Abstract
Adolescent sexuality is one of the most important reproductive health issues that confronts healthcare professionals with moral dilemmas and legal issues. In this study, we aim to justify the at-risk adolescents’ regulations on access to key reproductive health services (KRHSs) based on principles of Islamic biomedical ethics and jurisprudence. Despite the illegitimacy and prohibition of sexuality for both girls and boys in Islamic communities, in this study, using 5 principles or universal rules of purpose; certainty, no-harm; necessity; and custom, we argue that first, applying these principles in the context of the no-harm principle can provide the best interests of at-risk adolescents; second, it is permissible to provide KRHSs to these adolescents with their own assent, as long as necessary, only with the intention of preventing or reducing harm. In this framework, while preventing harm, it tries to provide the best interests of at-risk adolescent. Thus, the principle of no-harm requires that the government, by designating the responsibility to healthcare professionals, protects at-risk adolescents from harm, and obliges these professionals to choose and implement the option that best suits adolescents’ interests.
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References
Abouey Mehrizy, Hossien. 2010. A lawful Esteslah, the urgent need of Islamic jurisprudence. Jurisprudence and Essentials of the Islamic Law 42: 7–25.
Al-Ghāzalī, A-M. 1994. Islam Hukukunda Deliller ve Yorum Metodlojisi. Kayseri: Rey Yayincilik.
Bester, Johan C. 2018. The harm principle cannot replace the best interest standard: problems with using the harm principle for medical decision making for children. American Journal of Bioethics 18 (8): 9–19. https://doi.org/10.1080/15265161.2018.1485757.
Bester, Johan C. 2019. The best interest standard is the best we have: why the harm principle and constrained parental autonomy cannot replace the best interest standard in pediatric ethics. Journal of Clinical Ethics 30 (3): 223–231.
Birchley, Giles. 2016. Harm is all you need? Best interests and disputes about parental decision-making. Journal of Medical Ethics 42 (2): 111–115. https://doi.org/10.1136/medethics-2015-102893.
Committee on Adolescent Health Care. 2017a. Committee opinion no 699: adolescent pregnancy, contraception, and sexual activity. Obstetrics & Gynecology 129 (5): e142–e149. https://doi.org/10.1097/aog.0000000000002045.
Committee on Adolescent Health Care. 2017b. Committee opinion no. 710: counseling adolescents about contraception. Obstetrics & Gynecology 130 (2): e74–e80. https://doi.org/10.1097/aog.0000000000002234.
Committee on Pediatric Emergency Medicine. 2003. Consent for emergency medical services for children and adolescents. Pediatrics 111 (3): 703–706. https://doi.org/10.1542/peds.111.3.703.
Diekema, Douglas S. 2004. Parental refusals of medical treatment: the harm principle as threshold for state intervention. Theoretical Medicine and Bioethics 25 (4): 243–264. https://doi.org/10.1007/s11017-004-3146-6.
Diekema, Douglas S. 2011. Revisiting the best interest standard: uses and misuses. Journal of Clinical Ethics 22 (2): 128–133.
Fouquier, Katherine. 2017. Legal and ethical issues in the provision of adolescent reproductive health in the United States. Journal of Health Ethics 13 (1): 3. https://doi.org/10.18785/ojhe.1301.03.
Gillam, Lynn. 2016. The zone of parental discretion: an ethical tool for dealing with disagreement between parents and doctors about medical treatment for a child. Clinical Ethics 11 (1): 1–8. https://doi.org/10.1177/1477750915622033.
Godwin, John, Gabrielle Szabo, Justine Sass, and Josephine Sauvarin. 2014. Righting the mismatch between law, policy and the sexual and reproductive health needs of young people in the Asia-Pacific Region. Reproductive Health Matters 22 (44): 137–147. https://doi.org/10.1016/s0968-8080(14)44808-0.
Gostin, Lawrence O., ed. 2010. Public health law and ethics: a reader. Vol 4. 2nd ed. Berkeley, CA: University of California Press.
Gostin, Lawrence O., and Lindsay F. Wiley. 2015. Public health law and ethics. The Hastings Center, 23 September 2015. Accessed 13 February 2022. https://www.thehastingscenter.org/briefingbook/public-healtH/
Hedayat, K.M., and R. Pirzadeh. 2001. Issues in Islamic biomedical ethics: a primer for the pediatrician. Pediatrics 108: 965–971. https://doi.org/10.1542/peds.108.4.965.
Islamic Parliament Research Centre of Iran. 2020. Children and adolescents protection law. https://rc.majlis.ir/fa/law/show/1554444. Accessed 13 Feb 2022.
Khoo, Erwin J. 2017. A national effort to introducing paediatric bioethics in Malaysia: a report and declaration of a National Paediatric Bioethics Symposium. Asian Bioethics Review 9 (1–2): 153–155. https://doi.org/10.1007/s41649-017-0007-y.
Koelch, Michael, and Joerg M. Fegert. 2010. Ethics in child and adolescent psychiatric care: an international perspective. International Review of Psychiatry 22 (3): 258–266. https://doi.org/10.3109/09540261.2010.485979.
Mustafa, Yassar. 2014. Islam and the four principles of medical ethics. Journal Medical Ethics 40 (7): 479–483. https://doi.org/10.1136/medethics-2012-101309.
Pope, Thaddeus M. 2011. The best interest standard: both guide and limit to medical decision making on behalf of incapacitated patients. Journal of Clinical Ethics 22 (2): 134–138.
Sachedina, Abdulaziz. 2009. Islamic biomedical ethics: principles and application. New York, NY: Oxford University Press.
Salter, Erica K. 2012. Deciding for a child: a comprehensive analysis of the best interest standard. Theoretical Medicine and Bioethics 33 (3): 179–198. https://doi.org/10.1007/s11017-012-9219-z.
Smith, P.B., R.S. Buzi, and M.L. Weinman. 2005. HIV testing and counseling among adolescents attending family planning clinics. AIDS Care 17: 451–456. https://doi.org/10.1080/09540120412331291788.
UNESCO. 2013. Young people and the law in Asia and the Pacific: a review of laws and policies affecting young people’s access to sexual and reproductive health and HIV services. Bangkok: UNESCO.
United Nations General Assembly. 1989. Convention on the Rights of the Child vol 1577.
WHO. 2003. Adolescent friendly health services: an agenda for change. Geneva: World Health Organization.
WHO. 2014. Health for the world’s adolescents: a second chance in the second decade: summary. Geneva: World Health Organization.
WHO. 2017. Transformative accountability for adolescents: accountability for the health and human rights of women, children and adolescents in the 2030 agenda. Geneva: World Health Organization.
Wilkinson, Dominic, and Tara Nair. 2016. Harm isn’t all you need: parental discretion and medical decisions for a child. Journal of Medical Ethics 42 (2): 116–118. https://doi.org/10.1136/medethics-2015-103265.
Acknowledgements
This research is a deliverable product of the Postdoc Project in Bioethics and Health Law.
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This research was granted by UNAIDS, Iran (Project AIRSCl802618; Award 68578; Task 2.5)
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FA conceived the research idea, searched the literature, made arguments, and wrote the manuscript; AZ and MA made arguments, critically supervised the research, and reviewed and approved the manuscript.
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Akrami, F., Zali, A. & Abbasi, M. An Islamic Bioethics Framework to Justify the At-risk Adolescents’ Regulations on Access to Key Reproductive Health Services. ABR 14, 225–235 (2022). https://doi.org/10.1007/s41649-021-00200-3
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DOI: https://doi.org/10.1007/s41649-021-00200-3