medical_ethics_manual__persian_2_edition_2009
PDF Upload
:
:1942-.
Williams, John R. (John Reynold(
:] /
[
.
::1389.
:140:.)(5/19×5/9.
:22000:978-964-7976-76-3
:
::
Medical ethics manual,2nd ed.,2009.
:.
:.
:.
:
:1345-
:1363-
:
:World Medical Association
:1389294/724R
:174/2
:2252599
E.mail: gapnashr@gmail.com
:
:
:
:
:1389
:1200
:22000
:3-76-7976-964-978
:1–5994-14155
:3257500-0912-:66437332
2–..3531-41635
:2244315
:-)66490719()66970659(
)3-66960772()66978518(
w.w.w.iketab.com
4–77514462–021
/4
/4
2009
.10
.
.
:
The world Medical Association, B.P. 63,01212 Ferney–Voltaire
Cedex, France; Email: wma@wma.net, fax(+33) 450 40 59 37.
WMA
.
WMA.
–
WMA
.
[This book has been translated by Nazafarin Ghasemzadeh,
teacher of Medical Ethics in Urmia University of Medical
Sciences, Urmia- Iran, and Nariman Sepehrvand.]
/6
/6
/7
7/
.
.
.
.
.
.
.
/8
/8
.
.
1389
………………………………………………………………………………………….13
……………………………………………………………………………………………..15
……………………………………………………………………..15
………………………………………………………..18
………………………………..20
:…………………………………………..23
……………………………………………………………24
………………………………………………….25
…………………………….27
………………………………………………………….29
……………………..31
…………………………………………………………………32
WMA…………………..33
………………….34
»«…………………………………………………………………………………….40
:…………………………………………………………………..41
……………………………………………………………………………………………42
1……………………………………………………………………………….42
………………………………………………….43
…………………………………………………………………………….43
……………………………………………………………………….48
………………………………………………53
………………………………………………………………………………………….56
…………………………………………………………..61
/10
/10
…………………………………………………………..63
…………………………………………………………………..66
:………………………………………………………………..67
……………………………………………………………………………………………67
2……………………………………………………………………………..68
………………………………………..68
(DUAL LOYALTY)………………………………………..70
………………………………………………………………………………….73
(PUBLIC HEALTH)………………………………………..78
(GLOBAL HEALTH)……………………………………….81
………………………………………………………………..84
:…………………………………………………………85
……………………………………………………………………………………………85
3…………………………………………………………………….86
……………………………………………………………………86
………………………………………..88
……………………………………………91
………………………………………………………….93
………………………………………………………………………………93
………………………………………………………………………..96
:…………………………………………………..99
……………………………………………………………….100
………………………………………………………………………….101
………………………………………………………………………………104
……………………………………………………………………….105
………………………………………………………………………………106
/11
11/
……………………………………………………………………………….107
………………………………………………………………………………….108
………………………………………………………………………………109
………………………………………………………………………………………..110
……………………………………………………………………………….111
………………………………………………………………………111
(Whistle blowing)…………………………………………………….112
……………………………………………………………………….112
………………………………………………………..114
:CONCLUSION……………………………………..115
……………………………………………………………..116
…………………………………………………………………….119
………………………………………………………………………..120
-………………………………………………………………………123
-………………………………..127
-WMA………………………………………..129
……………………………………………129
(WFME)…………………………………….129
…………..125
-…………………..127
-………………………………………………………….129
/12
/12
/13
13/
)
(
.
.
!
1999.
”
.”
)(
.
.
/14
/14
.
.”
”
.
.
–
.
-.
.
.
.
.
/15
15/
:
1..
.
.
..
.
..
.
2..
.
.
.
3..
/16
/16
.
.
..
.
.
4..
(NSAID).
.
)(.
.
.
.
.
.
/17
17/
.
.
.
)(.
.
)
(.
)(.
(Morality)
–
.
.
“”””””””””)
“”(“”””””””.
(Morality)-
.
/18
/18
(Ethics)
)(Morality.
.
.””
.)
(
.
.
)
(
.
.
“”.
”
.”
“”
/19
19/
”
.”
“)(
.”
.
.
.
.
.
.
-.
.
.
.
.
/20
/20
.
)(.
.
.)(
.
.
.
.
