Bioethics and Health Law Journal (BHL)

Background and Aim: The present era witnesses new biomedical technologies that have brought about philosophical, moral, religious and social challenges. More questions, challenges and uncertainties in biotechnology have made applied ethics, as a part of its ethics and philosophy, investigate the issue and find relevant appropriate solutions based on ethical principles and theories.

Materials and Methods: The current study aimed at casting light on bioethics and its scope using primary and authentic sources on bioethics and seeking the related keywords in these sources.

Ethical Considerations: The principles of research ethics have been observed in studies and citing the primary texts and sources.

Findings: Providing an all-inclusive definition of bioethics and its place in different disciplines of ethics, this short discussion tackles the area, realm, and significance of the issues in bioethics. Technologies such as assisted reproductive, in vitro fertilization (IVF), human and animal cloning, obtaining stem cells and using them, euthanasia, and manufacture of human organs and their transplantation are the most challenging matters for which within bioethics, the fundamental answers and strategies against the questions and challenges of their emergence are elaborated.

Conclusion: Bioethics is a new area of interest in applied normative ethics which, as an interdisciplinary, examines systematically the moral challenges coming from biological science and medical innovations and organizes the must-to-dos in this connection. The realm of bioethics comprises the distinction of consequences of applying modern biomedical technologies against the ethical principles and standards within human life. The aforesaid technologies and advancements that make up issues in bioethics are grouped in four categories:

• Life preserver technologies at the beginning of life and during it;
• Life lasting technologies to promote the life quality;
• Reproductive and esp. cloning technologies;
• Technologies associated with genetic engineering and gene therapy.

^*Corresponding Author: Mohammad Reza Rahbarpour; Email: rahbarpour@atu.ac.ir;  ORCID: https://orcid.org/0000-0002-2383-6463 

Please cite this article as: Rahbarpour MR. Meaning and Conception of Bioethics and its Realm. Bioeth Health Law J. 2021; 1:1-11 (e1). http://doi.org/10.22037/bhl.v1i1.38123

Background and Aim: Daily development of human knowledge, promotion of biomedical technologies, and improvement of physicians' ability in diagnosis and treatment of different types of diseases have always accompanied plenty of discussions and challengeable subjects, especially from the viewpoint of ethical issues. Obtaining deep and accurate recognition of these subjects, the attention of the physicians and the scholars of different fields, especially of ethics has been drawn to medical ethics as a new solution in the comprehensive Healthcare System.

Materials and Methods: Available, published, and related articles were located with an Ovid MEDLINE search for "Ethics, Medical," and "Ethics". The Internet was searched for "medical and ethics," "ethics," "science and ethics," and "research and ethics" using the Google search engine (www.google.com).

Ethical Considerations: The principles of research ethics have been observed in studies and citing the primary texts and sources.

Findings: Despite the great changes in medical technologies, there are still some concerns about the physicians' abilities in decision makings that may directly or indirectly affect the health or life of the people. Therefore, these concerns have led to the appearance of new movements all calling for the patients' rights and the rights of society to participate in medical decision-making. On the other hand, we should notice some other cases that play effective roles in the policy-makings of the comprehensive healthcare system. For instance, the required resources will vary following the changes in technology; the population especially of the elderly is increasing; moreover, the time needed for the new workforces to be entered into the labor market has typically increased. Consequently, a higher number of people are waiting to benefit from the recourses and a lower number of them is involved in producing the recourses.

Conclusion: Thus, to work on the important topics like the requirements of human societies, ethical considerations of biotechnology and medical researches, Allocation of limited and immense resources, important ethical criteria of decision makings, representation of fundamental solutions, and medical ethics training is considered as one of the most necessities of comprehensive healthcare system among others.

^*Corresponding Author: Alireza Zali; Email: dr.zali@sbmu.ac.ir; ORCID: https://orcid.org/0000-0002-2298-2290 

Please cite this article as: Zali AR. Medical Ethics and Health Care System. Bioeth Health Law J. 2021; 1: 1-8 (e2). http://doi.org/10.22037/bhl.v1i1.38125 

Background and Aim: Nowadays, we are observing the increasing development of sciences, particularly biological sciences and medicine. In the Muslim world, the ethical requirements of such scientific developments are taken into account without paying sufficient attention to their indigenous and Islamic aspects. Even international institutions are not properly informed of the need for the religious aspects of bioethical discourse in Muslim countries. Hence, this study attempts to address the differences in the ideologies of these two ethical theories.

Materials and Methods: In this review article, the keywords "bioethics", "Islam", "secularism", "philosophy of ethics", "ideology differences" and "ethical theories in secularism" were searched in PubMed, SID, and Google Scholar databases and the relevant literature was determined and analyzed.

Ethical Considerations: Honesty and integrity were taken into consideration in searching, analyzing, and reporting the texts.

Findings: Of the appropriate methods in analyzing the texts, one is the comparative study between the ideological and meta-ethical foundations of Islamic bioethics and secular bioethics, some of which are: the differences in the belief in the origin of existence and the Creator of existence; differences in the attitudes towards the totality of existence; differences in the views of the materialistic existence and the laws governing it. In addition, there exist anthropological differences in these two ethical theories, among which we can refer to the differences in the attitudes towards the creation of human beings, the differences in the attitudes towards the dimensions of human existence, and life after death. Finally, we can also refer to the meta-ethical differences between Islamic bioethics and secular bioethics, including the difference in moral ontology, the difference in ethical epistemology, ethical semantics, as well as several similarities between Islamic bioethics and secular bioethics that are mostly normative.

Conclusion: Accepting the differences and similarities can be found as a present reality to begin a constructive bilateral dialogue and to introduce the fundamentals of Islamic bioethics.

