Journal of Medical Ethics and History of Medicine最新文献_第5页

Exploring the challenges and ethical requirements of medical sciences education during COVID-19: a qualitative study. 探讨新冠肺炎疫情期间医学教育的挑战与伦理要求:一项定性研究

IF 0.9

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-31 eCollection Date: 2021-01-01 DOI: 10.18502/jmehm.v14i30.8366

Ghobad Ramezani, Maryam Aalaa, Farzaneh Zahedi, Seyed Kamran Soltani Arabshahi, Davood Rasouli, Mohammad Hasan Keshavarzi

{"title":"Exploring the challenges and ethical requirements of medical sciences education during COVID-19: a qualitative study.","authors":"Ghobad Ramezani, Maryam Aalaa, Farzaneh Zahedi, Seyed Kamran Soltani Arabshahi, Davood Rasouli, Mohammad Hasan Keshavarzi","doi":"10.18502/jmehm.v14i30.8366","DOIUrl":"10.18502/jmehm.v14i30.8366","url":null,"abstract":"<p><p>The controversial role of ethics in clinical education and its ability to draw the attention of a large audience is inevitable. The issues and challenges of the COVID-19 pandemic have transformed the clinical education environment. This study was conducted to explore the challenges and ethical requirements of medical sciences education during the COVID-19 pandemic in 2020. The study was qualitative research and the instrument was a semi-structured interview. The participants included faculty members of the basic and clinical Sciences at Iran University of Medical Sciences. After 16 rounds of interviews, theoretical saturation was achieved. Qualitative data were analysed using conventional content analysis, which resulted in 81 preliminary codes and 28 sub-categories. Finally, two themes of \"ethical challenges\" and \"ethical requirements\", and 10 categories were achieved. The categories were consisted of \"being patient-centred\", \"social accountability of curriculums\", \"ethical challenges of the clinical environment\", \"the poor performance of the clinical faculty members and students\", \"being justice-centred\", \"raising awareness\", \"observing clinical research ethics\", \"preservation and promotion of mental health\", \"patient confidentiality\", and \"respect for individuals\". We hope the ethical challenges in medical education that were created due to the emergence of Covid-19 can be reduced and eliminated by defining a framework for ethical requirements.</p>","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41716888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Practicing patients’ rights in Iran: a review of evidence 伊朗病人权利的实践:证据综述

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-25 DOI: 10.18502/jmehm.v14i28.8284

T. Sharifi, Ehsan Shamsi Gooshki, A. Mosadeghrad, Ebrahim Jaafaripooyan

{"title":"Practicing patients’ rights in Iran: a review of evidence","authors":"T. Sharifi, Ehsan Shamsi Gooshki, A. Mosadeghrad, Ebrahim Jaafaripooyan","doi":"10.18502/jmehm.v14i28.8284","DOIUrl":"https://doi.org/10.18502/jmehm.v14i28.8284","url":null,"abstract":"Protection of patients' rights is critical in improving healthcare quality, and hence this study aimed at reviewing patient rights’ practices in healthcare organizations of Iran. Using systematic search, this review was conducted based on Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Several keywords, including \"patient rights\", \"patient bills of rights\" and \"patients rights’ charter\" were searched bilingually in the databases of SID, Magiran, PubMed, Scopus, and Web of Science from 2010 to 2021, and then, following a three-tier screening using the Critical Appraisal Skills Program (CASP) checklists, 76 articles were extracted. The degree of compliance with the Patients' Rights Charter (PRC) in healthcare organizations was 60.88% on average. As to the observance of the PRC dimensions, respectively, the highest and lowest scores were related to the \"right to privacy and confidentiality\" (70.16%) and \"right to access an efficient complaining system\" (53.01 %). Respect for patients' rights in organizations was assessed at a moderate level, and some aspects of patients' rights should be attended to immediately. Therefore, discrepancies in the dimensions of patients' rights and their implementation by organizations should be on the agenda of healthcare managers and policymakers.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47484340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Developing a comprehensive tool to assess professional attitude among physicians and medical students 开发一种综合工具来评估医生和医学生的专业态度

