مجله ایرانی اخلاق و تاریخ پزشکی
سال هفتم شماره 5 (دی 1393)

In recent decades، advancements in genetics and medical technologies have made it possible for clinicians to diagnose and sometimes treat fetal abnormalities in early gestational stages. This issue presents numerous ethical challenges for parents، doctors، ethicists، jurists and other professionals in terms of the continuation or termination of such pregnancies. A non-systematic review was performed to extract the main ethical codes that should be considered when offering counseling to pregnant mothers of fetuses with congenital anomalies. Moreover، since the attitude toward the status of such fetuses in the world of creation can strongly affect ethical decision-making، we attempted to investigate the issue further by offering some Islamic perspectives on the subject. Considering Islamic principles in offering ethical advice to Muslim parents of fetuses with congenital anomalies will help them make an informed and more appropriate decision in serenity. We hope the results of this study will facilitate ethical decision-making in health care and related disciplines، and thus help us deal properly with the issue of disabled fetuses. For future studies، it is recommended to compile related ethical guidelines based on Islamic principles to investigate various aspects of the issue.

It is universally acknowledged that death is a complex concept and different factors such as complicated philosophical ideas، contradictory descriptive approaches، and diversity in interpretations add to this complexity. Although a thorough understanding of the notion of death is important for everyone، this concept is of crucial importance to health care providers as they face enormous ethical challenges in the course of their careers. A few instances are controversial issues such as brain death، euthanasia and end-of-life care، where it seems essential to define a set of robust criteria for death. On the other hand، it can be argued that death is not a scientific concept and only different branches of medicine can provide a framework to clarify the subject of death. Therefore، it could be argued that theological approaches may shed some light on this concept. In this article، we aim to extract ontologic components of death mentioned in the Holy Quran، and will move on to propose a set of 12 criteria for death. This may help provide a clear understanding of the concept from the point of view of the Holy Quran، although more research is warranted to further illuminate this complex subject.

Abortion has remained a subject of intense controversy in medical ethics، particularly in the case of malformed fetuses. Review of the existing literature on the issue indicates that there are two main challenges in this regard: firstly، the question as to whether a malformed fetus has the right to live، and secondly، the fate of the soul (vegetative and animal) after induced abortion. This descriptive research presents different viewpoints in order to investigate the aforementioned questions in Mulla Sadra’s philosophy with a focus on the “right to live”. The results of the study demonstrate that according to Mulla Sadra’s theory، all fetuses possess potential human souls even if they are extremely malformed or disfigured. He considers the fetus a vegetable with the potential to convert into a human. Based on this ideology، which encompasses both creation and resurrection، the malformed fetus has the right to live. The assumption is founded upon Mulla Sadra’s Theory of Substantial Motion، which implies that abortion may influence the evolution of the soul in the limbo period (intermediate state) after abortion and might even affect its resurrection. It can be concluded that in the Iranian society، which has an Islamic background، theological views should be considered in decisions about abortion. It should be mentioned، however، that philosophical approaches alone cannot be relied on for decision-making regarding the abortion of a malformed fetus. Furthermore، interdisciplinary contributions are indispensable to a thorough analysis of this controversial issue so that the ethical challenges surrounding abortion in such cases can be overcome.

Nowadays academic life is closely related to the issue of publication. Consequently، there are numerous challenges in naming authors of scientific papers and publication ethics in general، making it essential to identify the various problems in this area. The present article acquires a historical view to investigate the challenges and solutions related to this topic. This is a review article based on a search of scientific databases from 1985 to 2014. Honorary authorship، coercion authorship، ghost authorship and non-compliance are instances of ethical issues in naming authors. To solve these problems، several agencies have provided ethical guidelines in this respect including the International Council of Medical Journals Editors (ICMJE)، contributorship، objective measurement tools and the National Directory of Ethics in Medical Research Publications. Nevertheless، studies point to the existence of problems in this area. In order to solve the existing issues، the evaluation system of scientific and research organizations should propel quantity-oriented evaluation over quality oriented criteria. We also believe that the educational system، specifically in the post graduate period، can affect scientific research and publication ethics to a great extent and thus promote ethical conduct in students and researchers.