^*Corresponding Author: Mahmoud Abbasi; Email: dr.abbasi@sbmu.ac.ir; ORCID: https://orcid.org/0000-0002-4223-6818 

Please cite this article as: Abbasi M, Shamsi Gooshki E. Islamic Bioethics and Secular Bioethics and Interaction between them. Bioeth Health Law J. 2021; 1:1-10: (e3). http://doi.org/10.22037/bhl.v1i1.38127

Background and Aim: Gender Dysphoria is the formal diagnosis of psychiatrists that is used to describe a person who has been seriously dissatisfied with his or her gender at birth or the gender role that society considered for them. Some research and studies have been conducted related to investigating social and family dimensions and consequences of this disorder. Surveys and case studies have been done regarding the personality disorders, and personality patterns, and the adaptability of the role and sexual identity of these patients with their new gender, but there are still unanswered questions in this case. Thus, by investigating the legitimacy of sex change surgery in terms of jurisprudence and legal elements before and after sex change, this study tries to remove the ambiguity in this area.

Materials and Methods: In this study, using keywords such as sex change, Gender Identity Disorder, and ‘Gender Dysphoria’ in the jurisprudence and legal areas of SID, Google Scholar, Magiran, Noormags databases, the related resources were studied and analyzed.

Ethical Considerations: Honesty and trusteeship were taken into consideration in the analysis of information and sources.

Findings: There is no single perspective in terms of legitimacy or prohibition of sex-change surgery among scholars and Grand Ayatollahs. Some have permitted sex-change surgery and some others believe that superficial sex change is not permissible without a creatural background. There is also a legal gap not only in the Islamic Penalty Code (IPC) but also in other Iranian laws on the provisions and conditions of sex change. This issue has raised ambiguity in the rights and duties of people seeking sex-change surgery. This is while, in the laws of many other countries, this issue has been explicitly mentioned, and this framework greatly contributes to many people with ‘Gender Dysphoria’ and removes confusion in this regard.

Conclusion: In Iranian law, the approval of laws regarding the provision of medical facilities, insurance services and the adoption of clear and transparent rules on the status of marriage, dowry, inheritance, custody, and guardianship of children will remarkably contribute to the process of recognition of people with difficulties in sexual identity among men and women. Also when considering the genetic and biological factors that contribute to Gender Dysphoria, the promotion of the culture of dealing with the phenomenon of sex transfer applicants through raising awareness in the media is felt.

^*Corresponding Author: Mostafa Vahedi; Email: mostafavahedi38@gmail.com; ORCID: https://orcid.org/0000-0002-2432-5323

Please cite this article as: Vahedi M. Alimardani A. Behrouzih MR. Rayejian Asli M. Gender Dysphoria in Iran: legal and Islamic Jurisprudence Perspectives. Bioeth Health Law J.  2021; 1:1-10 (e4). http://doi.org/10.22037/bhl.v1i1.38128

Background and Aim: Moral status of animals has been attended by philosophers such as Pythagoras, Aquinas, Kant, etc. But in the contemporary period, considering this issue both in terms of volume and in quality is not comparable with the previous period. So that the pursuit of philosophical works written in this regard, can also be done with difficulty. This article seeks to introduce the main philosophical mainstream in this area and analyze the philosophical method and introduce the most effective and appropriate for Iran society.

Materials and Methods: In this review article, to introduce major approaches and theories in this article is used some of the most important available philosophical and religious texts. This critical review method in this article can be contained following the analytical method (analytic philosophy).

Ethical Considerations: In this review article, honesty and integrity have been considered and it has been tried to provide reasonable criteria as the moral duty of the researcher, as far as possible.

Findings: The behavior that humans have with animals is the subject of a branch of applied ethics, which is called animal ethics. There are various approaches in animal ethics: an analytical approach, continental approach, pragmatic attitude, and theological approach. On the other hand, the ethics philosophers have used classical theories of ethics in this field and announced their position about animals. In a general classification, these views are in two categories: (1) direct theories (2) indirect theories. The indirect theories include theories of Kant and social contract and direct theories are divided into two categories: ideas and theories believing in the equality of human beings and animals and theories attached to the lack of equality.

Conclusion: Although the approaches and theories mentioned above, all can be effective as efficient theoretical tools in support of animal rights and decreasing their suffering, but since Iran is a less philosophical and more religious community, the theological approach can be more efficient in the field of animal rights.

^*Corresponding Author: Mohsen Jahed; Email: jahed.mohsen@znu.ac.ir; ORCID: https://orcid.org/00000-0002-3953-876X

Please cite this article as: Jahed M. Ethics and Animals: Approaches and Theories. Bioeth Health Law J.  2021; 1:1-9: (e5). http://doi.org/10.22037/bhl.v1i1.38130

Background and Aim: The high cost of health care and long waiting time of the patients caused the creation of the motivation that patients, especially from the developed countries, receive these services in other countries. On the other hand, also in developing countries, factors such as globalization and liberalization of trade in health services led the way for the rapid growth of medical tourism. However, this industry is facing several challenges, among the most important, legal aspects can be noted. Since little research has been done in this regard, this study aims to evaluate the legal aspects related to medical tourism.

Materials and Methods: This study is a review article on the legal issues of medical tourism. To collect information on the legal issues of medical tourism, databases, SID and PubMed, Google Scholar were examined using the keywords "medical tourism", "health tourism" and "legal aspects" and about 47 related articles were found, after studying the titles and abstracts of the articles found, 23 subjects which were associated with the research topic, were studied. Then the results obtained were analyzed.

Ethical Considerations: Honesty and integrity were taken into consideration in searching, analyzing, and reporting the texts.