/21
21/
.
.
.
.
.
.
.
/22
/22
.
.
.
.
.
.
.
.
.
.
.
.
:
:
.
.
.
/24
/24
—
.
.
.
.
.
.
.
.
.
.
//2525//25//
25//
.
.
.
.
.
.
..
.
.
/26
/26
.
)(:
.
.
)(
.
.
.
.
.
.
)(
:
.
//2727//27//
:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
/28
/28
.
.
.
.
.
.
:
.
”
”
.
.
(WMA)
.
//2929//29//
.
.
.:
.
.
.
.
.
.
.
.
/30
/30
.
.2005
”
“.
.
.(Self-care)
–
.
.
.
(Dual Loyalty).
.
.
.
//3131//31//
)(.
.
.
.
.
.
.
.
.
/32
/32
.
.
.
.
)WMA(
.
:
.
.
//3333//33//
.
)1947(
.
.
1948.
2006.
1949196819832006
..
.
1964
.
2000.
100
:
.
.
WMA
.
/34
/34
75
.
.
.
1997
2000.
.
.
.
.
.
.
.
.
//3535//35//
.
”
“.:
”
.”
.
.
.
.
.
:rationalnon-rational)
(.non-rational
.
(Non-rational)
–
.
.
/36
/36
Morality
.
)(
..
.
.
.
.
.
.
.
.
.
.
)()
(.
//3737//37//
.
.
(Rational)
.
.
(Deontology)(Consequentialism)
(Principlism)(Virtue).
:
.”
“.
)
.(
)
!(
:
.
.
.
(Utilitarianism)””
:””.
/38
/38
:-
QALYS)(DALYS)
(.
.
.
“”
.
:
.
.
.
.
.
.
.
)Virtue ethics:(
//3939//39//
..
.
.
.
.
.
.
.
.
.
.
:
1(.
2(
/40
/40
.
3(
.
4(
.
5(
.
6(
.
»«
:
.
.
.
.
.
.
/42
/42
:
:
–
.
-.
–
.
–
.
-.
-/
)(
.
1:
.
.
.
.
..
.
..
.
43//
–
.
“”
”
.”
–
.
.
)(.
:
.
.
.
.
/44
/44
.
.
.
»«
.
1718
:
Rationalism.
.
.
)(
.
.
1948″
.”
)
(.
.
.
.
”
45//
.”
.
)(.
.
.
.
.
(Compassion)
.
.
.
–
.
WMA
–
:”
.”
/46
/46
.
.
.
–
.
.
.
.
.
.
–
.
47//
.
.
.
.HIV/AIDS
.
.
.
.HIV/AIDS
:
.
HIV/AIDS
.
.
.
.
–
.
.
:”
/48
/48
…”
.
2500.
.
.
.
.
.
.
.
.
:
.
.
.
.
49//
.
..
.
.
)(.
–
.
.
.
.
.
.
.
.
/50
/50
“”(Consent)
“”
.
.
.
.
.
.
(explicit).
:
1(
)(
.
:”
.”
.
.
2(
.”
”
(End-Stage)
51//
.
.
.
.
.
.
.
.
.
.
.
/52
/52
.
.
.
)(
.
.
.
.
.
.
.
.
(Placebo Effect).
.
53//
.
.
.)(
.
.
.
.
.
)
..(..
.
:
”
.
/54
/54
.”
.
.
:”
.”
.
.
.
.
55//
.
:
((
(
(
.
.
.
.
.
.
.
:”
.
.”
.
/56
/56
.
.
.
.
.
.
.
.
.
.:”
.
57//
.”
.
.
WMA”
.”
.
.
.
.
.
.
.
.
.
/58
/58
-.
-.
.
.
.
.
:
.
.
.
”
“.
.
.
.
WMA
59//
..
.
.-
–
.
.
.
.
.
.
.
.
.
.
.
/60
/60
.
.
..
.
.
HIV
.
.
.
.
.
61//
.
.
.
.
HIV
.
:
.
.
.
.
.
/62
/62
.
.
–
.
–
IVF
)(
.(Surrogate)
.
.
–
.
.
–
.
“(Conviction)
(Individual conscience).”
-)(
63//
.
.
–
)(
.
.
)
(.
.
–
:
.
–
/64
/64
.
