Iranian Journal of Medical Ethics and History of Medicine

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Medicine is a branch of health science with the purpose of maintaining health and health promotion, diagnosis, treatment and prevention of diseases, and rehabilitation of patients. In addition to possessing academic qualifications and legal training, physicians and service providers should be familiar with moral and jurisprudential considerations in their profession, as is rationally and logically expected.Respect for moral values ​​and legal principles is important since on the one hand it gives the service provider a feeling of fulfillment, and on the other hand it causes the patient to feel satisfied with the service offered.Islamic laws must be observed in all aspects of life in our country and medical practices are not an exception. Therefore it is necessary for all practices to be approved by jurists and to comply with the principles of Islamic jurisprudence and ethics. Consequently, practitioners need a thorough understanding of Islamic laws and ethics in order to be considered qualified. In this regard it should be remembered that Islamic jurisprudence, or Sharia refers to a set of laws and rules of life defined by the Quran and its interpretation and explanation by the great Prophet of Islam (SAW) and Imams (AS). In Islamic culture, law and medicine are closely related to each other. Many physicians are staunch followers of the Islamic jurisprudence and try to observe them in their diagnostic and therapeutic approaches, and in cases where they have dilemmas and are not certain what course of action to take, religious standpoint is what guides them to make the right decision. In recent decades, physicians have tried to apply Islamic laws in the context of medical or jurisprudential problems. This article investigates the realm of medical jurisprudence and medical ethics.

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More than half a century has passed since the onset of successful life-saving and at times astonishing transplantations of organs from brain dead donors, numerous books and articles have been written on the subject, and local, regional and international meetings and conferences have been held. Nevertheless, no consensus has yet been reached among scholars of various fields such as medical sciences, religion, ethics and law on a number of generalities as well as theoretic and practical details of this issue. There have been discussions on topics such as the organ donor’s legal will, gaining consent while the donor is still alive, seeking consent from the brain dead patient’s family, nature of the required organ, observance of religious, cultural and conventional standards, individuals’ dignity and so on. The main challenge to overshadow other factors has so far been the discord among experts, physicians and religious scholars specifically, over determining the time the spirit leaves the body, and a unified definition of death. Some researchers have attempted to minimize religious, ethical and legal challenges and thus facilitate organ donation following brain death by emphasizing the urgency of organ donation and the practices related to certain specialties, and even maintain that brain death is the equivalent of death and a lifeless body. Others have focused on the time of death and the spirit leaving the body based on lexical, religious and medical evidence, regardless of equality of brain death and death, and ensuing rulings. These researchers have thus separated the solution to the problem of those in need of transplants from considering brain death to occur at the same time when the spirit leaves the body, and encourage experts to seek different solutions. Organ donation by brain dead patients is an undeniable social necessity that can be resolved without bringing about fundamental changes in lexical and jurisprudential concepts, and through other alternatives such as propounding “urgency”, declaring a patient “as good as dead” and in general “non-elucidated jurisprudential issues”. Through references to lexical, jurisprudential and medical sources and examination of previous research, the present article will review several definitions of death, spirit, and the time the spirit leaves the body, as these are concepts that are related to brain death for all practical purposes. The article also considers organ donation following brain death to be an undeniable and unavoidable fact of life in human societies, and will examine the necessity of altering lexical and jurisprudential concepts to accommodate current interests and goals.

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Disasters and accidents usually occur unexpectedly and without warning, and frequently cause the deaths of millions of people all over the world. In addition to general and specialized medical staff, volunteers, many of whom lack the necessary training for providing care to victims, enter the scene. In recent years, there has been rising concern about prosecution of volunteers who participate in relief operations due to the possibility of harm to victims. The aim of this study was to investigate the application of the "Ihsan rule" to liabilities resulting from unintentional and uninformed actions of volunteers who operate during disaster relief.

This was a review study conducted through examination of related articles on SID, Magiran, Google Scholar and Pubmed. The results showed that the Ihsan rule cannot absolutely and ubiquitously eliminate the liability of volunteers who participate in relief operations after disasters and accidents. The reason is that although the rule recognizes benevolent motives, good intentions and non-anticipation of monetary compensation, volunteer aid should be approved by experts, and the possibility of harming the injured should not exceed the expected benefits. Consequently, volunteer acts in disasters and accidents are acceptable if:

1. Basic training and education is provided to all employees of the medical profession who may volunteer for relief operations after disasters and accidents.
2. Volunteer deployment is executed in the form of committees or specific scientific groups that will organize and train members so that they will perform relief operations according to the guidelines of these institutions.

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 This Article has no Abstract.