Findings: According to the results of the study, the medical tourism industry is growing, but there are challenges related to the legal aspects of medical tourism include the areas of access to services, medical errors, health insurances, licensing, and regulatory approvals of centers, medical operations, and medical technologies.

Conclusion: Medical Tourism legal challenges should be taken into consideration by policymakers and trustee institutions in this industry, as according to the globalization of these challenges, trying to eliminate them is necessary, which by turning threats into opportunities, facilitates the attraction process of foreign patients.

^*Corresponding Author: Nazanin Abualhasani; Email: na_abolhassani@yahoo.com; ORCID: https://orcid.org/0000-0002-3616-3595

Please cite this article as: Abualhasani N. Legal Features and Aspects of Medical Tourism. Bioeth Health Law J.  2021; 1:1-6: (e6). http://doi.org/10.22037/bhl.v1i1.38131  

Background and Aim: The theory of consent and innocence are two major approaches in medical law that, studying them as one of the essential conditions of medical liability, has special significance. This study aimed to analyze the discussion of consent and innocence and its impact on medical liability falling.

Materials and Methods: In the present study, keywords of consent, innocence, doctor, and liability in databases PubMed, Magiran, SID, ISC, and Google Scholar were searched and relevant literature was searched and analyzed.

Ethical Considerations: Principles of ethics and integrity in the search, citation, and literature analysis were taken into consideration.

Findings: In this study, after explaining the concept of patient consent and satisfactory and capacity conditions in its declaration and also the concept of innocence and its terms, it is emphasized that every wise and mature person has the right to decide about the treatment or medical method recommended for him.

Conclusion: Although the legislator explicitly pointed to obtain consent from the patient or his legal representatives in surgeries and medical operations and the existence of such consent in all surgical and medical operations is known as a requirement except in cases of urgent, but because in our legal system to comply with Jurisprudence, the obligation to result in surgeries and medical operations indicates the nature of the commitment of doctors and theoretical basis of medical liability, obtaining patient consent, legitimation of medical procedures and respecting the legitimacy of scientific and technical aspects of the state system are not the complete reasons of the collapse of medical liability and compensation the physician is responsible for a compensation of the damages applied to the patient unless before starting treatment acquittal is received from the patient or his representatives.

^*Corresponding Author: Mahmoud Abbasi; Email: dr.abbasi@sbmu.ac.ir; ORCID: https://orcid.org/0000-0002-4223-6818 

Please cite this article as: Abbasi M. Requirements of Consent and Innocence and its Impact on Medical Liability Falling. Bioeth Health Law J.   2021; 1:1-8: (e7). http://doi.org/10.22037/bhl.v1i1.38132  

Background and Aim: Electronic health record is one of the most important achievements of the eHealth to achieve patient-centered care. The aim of patient-centered care is the accessibility of all patient information to clinicians to have the best decisions for the patients. Creating an environment for sharing information and developing e-health information caused the security and privacy of health information of patients to become an important and challenging issue. In this regard, healthcare organizations must create a security solution to protect the rights of their patients.

Materials and Methods: This review is based on library research and Internet searches in the major databases such as Web of science, Emerald, Proquest, EBSCO host research, PubMed, and search engines like Google and Google Scholar. In this review, essays, books in the field of medical informatics, and the security of information systems in the health system have been studied.

Ethical Considerations: Publication of the results is carried out without bias, honestly, and by citing the original reliable resources and references.

Findings In this review, how to maintain information security programs and health information systems in addition to improving quality of care to achieve three main objectives related to security, including confidentiality, accuracy, and the availability around three core axes of administrative safeguards, physical safeguards, and technical safeguards are discussed.

Conclusion: The health centers should be consistent in four main areas standards, rules and policies related to the contribution and access to information, communications and operations management, access control and security of human resources including awareness and education of the users about security issues should involve a range of users ranging from therapists to legal and technical experts and always consider the principle of "protecting the rights of patients with convenient access to patient information" to develop their security and development of programs.

^*Corresponding Author: Mahtab Karami; Email: m.karami@ssu.ac.ir; ORCID: https://orcid.org/0000-0003-2335-6627

Please cite this article as: Karami M. Patient's Electronic Environment Information Rights. Bioeth Health Law J. 2021; 1: 1-5 (e9). http://doi.org/10.22037/bhl.v1i1.38133

Background and Aim: Considering the history of Islamic and Iranian culture we should represent new solutions able to join the current medicine and the former Hikmat (Wisdom) in the light of the medical world-view and through making use of the historical instructions of hikmat.

Materials and Methods: In the present review study, using keywords such as Hikmat, Aristotle ethics, medical research, medical ethics as well as bioethics, we searched for the published articles and resources regarding this topic, and then they were analyzed.

Ethical Considerations: Honesty in the literature and citation analysis and reporting were considered.

Findings: From the old days, pious people always had sought wisdom. Medicine was considered a kind of practical wisdom that is called Pyrrhonism or wisdom and the physician was known as a pious person. A physician must reach the highest degree of knowledge so he would gain virtue. In the past, science was accompanied by the perfectness of soul and physician for achieving the truth, had to learn the medicine along with wisdom, because wisdom and medicine had a close relationship.

But nowadays seems that medical science enters into the age of instability and morals in all fields have collapsed and the continuance of this process has not any bright perspective for the future of medicine. One of the obvious reasons for this situation in two recent decades is the separation between medical sciences and humanism.

Conclusion: In recent decades that western world was in seek of ethics for the purpose of amends the lack of religion and virtuality in their society, we in a opposite attitude with separation of tentative science especially medicine from humanism, have caused a great and irrecoverable damages on the body of our medicine, so that unfortunately our country is following the west in this matter. The reason of this matter is in the collapse of values that was the foundation of previous wisdom, the wisdom that seems to be the missing segment of current medicine.

