Introduction: One of the most important duties of hospital ethics committees is to provide medical ethics consultation to the staff and patients. This study was conducted with the aim of the needs assessment of the staff for optimal provision of medical ethics consultation services. Materials and methods: The data collection tool was a self-administered questionnaire. Hospital managers, chief nursing officers, ward managers, and head nurses of all hospitals affiliated with Tehran and Iran University of Medical Sciences entered the study. The questionnaire together with an invitation letter was sent to the samples. In the next stage, telephone follow-up of the incomplete forms was performed by the research team. Results: A total of 448 persons participated in this study (response rate: 54.2%). The mean frequency of the need for ethics consultation in each ward was 5.2 times in the last 3 months with a median of 3. The highest needs for consultation, which were common in all wards, were observed in treatment rejection by the patient, providing necessary information to obtain informed consent and obtaining consent to high risk procedures, conflict between the decisions made by the patient and the family members, decision making for the high risk patient, request for futile or inappropriate treatments, giving bad news, and decision making for the incompetent patient. Conclusion: The prevalence of ethical issues in clinical wards is variably high. The ethical issues in the clinical setting are mainly related to respect for the patient's autonomy and competency for decision making.
Maintaining confidentiality, both in national and international codes of ethics, is considered an important principle in healthcare and the medical profession for both patients and physicians. This case-report article focused on a real case. Based on the request of the Iranian Blood Transfusion Organization (IBTO) for plasma donation from recovered COVID-19 patients, we asked the names and personal information of those patients from hospitals affiliated with Iran University of Medical Sciences (IUMS) and arranged for the subjects to be referred to the Medical Ethics Department of IUMS for consultation during the COVID-19 pandemic. Various ethical and legal aspects of this case were discussed in a special meeting, and practical solutions were then provided considering the limits of confidentiality and conditions for ethical access to patients’ information during a pandemic. Since plasma therapy is not a definitive cure for COVID-19 and considering the ethical and legal points presented in this article, it is not recommended to announce the names of patients in the early stages. Given the potential impacts of the procedure and the possibility of patients being cured, however, their consent should be obtained in different situations and, if necessary, providing information to patients or educating them should be considered.
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.
Background and Objectives: Patient autonomy is a recognized principle in modern medical ethics, and truth-telling to the patient; thus, it holds special importance for its contribution to this principle. In practice, however, several challenges emerge that can lead to different responses. This difference is more marked in studies conducted in the Eastern and Muslim countries due to variations in cultural and religious beliefs. Truth-telling is a challenging concept respecting placebos, medical errors, and delivering bad news on diagnosis and treatment to patients. Methods: This study employed an unsystematic review of library and online sources, as well as databases, including Google Scholar, Springer, PubMed, Ovid, and relevant Persian papers in an attempt to provide an overview of this concept and study the Islamic view, particularly the Shi’ite perspective, and the predominant approaches employed in Muslim countries. Results: Islamic scripture and hadith strongly advocate honesty and truth-telling. However, maleficence to patients and exposing them to serious harm is unallowed, and withholding the whole or a part of the truth; even lying is justified in extreme cases. Conclusion: Essentially, the philosophy of medicine is based on helping patients and reducing their pains. Considering the unique condition of each patient, a perfect solution cannot be prescribed for all of them and the same strategy to manage all cases. The emphasis on truth-telling in the Islamic view is no less than other schools of thought. However, if disclosing the truth may expose the patient to certain, serious biopsychological risks, denying the whole or a part of the truth might be advisable; even in frequent cases, lying can be justified to protect the patient.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.