the laws have been provided. After considering 126 different data elements in the handbooks and reviewing the cases of patients’ satisfaction and also according to their repetition frequency, 19 parts in the final model were designed in the final pattern, different cases such as introducing hospital, admission and discharge process, safety and religious cases are included. Providing a proper method to increase the awareness of the quality and quantity service recipients in hospitals can play an important role in advancing the goals of hospital services, and the implementation of the model introduced in this study can be an effective step in this direction.

Adolescents are at risk for many serious health problems including drugs, alcohol, depression and sexually transmitted diseases. Research on these issues is important to establish more effective prevention programs and therapies. However, research concerning adolescents faces challenges for several reasons. First, despite their developing maturity, generally people need to be at least 18 years before they may decide for themselves to participate in research. Below that age, parental permission is generally necessary. However, adolescents may not be willing to participate in research in sensitive topics if their parents are informed about their participation. Second, adolescents vary in their maturity, independence, and ability to make informed decisions. Although they may wish to make their own decisions, adolescents usually benefit from parental guidance. Finally, many of teenagers are exposed to the public health risks and many of them are abused by political aims and research on these problems is often socially controversial.Taking into account the mean age of the Iranian population and also huge number of observational studies which are being done amongIranian adolescents on one hand and the absence of researchers’ complete familiarity with the 26 Code relating to the protection of human subjects in medical research advised by Ministry of Health andMedical Education in 2010 on all the Universities of medical sciences across the country - the main purpose of this study is to summarize those issues and ethical considerations in observational studies on adolescents which should be taken into consideration.

one of the basic medical ethics of principles is to respect human privacy, patient´s independence character, confidentiality and autonomy. The patient’s autonomy in decision making and respecting that issue in fact means freedom in action and behavior. In this descriptive research, functions of 39 students of medical science that were selected by statistical method were evaluated on observing autonomies of 200 pregnant women bedridden in labour sections of five chosen hospitals of Tehran city, these persons by available sampling method entered in to this research.Research tools are two demographic questionnaires of pregnant women and student of medical science school and one observation check list made by the researcher. Descriptive statistics and Spss software version 17 were used to analyze the data. Average score of students in the field of patient´s autonomy is 12/23 that in this research it shows the average level of function. Based on the principle of patient´s autonomy, before taking any action related with the diagnosis and treatment it should be spoken with patients and they should be informed of all actions. To inform patients cause the reduction of their anxiety and stress and it will be followed by their cooperation health group and their satisfaction.

Human cloning is newly emerged phenomenon, which is still in the beginning of its tremendous and unique route. Hence it has attracted the concerns of the thinkers throughout the globe, particularly the scholars in the fields of religion and ethics. Although some regard it as exaggeration because of high cost of cloning technology, its outbreak and consequently the ethical questions around it, but answering this basic question is an inevitable necessity: Is the human cloning authorized ethically or not?After studying and testing the hypotheses in this research, we may conclude that it seems that no real corrupt is presumed for cloning phenomenon. For this reason we may say that now that the research has begun in the field of human cloning, there is no possibility to reverse it, prohibit it or ignore it. Instead we should orientate the research in this area and pass cloning regulations in this respect. It is necessary to explain exactly about ethical dos and don’ts in this regard according to the customary and religious standards.

No topic in the medical education has received attentions and generated discussions in recent years than ‘‘professionalism’’. The loss of “virtue based ethics” in medicine has become the main concern of medical educators, physicians, ethicists, and also the community.Although, there are important considerations in ethical, social, historical, legal issues in the medical profession, but there is an essential need for professional ethics grounded on the teaching of virtue based ethics. Medical educators are concerned about how to restore virtue based professional ethics in medicine, and particularly in the physician- training process of medical education. Can these virtues be retrieved? And how this is possible?This paper emphasizes on virtue-based ethics theory and its utilization in shaping the characters and behaviors of the physicians and supporting professional commitment. Teaching virtue base ethics is a support for physician’s professionalism.This paper by reviewing different aspects of virtue based ethics in medical profession seeks to mention necessary approaches in the medical education to shape the professional charter and behavior and the necessity of virtue based ethics education.

In the rapid change of health care atmosphere, many factors, including the rights of patients, are affected by health care practices. Patient rights have recently become the center of national attention in the practice of medicine. The main policy is the push for legislation of a patient's charter of rights to provide laws that would prevent health maintenance organizations (HMOs) and other managed health plans from refusing to pay for appropriate care practice.Often, people do not realize their specific rights at the time of their care because those rights are often not clearly defined.Right to having health indicators has been subject to debate. Indeed, inadequate monitoring or reporting by states, missing or contradicting data as well as a lack of consensus for developing indicators of health, have led to creation of personalized ideas in this field. Until now any sets of extensive applicable and beyond bias indicators in patient right have not been developed Implementation of many mentioned rights in the charter of patient rights including having right of high quality health care, right to information, right to informed consent and the right to complaining, will not be achieved without considering clinical governance principles. The clinical governance is one of the main tools and inalienable infrastructures for achieving the rights of patients and it moves through the four main pillars (consumer value, clinical audit, clinical risk management, management and professional development) toward the survey of patient satisfaction, complaints management, consumer involvement in health planning, monitoring and evaluation of evidence based clinical standards, reducing of clinical errors, recruitment of clinical staff and continuous professional development. Clinical governance is reliable and consistent in health services delivery and is recognized for its high standards and its commitment to continually reviewing and updating practice in the light of tested and evaluated evidence and providing high quality services. So people can be sure to receive high quality, modern, effective, and safe services in a good time that are the main rights of patients in the patient's rights charter. Clinical governance by creating the biggest change on behavior, thinking and function of people in organizations, health care can convert providers to learning organizations, where constructive criticism, cooperative development and inter-professional respect allow successes to be celebrated and mistakes are not considered but will be changed to development.In fact, clinical governance by recognition of the local and national infrastructure can act as a driving force for the development of high quality and safe health services that moves toward the revival of patient rights.