In this article we show the necessity of attention to the medical ethics as a fundamental element in reaching the goal of medicine based on wisdom.

^*Corresponding Author: Mahmoud Abbasi; Email: dr.abbasi@sbmu.ac.ir; ORCID: https://orcid.org/0000-0002-4223-6818 

Please cite this article as: Abbasi M. In Quest of Wisdom; Missing Segment of Current Medicine. Bioeth Health Law J. 2021; 1: 1-9 (e9). http://doi.org/10.22037/bhl.v1i1.38133

Background and Aim: Soft drugs are those drugs that are very weak in terms of addiction and the effects are highly treatable. The challenging issue regarding this type of drug is the decriminalization of its use. The criminal policy of some countries such as the Netherlands agrees with the decriminalization and the criminal policy of many others such as the United States of America is against it.

Materials and Methods: To review the reasons and justifications of each of parties for and against soft drug decriminalization, ideas of lawyers and scientific studies in the Netherland and the United States have been considered, and criminal poly makers’ ideas will be reviewed.

Ethical Considerations: Honesty in the literature and citation analysis and reporting were considered.

Findings To justify soft drug criminalization, two classifications of legal and health reasons and justifications can be cited. Legally, it has been stated that drug issue is a problem related to the health and treatment domain, and criminal legal intervention in this area must be considered just as the last weapon. In addition, Penologically, punishing soft drug users is unnecessary, ineffective, without favor, and unnecessary. Regarding health, it has been stated that not only using some soft drugs such as cannabis is not the reason for being sick, but also it has an effective role in treating incurable diseases such as multiple sclerosis, AIDS, hepatitis, chronic pain, and ….

Conclusion: Decriminalization of soft drugs has a theoretical and practical background in countries such as the Netherlands and the United States. Soft drugs like cannabis not only have a lower degree of addictive rate rather than Hard drugs like heroin, but also it has some therapeutic benefits. Legally, the decriminalization of soft drugs has roots in human rights, penology, and criminological justifications.

^*Corresponding Author: Seyed Reza Ehsanpour; Email: ehssanpour@shahed.ac.ir; ORCID: https://orcid.org/0000-0001-9135-3968

Please cite this article as: Ehsanpour SR. Criminal Policy of Netherlands and U.S.A on Decriminalization of Soft Drugs. Bioeth Health Law J. 2021; 1: 1-0 (e11). http://doi.org/10.22037/bhl.v1i1.38155

Background and Aim: Rejection of transplanted organs refers to a phenomenon where the immune system of the recipient body refuses to accept the transplanted organ. This review is conducted to identify the liability of the health staff in complications of the organ transplantation process and in particular, the role of donor and recipient in the liability arising from it.

Materials and Methods: In the present review, utilizing the keywords of organ transplantation, civil liability, and rejection in databases of Magiran, Google, SID, the related articles are studied and analyzed.

Ethical Considerations: Honesty in the literature and citation analysis and reporting were considered.

Findings: The liability arising from rejection and other complications of transplantation, has usually a contractual figure, and unlike other medical responsibilities, it has a feature that there are two contracts of "transfer of organ between donor and recipient" and "therapy contract" behind it. In cases where transplant rejection is caused by a defect in the transplanted organ and the donor is aware of it, transplant rejection is attributed to the recipient with no goodwill; with violation of "implied term of the transplanted organ health" in the contract between the donor and recipient, his liability is the case. The therapy contract follows the general rule enacted by the new Islamic Penal Code adopted in 2013, and the doctor and other factors that caused transplant rejection, in case of fault, are responsible for compensation for the damages to the transplanted organ recipient.

Conclusion: In principle, donor and devisees of a person who is brain dead, in many cases, are exempt from the liability arising from transplant rejection or other complications, according to the benefaction rule, and in cases where transplant rejection is attributed to the recipient, he/she is exempt from compensation.

^*Corresponding Author: Ebadolah Rostami Chelkasari; Email: e-rostamy@guilan.ac.ir; ORCID: https://orcid.org/0000-0002-3969-3284

Please cite this article as: Rostami Chelkasari E, Khafi S. Rejection of Transplanted Organ in the Legal System of Civil Liability in Iran. Bioeth Health Law J. 2021; 1:1-9: (e12). http://doi.org/10.22037/bhl.v1i1.38156

Background and Aim: Having one's child is one of the strong desires in human beings especially in married persons who sometimes and for some reason are not capable to achieve. Using ARTs is one of their choices to have a baby while there are some barriers and restrictions for the ARTs applicants, both married and singles, to access which may evaluate in different ways, especially in the light of some basic principles of human rights, including the principles of freedom and non-discrimination and along with, because of the vital importance of respect to child’s rights, the principle of the best interest of a child also is a good criterion for this evaluation.

Materials and Methods: In the present study, keywords of persons with disabilities, the best interest of the child, principle of freedom, and non-discrimination in databases PubMed, Magiran, SID, ISC, and Google Scholar were searched and relevant literature was searched and analyzed.

Ethical Considerations: Honesty in the literature and citation analysis and reporting were considered.

Findings: This paper examines the limitations and prohibitions imposed for access to these technologies based on human rights principles. While the respect to freedom and equality of people demands to minimize this restriction, the best interest of a child principle should be the paramount consideration. In the other words, it is necessary to create a balance between the rights of applicants and the rights of the future child with a focus on the best interests of the child and to the main purpose of the application of these techniques for humans, with an approach, preventing dehumanization of the technologies. Accordingly, they recommend the adoption of legislation and regulations, as well as providing specialized counseling services to the applicants and help them during the decision-making by explaining all existing concerns regarding their child's rights in the future and create a balance between their rights and the future child's.

