ABSTRACT
In the recent years, advances in medical technologies for end stage cancer patients' care have affected the end-of-life decision-making in clinical practice and exposed oncologists to serious ethical dilemmas. But little is known about oncologists' viewpoints in our country regarding their ethical problems in this mention. We aimed to clarify the ethical dilemmas which Iranian oncologists may face in our health care setting and to determine factors influencing decision-making process. In this qualitative study, a phenomenological approach was used. We interviewed 8 cancer specialists in teaching hospitals in Iran and used content analysis to identify codes and categorize themes in the data. During the process of analysis, three main themes emerged about ethical dilemmas in end of life care for advanced cancer patients: illness factors, socio-cultural context and patient-physician relationship. Cancer specialists identified ethical problems on several main issues, the most important of which were telling the truth in Iranian cultural context, uncertainty in end stage definition, multidisciplinary team working and cost consideration in Iranian health care system. Health care and insurance system in Iran face to end of life care challenges; therefore, health care providers and policy makers need to allocate appropriate resources and programs to improve quality of care in terminal stages. Appropriate physicians' communication skills training, multidisciplinary team working and supplementary insurance services that provide essential health care can improve the quality of care of patients with end stages of cancer. the findings of this study can help us to provide ethical policies for decision-making in end-of-life care
ABSTRACT
The importance of pediatric research especially in the ethically proven trials resulted in considerable legislative attempts in association with compiling ethical guidelines. Because of children's vulnerability conducting pediatric research raises different ethical issues; the two most important of which are informed consent and risk-benefit assessment. Differences in religious and socio-cultural context limit implication of ethical standards. At the aim of finding a solution we critically reviewed guidelines, and literatures as well as Islamic points in addition to comparing different viewpoints in application of ethical standards in pediatric research. The literature review showed that pediatric research guidelines and authors' viewpoints have the same basic ethical core, but there are some variations; depend on cultural, religious, and social differences. Furthermore, these standards have some limitations in defining informed consent according to child's age and capacity upon application In this regard Islamic approach and definition about growth development and puberty sheds light and clarifies a clearer and more rational address to the issue
ABSTRACT
The number of research misconduct cases seems to be increasing so the need for developing a disciplinary charter of research misconduct is felt more than ever. This study was aimed to propose and develop a charter to determine types of research misconduct and dealing with them. In this qualitative study, three consensus rounds were conducted. Each round consisted of five to six qualified experts with related specialties. They included one member of academic staff with sufficient experience in research management, two experts in professional ethics, and two experts in legal affairs. Each session lasted for 1.5 to 2 hours. Based on an extensive literature review and personal experiences, the different types of research misconduct were extracted in the first two sessions and in the third round, agreement on classification of research misconduct was made In general, 49 types of research misconduct were explored and defined including 17 mild, 22 moderate and 10 severe ones. Based on the severity of each type, an appropriate penalty like "verbal warnings and summons" to "early retirement with reduced payment base" was determined. Finally the expert panel made some comments. The results of this study revealed different types of research misconduct and dealing with them. Such an understanding can lead to a better design of national charters compatible with Iranian culture and it can also be as a base for preventive interventions
Subject(s)
Humans , Teaching Rounds , Fraud , Biomedical Research , Ethics, ProfessionalABSTRACT
Substance abuse is an important health, psychological and social problem in the world. Gabapentin is a new antiepileptic drug. It is used in neurological and psychiatric disorders. Moreover the effects of gabapentin on increasing the analgesic effect of morphine and its inhibitory effects on dopamine release due to morphine in animal models have been proved. In the present study, the effect of gabapentin on withdrawal signs and symptoms in opium-addicted participants and on psychiatric disorders and electroencephalogram of these patients during the detoxification period has been investigated. Two groups of patients were selected randomly. The first group [n=36] received the current drugs based on their withdrawal symptoms and the second group [n=35] received an additional 900 mg gabapentin daily. All the patients were evaluated by electroencephalography and Symptom Check List-90-Revised on the first and last days of hospitalization and their demographic characteristics were gathered by using a general questionnaire. During the hospitalization period [10 days] all the patients were visited daily for withdrawal signs and symptoms. The analysis of data showed the excellent effect of gabapentin on all psychiatric symptoms and in decreasing signs and symptoms significantly. A gradual decrease of withdrawal signs and symptoms in the second group shows the efficacy of gabapentin. There was no significant difference between the two groups, regarding to the electroencephalogram indices. The results show that gabapentin improves the quality of therapeutic management in opium-addicts during the detoxification period