2026-10-18T02:19:43+03:30 http://sjfm.ir/browse.php?mag_id=44&slc_lang=fa&sid=1

44-838 2026-10-18 10.1002

Iranian Journal of Forensic Medicine Iran J Forensic Med 1027-1457 2383-0034 2016 22 3 Fatemeh Kamiab Pourandokht Afshari Bijan Keikhahi Mitra Tadayon mitratadayon2000@yahoo.com Touraj Vahabi Shekarloo Mohammad Hosein Haghighizadeh Background: Medical malpractice means taking measures that do not comply with the accepted standards of medical practice and therefore may lead to death or permanent disabilities and evaluating its reasons can prevent its occurrence or reduce it. Our previous study revealed that most malpractices relate to gynecologists and occur at night shift. Since other factors play a role in malpractice, the aim of this study was to evaluate the role of other factors in occurrence of malpractice. Methods: This study is a retrospective cross-sectional one performed in 2013. The observed cases were all patients' claims against obstetrics and gynecology and midwifery stuff of hospitals, clinics and health centers (2006-2012) in Ahwaz. The data were collected by checklist and analyzed by SPSS software version 21. Findings: The results revealed that, most malpractices included mistakes in treatment decision (in university hospitals), neonate's death, human mistakes, and non-emergency cases, which have occurred in Ob & Gyn wards. Conclusion: Since the majority of malpractice cases were due to human mistakes (mistakes in treatment decision) and resulted in neonates death, it seem necessary to pay more attention to staff's problems, including professional ones, work overload, etc. Additionally, due to the fact that most cases of malpractice have occurred in university hospitals and in obstetrics and gynecology wards, special attention to governmental health centers seems necessary, in order to obviate the reasons for malpractice. Midwifery Obstetrics & Gynecology Malpractice 2016 11 01 165 171 http://sjfm.ir/article-1-838-en.pdf

44-839 2026-10-18 10.1002

Iranian Journal of Forensic Medicine Iran J Forensic Med 1027-1457 2383-0034 2016 22 3 Behzad Joudaki Keyvan Ghani keyvan.ghani@gmail.com Mohammad Amraei Medical measures performed by the medical staff, are in fact a kind of intervention, subject to legal provisions mentioned in various laws (e.g. Articles 158 and 495 of the Iranian Civil Law). Given the legal and jurisprudential backgraound of these articles, patient's consent relates only to legitimacy of the "physician's deed" (i.e.treatment) and not to its consequences (either incidental or intentional), and that is the reason for having the patient to sign a disclaimer (to relieve the physician from legal liabilities). All shia'a Faqihs (jurisprudence experts) believe in the necessity of obtaining patient's consent, except in cases of emergency, for initiating treatment, while there is disagreement regarding the issue of disclaimer, and a majority of Faqihs recommend obtaining disclaimer from the patient in case treatment-induced harms occur. However, the Islamic Penal Code of 2013, does not mention various kinds of consent (i.e.explicit, implicit, informed) and sanctions of not obtaining it, and considers it, by altering the bases, a vain deed, since it depends on non-guiltiness of the physician. The present article discusses various kinds of consent, disclaimer and sanctions of not obtaining it, load of proof, timing of obtaining consent, from legal as well as jurisprudential viewpoints. Patient Physician Consent Disclaimer Responsibility 2016 11 01 173 182 http://sjfm.ir/article-1-839-en.pdf

44-840 2026-10-18 10.1002

Iranian Journal of Forensic Medicine Iran J Forensic Med 1027-1457 2383-0034 2016 22 3 Khalid Aslani Maryam Ahmadi ahmadi.maryam1989@gmail.com Mansor Sodani Background: Domestic violence is a risk factor for a broad range of health problems, (physical, psychological, social, and family health). The current research aims to determine the effectiveness of Motivational Interview (MI) in reducing violence against women referred to courts, dispute resolution councils, and counseling centers in Ahwaz. Methods: The studied population included all of couples referred to courts, dispute resolution councils, and counseling centers in Ahwaz during 2014-15, collected using available sampling method. The research plan was test-re-test with a control group. The sample included 20 married men who, as reported by their wives, had violent behavior with their wives. They were randomly assigned to experiment and control groups. The experiment group received 5 MI (120 minute) sessions while the control group received no treatment. Haj Yahya's Violence toward women questionnaire was given to both groups of women whose husbands were receiving intervention in pre- and 1-week post-treatment. Data were analyzed using descriptive and inferential statistics including covariance analysis. Findings: The findings of the current research showed that the MI reduced the physical violence (F= 6.33, P= .02) and psychological violence (F = 40, P = .00) against women. But no significant impact was found in sexual violence (F = 3.02, P = .10) and economic violence (F = .38, P = .54) against them. Conclusion: Based on the results of the current research, the MI reduces psychological and physical violence against women. Performing other psychological interventions which decline other types of violence towards women are suggested. Motivational Interview Domestic Violence Women 2016 11 01 183 191 http://sjfm.ir/article-1-840-en.pdf