Conclusion: Access to infertility treatment technologies for infertile couples has always created concerns for service providers about the balance between the rights of parents and future children and policymakers at the macro level. Adoption of laws and regulations, as well as providing specialized counseling services to the applicants and help them during the decision-making by explaining all existing concerns regarding their children's rights in the future could play an important role in creating a balance between their rights and future child's.

^*Corresponding Author: Mahrou Ghadiri; Email: m_ghadiri@sbu.ac.ir; ORCID: https://orcid.org/0000-0001-6756-2188

Background and Aim: One of the questions that may be raised about infertility treatment through surrogacy is the ethicality of this approach. There are many methods for the ethical clarification of the medical issues. If we accept the utilitarian philosophers’ views stating that an ethical measure is beneficial to the community and individuals, we may come up with the question whether the actions of the infertile couples or surrogate mother are considered ethical since these actions are beneficial for both individuals and community. Regarding this, the present study aimed to evaluate the infertile treatment through surrogacy based on the ethical theories of utilitarianism.

Materials and Methods: This analytical-descriptive research gathered relevant data in a literature search. After a description of the fundamentals and definitions, ethical texts were subsequently analyzed and one of the viewpoints regarding of Infertility Treatment through Surrogacy Based on Utilitarian Principle was selected.

Ethical Considerations: Ethical principles were considered in searching and citing the literature.

Findings: According to the rule utilitarianism, the ethicality of an action is measured based on its collective benefit and its placement in an ethical principle framework. Therefore, we cannot treat surrogacy like an accepted ethical principle, such as sacrifice, and provide a general rule for the determination of the effect of different social, cultural, economic, and political factors on the people involved in this act. However, the use of this method in different situations and for various people could be very beneficial and be considered ethical.

Conclusion: Although the comprehensive investigation of the harmful use of surrogacy has not been accomplished, the various problems and factors affecting the evaluation of the overall profit and loss of this act grab the possibility of determining its morality as a valid rule in the rule-based ethics. However, such a provision is justified in the utilitarian and pragmatic ethical systems.

^*Corresponding Author: Saeid Nazari Tavakkoli; Email: sntavakkoli@ut.ac.ir; ORCID: https://orcid.org/0000-0002-6398-521X

Please cite this article as: Nazari Tavakkoli A, Karachian Sani F. Ethical Aspect of Infertility Treatment through Surrogacy based on Utilitarian Principle. Bioeth Health Law J. 2021; 1:1-8: (e17). http://doi.org/10.22037/bhl.v1i1.38171

Background and Aim: Criminal procedure is the way of prosecution and sentencing accused persons and offenders. Based on different kinds of offenders, there need to be different kinds of procedural attitudes. Where the offenders are children or patients, differential procedures especially in detention is necessary. The purpose of the study is to investigate the differences of the defendants in determining criminal penalties in the process of criminal procedure.

Materials and Methods: In order to discuss the penalty as punishment intolerances, the rules of Criminal Procedure Acts in 1999 and 2013 will be reviewed.

Ethical Considerations: Ethical principles were considered in searching and citing the literature.

Findings: According to Article 502 of Criminal procedure 2013, if forensic medicine believes that defendant was not able to endure imprisonment and the imprisonment have physical danger for him, by observing legal requirements imprisonment will be prevented. There is also the Penal Code provision in exercise of slash as a punishment.

On the other hand, temporary detention as the most severe criminal provision in cases based on the article 237 and 238 of the Criminal Procedure Law 2013 is necessary. Also many cases of other criminal rules have conclusion similar temporary detention for reasons such as Inability to introduce bail.

Conclusion: Iranian Criminal procedure Law in article 250 refers to the need to pay attention to physical and mental state of the people in the pretrial phase, but it did not pay attention to its methods and methods.

This issue has been left to the judge's discretion that it is best to anticipate the precise criteria of this issue in law in order to avoid unequal judgment.

^*Corresponding Author: Mohammad Ashouri; Email: ashouri.mohammad@yahoo.com; ORCID: https://orcid.org/0000-0002-8908-5949

Please cite this article as: Rahmat MR, Ashouri M, Mahdavi Sabet MA, Shiri A. Pretrial Detention of Ill Offenders. Bioeth Health Law J. 2021; 1:1-8: (e18). http://doi.org/10.22037/bhl.v1i1.38172

Background and Aim: The principle of nonmaleficence is one of the four principles of bioethics. This principle, along with other principles of bioethics has been set as a moral code and guide in the deployment of new biological technologies, especially new achievements in the medical field. The principle of nonmaleficence states that the use of new technologies should not cause injury to any person of people, human beings, and even nature and animals. This review aims to recognize this principle in the holy religion of Islam that has a very large range and a long history, which is coincided with its emergence and in the Islamic jurisprudence and law it's called the "la-zarar act" (the rule of no harm).

Materials and Methods: In this review, using the keywords of the principle of nonmaleficence, the rule of no harm, self-harm, and to ward off likely harm we searched for relevant literature in interpretations of the Holy Quran, narrative texts, juridical reference texts, and databases of Google Scholar, SID, Magiran, and NoorMags and related articles were studied.

Ethical Considerations: Honesty and ethics have been observed in searching and referencing.

Findings: The principle of nonmaleficence governs over humans' all the personal and social relationships and interactions as an inclusive rule and Islam give veto power to this principle over the other laws and regulations. This principle which is also presented as an ethical principle also includes the principle of nonmaleficence determined in the bioethics of today's global society, but it has quite a different scope and principles.