.
.
.
.
.
.
.
:
.
.
65//
.
.
.
.
.
.
.
.
.
..
.
.
/66
/66
.
.
.
.
:
–
:
1(-
.2(-
.3(-
.
.
:
:
1(
.
2(
.
3(
.
/68
/68
2:
.
.
.
.
.
–
)profession(.
:)1(
.)2(
.””
.
–
-)(
–.
.
“”
69//
.
.
.
.
.
.
“”
“”
“)community(“”)(nation”
.
.
.
/70
/70
.
:”
“.
.
.
)Dual Loyalty(
)Third party(
“”)
(.
)
(
.
:”
”
..
71//
.
.
.
.
:
.
.
.”2003
”
.
.
.
.
(WMA)
/72
/72
.
.
.
.
)(actual
.
.
.
2004
.
73// .
.
.
.
“”:
1-)Macro(:
.
.
2-)Meso(:
.
/74
/74
.
3-)Micro(:
.
80
.
.
)Micro(..
.
.
.
.
75//
.
.
.
)WMA(
:”
.
“.
.
.
.
.
.
.
/76
/76
.
.
.
:
.
.
.
)(
.
.
.
:
77//
(Libertarian):
.)
(
(Utilitarian):
.
(Egalitarian):
.
(Restorative):
.
)libertarian(
.
.
.
.)
–
/78
/78
(
-.
.
.
)(.
.
.
(Public Health)
)
“”””(.
.
79//
.
”
“)
(
”
“)
(
.
“”
.
.
)””””
Community Medicine(
.
.
.
/80
/80
.
:”
.”
.
.
.
.
.
81//
“”)Confidentiality(.
.
.
.
.
.
)Global Health(
.
.
)Globalization(
.
/82
/82
.
.
.
.
.
.
)
(
.
HIV/AIDS
.
.
.
.
83//
.
.
.
.
.
.
:
)((Cleft Palate)
.
.
/84
/84
:
-.
.
.
.
..
.
!.
.
:
:
.
)(
.
.
.
/86
/86
3:
.
.
.
.
.
.
.
.
:
.
.
.
..
.
87//
.
.
][.
.
.
.
.
.
)
(
.
.
.
.
/88
/88
.
.
.
“”
.
.
.)WMA(
“.”
.
(fee-for-service)
”
“(Professional Courtesy)
.
)
89//
(.
) :1(
)2(.
:
.
”
“.-
.
.
.
“”(hidden curriculum)
.
/90
/90
.
.
:
)IV(
.
.
.
.
.
91//
.
(on-call)
.
.
)
(
.
.
.
.
.
:
”
.”
.
/92
/92
.
)
(.
.
.
)
(.
)(.
.
.
)(
.
.
-.
)(.
93//
.”
–
)(.
.
.
.
.
)
(.
.
.
.
“.”-
/94
/94
.
.
.
.
)(
.
”
.”
)
(.
–
.
.
95//
.
.
.
.
.
.
.
)
(.
.
.
/96
/96
.
.
.
.
.
.
.
.
.
.
97//
.
:
.
.
.
.
.
.
.
.
.
/98
/98
:
..
..
.
.
.
.
.
:
:
.
.
.
/
/100
:
.
(NSAID)
.
.
)(
.
.
.
.
90
10.
.
.
.50
.
.
101//
)(
.
.
)(
)
()
()()(
.
.
.
(CME)
.
.
.
.
.
/
/102
)Clinical Trial(.
.
.
.
.
.
.
.
–
–)(
.”
”
.
.
.
.
103//
.
.
.-
–
.
.
..
.
.
.
.
)subject(
.
.
–
-.
/
/104
.
.
—
..
.
1920
)(
.
.
.”
”
.
.
(WMA)1947
.
105//
.1954
“”.
1964
Declaration of Helsinki (DOH)
.19751983198919962000
2008..
)
”
“19932002(
)Nuffield
[UK]”
“2002(
.
.
(DOH):
:15DOH
.
/
/106
.
)(
)(
.
.
.
.
.
.
.
.
12
.
107//
.
.
.
11
.
.16:
.
.
.
.
.
.
/
/108
1721
.
)(
.
.
.
.
.
.
)(
)
(.
)(
) :1(
)
()2()
.