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-12 DOI: 10.18502/jmehm.v14i27.8283

N. Yavari, F. Asghari, Z. Shahvari, S. Nedjat, B. Larijani

{"title":"Developing a comprehensive tool to assess professional attitude among physicians and medical students","authors":"N. Yavari, F. Asghari, Z. Shahvari, S. Nedjat, B. Larijani","doi":"10.18502/jmehm.v14i27.8283","DOIUrl":"https://doi.org/10.18502/jmehm.v14i27.8283","url":null,"abstract":"It appears that up until now, no comprehensive tool has been developed to assess medical students’ attitudes toward the different dimensions of professionalism. The present study aimed to develop a comprehensive quantitative tool to evaluate medical students’ attitudes toward professionalism. This study consisted of two phases: The first phase was item generation and questionnaire design based on literature review and a qualitative survey. The qualitative data were extracted from 49 semi-structured individual interviews and one focus group discussion. In the second phase, the questionnaire was developed and its face, content, and structure validity and reliability were evaluated. To measure the construct validity of the questionnaire, a cross-sectional study was conducted on 354 medical students at different academic levels at Isfahan University of Medical Sciences. The final questionnaire was loaded on five factors. The factors accounted for 43.5% of the total variance. Moreover, Cronbach's alpha was 0.84 for the total scale, and the interclass correlation coefficient was 0.77 for the test-retest reliability. The 17-item questionnaire measuring medical students’ professional attitude had acceptable validity and reliability and can be adopted in other studies on physicians’ and medical students’ professional attitudes.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2021-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46812774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges of hospital ethics committees: a phenomenological study 医院伦理委员会的挑战:现象学研究

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-11 DOI: 10.18502/jmehm.v14i26.8282

Samira Raoofi, Seddighe Arefi, Rahim Khodayari Zarnaq, Bashir Azimi Nayebi, Mir Sajjad Seyyed Mousavi

{"title":"Challenges of hospital ethics committees: a phenomenological study","authors":"Samira Raoofi, Seddighe Arefi, Rahim Khodayari Zarnaq, Bashir Azimi Nayebi, Mir Sajjad Seyyed Mousavi","doi":"10.18502/jmehm.v14i26.8282","DOIUrl":"https://doi.org/10.18502/jmehm.v14i26.8282","url":null,"abstract":"Medical ethics committees play an important role in examining and resolving ethical problems in hospitals by developing ethical guidelines and making ethical decisions. This study aimed at investigating the challenges that these committees typically face. This qualitative phenomenological study was conducted in 2020. Data was collected through semi-structured interviews with purposive sampling and participation of 19 ethics committees’ members in Tehran hospitals. Then, data were analyzed by the content analysis method using MAXQDA-10 software. Challenges of hospital ethics committees were classified into three main themes including external factors, intra-organizational factors, and ethics committee structure, in addition to six sub-themes including inadequate supervision, lack of instructions, organizational culture, human resources, nature of the committee, and ineffectiveness of committees’ decisions. Since many challenges are faced by ethics committees, plans should be developed and implemented to fulfill the following purposes: (i) strengthen the position of these committees in hospitals, (ii) continuous supervision over the formation and holding of the committees, (iii) their operation process, (iv) their decision-making process, and (v) process of sharing committees’ decisions with all hospital stakeholders and staff.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2021-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46345906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges for ethics committees in biomedical research governance: illustrations from China and Australia 生物医学研究治理中伦理委员会面临的挑战:来自中国和澳大利亚的例证

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-10 DOI: 10.18502/jmehm.v14i25.8279