Conclusion: Based on the principle of nonmaleficence in Islamic Jurisprudence and law and based on wisdom as using medical and biotechnology and testing and research, the human and mankind should not be damaged at all and even if loss or damage is probable, the caution should be made and the harm should be prevented. This principle is general and includes self-harm, too.

^*Corresponding Author: Soheila Safaei; Email: ssafaei_57@yahoo.com; ORCID: https://orcid.org/0000-0001-8484-0282

Please cite this article as: Safaei S. Abbasi M. Principle of Nonmaleficence in Islamic Jurisprudence and law and its usage in Biomedical Jurisprudence. Bioeth Health Law J. 2021; 1:1-7 (e19). http://doi.org/10.22037/bhl.v1i1.38174

Background and Aim: HIV/AIDS and its carrier are not only known as a disease and a patient, respectively. Since the transmission of the disease is most relevant to human deviant behavior, a stigma against the disease has been formed. This study seeks to examine the effect of the stigmatization of the disease imposed on the treatment process and interaction between the physician and HIV/AIDS-positive patient in Iranian society.

Materials and Methods: A qualitative research method has been used in this study. Data collection has been carried out through interviews. Depth interviews and semi-structured interviews have been employed for the patients and doctors respectively. This study was done in the consultation center and infectious disease ward of Imam Khomeini hospital. Six clients of the consultation center and seven infectious disease specialists were selected.

Ethical Considerations: The study followed standard ethics guidelines concerning informed consent and confidentiality.

Findings: HIV/AIDS-related stigma has sparked illogical fears, affects physician-patient interaction in the medical community, and has led to discrimination among these patients in many cases in terms of the right to treatment.

Conclusion: The results obtained showed the unfavorable impacts of the AIDS-related stigma imposed on the medical community and this is an obstacle facing patients with HIV/AIDS to achieve equal treatment rights. The results of the present study show the role of stigma in converting this disease into a socio-cultural phenomenon. Physicians, like other members of society, are affected by values, norms and are constructs of society.

^*Corresponding Author: Mohammad Tavakol; Email: mtavakol@ut.ac.ir; ORCID: https://orcid.org/0000-0001-7300-2814

Please cite this article as: Tavakol M. Nikayin D. Rezaei M. The Effect of AIDS Stigmatization on Curing Patients and Physician- HIV/AIDS Patient Relationship. Bioeth Health Law J. 2021; 1:1-9: (e8). http://doi.org/10.22037/bhl.v1i1.38133

Background and Aim: Metaethics reflects knowledge of persons from moral nature, principles, and processes. Metaethics is effect by many variables such as moral reasoning, moral behavior, and mental health. The aimed to investigate the predicting metaethics of nurses based on moral reasoning, moral behavior, and mental health.

Materials and Methods: This is a cross-sectional study of correlational type. The statistical population included all nurses of Varamin hospitals in 2016 years. Totally 90 nurses were selected through simple random sampling. All of them completed the questionnaires include metaethics, moral reasoning, moral behavior, and mental health. Data were analyzed using Pearson correlation and multivariate regression with stepwise model methods and with using SPSS-19 software.

Ethical Considerations: In this study, verbal informed consent of participants was obtained followed by an explanation about the purpose of the study, anonymity, and confidentiality of patients' information.

Findings: The results showed a positive and significant relationship between moral reasoning, moral behavior, and mental health with metaethics of nurses. In a one-predicted model, moral behavior, mental health, and moral reasoning predicted 37/2 percent of the variance of metaethics among nurses (p≤0/01).

Conclusion: According to findings, moral behavior, mental health, and moral reasoning were the most important predictors of metaethics of nurses. Therefore, it is suggested that planners and counselors consider the symptoms of these variables and design and Implement appropriate programs to improve the metaethics of nursing.

^*Corresponding Author: Jamal Ashoori; Email: jamal_ashoori@yahoo.com ; ORCID: https://orcid.org/0000-0001-5371-040X

Please cite this article as: Ashoori J. Predicting Metaethics of Nurses based on Moral Reasoning, Moral Behavior and Mental Health. Bioeth Health Law J. 2021; 1:1-7: (e14). http://doi.org/10.22037/bhl.v1i1.38164

Background and Aim: Giving bad news is an inevitable part of the medical profession. There are different opinions about telling the truth and giving bad news to patients in different cultures and societies. Thus, the purpose of this study was to investigate attitudes of cancer patients about methods of awareness of bad news.

Materials and Methods: The study was cross-sectional research that has been done on a sample of 160 people of cancer patients. This study used a questionnaire that its validity was confirmed by communication sciences professors and medical experts. The reliability of the questionnaire and Cronbach's alpha for all items of the questionnaire was 95 percent in estimating the validity of the questionnaire was determined that all questions were significantly correlated. SPSS software, regression analysis, and Fisher test were used.

Ethical Considerations: In this study, verbal informed consent of participants was obtained followed by an explanation about the purpose of the study, anonymity, and confidentiality of patients' information.

Findings: In this study investigated 160 patient points of view.37.5% of participants were men and 62.5 of them were women (18-77years). The results show that 57.7 % of patients agreed with a historical approach, 78.8% of them agreed with the direct source style and 94.4% agreed with the informal style of giving information. 18.1% of patients disagree with the flow of the companions of patients of the disease.

Conclusion: Findings indicates on better breaking of the bad news to the patients with a historical approach and telling to the patient by physician, directly.

^*Corresponding Author: Ashraf Karimi Rahjerdi; Email: rahjerdi632@gmail.com; ORCID: https://orcid.org/0000-0002-9329-3206 

Please cite this article as: Karimi Rahjerdi A, Nasiri B, Shamshiri AR. Study on Attitudes of Cancer Patients about Breaking Ways of Bad News.Bioeth Health Law J. 2021; 1:1-5: (e15). http://doi.org/10.22037/bhl.v1i1.38165

Background and Aim: In the recent decade, nursing and medical schools increasingly tend to incorporate spirituality education in curriculums. This study was conducted to determine the spiritual education status and the gaps in Iranian nursing and medical schools and identify the best interventional tools to improve.

