Galen is regarded as one of the most enduring and influential figures in the history of medicine. What distinguishes his intellectual legacy is his ability to integrate three fundamental domains, namely medicine, philosophy, and ethics, into a coherent intellectual system. This study aimed to identify and comprehensively examine the medico-ethical foundations of Galen’s thought by analyzing the impact of philosophical doctrines on the formation of his approach to medicine and ethics. The study was based on a critical analysis of Galen’s primary texts alongside relevant historical and philosophical secondary sources. Employing a descriptive-analytical and conceptual approach, it sought to reconstruct the medical and ethical foundations of his thought systematically and to elucidate the relationship between them. Galen conceived of health as a multilayered concept encompassing not only physical well-being but also psychological and social dimensions. He further maintained that medicine can attain genuine meaning and effectiveness only when integrated with moral virtues; on this basis, he advanced the notion of the “physician-philosopher.” Galen’s theoretical foundations, including the theory of the four humors, the five determinants of health, the principle of treatment through opposites, and a strong emphasis on prevention, constitute essential elements of his coherent theoretical framework. In the field of medical ethics, principles that are reflected today, to some extent, in the four principles of contemporary bioethics are repeatedly articulated throughout his works. Although some of Galen’s theories no longer possess scientific validity, a renewed examination of his medico-ethical foundations may provide a conceptual model for rethinking the interrelation of science, ethics, and philosophy in contemporary medicine.
Curriculum is one of the most crucial instruments for achieving educational objectives. The hidden curriculum refers to the emotional climate and unwritten conditions that exert the greatest influence on the values and emotions of learners in medical sciences, particularly in nursing. This qualitative study aimed to elucidate the hidden curriculum in professional ethics education in nursing, employing a grounded theory approach. Purposive sampling was initiated and subsequently continued through theoretical sampling. Data were collected using in-depth semi-structured interviews with 14 participants (students, nurses, and faculty members), along with observations and field notes, until theoretical saturation was achieved. Data analysis was performed using the Corbin and Strauss (2008) method. Data analysis revealed that the participants’ main concern was “ineffective management of interactions resulting from deficiencies in nurses’ communication and individual skills”. The core strategies adopted to address this concern included “faculty members’ professional competence in serving as role models for learners”, “introducing exemplary nurses and promoting professional role modeling”, and “the necessity of enhancing professional competencies for patient care”. The outcomes of these strategies were “ improved nurses’ satisfaction with care based on professional ethics”, “creating opportunities to enhance professional behaviors in clinical practice”, and “the development of patient needs-based care”. The study identified “enhancement of nursing care through adherence to professional ethics” as the main category. These findings can inform the development and enhancement of the hidden curriculum in professional ethics education in nursing. Accordingly, attention to individual and environmental factors, as well as the role of faculty members in teaching professional ethics, can provide a foundation for designing targeted interventions aimed at improving clinical interactions and narrowing the theory-practice gap in clinical settings.
Nursing is a profession intertwined with profound concepts such as meaning, suffering, death, freedom, and choice, concepts that lie at the core of existential philosophy. An understanding of the philosophical foundations of nursing plays a pivotal role in enhancing human-centered (person-centered) care. Accordingly, this study aimed to review and analyze the existing literature on the role of existential philosophy in nursing. This study employed a narrative review design. A systematic search of reputable databases, using the Persian and English keywords “existentialism” and “nursing”, identified ten eligible studies for inclusion. The review revealed that existential concepts have been applied in nursing primarily in areas such as fostering meaningful nurse-patient interactions, enhancing the sense of meaning in nursing practice to reduce burnout, providing meaning-centered consolation in end-of-life care, and educating in meaning-centered care. The findings of this review indicated that existential philosophy, through its emphasis on concepts such as meaning, freedom, responsibility, and suffering, can deepen person-centered approaches in nursing and play a significant role in enhancing therapeutic relationships, ethical decision-making, and care provision in sensitive and existentially challenging situations, particularly in end-of-life care.
