Gestational surrogacy as a treatment for infertility is being practised in some well-known medical institutions in Tehran and some other cities in Iran. While the majority of Muslims in the world are Sunni, the majority of Iranians are Shiite. Most Sunni scholars do not permit surrogate motherhood, since it involves introducing the sperm of a man into the uterus of a woman to whom he is not married. Most Shiite scholars, however, have issued jurisprudential decrees (fatwas) that allow surrogate motherhood (...) as a treatment for infertility, albeit only for legal couples. They regard this practice as transferring an embryo or fetus from one womb to another, which is not forbidden in Shiite jurisprudence. Nevertheless, there are some controversies concerning some issues such as kinship and inheritance. The main ethical concern of Iran’s experience with gestational surrogacy is the monetary relation between the intended couple and the surrogate mother. While monetary remuneration is practised in Iran and allowed by religious authorities, it seems to suffer from ethical problems. This article proposes that this kind of monetary relation should be modified and limited to reimbursement of normal costs. Such modification requires new legislation and religious decrees. (shrink)

During the past two decades, Iran has experienced a noteworthy growth in its biomedical research sector. At the same time, ethical concerns and debates resulting from this burgeoning enterprise has led to increasing attention paid to biomedical ethics. In Iran, Biomedical research ethics and research oversight passed through major periods during the past decades, separated by a paradigm shift. Period 1, starting from the early 1970s, is characterized by research paternalism and complete reliance on researchers as virtuous and caring physicians. (...) This approach was in concordance with the paternalistic clinical practice of physicians outside of research settings during the same period. Period 2, starting from the late 1990s, was partly due to revealing of ethical flaws that occurred in biomedical research in Iran. The regulatory and funding bodies concluded that it was not sufficient to rely solely on the personal and professional virtues of researchers to safeguard human subjects' rights and welfare. The necessity for independent oversight, emphasized by international declarations, became obvious and undeniable. This paradigm shift led to the establishment of research ethics committees throughout the country, the establishment of academic research centers focusing on medical ethics and the compilation of the first set of national ethical guidelines on biomedical research–one of the first and most important projects conducted by and in the MEHR. Although not yet arrived, ‘period 3’ is on its way. It is predictable from the obvious trends toward performance of high-quality clinical research and the appearance of a highly educated new generation, especially among women. (shrink)

The central role of the virtue of compassion in the shaping of the professional character of healthcare providers is a well-emphasized fact. On the other hand, the utmost obligation of physicians is to alleviate or eliminate human suffering. Traditionally, according to the Aristotelian understanding of virtues and virtue ethics, human virtues have been associated with masculinity. In recent decades, the founders of the ethics of care have introduced a set of virtues with feminine nature. This paper analyzes the notion of (...) compassion as a common virtue between the traditional/masculine and care/feminine sets of virtues and shows that compassion is a reunion and merging point of both sets of human virtues. This role can be actualized through the development and promotion of compassion as an important part of the character of an ideal physician/healthcare provider. In addition, this paper argues that the notion of compassion can shed light on some important aspects of the contemporary debates on healthcare provider-patient relationship and medical futility. Despite the recent technological and scientific transformations in medicine, the interpersonal relationship between healthcare providers and patients still plays a vital role in pursuing the goals of healthcare. The virtue of compassion plays a central role in the establishment of a trust-based physician-patient relationship. This central role is discernible in the debate of medical futility in which making difficult decisions, depends largely on trust and rapport which are achievable by compassion in the physician and the recognition of this compassion by the patients and their surrogate decision makers. (shrink)

In his seminal book on the historical periods of Western attitudes toward death, Philippe Aries describes four consecutive periods through which these attitudes evolved and transformed. According to him, the historical attitudes of Western cultures have passed through four major parts described above: “Tamed Death,” One’s Own Death,” “Thy Death,” and “Forbidden Death.” This paper, after exploring this concept through the lens of Persian Poetic Wisdom, concludes that he historical attitudes of Persian-speaking people toward death have generally passed through two (...) major periods. The first period is an amalgamation of Aries’ “Tamed Death” and “One’s Own Death” periods, and the second period is an amalgamation of Aries’ “Thy Death” and “Forbidden Death” periods. This paper explores the main differences and similarities of these two historical trends through a comparative review of the consecutive historical periods of attitudes toward death between the Western and Persian civilizations/cultures. Although both civilizations moved through broadly similar stages, some influential contextual factors have been very influential in shaping noteworthy differences between them. The concepts of after-death judgment and redemption/downfall dichotomy and practices like deathbed rituals and their evolution after enlightenment and modernity are almost common between the above two broad traditions. The chronology of events and some aspects of conceptual evolutions and ritualistic practices are among the differences. (shrink)