Materials and Methods: It was performed a descriptive-comparative research by using an advanced search in international and national databases to collect all related materials on spiritual education.

Ethical Considerations: Moral rules such as honesty and integrity in the search, analysis, reporting of the searched literature, and citation of the sources were taken into consideration.

Findings: The final sample comprised 48 articles concerning spirituality integration in nursing and medical education. According to didactic various aspects, the findings subdivided into the associated subjects including; spiritual care education status in nursing and medical schools, educational patterns, interventions evaluation, and Iranian studies assessment.

Conclusion: There is a leading gap regarding the spirituality integration in nursing and medical curriculums in Iran, while the religious context and the centralized management of health education in Iran can be considered as appropriate opportunities for this aim. Based on the findings, the development of a structured educational system, sensitizing educational stakeholders, and their stimulation by competitive award programs can be considered to more effective integration of spiritual training in the health curricula.

^*Corresponding Author: Mahmoud Abbasi; Email: dr.abbasi@sbmu.ac.ir; ORCID: https://orcid.org/0000-0002-4223-6818

Please cite this article as: Mehrabi M. Memaryan N. Mohaghegh N. Abbasi M. The Spirituality Integration in Iranian Health Education: Best Lessons for Development. Bioeth Health Law J. 2021; 1:1-9: (e16). http://doi.org/10.22037/bhl.v1i1.38167  

Background and Aim: A set of management practices called critical success factors and organizational culture can lead to a misplaced program for reaching a goal in the hospital. The incidence of medical errors, one of the most important issues influenced by multiple factors, undermines the quality of healthcare provision and satisfaction and increases costs. Considering that medical errors constitute 44,000-98,000 of the annual deaths in the United States and the lack of reliable statistics in Iran, we aimed to examine the roles of organizational culture and critical success factors in reducing medical errors.

Materials and Methods: This applied cross-sectional study was performed among the staff of hospitals affiliated with Arak University of Medical Sciences, Arak, Iran. A 44-item questionnaire was used to collect the data. The questionnaire was designed based on the studies by McFadden, Cameron, and Quinn, and Gowen, and Tallon, the validity and reliability of which were confirmed in this study. Descriptive (frequency distribution) and inferential statistics (ANOVA,two-sample-test, and linear regression) were employed to analyze the data in SPSS, version.

Ethical Considerations: The informed consent was obtained from participants after explaining the research aims and the participants were assured about the confidentiality of information.

Findings: Most of the respondents were women (58.1%) and within the 30-40 years age group (52.5%). Further, 50.4% of the participants had a Bachelor’s degree. Two main hypotheses and 10 sub-hypotheses were tested and partially accepted. Our results suggested that staff participation, error report, cultural change, education and training, statistical reports, system redesign, collaborative culture, hierarchical culture, mission culture, compatibility culture, and implementation of critical success factors can contribute to reducing errors.

Conclusion: Hospital managers must try to encourage the development and maintenance of a culture that emphasizes interpersonal relationships, development of human resources, mentoring co-workers, teamwork and participation, trust, and commitment. To this end, hospital managers should recognize the role of organizational maturity in reducing medical errors and encourage employees to develop organizational culture and increase organizational maturity.

^*Corresponding Author: Morteza Ghasemi; Email: m-ghasemi@iau-arak.ac.ir;  ORCID: https://orcid.org/0000-0002-2142-801X 

Please cite this article as: Rahbarpour MR. Meaning and Conception of Bioethics and its Realm. Bioeth Health Law J. 2021; 1:1-8 (e20). http://doi.org/10.22037/bhl.v1i1.38178

Background and Aim: With the emergence and proliferation of assisted reproductive techniques, the needs of societies have altered. Therefore, measuring the level of legal awareness of gynecologists and obstetricians as the primary consultants of infertile couples can be significantly influential. In this study, we aimed to provide insight into the lack of legal knowledge of this group of specialists, which undermines the quality of healthcare services.

Materials and Methods: This cross-sectional study was conducted among 80 gynecologists and obstetricians in Tehran, Iran, in 2016. We used a 26-item questionnaire on the common legal challenges of infertile couples.

Ethical Considerations: Verbal informed consent of the participants was obtained after explaining the purpose of the study and the positive consequences of enhancing medical education and improving the doctor-patient relationship.

Findings: In general, 30% of the participants were male and 70% were female (age range: 35-75 years). Further, 24% of the participants did not respond to the questionnaire due to limited or lack of knowledge, and 28% knew the permitted types of artificial insemination by Iran’s laws. Concerning the basic rights of the child, 17% provided the correct response, and regarding the parental rights, 4% were aware of the existing legal condition. Finally, on the subject of surrogacy contracts, 22% were cognizant of the critical basics.

Conclusion: Based on the mentioned results and due to the deep gap between the fields of law and medicine, improvement of the existing curriculum in Iran is highly recommended.

^*Corresponding Author: Tara Mohseni; Email: taara.mohseni@gmail.com;  ORCID: https://orcid.org/0000-0003-2704-0689  

Please cite this article as: Mohseni T, Chaichian Sh, Mohseni M, Moazzami B. The Assessment of Legal Knowledge among Obstetricians and Gynecologists about Legal Consequences of Assisted Reproductive Techniques.  Bioeth Health Law J. 2021; 1:1-6 (e21). http://doi.org/10.22037/bhl.v1i1.38180

Background and Aim: This research has been done to determine the correlation between the development of ethical behavior and its consequences in a workplace environment, and the health of an organization.