Moral sensitivity, as a fundamental component of nursing ethics, should be emphasized from the very beginning of nursing education. It is hypothesized that individual characteristics such as self-compassion and emotional intelligence are associated with moral sensitivity. This descriptive-correlational study aimed to examine the predictive value of self-compassion and emotional intelligence for moral sensitivity among nursing students at Birjand University of Medical Sciences. The study population consisted of 263 nursing students who were selected using the census sampling method. Data were collected using the standardized Self-Compassion Scale developed by Raes, the Bradberry and Greaves Emotional Intelligence Questionnaire, and the Lützén Moral Sensitivity Questionnaire. Data were analyzed using descriptive and inferential statistics in SPSS version 19. The findings revealed a significant positive relationship between moral sensitivity and emotional intelligence (r=0.37, p<0.01). However, no significant relationship was found between moral sensitivity and self-compassion (r=0.44, p>0.05). Stepwise multiple regression analysis further indicated that emotional intelligence, as a predictor variable, explained 13% of the variance in moral sensitivity (p < 0.001), while self-compassion did not make a significant contribution to the prediction of moral sensitivity (p > 0.05). The most important finding of this study was that emotional intelligence can serve as a predictor of moral sensitivity among nursing students. Therefore, it is recommended that emotional intelligence training be incorporated into the nursing curriculum and that effective educational strategies be further investigated
The moral status of the fetus constitutes one of the fundamental foundations in discussions concerning the fetus and the respect owed to it. This issue requires a profound examination of its philosophical and religious underpinnings. Employing a descriptive-analytical method and drawing on Islamic philosophical texts through library-based research, this study sought to investigate the philosophical foundations for attributing moral status to the fetus. The primary question of this study was whether, from the perspective of Islamic philosophy, the fetus possesses moral status and what arguments may be advanced to substantiate this claim. The findings indicated that within the works of Muslim philosophers, one can identify arguments grounded in the species-essence of the human being, developmental potentiality, the bestowed nature of life as a divine gift, and existential continuity, all of which lead to the conclusion that the fetus possesses moral status. Through an analysis of the views of Muslim philosophers within their philosophical context, this study endeavored to present a systematic interpretation of the arguments put forth by proponents of the rational soul and the doctrine of substantial motion in defense of fetal rights. The application of these arguments extends beyond purely scientific and philosophical discourse and can significantly influence ethical decision-making in society
Art therapy is a promising approach for the psychological rehabilitation of children and adolescents affected by war. International studies indicate that art-based interventions can reduce trauma-related symptoms, improve emotional expression, and enhance resilience. Ethical considerations, including informed consent, confidentiality, cultural sensitivity, and prevention of re-traumatization, are essential for implementing these interventions. This paper analyzes these ethical considerations and proposes practical recommendations based on international evidence and the Iranian context.
contemporary armed conflicts, particularly in geopolitically sensitive regions, pose significant ethical challenges to public health and humanitarian systems amid advancements in military technology. Recent experiences, notably the Gaza war, illustrate that ethics committees lacking structural independence, transparency, and genuine commitment to human dignity may fail to protect civilian rights and risk becoming politicized entities. This letter to the editor underscores the critical need to strengthen the role of ethics committees in war crisis management by ensuring their structural independence, establishing transparent oversight frameworks, developing international guidelines for emerging military technologies, and fostering enhanced international cooperation. Strengthening these committees’ capacities can contribute to mitigating human suffering, facilitating sustainable post-war reconstruction, and rebuilding public trust
Physicians often refrain from disclosing their errors for various reasons, including fear of legal claims and the stigma of incompetence. Engaging in professional behavior requires not only adequate knowledge but also a proper attitude toward the behavior in question. Accordingly, understanding physicians’ attitudes is essential for preventing unprofessional conduct under different circumstances. Consequently, the present study aimed to evaluate the attitudes of medical interns toward the disclosure of medical errors at Iran University of Medical Sciences. This descriptive cross-sectional study was conducted among all interns admitted in 2017 at Iran University of Medical Sciences. Data were collected using the Persian version of the Medical Errors Scale and analyzed with SPSS software version 26. Among the 186 participants, 66% reported having committed a medical error. Only 21% of interns fully disclosed errors that had no significant adverse effects on the patient, and the final outcome was favorable. In contrast, in situations where errors resulted in severe consequences for the patient, 31% of participants fully disclosed the error. The findings indicated that most interns avoid fully disclosing their medical errors. Fear of legal action by patients and concerns about being underestimated by them were the two primary reasons reported by participants for nondisclosure of errors. Therefore, further studies are required to propose effective solutions and improve physicians’ performance and patient safety.
