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Showing 27 results for Life
Ethical considerations of futile care
Mansureh Madani,
Volume 6, Issue 2 (5-2013)
Abstract
When medical treatment is futile, the physicians must refrain from treating patients, and this can lead to serious and stressful problems. In this paper, in order to facilitate ethical decision making relevant literatures have been reviewed. This review article aimed to explaining the different clinical forms of futile treatment, and exploring theoretical and practical dimensions of futility. The first problem in this field is ambiguity in the definition of futility. The next problem is determining the practical criteria and attributing the meaning of futility to particular treatments. This ambiguity is partly due to different perspectives about the goal of treatment, and variations in physicians' and patients’ values and also disagreements regarding the person who should have the right to make decisions ultimately. It may also be related to finances and immoral motives. The third problem is some practical conflicts the most notable are futile care, requested by the patient and the sanctity of life, especially in the concern of religious considerations. In this regard, several definitions have been proposed for the futile treatment. Studies indicate that requesting futile care is often due to emotional problems or lack of trust a case that requires the physician’s tact to resolve and rarely is resolved by rule. Another serious problem that is regarding to end of life cares, especially in the context of religious views, is the necessity of life saving, that is closely related to the inactive euthanasia. This can be solved by giving priority to more important issues such as health budget constraints.
The relationship between perceived organizational justice and quality of work life among the personnel of a selected hospital in Ahvaz
Ali Akbar Aminbeidokhti, Ebrahim Mardani,
Volume 7, Issue 2 (7-2014)
Abstract
Organizational justice can dramatically impact the personnel’s attitudes and behaviors and is therefore considered to be of great importance. Moreover, high quality of work life is known as the basic prerequisite to empower human resources in healthcare systems. The aim of this study was to determine the relationship between perceived organizational justice and quality of work life among hospital personnel.In this descriptive correlational study, the samples consisted of 268 staff members of a public hospital in Ahvaz. Samples were selected through census. Data were gathered by a demographic information questionnaire, Niehoff and Moorman Organizational Justice Scale, and Quality of Work Life Questionnaire. Data analysis was performed using descriptive and analytical statistics.Results showed that quality of work life among the hospital personnel in this study was moderate (64.2 %), relatively good (16%), poor (13 %) and good (6.8%). Dimensions of organizational justice including distributive and procedural justice had a significant relationship with quality of work life.Since there is a direct relationship between perceived organizational justice and quality of work life, hospital managers should pay attention to this issue, which will lead to enhanced quality of work life in personnel.
Great Muslim scholars’ lifestyles as an approach to spiritual health: the views and practices of Ayatollah Hassan Zadeh Amoli
Bagher Larijani, Farzaneh Zahedi, Zeinab Poorzahbi, Samaneh Tirgar, Fatemeh Mirzaei ,
Volume 7, Issue 3 (9-2014)
Abstract
It has been over five decades since the concept of “spiritual health” was first introduced in academic texts, and although many studies have been conducted on the subject, there exists no consensus on its definition and components yet. Nonetheless, this concept has been an inextricable part of Islamic Theology, which is more than several hundred years old. Therefore, it can be asserted that observation and analysis of the lifestyles of Muslim scholars may shed some light on this seemingly complex concept. This analytic-descriptive article was designed to provide a straightforward definition for spiritual health and explore its different components from the viewpoint of Ayatollah Hassanzadeh Amoli, a renowned Shiite scholar. In this article, spiritual health refers to the health of the soul and is related to both material soul and the body itself. The Ayatollah puts special emphasis on the importance of living a healthy lifestyle and on the health of the material soul in order to promote spiritual health. In this article, we endeavor to conduct a thorough analysis of the lifestyle and views of Ayatollah Hassanzadeh Amoli.
A Discussion on Some ontological components of death in Holy Quran
Bagher Larijani, Mina Mobasher, Samaneh Tirgar, Farzaneh Zahedi, Soodeh Tirgar, Farideh Shariati, Banafsheh Karimi, Fatemeh Mirzaei (lotfi Azar),
Volume 7, Issue 5 (1-2015)
Abstract
It is universally acknowledged that death is a complex concept and different factors such as complicated philosophical ideas, contradictory descriptive approaches, and diversity in interpretations add to this complexity. Although a thorough understanding of the notion of death is important for everyone, this concept is of crucial importance to health care providers as they face enormous ethical challenges in the course of their careers. A few instances are controversial issues such as brain death, euthanasia and end-of-life care, where it seems essential to define a set of robust criteria for death. On the other hand, it can be argued that death is not a scientific concept and only different branches of medicine can provide a framework to clarify the subject of death. Therefore, it could be argued that theological approaches may shed some light on this concept. In this article, we aim to extract ontologic components of death mentioned in the Holy Quran, and will move on to propose a set of 12 criteria for death. This may help provide a clear understanding of the concept from the point of view of the Holy Quran, although more research is warranted to further illuminate this complex subject.
A Quranic review of the stages of death and its applications in end-of-life spiritual care
Fatemeh Mirzaei (lotfi Azar), Samaneh Tirgar, Farzaneh Zahedi, Soodeh Tirgar, Farideh Shariati, Bagher Larijani,
Volume 9, Issue 3 (10-2016)
Abstract