44-841 2026-10-18 10.1002

Iranian Journal of Forensic Medicine Iran J Forensic Med 1027-1457 2383-0034 2016 22 3 Mohammad Majidi Sima Ghaemi Mehrnush Javaezi Mohammad Delirrad Delirrad@umsu.ac.ir Background: Study of human mortality indicators has a significant influence on health system planning. Therefore, a careful survey of causes of death is necessary in both national and regional levels. The aim of this survey was to study human mortalities to understand the current situation and shortcomings of death registration system in West Azerbaijan province of Iran. Methods: In this cross-sectional descriptive study, the data of all mortalities of the province during 2011 were obtained through relevant sources in Health Department of Urmia University of Medical Sciences and West Azerbaijan Legal Medicine center. Causes of death were encoded on the basis of international classification of diseases. Demographic data and statistics of vital events were obtained from websites of Statistical Center of Iran and Civil Registration Organization, respectively. Data were analyzed using Microsoft Excel and the results were reported. Findings: In 2011, 4.1% of population and 3.77% of mortalities of Iran were related to West Azerbaijan province. Overall, 12440 death events (78.1% of provincial mortalities) had been recorded in the death registration system. The most common cause of death was cardiovascular disease. Among 1913 investigated deaths by legal medicine system, 138 were natural, 1230 were unnatural, 7 were white autopsies and in other 538 cases the cause of death was still under investigation. Conclusion: Mortality indicators of the province are approximately similar to those of other regions of the country. The main shortcomings of the death registration system are failure to register or inaccurate registration of death events. Solving these problems requires an integrated death registration system, to be developed and launched. Mortality Cause of Death Legal Medicine Iran 2016 11 01 193 202 http://sjfm.ir/article-1-841-en.pdf

44-842 2026-10-18 10.1002

Iranian Journal of Forensic Medicine Iran J Forensic Med 1027-1457 2383-0034 2016 22 3 Nasib Babaei Mohammad Zirak Azad Rahmani Azad.rahmani@yahoo.com Marzieh Avazeh Abbas Dadashzadeh Background: Workplace violence has a negative impact on nurse’s health, welfare, safety and quality of nursing care. This study aims to determine the nature of workplace violence against nurses from the nurses and patients perspective in Tabriz University of Medical Sciences' hospitals. Methods: This descriptive-comparative study was carried out in hospitals of Tabriz University of Medical Sciences in 2013. The World Health Organization's modified questionnaire was used to investigate the nature of the violence. Totally 373 nurses and 384 patients participated in the study. The data were analyzed using descriptive statistics (number, percent, mean and standard deviation) and inferential statistics(x2 square). Findings: The results revealed a high prevalence of violence in clinical settings. (Nurses reported 273 and patients reported 157 cases of violence).  Nurses thought that the most frequent violences were: verbal, 248(66%); physical, 68(18%); racial, 42(11%) and sexual, 9(2%) and patients reported that the most prevalent violences against nurses were: verbal, 135(35%); racial, 39(10%); sexual, 20(5%) and physical, 10(3%). Analyses showed that there is a statistically significant difference between these groups regarding violence in clinical settings. (p<0.05). Conclusion: Violence in clinical settings is an undeniable fact. This study showed that violence exists in clinical settings but its nature is different from the viewpoint of nurses and patients and the difference requires more investigation, hence it can be an efficient requires more investigation, hence it can be an efficient become an efficient step in management and measure to manage and reduce this type of violence. Work Setting Violence Perception of Violence's Nature Nurses; Patients 2016 11 01 203 210 http://sjfm.ir/article-1-842-en.pdf