Professional guidelines, such as the Disciplinary Regulations of the Medical Council of Iran, serve as a framework for regulating the professional conduct of healthcare professionals and play a vital role in safeguarding the ethical and professional standards of medical services. This study aimed to examine the historical and substantive evolution of the disciplinary regulations of the Medical Council of Iran from 1969 to 2011. These regulations constitute the first legally binding document in modern Iranian medicine with enforceable authority, introducing certain standards of medical professional ethics in a relatively systematic manner and mandating their observance based on the powers granted by the law establishing the Medical Council. The study employed a historical and comparative content analysis of the relevant documents and regulations, assessing their structural, substantive, and supervisory changes. The findings indicated that these regulations have undergone five revisions. Over time, the content has moved away from virtue-oriented language and an emphasis on ethical values, adopting instead a more legalistic approach centered on medical negligence and malpractice. Other changes include the expansion of the scope from physicians to encompass all healthcare professionals; a shift in the conceptualization of the physician–patient relationship; a reduced emphasis on moral virtues; and an increased prominence of bureaucratic, administrative, and procedural aspects. These developments reflect broader social, legal, and professional transformations in Iran, studying which contributes to a clearer understanding of the trajectory of these regulations, thus providing a foundation for their future revision and improvement.
Spiritual health refers to having purpose and meaning in life and a sense of belonging to something beyond the self, which strengthens inner peace, satisfaction, and happiness. This qualitative study was conducted in 2024 using an interpretive phenomenological approach. Through semi-structured interviews with 47 policymakers, managers, faculty members, staff, and students, a total of 183 benefits of spiritual health education in universities of medical sciences were identified. These benefits were categorized into six groups: benefits for faculty members, students, staff, patients, society, and the university. For faculty members, spirituality education leads to enhanced ethical awareness, increased motivation, job satisfaction, professional commitment, and improved quality of education. Students, by strengthening spirituality, gain greater communication and empathy skills, experience reduced stress and anxiety, and demonstrate improved professional competencies. Healthcare staff benefit from reduced medical errors, increased resilience, improved social relationships, and enhanced quality of care. Patients receiving spiritual care experience lower levels of stress and depression, improved mental health and quality of life, and a more rapid course of treatment and recovery. At the societal level, spiritual health education contributes to more positive social behaviors and the development of a healthier community. Furthermore, universities implementing such education can design more comprehensive curricula, promote interdisciplinary research, strengthen professional ethics, and train holistically oriented healthcare professionals, thereby increasing their credibility and productivity. Spiritual health education in Iranian universities of medical sciences, by exerting positive effects on faculty members, students, staff, patients, society, and the university itself, results in the improvement of psychological and professional well-being, the enhancement of educational quality, and the increased productivity and credibility of the higher education health system of the country.
The history of medicine during the Safavid period (907-1135 AH) in Iran, as one of the important periods, has always been the focus of researchers. The main objective of this study was to conduct a quantitative evaluation of articles related to the “history of medicine in the Safavid period” in Iran. This descriptive-analytical, applied study was conducted using a quantitative approach. The statistical population of the study comprised all scientific productions on the history of medicine in the Safavid period indexed in domestic and international scientific databases over 22 years, from 2001 to March 2024. During the period under review, a total of 247 articles in the field of the history of medicine in the Safavid period were published with the participation of 542 authors. In terms of thematic orientation, 18.2% of the published works were on the biographies of physicians, while research, translation, and editing of medical manuscripts ranked next with 16.1%. Among universities and scientific centers, Tehran University of Medical Sciences and Islamic Azad University ranked first. Male participation accounted for approximately 60%, exceeding that of female authors, and about 68% of the works were the result of collaborative research. The Journal of Islamic and Iranian Traditional Medicine published the highest number of articles. The most common type of publication was original research articles. Content analysis showed that, despite significant growth in this research field, an excessive concentration on specific topics, such as physicians’ biographies, has limited scholarly attention to other dimensions of medical history in this period, highlighting the need for broader and more balanced research perspectives.
