Ghasemzadeh Nazafarin, Asghari Fariba, Shirazi Mandana, Faramarzi Razini Fatemeh, Larijani Bagher
PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Med Ethics Hist Med. 2018 Dec 16;11:14. eCollection 2018.
End-of-life care and protection of the patient in the near-death moments are part of a patient's rights and the duties of the medical staff. As the beginning and end of human life are most sensitive moments, there are various religious rules associated with them. The ethical issues regarding practicing medical procedures on nearly dead patients are of particular complexity and are consistent with invaluable and profoundly religious recommendations. In addition, the purpose of medical training is to provide physicians with the knowledge and skills necessary to practice appropriately and within legal and ethical frameworks. Therefore, respecting patients' cultural and religious beliefs is an ethically accepted principle in the health systems of different countries and is the basis of respect for human dignity. The present study used a qualitative content analysis to explain how to practice medical procedures on a dying or nearly dead patient in accordance with Islamic jurisprudential rules. It was finally concluded that according to the Islamic jurisprudential rules of "authority", "no harm", "necessity", and "public interest", procedures performed on a dying patient could be used for training purposes under certain circumstances. Nevertheless, such activities should only be done with the patient's permission and provided they cause no unnecessary harassment, and they may take place in the absence of alternative methods.
临终关怀以及在患者濒死时刻对其进行保护，是患者权利的一部分，也是医务人员的职责。由于人生的起点和终点是最为敏感的时刻，与之相关存在着各种宗教规则。对濒死患者实施医疗程序所涉及的伦理问题格外复杂，并且与极其宝贵且深刻的宗教教义相符。此外，医学培训的目的是为医生提供在合法和道德框架内恰当行医所需的知识和技能。因此，尊重患者的文化和宗教信仰是不同国家卫生系统中在伦理上被认可的原则，也是尊重人类尊严的基础。本研究采用定性内容分析法，来阐释如何依据伊斯兰法学规则对濒死或已濒死患者实施医疗程序。最终得出的结论是，根据伊斯兰法学的“权威”“无害”“必要”和“公共利益”规则，在某些情况下，对濒死患者实施的程序可用于培训目的。然而，此类活动仅应在获得患者许可的情况下进行，且前提是不会造成不必要的困扰，并且在没有其他替代方法时才可以开展。
