Journal of Medical Ethics and History of Medicine最新文献

The concept of common morality is fundamental in medical ethics, and lack of universal content and characteristics of common morality is a product of its multifaceted nature. This study aimed to identify the ideas and experiences of academic faculties regarding common morality in a pluralistic setting to promote conceptual knowledge and strengthen moral reasoning and ethical decision-making. The study was conducted using a qualitative method, employing semi-structured in-depth interviews with thirteen faculty members who were selected purposively. In order to assess their ideas and experiences, the transcripts of the interviews were analyzed using the content analysis method through directed and conventional approaches. The interviews were coded manually. Two themes were reflected in the interviews: ontology and epistemology of common morality. The study indicates that the debate about the subjective or objective dependence of common morality questions the coherence of Beauchamp and Childress' common morality (CM) theory, as common morality is the result of various individual and social factor that influence moral and decision -making in pluralistic environments. Additional studies are needed in order to investigate the effect of cultural, social, theoretical, ideological and individual factors on promoting clinical ethical reasoning and decision-making skills.

In order to lessen health inequalities, the obstacles to health equity will need to be identified. This study aimed at investigating the barriers to access to health-care services from the medical ethics point of view. Data were collected through a qualitative study by performing semi-structured interviews. Purposive sampling was used to recruit participants involved in health provision and/or management. Content analysis was done using MAXQDA software. Overall, 30 interviews were conducted. The content analysis of the interviews identified two themes including "micro factors" and "macro factors", five sub-themes including "cultural, financial, geographical, social and religious barriers", and 44 codes. Based on our findings, differences in individuals' perceptions, cultural control, religious beliefs and social stigmas create cultural barriers. Financial barriers consist of the financial connection between service recipients and service providers, insurance premiums, and inadequate coverage of health-care services. The most important geographical barriers identified in our study were differences in urbanization, inequality in various geographical areas, marginalization, and inequality in resource distribution. Finally, differences in the level of income, education and occupational diversity were among the social barriers. Given the wide range of barriers to access to health-care services, a comprehensive plan covering various dimensions of health equity should be implemented. To this end, innovative and progressive strategies emphasizing the principles of equity and social equality should be developed.

Due to the high value of human life, the occurrence of even one error that leads to death or complications is of great consequence and requires serious attention. Although significant efforts have been made to ensure patient safety, serious medical errors continue to exist. This study aimed to identify the factors associated with the recurrence of medical errors and strategies to prevent them through a scoping review. Data were gathered through a scoping review of PubMed, Embase, Scopus, and Cochrane Library databases during August 2020. Articles related to factors influencing the recurrence of errors despite the available information, as well as articles related to measures taken worldwide to prevent them, were included in study. Overall, 32 articles were selected out of the 3422 primary papers. Two main categories of factors were identified as influential in error recurrence: human factors (fatigue, stress, inadequate knowledge) and environmental and organizational factors (ineffective management, distractions, poor teamwork). The six effective strategies for preventing error recurrence included the use of electronic systems, attention to human behaviors, proper workplace management, workplace culture, training, and teamwork. It was concluded that using a combination of methods related to health management, psychology, behavioral sciences and electronic systems can be effective in preventing the recurrence of errors.

Using genetic tests on deceased patients' samples for diagnostic purposes affects the family members' health and lives but raises some ethical issues in today's practice of medicine and research. In this paper, we address a common ethical dilemma of clinicians regarding whether to perform genetic tests on a deceased patient's sample upon a request from first-degree relatives against the patient's wishes in the last days of life. In this paper, a real case scenario is presented that echoes the above-mentioned ethical challenge. Reviewing the genetic basis of the case, the ethical arguments for and against the reuse of genetic material in a clinical context are discussed. An ethico-legal analysis of the case is proposed based on Islamic medical ethics resources. As reusing stored samples of expired patients without their consent also challenges the researchers in the field of genetics, a debate is included on the post-mortem use of genetic data and samples for research. Finally, defining the special features of the presented case and positive benefit-risk ratio, it is concluded that reusing the patient's sample may be justified if the first-degree family members insist on genetic testing and are comprehensively informed about the benefits and harms.

One critical tactic that leads to a better understanding of the ethical status of dentists is to assess their ethical attitude by using an appropriate scale. This study aimed to design and evaluate the validity and reliability of the ethical attitude of dentists scale (EADS). This study was conducted based on a mixed-method design. The first qualitative part of the study was conducted in 2019 and the items of the scale were produced from the ethical codes compiled in a previous study. In this part, the psychometric analysis was conducted. The reliability was evaluated by Cronbach's alpha coefficient and intraclass correlation coefficient. Factor analysis was used to assess the construct validity (n = 511), and the following three factors were extracted with a total variance of 48.03. 1) Maintaining the standing of the profession in relationships. 2) Providing dental services while maintaining trust in the profession, and 3) Providing information for the benefit of the patient. In confirmatory factor analysis, appropriate values were obtained for the goodness of fit indices, and Cronbach's alpha was 0.68 - 0.84 for the various factors. Based on the results mentioned above, this scale showed an appropriate validity and reliability for measuring the ethical attitude of dentists.

The professional quality of life of pre-hospital emergency technicians has been adversely affected during the COVID-19 pandemic. The present study was performed to investigate the professional quality of life and resilience and their relationships in pre-hospital emergency technicians of Kermanshah Province, Iran during the COVID-19 pandemic. This cross-sectional, descriptive correlational study was conducted on 412 pre-hospital emergency technicians in Kermanshah Province in 2020 using the census method. Data collection tools were the Stamm Professional Quality of Life Questionnaire and the Emergency Medical Services Resilience scale. Pre-hospital emergency technicians experienced moderate levels of the professional quality of life dimensions and high/acceptable levels of resilience. There was a significant correlation between resilience and the dimensions of the professional quality of life. The results of the regression test showed that resilience had a significant effect on all three components of the professional quality of life. Therefore, the use of resilience enhancement strategies is recommended to improve the professional quality of life of pre-hospital emergency technicians.

Ethical decision-making and professional behavior are essential skills in nursing profession, hence educational programs should be designed to enable future nurses to tackle problems related to ethical decision-making. This descriptive, correlational and analytical study aimed at determining the ability of Iranian nursing students to make ethical decisions as well as relationship between such decisions and professional behavior. The present study used census to select 140 freshmen from the School of Nursing and Midwifery of Tabriz University of Medical Sciences, Tabriz, Iran. Data collection tools included a demographic questionnaire, the Nursing Dilemma Test (NDT) comprising two indices of "nurse's principled thinking" and "practical consideration", as well as the Nursing Students Professional Behaviors Scale (NSPBS).