Professional ethics, as a critical aspect of medical ethics, holds significant importance in healthcare professions that directly involve human lives. Accordingly, this study aimed to compare adherence to professional ethics principles among operating room (OR) students and staff in selected teaching hospitals affiliated with Iran University of Medical Sciences during 2021–2022. This cross-sectional descriptive study included 200 OR staff from six hospitals (selected via stratified quota sampling) and 60 OR students (recruited via convenience sampling). Data were collected using a demographic questionnaire and Kadushin’s Professional Ethics Questionnaire (2002) and analyzed in SPSS-24 using descriptive statistics (median and interquartile range) and inferential tests (Chi-square and Mann-Whitney U tests). Results indicated strong professional ethics in 98.4% of students and 75% of staff. Students scored significantly higher in loyalty and accountability (median score, P < 0.0001), while staff outperformed in honesty (median score, P = 0.003). No significant differences were observed in other dimensions. Overall, both groups demonstrated favorable professional ethics. These findings can guide educational interventions and developmental programs to further enhance professional ethics in these populations
The vegetative state is a condition in contemporary medicine that raises numerous ethical, jurisprudential, and legal challenges. The most fundamental question when confronting this condition concerns whether individuals in such a state are considered alive or deceased, as subsequent rulings and implications are typically contingent upon the answer to this question. Some contemporary Islamic jurists, drawing upon the jurisprudential division of life into “stable life” and “unstable life”, have deemed individuals in a vegetative state to be deceased, given their lack of volition and consciousness. This study argues that the concept of “unstable life” does not apply to these individuals, particularly in cases of persistent and chronic vegetative states where the possibility of regaining consciousness, however remote, exists. Furthermore, the continued function of the brainstem and the non-fulfillment of the medical and legal criteria for brain death in many systems affirm that the designation of “deceased” is incorrect. From an Islamic perspective, the definitive separation of the soul from the body, which is the condition for the occurrence of death, cannot be ascertained in the vegetative state. Ultimately, in circumstances of doubt regarding the life or death of a person in a vegetative state, this uncertainty constitutes a “case-specific doubt”, and by applying the legal principle of “presumption of continued life”, the individual must be deemed alive and all the corresponding legal and religious consequences of life must be accorded to them.
Cyberloafing, may increase significantly among healthcare professionals during geopolitical crises such as war. Heightened anxiety, constant news monitoring, and excessive social media use can distract staff from clinical responsibilities. The article recommends organizational, team-based, and individual interventions to reduce cyberloafing and maintain ethical, safe healthcare delivery during crises.
Health inequalities in different populations continue to be the main challenge of health systems; Therefore, it is necessary to address health equity in the developed policies. The study aims to review the studies related to tools and models for assessing the impact of policies on equity in health. This study was conducted as a systematic review to identify the tools and models of assessing the impact of policies on equity in health and the process of assessing health outcomes from 2005 to 09/30/2022 in English and Farsi. National and international databases such as Scopus, PubMed/Medline, and Google Scholar were searched. First, 16901 studies were obtained. After the initial screening, 243 articles entered the abstract review phase. Then, 99 studies entered the phase of studying the text. Finally, 53 studies entered the final phase of analysis. Screening steps, identification of decision-making assessment scope, evaluation, and follow-up were the four dominant steps in most of the developed tools. The study showed that to choose the appropriate tool to assess the impact of policies on equity in health, it is necessary to pay attention to various factors such as assessment time, policy level, available resources, and the population affected by the desired policy
Identifying an effective coping strategy for moral distress, as an important and common phenomenon among intensive care unit nurses, seems essential. The knowledge-to-action model aims to identify effective methods for implementing evidence into clinical practice. The present study sought to determine the effect of an intervention based on the knowledge-to-action model on moral distress among nurses working in intensive care units. This was an experimental study, and the statistical population included nurses working in the intensive care units of Namazi Hospital in Shiraz, Iran. A total of 100 eligible nurses were selected through convenience sampling and then randomly assigned to intervention and control groups. For the intervention group, the knowledge-to-action model was implemented. Data were collected using the Hamric Moral Distress Scale before and one month after the intervention. Both groups completed the questionnaire at these time points. Data were analyzed using descriptive and inferential statistics with SPSS version 19. The findings showed that the two groups were similar in terms of demographic characteristics and mean moral distress scores before the intervention. After the intervention, the mean scores of moral distress in the intervention group were significantly reduced in the frequency dimension (2.12±0.34) and severity dimension (2.32±0.46) compared to the control group (frequency: 2.51±0.43; severity: 2.57±0.55) (p<0.001). The results indicated that implementing the knowledge-to-action model reduces moral distress in intensive care unit nurses. Therefore, it is recommended that nursing managers adopt this model to improve the quality of care.