Despite all recent advancements in medical sciences and the related technologies, the concept of death still remains obscure. It can be asserted that as death includes both physical and spiritual dimensions, medicine alone is not capable of fully illuminating its different features. Therefore, inter-disciplinary collaboration between different branches of science such as Quranic studies, humanities, and philosophy seems necessary in order to shed some light on this hitherto undiscovered subject. Through description of what the soul experiences before and during death, such collaborations may even enrich the knowledge and broaden the minds of physicians who are capable of the analysis of physical changes caused by death. This insight can promote the ethical decision-making process as well as the provision of end-of-life care and spiritual support in different stages of death. The current research, as a library literature review, endeavors to provide a descriptive view of death from a medical perspective, and then, a Quranic depiction of its different stages through an analysis of verses and quotations from the holy Quran and Islamic scriptures whose primary focus is the process of dying. The final discussion section presents some similarities and differences observed between viewpoints and raises questions which can be considered as being of great practical importance in terms of provision of necessary end-of-life spiritual support. We hope that further research in this field can better clarify the issues raised in this article so that practical measures aiming at the provision of Quran-based spiritual end-of-life care are designed and implemented.


Euthanasia: An Analytical review based on the Article 372 of the Islamic Penal Code
Aria Hejazi, Alireza Moshirahmadi, Golnaz Sabetian, Nazila Badieeyian Mousavi ,
Volume 9, Issue 5 (1-2017)
Abstract

Euthanasia is still a controversial issue worldwide. There are different and sometimes contradictory opinions about euthanasia and its practice.  By exchange of ideas and opinions about this issue, some countries have explicitly accepted euthanasia and it has been legalized. Whereas, some other countries distinctly rejected euthanasia and in result it has been criminalized. Among countries there is a third group, with a passive or neutral position. In those countries, like Iran, the acceptance or rejection of euthanasia has been discussed among the law experts but there is no legislation to address the issue. This article aims to evaluate euthanasia based on the Article 372 of Iran's Islamic penal code.


Perception of futile care of nurses in intensive care units
Somaye Rostami, Ravanbakhsh Esmaeali, Hedayat Jafari, Jamshid Yazdani Charati, Seyed Afshin Shorofi,
Volume 10, Issue 0 (3-2017)
Abstract
Futile medical care is considered as the care or treatment that does not benefit the patient. Thus, perception of the clinical team regarding futile care is of great importance and it has an important role in the quality of nursing care and health of clinical team. This study aimed to determine the relationship between perception of nurses regarding futile medical care and their caring behaviors toward patients in the final stages of life admitted to intensive care units. This correlational, analytical study was performed on 181 nursing staff of the intensive care units (ICUs) of health centers affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran. The data collection tool included a two-part questionnaire containing demographic characteristics form, perception of futile care questionnaire, and caring behaviors inventory. To analyze the data, statistical tests and central indices of tendency and dispersion were used. Pearson’s correlation coefficient, partial correlation, t-test, and ANOVA tests were performed to assess the relationship between the variables. Findings illustrated that the majority of nurses (65.7%) had a moderate perception of futile care. In addition, it was only the mean working hours per week among the demographic variables that had a statistically significant relationship with perception of futile care (P<0.05). Given the moderate perception of nurses concerning futile care, implementing suitable interventions for minimizing the frequency of futile care and its resulting tension seems to be mandatory. It is imperative to train nurses on adjustment mechanisms and raise their awareness as to situations resulting in futile care.
Right to Choose between Life- Sustaining Treatments and Palliative Care in the Shi'ite Jurisprudential Perspective
Saeid Rahaie, Fatemeh Heidari,
Volume 10, Issue 0 (3-2017)
Abstract
Patients with advanced, progressive, non-curable, or hardly cured illnesses, found themselves in a situation where therapeutic measures have no effect in improving their condition and health status and they are gradually pushed toward death. Care provided to the patient, during this period, is known as end-of-life care which include life-sustaining treatments and palliative care. Life- sustaining treatments are such that give patient the chance for living longer but inflict lots of suffering upon the patient. While in palliative care, the patient probably survives for a shorter period, but suffers less. The question is whether the patient can choose between the two methods? Considering the Jurisprudential rule of “the necessity to safeguard human life”, most of the Muslim Jurists believe that the patient cannot rule out the first method (i.e. life- sustaining treatment). This study first examines the evidence of the rule, and explained the viewpoints of the Muslim Jurists about choosing between these caring methods, and proves that, despite accepting the rule, it is limited by the rules of “no hardship“ (la haraj) and “prohibition of detriment”(la zarar) and moreover the rule of “the domination”(saltanat). However, it can be said that, regarding the evidence of rule “the necessity to safeguard human life”, patients who are at this stage are excluded from the subject matter of this rule.

