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Karl Marx could only pen the memorable line, “the history of all hitherto existing society is the history of class struggles” because he was heir to the sanitary and public health reforms of the nineteenth century (Marx [1848] 1972, p. 335). The Black Death, which had wiped out much of fourteenth-century Florence and which had regularly decimated sixteenth- and seventeenth-century London, was now but a faint memory. Yet had a historian of some earlier period of European history thought to pen a line as presumptuous as Marx's, it might have read: “the history of all hitherto existing society is the history of struggle with plague or pestilence.” Epidemics and pandemics have haunted human societies from their beginnings. The congregation of large masses of humans in urban settings, in fact, made the evolution of human infectious disease microorganisms biologically possible (McNeill, 1976; Porter, 1997, pp. 22–25). Epidemics have been as determinative of the course of economic, social, military and political history as any other single factor – emptying cities, decimating armies, wiping out generations and destroying civilizations.

This chapter argues for appreciating the distinctiveness of medical ethics. If the ethics of medicine is different from the ethics of everyday life, it follows that the character of physicians is and should be different from the character of others. Molding the character of future physicians therefore becomes an important matter for the attention of medical educators. In that light, this chapter explains the appropriate goals for such an educational program and discusses the means for teaching and inculcating the principles, attitudes, and behaviors that physicians need to embrace in order to fulfill their special social role and professional obligations.

Recent accreditation standards have changed for all US and Canadian medical schools and residency programs. Newly mandated knowledge, skills, behavior, and attitudes required of the learner to become a medical professional are permeated with professionalism and associated curricular themes. The art of medicine now emphasizes humanistic skills, ethical precepts, and principle-based values. To this end, this chapter calls for enhanced learner collaboration with educators, as well as a required longitudinal ethics curriculum and medical apprenticeship for all phases of medical education. These efforts can thereby result in greater moral reflection on professionalism and its successful assimilation into clinical practice.

Current covid-19 pandemic challenges health-care ethics. Ones of the most important challenges are medical resources allocation and a duty to treat, often addressed to medical personnel. This paper suggests that there are good reasons to rethink our health-care ethics for future global catastrophic risks. Current pandemic shows how challenging can be an issue of resources allocation even in a relatively small kind of catastrophic event such as covid-19 pandemic. In this paper, the authors show that any future existential bigger catastrophe may require new guidelines for the allocation of medical resources. The idea of assisted dying is considered as a hypothetical scenario.

This is a conceptual work based on conceptual analysis at the intersection of risk studies, health-care ethics and future studies. This study builds the argument on the assumption that the covid-19 pandemic should be treated as a sort of global catastrophic risk. Findings show that there are no such attempts in currently published peer-reviewed academic literature. This is crucial concept for the meta-analysis. This study shows why and how current pandemic can be interpreted in terms of global catastrophic risk even if, literally, covid-19 does not meet all criteria required in the risk studies to be called a global catastrophe.

We can expect an emergence of discriminatory selection policy which will require some actions taken by future patients like, for example, genetic engineering. But even then it is inevitable that there will still be a large number of survivors who require medical assistance, which they have no chance of receiving. This is why this study has considered the concept of assisted dying understood as an official protocol for health-care ethics and resources allocation policy in the case of emergency situations. Possibly more controversial idea discussed in this paper is an idea of assisted dying for those who cannot receive required medical help. Such procedure could be applied in a mass-scale during a global catastrophic event.

Philosophers and ethicists should identify and study all possible pros and cons of this discrimination rule. As this study’s findings suggested above, a reliable point of reference is the concept of substantial human enhancement. Human enhancement as such, widely debated, should be studied in that specific context of discrimination of patients in an access to limited medical resources. Last but not least, scientific community should study the concept of assisted dying which could be applied for those survivors who have no chance of obtaining medical care. Such criteria and concepts as cost-benefit analysis, the ethics of quality of life, autonomy of patients and duty of medical personnel should be considered.

Politicians and policymakers should prepare protocols for global catastrophes where these discrimination criteria would have to be applied. The same applies to the development of medical robotics aimed at replacing human health-care personnel. We assume that this is important implication for practical policy in healthcare. Our prediction, however plausible, is not a good scenario for humanity. But given this realistic development trajectory, we should do everything possible to prevent the need for the discriminatory rules in medical care described above.

This study offers the idea of assisted dying as a health-care policy in emergency situations. The authors expect that next future global catastrophes – looking at the current pandemic only as a mild prelude – will force a radical change in moral values and medical standards. New criteria of selection and discrimination will be perceived as much more exclusivist and unfair than criteria applied today.

Based on the developmental process of pharmacy in medical relationships, it is essential to pay attention to ethical issues in this field and develop a good pharmacist–patient relationship. The present study aimed to mention the frequency of ethical challenges of pharmacy in Iran as a fundamental step towards designing a practical ethical guideline for professionals.

In this observational study, data were collected using a two-part questionnaire with 64 items developed after examining relevant texts and conducting unstructured interviews with pharmacy specialists. The first part determined the frequency of ethical challenges that the pharmacist confronts, using 43 short scenarios, whereas the second part comprised 21 questions with short answers. For validation, the questionnaire was sent to 20 medical ethics specialists who were familiar with issues in pharmacy ethics.

Data were collected from 48 members of the Iranian Association of Pharmacists (Working Group of Hospital Pharmacists). and the frequency of ethical challenges was determined. The most frequent issues were patient's request for over-the-counter drugs, asking about their lab results, asking drug for another person and returning the drug.

One of the limitation of our study is its population, there were hospital pharmacist, other pharmacist such as community pharmacist may face different challenges.