Genes are considered as “green gold” in this era of biotechnology. Currently، multinational companies and governments search continents to find this valuable asset in the hope to discover people with unique genetic characteristics that can be converted into capital and marketed in the future. Modern economy provides the framework to analyze any new technology from the advantage perspective and has vastly transformed the concept of capital and market; thus، humans or any organism with specific genetic characteristics can be converted to capital and offered in profitable markets. Patenting and ownership of genetic resources without consideration for principles of inherent human rights will impact the society and result in a violation of these rights، especially those of vulnerable individuals and groups. In spite of the numerous benefits of biotechnology for individuals and the society، the risks to human dignity، equality، health، autonomy and research، as well as the possibility of information abuse should not be ignored، especially considering the alliance between technology and economy. Biotechnology can make claims to ownership of human life and desired genetic traits، and this is a problem caused by the biotechnology revolution in developing countries and consequently، indigenous peoples of these countries have shown different reactions to such issues. This article will discuss “human commodification”، which is a serious concern in the field of biotechnology in our world today

The nature of human dignity is among the most basic queries about the essence of humanity، and research in this area can produce results that may be applied to various health related topics. There is a need for defining comprehensive criteria for the bio-human in order to protect human rights and other values that are attributable to human biology. The present paper first attempts to determine whether abstraction is the base of human dignity، as opposed to contraction. The authors argue that the former may not be the case، as dignity is value-based and therefore implicates moral orders. Such issues cannot be abstracted from external existence، so one can assume contraction to be the base of human dignity. In that case، contraction requires a contractor or an origin for contraction. Self-contracted values are invalid and worthless، and by the same token، external existences are incapable of dignity. Therefore، a stable contractor is required to justify stability and the native essence of contracted dignity، and only God can be that stable، conscious، senior contractor. Among the criteria for dignity، the authors focus on those essential characteristics that differentiate humans from other organisms، and argue that these could be considered as the basis for dignity.

Breaking bad news to patients and their families is an important issue in health care services. Since access to information is among the basic rights of the patient، investigating the experiences of patients and their families after receiving bad news can make the process more purposeful and prevent unnecessary suffering. This study aimed to describe the experiences of patients and their families after hearing bad news from health providers. The present study was conducted with a qualitative، phenomenological approach. Participants were selected through purposive sampling from people who had the experience of receiving bad news during 2013 in Birjand، Iran. The sampling process continued up to the point of data saturation، which reduced the number of participants to 10. Note-taking was used to complete the data collection process. In this study Colaizzi''s method was used for data analysis، while robustness of the study was assessed based on the criteria of precision. The subjects were between 25 and 70 years of age. First، according to Colaizzi''s Method، 280 codes were obtained which were the same as the developed concepts. At this point، the code lists were extracted. Different thematic categories with similar meanings were placed in 5 thematically larger groups as follows: 1) tension at the beginning of the encounter، 2) adaptive responses، 3) spiritual relief، 4) family crises، and 5) seeking support. Patients and their families showed different reactions upon receiving bad news. The study showed that health providers can contribute to a better adjustment of patients and families and promote peace by acquiring a methodical approach while delivering bad news. This can be achieved by identifying the reactions، confusions and tensions، as well as introducing adaptive or supportive resources to patients and their families.

The climate of clinical settings is one of the effective factors on the quality of clinical education and students'' attitude toward their field of study. This research aims to determine the relationship between the ethical climate of operating rooms and the students’ attitude toward their field of study in hospitals of Tabriz University of Medical Sciences. All medical students in the operating rooms of Tabriz University of Medical Sciences in their second semester during the academic year 2013 - 2014 were entered into this analytic study. In addition to the demographic questionnaire، Olson’s Hospital Ethical Climate Survey and a student attitude questionnaire were used to collect the information. Data were analyzed by the SPSS 18 software using descriptive and analytical statistics methods including chi-square test and Spearman''s ordinal correlation coefficient. Most of the students were female (61. 4%) and single (86. 8%) and the mean of their age was 20. 87 ± 1. 54. Additionally، 64. 9% of the students had a negative perception of the ethical climate in operating rooms، while 51. 8% had a positive attitude toward their field of study. Moreover، a significant relationship was found between the ethical climate and attitude of operating room students toward their field of study (P ≤ 0. 001، r = 0. 56). Despite the negative ethical climate of operating rooms، most of the students had a positive attitude toward their field of study. In view of the direct relationship between these two variables، improvements in the ethical climate of operating rooms and students’ attitude toward their field of study can positively affect their future career.