Background: In modern-day medicine, there is plenty of evidence-based communication studies implying that good physician-patient communication provides better diagnosis and treatment, as well as patient satisfaction and compliance with the therapeutic plan. Medical educators who promote better communication to strengthen the physician-patient relationship believe that shared decision-making is the most favorable model after the era of paternalistic and consumeristic models as the dominant types of interpersonal communication between doctors and their patients. On the other hand, different media, especially medical dramas, if properly targeted, can be used as an educational tool for health workers and a cultural factor for the whole society to ameliorate the current difficulties in the physician-patient relationship. Objectives: Therefore, this study aimed to determine how the Iranian national TV medical drama represents the physician-patient relationship. Methods: We used a qualitative inquiry to analyze a medical drama about hospital affairs, named The Nurses, which was produced by the Iranian national television with the cooperation and sponsorship of Iran’s Ministry of Health and broadcasted as a two-season television drama in 46 episodes during 2016 - 2017. In this regard, all aspects of physician-patient communication were analyzed based on the thematic deductive content analysis method. Results: The study reviewed 46 out of 51 episodes. Each sene that represented the physician-patient relationship was analyzed based on a developed checklist. The checklist was prepared based on a literature review, and its content validity was approved by the medical ethics experts. Conclusions: The findings of this study showed that this medical drama paradoxically represented the paternalistic model of the physician-patient relationship that was inconsistent with the formal views of Iranian authorities.
Background: Breaking bad news to patients is an unpleasant process, but it is essential for the medical team, which is giving information about a person’s illness; without proper planning, it leads to a negative impact on people’s feelings and quality of life. Cultural differences can be effective in telling bad news. Objectives: This study aimed to identify the attitudes of physicians, patients, and patients’ families towards breaking bad medical news. Methods: This cross-sectional study was performed among physicians, patients, and their families referred to Namazi Hospital, Shiraz, Iran, during 2016 - 2017. Their attitudes regarding how to tell bad news were evaluated by self-administrated questionnaires. Results: A total of 397 valid questionnaires completed by physicians, patients, and their families were analyzed in this study. All groups of participants preferred telling bad news to patients about the diagnosis of their disease; they also believed that in the case of a patient’s dissatisfaction, this information should not be given to other family members. Patients’ family members would rather tell lies to the patient about their diagnosis. Conclusions: There is a tendency towards not telling bad news in Iranian culture; Iranian people tend to protect those around them, and the desire to give bad news to those around them is lower than the tendency to hear bad news about one’s own illness. With increasing education, the tendency to telling bad news increases.
Cord blood is a rich source of hematopoietic stem cells used to treat many diseases of blood origin. Thus, storage banks were created to store and provide umbilical cord cells. With the development of diagnostic and therapeutic technologies and techniques in medicine, ethical issues have also become more widespread and complex. After the creation of the cord blood banks, efforts were made to address the ethical issues associated with such banks. The present study attempts to identify the ethical challenges in these banks in the published studies. Databases including PubMed, Scopus, Web of Science (WOS), Embase, Proquest, and Google Scholar were searched from January 1996 to January 2021. Then, the ethical challenges of the cord blood bank were extracted from the results section using thematic content analysis. 22 studies were selected based on inclusion and exclusion criteria. The ethical challenges raised in the studies included private or public ownership of the bank, fair access to banking services, informed and voluntary consent, failure to provide sufficient information to individuals about the process, confidentiality of user's information, conflict of interest of bank founders (who are commonly doctors). The findings of this study indicated that there are serious ethical concerns regarding umbilical cord blood banks. Responding clearly to these ethical challenges calls for the attention of policymakers and medical ethics professionals; this will require a clear statement of the various aspects of these banks for society.
Medical ethics and law are essential topics that should be included in medical residency programs. However, surgery training programs in Iran lack a specific course in medical ethics and law, which can lead to patient dissatisfaction with surgical outcomes. This study aimed to assess surgery residents' knowledge of medical ethics and law and suggest improvements for future residency programs. This descriptive cross-sectional study involved 112 surgery residents from six teaching hospitals. A valid and reliable questionnaire comprising 15 items on medical ethics and 12 items on medical law was used to assess participants' knowledge. Most participants were female (31-40 years old), and their mean knowledge score for medical ethics was 3.26±0.53 out of 5, with the lowest score in "futile treatment and DNR orders." The mean knowledge score for medical law was 3.69±0.69, with the lowest score in "surrogate decision-maker." Age did not affect residents' knowledge, but gender did, with female residents demonstrating significantly better knowledge of medical ethics (3.344/5 vs. 3.112/5) and law (3.789/5 vs. 3.519/5). Surgery residents had a relatively favorable knowledge of medical ethics and law, but they require further training in some areas to improve their knowledge. Training should include journal clubs, role-play programs, standardized patient programs, and debates to achieve better results, as purely didactic lectures appear inadequate.
Background: Clinical trials are the golden key in medical science research with human participants. They have always been considered interesting topics by researchers and scientists working in this field. However, the samples are “human participants,” so the research should be carefully conducted. Methods: In the present study, the published articles on the ethical challenges of conducting clinical trials were evaluated between 2010 and 2019 in Google Scholar, PubMed, and Scopus. The English search keywords were “clinical trial,” with at least one of the phrases of “ethical consideration” or “standard”. Results: In this article, we examined the ethical requirements and considerations in these research studies in four stages: research design and question, proposal review and approval, supervision and implementation, and publication of the results. We have examined them using relevant articles published between 2010 and 2019 and identified important and prominent issues or neglected ones. Conclusion: During this study, it was found that the “research design and question” stage was the most discussed and challenging stage, and the authors’ sensitivity about it has been more than the other three stages. On the other hand, the “results publishing” stage has been considered less sensitive with the least number of references in articles.
The code of ethical conduct for physiotherapy services must be compatible with the local culture. The ethical guidelines proposed here were developed through a literature review, focus group discussions, and finally a modified Delphi technique to achieve consensus after the data were analysed. At first, the collection of different ethical codes yielded 132 items. In the second stage, repetitive items were discarded, some new items were added, and the various codes were categorised into three domains. Overall, 175 items were considered in the Delphi stage. Subsequently, the items were reduced to 134 in total – 59 in the treatment domain, 41 in research, and 34 in the education domain. The resulting code of ethics will support patients, researchers, students, and teachers in the field of physical therapy with sensitivity to current Iranian legislation and culture.
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