Huanhuan Cao, Ming Li, Mingxu Wang, D. Roder, I. Olver

{"title":"Challenges for ethics committees in biomedical research governance: illustrations from China and Australia","authors":"Huanhuan Cao, Ming Li, Mingxu Wang, D. Roder, I. Olver","doi":"10.18502/jmehm.v14i25.8279","DOIUrl":"https://doi.org/10.18502/jmehm.v14i25.8279","url":null,"abstract":"In this paper, the evolution of the ethics committees for health research, their history, membership, and function in China and Australia is described. Investigators in each country compared the history and governance of their ethical systems based on the published evidence rather than personal opinions. Similarly, examples of challenges were selected from the literature. In both countries, the aim was to maximize the social benefits of research and minimize the risk imposed on the participants. Common challenges include maintaining independence, funding and delivering timely ethical reviews of the research projects. These challenges can be difficult where research ethics committees rely on voluntary contributions and lack a strong resource base. They must adapt to the increasingly rapid pace of research as well as the technological sophistication. Population health research can challenge the conventional views of consent and privacy. The principles of the sound ethical review are common in both countries; governance arrangements and operational procedures, however, can differ, reflecting the cultural values and norms of their host countries and in respect of legal environments. By studying the evolution and function of ethics committees in the two countries, we established the differences in the governance and health systems, while similar ethical objectives helped sustain collaborative research.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46781825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Applying ethical theories to the Iranian health system governance: a critical empirical assessment 将伦理理论应用于伊朗卫生系统治理:关键的实证评估

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-08 DOI: 10.18502/jmehm.v14i23.8183

N. Bahmanziari, S. Mohammadi, A. Takian, M. Arab, I. Harirchi

{"title":"Applying ethical theories to the Iranian health system governance: a critical empirical assessment","authors":"N. Bahmanziari, S. Mohammadi, A. Takian, M. Arab, I. Harirchi","doi":"10.18502/jmehm.v14i23.8183","DOIUrl":"https://doi.org/10.18502/jmehm.v14i23.8183","url":null,"abstract":"The policies of health systems are inspired by ethical priorities. A critical review of policies can reveal the ethical theories/justice schools behind them. This study aimed to identify the ethical theory(ies) underpinning the Iranian health system governance over the past 50 years. This was a qualitative study conducted in two stages during 2019. First, we identified and constructed the key concepts and distinctive notions of prominent ethical theories/justice schools. Then, we spotted and selected 24 strategic laws and policy documents in the Iranian health system governance during the past 50 years and analyzed their content to surmise their underlying ethical theory. The results showed that the dominant theory affecting the policies of the Iranian health system governance over the past 50 years was egalitarian liberalism and then objective utilitarianism and relativist communitarianism. Retrospective empirical application of ethical theories to health system governance is methodologically doable, and this application reveals the mood or priorities of the politics. Also, highlighting the underpinning ethical theories of health system governance as well as the gap between ambitions versus realization are insightful and may prospectively empower and strengthen egalitarianism","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42522058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When complementary and alternative medicine intervenes in the conventional treatment of cancer patients: ethical analysis of a clinical case 当补充和替代医学干预癌症患者的传统治疗:临床病例的伦理分析

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-07 DOI: 10.18502/jmehm.v14i22.8182

M. Saber

引用次数: 1

The role of narrative medicine program in promoting professional ethics: perceptions of Iranian medical students 叙事医学课程在促进职业道德方面的作用：伊朗医学生的看法

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-06 DOI: 10.18502/jmehm.v14i21.8181