109//
(.
.
)(.
20
.
)
(
.
:
”
.”
)(”
.”
.24
.26
.
2729
)
(.
.
.
/
/110
) .24(
.
.
.
.
.
.
.
.
.
111//
.
–
–
.31
.
)(
.
.
(Plagiarism)
(Data fabrication)
(Duplicate
publication)
(Gift authorship).
.
.
/
/112
(Whistle blowing)
.
.
.
.
.
)
(.
.
.
90
.
113//
.
.
.
90
10
)
90
(
.
.
)(.
-.
/
/114
:
..
.
.
.
.
)(.
)
(.
.
)
(.
/
/116
.
.
.
.
.
1847
..
”
)(.
”
”
……
…”.
.
117//
.
:
1984
“.
1986:
”
.””
.”
1995
.
.
1997
/
/118
.
2003
”
.””
)
(“.
.
.
)
(
.
.
–
-.
.
.
119//
.
🙂
(.
.
.6080
.
.
.
.
(Life Style)
.
.
/
/120
.
.
.
.
.
.
.
!
HIV/AIDS
.
121//
.
.
.
)(
.
.
.
.
“”
.
.
.””
.
/
/122
)Consensus(:
.
Bioethics/Biomedical Ethics:
:
Clinical Ethics
)(
Research Ethics
)(
Professional Ethics
)
Medical Ethics(
Public Policy Ethics
.
)Value(:)() .(
.
/
/124
)Profess(:.
ProfessionProfessionalProfessionalism
)(.
)Wistle-Blower(:
.
)
(.
)Accountable(:)
.(
.
)Physician(:.
“”Physician
“”.
“”
Ph.D
.””
.
Physician
.
.
)Advance Directives(:
)
(
125/
.
.
)Surrogate or Substitute gestation(:
)Artificial insemination(Embryo
)In Vitro(
.
)Plagiarism(:
)(.
)Hierarchy(:
.Hierarchical
.Hierarchy
.
)Beneficience(:””.
.
)Justice(:
.
)Non-Maleficence(:”
“.
.
)Rational(:.
.
/
/126
)Virtue(:
.
:
.
Virtue.
)Pluralistic(:
..
)Anaesthetist(:
(Anaesthesiologist)
.
)Palliative Care(:
)
(
.
)Hospices(
.
)Managed HealthCare(:
)
(
)(.
)Advocate(:)(
)(.
.
127/
www.wma.net/e/policy/handbook.htm
–
.
–www.wma.net
:
.
.
.
.
.
.
.
.
.
.
/
/128
:www.who.int/ethics/topics/cloning/en/
–reproductive/int.who.www
htm.content_report/infertility/health
:www.nih.gov/sigs/bioethics/endoflife.htm
:
www.epec.net/EPEC/webpages/index.cfm
-www.hospicecare.com/Ethics/ethics.htm
-www.euthanasia.com
HIV/AIDS
:www.wits.ac.za/bioethics/
UNAIDS:
www.unaids.org/en/in+focus/hiv_aids_human_rights/unaids+ac
tivities+hr.asp
:
:www.ama.org/ama/pub/category/5689.html
:www.who.int/ethics/research/en/
:
www.hsph.harvard.edu/bioethics/
:
www.trree.org/site/en_home.phtml
129/
WMA
)
1999(.
1(
2(
3(
.
(WFME)
–
(www2.sund.ku.dk/wfme/)
:
/
/130
4-1(:
)
(
.
4-4(-:
.
5-4(-:
.
.
4-4(-:
.
131/
.
.
.
1.:
Curricululm Committee
Faculty Council
2.:
/
/132
3.:
–
)
(
4.:
) .WMA
:
html.education/ethicsunit/e/net.wma.www(
WMA.
5.:
133/
.
.
.
.
.
.
.
.
/
/134
.
.
..
.
.
.
.
.
HIV
..
.
HIV..
.
.HIV
.
..
.
)(
.
..
HIV
.
135/
.
.
.
.
.
.
.
“”.
..
.
.
.
.
)(.
/
/136
:
–
http://research.haifa.ac.il/~medlaw/
–
www.ethics-network.org.uk/Cases/archive.htm
:
www.hsph.harvard.edu/bioethics/
137/
/
/138
139/
/
/140