The electronic health record system (SPAS in Iran) records information related to the health of individuals in an electronic format. It is the center for collecting health information and data on outpatients and inpatients. This system records information such as the patient's full name, marital status, gender, date of admission, level of education, occupation, type of admission, and other relevant medical data. The core values and ethical requirements of SPAS include safeguarding citizens' rights, respecting individuals, observing justice and fairness, transparency, encouraging participation, and accountability. In this study, the ethical aspects of SPAS were evaluated using the model proposed by the World Health Organization (WHO) for ethical evaluation. This model emphasizes fundamental ethical principles such as human well-being and health, respecting individuals and communities, justice, and fairness. Concerning human well-being and health, SPAS can prevent unnecessary and redundant interventions and provide physicians with quick access to an accurate patient history. Furthermore, the system ensures the confidentiality of information, which is essential to respect individuals and communities. Regarding justice and fairness, the system can improve access to health services for disadvantaged and remote areas. Moreover, SPAS adheres to procedural ethical principles such as solidarity, transparency, participation, and accountability. Therefore, by critically examining the ethical dimensions of the electronic health record system (SPAS), the findings of the present study provide valuable insights for policymakers, health professionals, and regulatory organizations to ensure the ethical and efficient performance of electronic health record systems in Iran.
Maintaining patient privacy is a fundamental right of patients and an ethical duty of healthcare professionals. The present descriptive, cross-sectional study was conducted in 2022 to compare the perspectives of patients and staff in obstetrics and gynecology operating rooms in Mashhad, Iran, on the extent to which patient privacy was preserved. Patients were selected using random sampling in the operating rooms of hospitals affiliated with Mashhad University of Medical Sciences. Data were collected through a demographic information form and a standardized questionnaire to assess hospitalized patients’ privacy. Data were analyzed via SPSS-22, utilizing descriptive and inferential statistics, with a significance level of P<0.05. The mean ages of patients and staff participating in this study were 39.07±12.56 and 31.65±8.42 years, respectively. The mean score of preserving privacy from the patients' perspective was 38.92±22.41, whereas from the staff's perspective, it was 64.26±8.02, and the difference was statistically significant (p=0.0001). The lowest scores in both groups for personal privacy were 4.97±8.77 for patients and 13.37±2.66 for staff. Results indicated that the staff perceived the level of preserving patient privacy to be above average, while patients considered it below average. Therefore, given the patients’ specific conditions, high stress levels, and physical and mental limitations to support themselves, it is essential to implement targeted training and take necessary measures to encourage the staff to pay more attention to patient privacy and raise patient awareness in this regard.
Patients’ perceptions of healthcare service quality and satisfaction with their legal rights constitute the primary objective of the care team and should be considered a criterion for accreditation evaluation. In this regard, a thorough examination of healthcare providers’ and patients’ perceptions, emotions, and experiences regarding the reasons for ‘Discharge Against Medical Advice’—as a patient’s legal right—can help identify hidden factors influenced by temporal and spatial conditions. This qualitative study employed a conventional content analysis approach, involving semi-structured interviews with 24 healthcare providers and patients selected purposively. Researchers repeatedly reviewed recorded content and notes to code the data. Subsequently, key codes and themes were clustered, categorized into specific topics, and labeled. Finally, an interpretation of the obtained data reflecting the study’s approach was presented. Through conventional content analysis, 203 codes were extracted. After categorization, four subthemes, including human factors, processes, facilities, and environment, were identified under the core theme of “uncertainty and distrust” as reasons for discharge against medical advice. Discharge against medical advice is recognized as both a challenge for hospital accreditation and an adverse outcome for patients. Addressing uncertainty-related issues and fostering public trust through team collaboration and implementing novel policies can mitigate discharge against medical advice.