The finding of this study could lead the policymakers to develop ethical guidelines for pharmacy practices.

The pharmacist–patient relationship is one of the important aspects of health system, and therefore regulating this relationship based on the professional ethics guidelines could have a positive impact on therapeutic relationships.

Results showed that designing codes of ethics and practical guidelines based on the frequency of the noted challenges enhances the quality of treatment, improves the pharmacist–patient relationship, increases the level of cooperation and decreases patient complaints.

Education systems throughout the world seek to take the advantage of every presenting opportunity for achieving a standard level of ethical accountability and capability. The purpose of this paper is to explain the challenges of professional ethics training from the perspective of faculty members at the Ardabil University of Medical Sciences (ARUMS).

The present qualitative framework analysis held interviews with 21 key faculty members were selected using the purposeful and snowball method to interview from ARUMS in 2016. The duration of each interview varied between 45 and 120 min. The data obtained were analyzed in MAXQDA-10. Codes were extracted using inductive methods.

Three main themes were extracted from the interviews, namely, educational efficacy, professional interaction and equity in education along with 12 subthemes, namely, teacher’s personal capability, work in the area of expertise, regular class attendance, quality class attendance, inclusion of theoretical bases, the teacher as an ethical role model, respect for the student, encouragement of ethical behaviors, respect for the patient’s rights, fair assessment, attention to differences and positive discrimination.

This study results could help to improve the quality of training and ethical standards in medical education.

To comply with the codes of ethics in research, permission was obtained from the Ethics Committee and the participants were ensured about the confidentiality of their data and their right to withdraw from the study at any stage. Given that this project was a qualitative study, the authors did not have a moral or practical problem in the study. This study was approved with number “IR.ARUMS.FEC.1394.25” at the Ardabil University of Medical Sciences Research Ethics Council. The cooperation of participants in the study was completely voluntary; moreover, the authors obtained written consent from participants for the study.

Health care practitioners in prison face the challenge of providing high standards of health care within the unique peculiarities and restraints of the prison environment. The strict adherence to principles of medical ethics by the prison health care staff and the knowledge and acceptance of these principles by the whole prison community not only results in ethical conduct but also yields practical professional advantages such as guidance in situations of conflict, promotion of confidence and avoidance of misunderstandings. The internationally consented conventions, declarations and recommendations relevant on medical ethics in prison are presented and their basic principles ‐ the primary task of the prison doctor, access to a doctor, equivalence of care, patient’s consent and confidentiality, preventive health care, humanitarian assistance, professional independence, professional competence ‐ are discussed. In addition, the personal obligation of the prison doctor for ethical reflection and decision making in individual ethical issues not covered by the quoted documents and in ethically controversial issues is emphasized. A training course and published guidelines for ethical conduct in prison health care are recommended.

The purpose of this study is to explore the presence of ethical standards in the content of international hospitals codes of ethics disclosed in their websites.

Firstly, the focus is on developing an integrated framework of universal values and hospital responsibilities for the content of hospitals’ codes of ethics documents. A list of key ethical issues was determined through an examination of the American Medical Association Code of Medical Ethics (2016), the WAMA (2017), International Code of Medical Ethics and relevant peer-reviewed journal articles (Finseschi, 1997; Vergallo, 2016; Suhonen et al., 2011; Reader et al., 2014). Based on the detailed literature review, 48 concepts, which were evenly, classified under two groups; professional conduct issues and patients’ rights. In the second stage, the issues were ranked related to professional conduct and patients’ rights from most to least frequent for the proposed conceptual framework, using World Global Hospitals codes of ethics.

It was found that only 62% of the top 100 hospitals have an ethics code report in their websites. The findings of the study have significant theoretical and practical implications. First, most of the hospitals’ ethical codes extensively emphasize professional conduct and patients’ rights, whereas they differ in what they include or exclude from their codes and the wording used. The number and frequency of the professional conduct issues is higher than patients’ rights. Emerging ethical issues, such as physicians’ and patients’ freedom of choice, sperm donation and artificial reproduction, were not widely mentioned, whereas abortion, euthanasia, human rights and transplantation issues were disregarded entirely.

This study provides a benchmark for hospitals to assess their codes against other hospitals’ codes in terms of the specific items they address.

The results of this study provide a benchmark for evaluating and developing ethical codes for hospitals in light of the international health standards and norms.

To the best of the knowledge, no previous study has theoretically or practically analyzed hospitals’ codes of ethics.

Is there a sound philosophical foundation in the nature of professional activity for resolving the tension between altruism and self‐interest in favor of virtue and character? I believe there is, and I ground my proposal in six characteristics of the relationship of professionals to those who seek their help. Considered individually, none of these phenomena is unique in kind or degree. They may exist individually in other human relationships and occupations. But as a moral cluster they are, in fact, unique; they generate a kind of “internal morality”—a grounding for the ethics of the professions that is in some way impervious to vacillations in philosophical fashions, as well as social, economic, or political change. This internal morality explains why the ethics of medicine, for example, remained until two decades ago firmly rooted in the ethics of character and virtue, as were the ethics of the Hippocratic and Stoic schools. It is found in the seminal texts of Moslem, Jewish, and Christian medical moralists. It persisted in the eighteenth century in the writings of John Gregory, Thomas Percival, and Samuel Bard, who, although cognizant of the philosophies of Hobbes, Adam Smith, and Hume, nonetheless maintained the traditional dedication of the profession to the welfare of the patient and to a certain set of values. Only in the last two decades has there been—to use Hume's terms—a “sentiment of approbation” regarding self‐interest.