Monetary compensation for human eggs used in research is a controversial issue and raises major concerns about women’s health and rights, including the potential of exploitation and undue inducement. Human eggs are needed for various types of studies and without payment, it would be impossible to procure sufficient eggs for vital research. Therefore, a solution seems necessary to prevent exploitation and resolve other ethical concerns while ensuring sufficient supplies of human eggs for research. A brief review of legislation in different (...) countries shows the existing diversity and controversy over compensating human egg donation for research purposes. While in more economically developed countries procreative liberty and consumer orientation seem to be defensible, in some developing countries, where concerns about exploitation exist, adopting a more regulated approach to assisted reproduction is more prudent and wise. Egg sharing is a program that has been proposed to solve both the ethical problems of purchasing eggs and the shortage of human egg supply for research. In developing countries, however, regardless of whether the egg sharing or the monetary compensation model is adopted, some steps should be taken to guarantee the ethical nature of this practice. These steps include ensuring the existence of independent institutional review boards, confirming the validity of all steps in the process of obtaining informed consent, and ensuring the existence and viability of independent supervising and auditing bodies. (shrink)

Hinduism and Zoroastrianism have strong historical bonds and share similar value-systems. As an instance, both of these religions are pro-life. Abortion has been explicitly mentioned in Zoroastrian Holy Scriptures including Avesta, Shayast-Nashayast and Arda Viraf Nameh. According to Zoroastrian moral teachings, abortion is evil for two reasons: killing an innocent and intrinsically good person, and the contamination caused by the dead body. In Hinduism, the key concepts involving moral deliberations on abortion are Ahimsa, Karma and reincarnation. Accordingly, abortion deliberately disrupts (...) the process of reincarnation, and killing an innocent human being is not only in contrast with the concept of Ahimsa, but also places a serious karmic burden on its agent. The most noteworthy similarity between Zoroastrianism and Hinduism is their pro-life approach. The concept of Asha in Zoroastrianism is like the concept of Dharma in Hinduism, referring to a superior law of the universe and the bright path of life for the believers. In terms of differences, Zoroastrianism is a religion boasting a God, a prophet, and a Holy book, while Hinduism lacks all these features. Instead of reincarnation and rebirth, Zoroastrianism, like Abrahamic religions, believes in the afterlife. Also, in contrast with the concept of Karma, in Zoroastrianism, Ahura Mazda can either punish or forgive sins. (shrink)

Using human dead body for medical purposes is a common practice in medical schools and hospitals throughout the world. Iran, as an Islamic country is not an exception. According to the Islamic view, the body, like the soul, is a "gift" from God; therefore, human being does not possess absolute ownership on his or her body. But, the ownership of human beings on their bodies can be described as a kind of "stewardship". Accordingly, any kind of dissection or mutilation of (...) the corpse is forbidden, even with the informed consent of the dead or his/her relatives. The exception of this principle is when such procedures are necessary for saving lives of other persons. In this article using the human dead body for medical education, research and treatment is discussed and the perspective of Iranian Shiite religious scholars in this regard is explained. (shrink)

Euthanasia is one of the controversial topics in current medical ethics. Among the six well-known types of euthanasia, passive voluntary euthanasia seems to be more plausible in comparison with other types, from the moral point of view.According to the Kantian framework, ethical features come from 'reason'. Maxims are formulated as categorical imperative which has three different versions. Moreover, the second version of categorical imperative which is dubbed 'principle of ends' is associated with human dignity. It follows from this that human (...) dignity has an indisputable role in the Kantian story. On the other hand, there are two main theological schools in Islamic tradition which are called: Ash'arite and Mu'tazilite. Moreover, there are two main Islamic branches: Shiite and Sunni. From the theological point of view, Shiite's theoretical framework is similar to the Mu'tazilite one.According to Shiite and Mu'tazilite perspectives, moral goodness and badness can be discovered by reason, on its own. Accordingly, bioethical judgments can be made based on the very concept of human dignity rather than merely resorting to the Holy Scripture or religious jurisprudential deliberations. As far as PVE is concerned, the majority of Shiite scholars do not recognize a person's right to die voluntarily. Similarly, on the basis of Kantian ethical themes, PVE is immoral, categorically speaking. According to Shiite framework, however, PVE could be moral in some ethical contexts. In other words, in such contexts, the way in which Shiite scholars deal with PVE is more similar to Rossian ethics rather than the Kantian one. (shrink)

In recent years, scientific misconduct has received significant attention within the scientific community. Plagiarism is the most frequent type of scientific misconduct and is defined as ‘unauthorised appropriation of another's work, ideas, methods, results or words without acknowledging the source and original author’.1 ,2 ….