Materials and Methods: This research is theoretically correlative descriptive and benefits a practical purpose. The research population included 5083 people from the staff of Azad and state universities in Mazandaran, among them, based on Kerjecy and Morgan table via simple random sampling 346 people were selected as the sample of research. The instruments included two questionnaires, standard health of organization questionnaire with 21 questions, and a researcher-made questionnaire of development of ethical behavior in a workplace environment with 35 questions which by applying the preliminary design on a sample of 30 people the reliability was reported 0.94. The data were analyzed descriptively and inferentially by using mean, standard deviation, Pearson correlation coefficient, fisher, and Regression statistics.

Ethical Considerations: Before the distribution of the questionnaires, the objectives and method of implementation of the study were explained to the participants. In addition, written informed consents were obtained from the subjects before the study, and they were assured of the confidentiality terms regarding their personal information. The participants were also allowed to withdraw from the study at any time.

Findings: The results show a linear relationship between teaching ethical principles, selection of the staff with ethical potentiality, propagation of ethical rules and codes, degree of managers’ commitment to ethical standards, and eventually the development of ethical behavior and the health of the organization.

Conclusion: Considering the results and to have a healthy organization founded on a healthy basis it is recommended that officials and authorities at high levels of the organizational hierarchy have a special attitude towards selecting managers with good ethical manners, and diligently try to adopt policies to draft an ethical charter in the organization.

^*Corresponding Author: Farshideh Zameni; Email: f_zameni@yahoo.com;  ORCID: https://orcid.org/0000-0001-9228-3527

Please cite this article as: Zameni F. Correlation between Development of Ethical Behavior and its Consequences in Workplace Environment, and Organizational Health. Bioeth Health Law J. 2021; 1:1-4 (e22). http://doi.org/10.22037/bhl.v1i1.38183

Background and Aim: In recent years, the spiritual dimension of human nature has received ever-increasing attention for better healthcare. One way of responding to this issue is taking the patients’ spiritual history in a healthcare setting. Spiritual history is a set of questions that can explore the spiritual experiences and beliefs of a patient with a simple interview. This study seeks to establish a new framework for obtaining spiritual history based on Islamic culture. The present study aimed to establish a new framework for obtaining the patients' spiritual history by using a qualitative approach.

Materials and Methods: For the qualitative study, first, the conceptual framework of spirituality was grounded by a team of experts. Then, a two-part questionnaire was developed based on the selected available tools and the Delphi method.

Ethical Considerations: The principles of ethics and integrity in the research, citation, and literature analysis were taken into consideration.

Findings: The 16 finalized questions were divided into two sections. In this regard, the first part was concerned about the beliefs, ethics, values, behaviors, and experiences related to spirituality, which can be used to derive the required spiritual information from all patients in any situation. The second part was developed based on the spiritual needs of the patients.

Conclusion: As the findings indicated, taking spiritual history can facilitate the establishment of a more intimate relationship between the patient and therapist. It is hoped that the utilization of this Islamic model can improve the patients’ quality of life.

^*Corresponding Author: Zeinab Ghaempanah; Email:  zeinab.ghaempana@gmail.com;  ORCID: https://orcid.org/0000-0002-8291-0811

Please cite this article as: Memaryan N. Rasouli M. Ghaempanah Z. Mehrabi M. An Islamic Model for Taking Patients' Spiritual History. Bioeth Health Law J. 2021; 1:1-8 (e23). http://doi.org/10.22037/bhl.v1i1.38185

Background and Aim: Cesarean section is a type of delivery, which has recently attracted the interest of numerous pregnant women. According to the general principles of medical ethics, to respect the individuals’ right to independence, the medical staff must provide the patients with the necessary information to enable them to involve in the decision-making process freely and informedly. In addition, the medical staff must adhere to the rule of “evaluation of risks and benefits” in the treatment process. This rule should be also applied in the selection of delivery methods for pregnant women. The present study aimed to evaluate the social factors affecting the tendency of pregnant women toward an elective cesarean section in the past few years.

Materials and Methods: This descriptive-analytical study was conducted on 200 women in the third trimester of pregnancy referring to the hospitals located in the District one of Tehran, Iran. The data were collected using a researcher-made questionnaire. Data analysis was performed using descriptive and inferential statistics.

Ethical Considerations: After the explanation of the study objectives, written informed consent was obtained from all participants.

Findings: According to the results, elective cesarean delivery showed a significant relationship with maternal awareness of cesarean birth complications, encouragement by physicians, fear of normal delivery, imitation of others, maintenance of the body beauty, social and economic status, maternal occupation, family income, and parental occupation. However, the elective cesarean section had no significant association with awareness about the benefits of vaginal birth and decreased maternal role.

Conclusion: Although pregnancy and delivery are physiological phenomena, they are regarded as a “disease” in modern medicine. Moreover, gynecologists have prevented the women from consciously deciding about their own choice of delivery. The encouragement of the mothers to undergo cesarean section by the specialists, along with the women’s attitudes about vaginal delivery, has led to the enhanced use of cesarean birth in Iran. The women’s higher awareness about the benefits of normal delivery and cesarean section complications assisted them in making a better choice about their delivery method.

^*Corresponding Author: Ashraf Zafari Dizaji; Email:  az9405@gmail.com;  ORCID: https://orcid.org/0000-0002-5357-1785

Please cite this article as: Tavassoli A, Zafari Dizaji A. Social Factors Affecting Elective Cesarean in Iran. Bioeth Health Law J. 2021; 1:1-7 (e24). http://doi.org/10.22037/bhl.v1i1.38186