Ethics, Professionalism, and Health Law
What this domain tests
Ethics and law items test informed consent, confidentiality, abortion law, error disclosure, and professionalism in Iranian practice.
Core rules
- Consent. Valid consent requires capacity, voluntariness, and adequate disclosure of benefits, risks, and alternatives. Document the discussion. In emergencies, treat under the doctrine of necessity.
- Confidentiality. Share information only with the patient's permission, except where law requires reporting or there is serious risk to others. Discussing a case with family members without consent is a common violation.
- Abortion law. The 2005 Therapeutic Abortion Act permits abortion before 19 weeks (before ensoulment) for fetal anomalies incompatible with life or for maternal life-threatening disease, with confirmation by three specialist physicians and the Legal Medicine Organization. After 19 weeks, termination is only to save the mother's life. Abortion for sex selection is prohibited.
- Error disclosure. Disclose harmful errors honestly, explain what happened, apologize, and document. Concealment is both unethical and legally aggravating.
- Research. Ethics committee approval, informed consent, and trial registration are mandatory. Vulnerable groups need extra protection.
- Professionalism. Avoid conflicts of interest, maintain boundaries, and use social media without revealing patient identity.
Worked example
At 17 weeks a fetus is diagnosed with bilateral renal agenesis. The parents request termination. Because the anomaly is incompatible with life and gestational age is under 19 weeks, the request can proceed after three specialist opinions and Legal Medicine Organization confirmation, with documented counselling.
Traps
Terminating a pregnancy on request without legal criteria; disclosing a diagnosis to a spouse without the patient's consent; obtaining consent from a minor without a guardian; treating a needle-stick injury as a confidentiality issue rather than following post-exposure protocols.