44-843 2026-10-18 10.1002

Iranian Journal of Forensic Medicine Iran J Forensic Med 1027-1457 2383-0034 2016 22 3 Arya Hedjazi Arya_hedjazi@yahoo.com Laleh Koohestani Akram Fotovat fatemeh Sadeghipur Somaye Rahimi Ahmadabadi Background: Lack of precise definitions for terms such as volition and discernment from that point of view of law and psychology; the need to conform the definitions with mental disorders; disagreement among the experts to determine the penal responsibility of the mental patients according to section 149 of the Islamic penal code of Iran, were the main causes of carrying the present study out. Methods: This study used focus groups technique in five meetings participated by psychiatrists, lawyers and judges. In each meeting the text of the section 149 of the Islamic penal code of Iran was given to audience and they were asked to define the terms of will and discernment that are mentioned in this section. Findings & Conclusion: Applied definitions of volition and discernment are achieved by summarizing the comments presented by judges, psychiatrists and lawyers, including: will "a kind of mental ability coupled with intelligence that is the direct source of behavior and in conjunction with power leads to free choice versus compulsion and coercion ". If the agent does not have the power, the act does not occur and power without will leads to an act that is not regarded as volitional and authority cannot be regarded as action. The power of discernment may also be described as "the ability to understand the nature of the actions and understand and predict the consequences for themselves and others and recognize the difference between permissible and forbidden". Distinguish Volition the Islamic Penal Code of Iran Insane 2016 11 01 211 218 http://sjfm.ir/article-1-843-en.pdf

44-844 2026-10-18 10.1002

Iranian Journal of Forensic Medicine Iran J Forensic Med 1027-1457 2383-0034 2016 22 3 Masoud Ghadipasha Farideh Khodabandeh Fares Najari fares.hospital@yahoo.com Majid Tabaghchi Ezati Background: Determining the cause of death is one of the most important diagnoses issued by physicians and lack of enough precision and failure to observe scientific principles can lead to serious legal problems for physicians. Death can be accrued in two forms; apparent death and  definitive, Lack of attention to the possibility of apparent death in the diagnosis of death, in addition to causing delay in CPR proceedings, can lead to complaints by patient's relatives, which make physicians face serious problems. This study was carried out to examine the cause of death determined after autopsy in dissection hall of Tehran Legal Medicine Center and compare it with the cause of death determined in treatment centers during 2012. Methods: A retrospective cross-sectional study was designed with two data collection tools: the first consisted of clinical information available in 4641 death files referred from health centers to Tehran Legal Medicine Center in order to determine the cause of death; the second part related to autopsy findings (both pathology and serology) and definite cause of death. Data were analyzed by statistical software SPSS version 13. Chi-square and kapa conformation were used for nomination of concurrence between forensic reports and other report. Findings: The highest percentage of non-identical cause of death is related to internal medicine specialists with 47.40 % and the lowest percentage is related to neurosurgery specialists with 1.85%. Conclusion: Considering the low rate of correct clinical diagnosis of cause of death in this study, post-mortem examination remains a valuable source of pertinent information. Based on the results we suggest that considering the high rate of mistakes in determining the cause of death by doctors, they should be informed of the results of autopsy and determination of the final cause of death of their patients in order to have more accurate clinical diagnosis when facing with similar cases. The Cause of Death Autopsy Hospitalized Patients Treatment Centers 2016 11 01 219 227 http://sjfm.ir/article-1-844-en.pdf

44-845 2026-10-18 10.1002

Iranian Journal of Forensic Medicine Iran J Forensic Med 1027-1457 2383-0034 2016 22 3 Ali Banagozar Mohammadi Maryam Zaare Nahandi dr_mzaare@yahoo.com Background: Although euthanasia is sometimes justified in terms of emotional and sometimes we see some cases of attempted euthanasia, but according to the current laws in our country, acting on each type of euthanasia can be considered a criminal act and it should be avoided. Accordingly, the purpose of the present study is evaluating the medical students' awareness about legal issues relating to euthanasia. Methods: In this study, a blind standard questionnaire was designed & given to medical students volunteered for responding to questions. After reviewing the information, data analysis was performed by the statistical software. Findings: In this study, out of a total of 150 participating students 101 thought that in certain conditions euthanasia can be ethical and 76 considered it legal. A majority (72.7%) of these students agreed with passive euthanasia (including interruption of treatment and not beginning the needed treatment), while 75.3% of them tended to participate in such measures. Also, 86 agreed with, and tended to do, voluntary euthanasia. And 47 thought that even compulsive euthanasia is legal. Conclusion: Considering the facts such as: low level of knowledge about related laws among students and physicians; legal, ethical and jurisprudential inhibitions regarding euthanasia; and physicians' duty and intent to abide the law, appropriate treatment and saving patients' lives; informing all physicians about legal issues and managing such cases will have a significant effect on reducing the consequences of these problems regarding the patient's rights. Euthanasia Education Medical Student Law 2016 11 01 229 236 http://sjfm.ir/article-1-845-en.pdf