Recent advances in life-sustaining treatments and technologies, have given rise to newly-emerged, critical and sometimes, controversial questions regarding different aspects of end-of-life decision-making and care. Since religious values are among the most influential factors in these decisions, the present study aimed to examine the Islamic scholars' views on end-of-life care. A structured interview based on six main questions on ethical decision-making in end-of-life care was conducted with eight Shiite experts in Islamic studies, and was analyzed through deductive content analysis. Analysis (...) revealed certain points in Islamic views on the definition of death and the persons making decisions about end-of-life care. According to the participants, in addition to conventional criteria such as absence of heartbeat and respiration, the irreversible cessation of human voluntary acts are considered to be the criteria in establishing death. The participants also recognized physicians as the main authorities in verifying signs of death. Furthermore, it was emphasized that life preservation and continuation of care must be sensible, and the patient can request not to have death-prolonging procedures started or continued. In the view of participants, patient's autonomy cannot be the sole basis for all measures, but Islamic ethical and jurisprudential principles should be relied upon to make correct and sensible decisions whether to continue or stop terminal patients' care. Final decisions should be made by a team of experts, and physicians must be at the center of such a team. Finally, we suggest that a guideline in keeping with Islamic norms on human life and death, purpose of life, God's will, boundaries of man's authority, and the physician's ethical duties and obligations should be developed. (shrink)

The nature of the doctor-patient relationship as a keystone of care necessitates philosophical, psychological and sociological considerations. The present study investigates concepts related to these three critical views considered especially important. From the philosophical viewpoint, the three concepts of "the demands of ethics “,” ethical phenomenology and "the philosophy of the relationship" are of particular importance. From a psychological point of view, the five concepts of "communication behavior patterns", "psychic distance", "emotional quotient", "conflict between pain relief and truth-telling", and "body (...) language" have received specific emphasis. Lastly, from the sociological perspective, the three notions of "instrumental action", "communicative action", and "reaching agreement in the light of communicative action" are the most significant concepts to reconsider in the doctor-patient relationship. It should be added, however, that from the sociological point of view, the doctor-patient relationship goes beyond a two-person interaction, as the moral principles of doctors and patients depend on medical and patient ethics respectively. The theoretical foundations of the doctor-patient relationship will finally help establish the different dimensions of medical interactions. This can contribute to the development of principles and multidisciplinary bases for establishing practical ethical codes and will eventually result in a more effective doctor-patient relationship. (shrink)

In Western literatures, "conflict" is a general term that refers to discord between two or more entities. In Islamic jurisprudence, however, in addition to the term "conflict", there is another term which is called tazāhum. The two terms, however, have different definitions. Conflict between two concepts, for instance, indicates that one is right and the other is wrong, while tazāhum does not necessarily have to be between right and wrong, and may appear between two equally right concepts. Moreover, conflict exists (...) on a legislative level, while tazāhum is a matter of obedience and adherence, meaning that in practice, both sides cannot continue to coexist. Conflict of interest is a known term in Western literatures, and according to D.F. Thompson, it refers to a situation where professional judgment regarding a primary interest is improperly and unjustifiably influenced by a secondary interest. Taking into account Thompson's definition and the distinction between "conflict" and "tazāhum", the English term "conflict of interest" translates to "tazāhum of interest" in Islamic jurisprudence as it refers to a person's action without reflecting right or wrong, and simply concerns priority of one interest over another. The resolution to tazāhum in Islamic jurisprudence lies in two principles: the principle of significance and the principle of choice. For instance, in case of conflict or tazāhum between the interests of patient and physician, the patient's interest should be the main concern based on the principle of significance. Although Western literatures propose methods such as disclosure or prohibition in order to resolve conflict of interest, the foundation for these solutions seems to have been the principle of significance. (shrink)