S. Daryazadeh, P. Adibi, N. Yamani

{"title":"The role of narrative medicine program in promoting professional ethics: perceptions of Iranian medical students","authors":"S. Daryazadeh, P. Adibi, N. Yamani","doi":"10.18502/jmehm.v14i21.8181","DOIUrl":"https://doi.org/10.18502/jmehm.v14i21.8181","url":null,"abstract":"Narrative medicine (NM) is an educational tool that can be used to promote the professional competencies of medical students. This study aimed to investigate Iranian medical students’ perceptions of the first NM program offered in 2019. The study was conducted on 69 medical interns who participated in the weekly NM program that was part of the professional ethics course for two months. We used a questionnaire to determine medical interns' perceptions and personal attitudes toward NM. Three experts confirmed the validity of the questionnaire in Persian, and its reliability was verified by internal consistency (α = 0.879). The independent t-test was used to compare the differences in the total scores of students' perceptions. Data analysis was conducted using SPSS 23 software (P < 0.05). The response rate to the questionnaire was 95.65%. The results showed overall students' perceptions of the program were found to be positive. Furthermore, the scores showed a significant difference in terms of gender (P = 0.014), but none in terms of marital status (P = 0.936). According to the results, NM was effective in improving students’ reflections and their empathy with patients. Therefore, it is recommended to include NM in professional ethics education.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43357252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Professional moral courage and moral reasoning among nurses in clinical environments: a multivariate model 临床环境下护士职业道德勇气与道德推理的多元模型研究

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-05 DOI: 10.18502/jmehm.v14i20.8180

M. Khatiban, Seyede Nayereh Falahan, A. Soltanian

{"title":"Professional moral courage and moral reasoning among nurses in clinical environments: a multivariate model","authors":"M. Khatiban, Seyede Nayereh Falahan, A. Soltanian","doi":"10.18502/jmehm.v14i20.8180","DOIUrl":"https://doi.org/10.18502/jmehm.v14i20.8180","url":null,"abstract":"Improving ethical practice needs recognizing the relationship between moral reasoning and moral courage among nurses. We examined factors (moral reasoning, practical consideration, moral dilemmas familiarity, and demographic and work characteristics) associated with moral courage among nurses. A cross-sectional design was run at all five hospitals affiliated to Hamadan University of Medical Sciences in west of Iran. A proportionate random sampling due to the total size of the nurse population in each hospital, 224 eligible nurses were completed the study questionnaires: demographic-work characteristics, Professional Moral Courage (PMC), and Nursing Dilemma Test. The relationships were examined by multiple regression analysis. Participants reported a more than moderate level of moral reasoning and PMC (43.21±5.98 and 56.16±10.18 respectively). The multivariate model showed the nurses’ PMC is positively predisposed with moral reasoning (β=0.21, p<0.01), but negatively with practical consideration (β=-0.16, p<0.01). More moral courage was found in the nurses who were never married (p<0.001), graduated from a public university (p<0.01), working in the critical care and emergency environments, as well as night shifts (all p<0.001). Moral reasoning is a predictor of moral courage, and both should be considered in designing nursing education to improve ethical nursing practice.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2021-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42628266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Telephone communication with relatives of hospitalised COVID-19 patients by a specialised family support team: lessons learned 专业家庭支持小组与COVID-19住院患者亲属的电话沟通:吸取的经验教训

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2021-12-03 DOI: 10.18502/jmehm.v14i18.8178

Ara Ayora, C. Nogueras, Sonia Jiménez-Panés, Sergi Cortiñas-Rovira

{"title":"Telephone communication with relatives of hospitalised COVID-19 patients by a specialised family support team: lessons learned","authors":"Ara Ayora, C. Nogueras, Sonia Jiménez-Panés, Sergi Cortiñas-Rovira","doi":"10.18502/jmehm.v14i18.8178","DOIUrl":"https://doi.org/10.18502/jmehm.v14i18.8178","url":null,"abstract":"During March and April 2020, the number of hospital admissions and deaths due to the first wave of COVID-19 peaked. The objective of this study was to analyse the experiences of a team of health professionals in charge of breaking bad news over the telephone to the relatives of patients admitted to the respiratory ward of a large hospital in Barcelona. This was a qualitative research based on semi-structured individual interviews with all the members of the team and a group interview. The interviews were analysed using Condensation of Meaning techniques. Three central themes emerged after analysing the interviews: (1) the call itself, (2) the need for good organisational support both before and during a crisis, and (3) the care that the professionals themselves need. To set up a large-scale operation to break bad news over the phone, some organisational aspects must be considered that go beyond the call itself. All these aspects are interrelated to a large extent, and due attention should be given to proper communication and adequate care practices for both relatives and health workers.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47360537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1