Structural Modeling of Relationship Between Spiritual leadership and Professional Ethics with Organizational Performance and Quality of Work Life with Role of Organizational Learning among Employees of Imam Reza Hospital, Urmia
Mohammad Hassani, Afsaneh Abbaskhani,
Volume 11, Issue 0 (3-2018)
Abstract
Today, the role of spiritual leaders is to stimulate employees by employing a spiritual perspective and creating cultural backgrounds based on human values to raise capable employees. On the other hand, professional ethics is one of the variables that has a significant impact on individual and group activities and outcomes of the organization. The purpose of this study was to investigate the relationship between spiritual leadership and professional ethics with organizational performance and quality of work life with the intermediate role of organizational learning among employees of Imam Reza Hospital in Urmia. The design of this research was a descriptive-correlational cross-sectional design model of structural equations. The statistical population of this research included 759 employees, 240 of them were selected by random sampling method. For data collection, standard questionnaires were used. Pearson Coefficient and Structural Equation Model Finding were used to analyze and examine the assumptions and the relation between the variants. The results show that there is a significant relationship between spiritual leadership variables and Professional Ethics with organizational performance and quality of life of employees (P<0.01, r=0.42, r=0.51), (P<0.01, r=0.36, r=0.75). Furthermore, the results showed that the intermediate role of organizational learning in the association between spiritual leadership and professional ethics with organizational performance and quality of work life (β = 0.17, β = 0.18, β = 0.16, β = 0.17) ) is confirmed. According to the findings, it can be concluded that paying attention to spiritual leadership and professional ethics can improve the organizational performance and quality of work life, as well as enhance organizational learning among the staff of Imam Reza Hospital.

The Virtue of Not Being; Reviewing and Criticizing of Benatar’s Approach of Avoiding Ethical Preference of Not Being
Maryam Khoshdel Rohani, Rahim Dehghan Simakani,
Volume 11, Issue 0 (3-2018)
Abstract
David Benatar, influenced by Nietzsche and Schopenhauer, sees the life of this world full of pain and suffering, and believes that not being in this world is preferred to be. The purpose of this article is to challenge Benatar's approach in an analytical and citation way. Benatar expresses two arguments for his claim. One is the argument of asymmetry and the other is the quality of life argument. In this paper, both of his arguments are explained and criticized. In the first argument, Benatar provides ample of evidence for his claim that he does not provide the preference for the pain and suffering which humankind experiences in this world. In the second argument, while ignoring the element of individual satisfaction and the independence of the personality of human beings, their judgments regarding their lives are considered to be due to optimism, and believes that humans, because of their ability to get accustomed to the conditions believe that their being is preferred to not being. By this statement, instead of solving the problem of suffering, he cleansed the principle of the problem and preferred not being. The morality of abortion, the immorality of reproduction and marriage, the validity of non-voluntary euthanasia, and the belief in the extinction of the human race are consequences of Benatar's approach, which are untenable.
 

Contradiction between Mother's Right and the Right to Life of the Fetus in the View of Legal Systems
Mohaddeseh Moeinifar,
Volume 12, Issue 0 (3-2019)
Abstract
In general, there are four types of policies in the world in relation to the issue of abortion, based on five basic approaches such as social, feminist, liberal, population-based, and religious-based. Each of these approaches provides a solution to the conflict between mother's rights and the right to life of the fetus, so based on the first three perspectives, abortion is permissible and based on the fourth view, it can be permissible or not and finally according to the religious view (Islam and Christianity) the abortion is forbidden. In the present paper, we tried to answer the main question by using the descriptive-analytical method, why in some of these approaches the right of the mother is preeminent, but in others, the right to life of the fetus proceeds? It seems that the way of Islamic legal system seems to be more logical, because in Western countries the rights of parents are always prioritized in the conflict between the rights of children and their parents. However, in the legal system of Islam, in addition to the moral orders, there are some principles that are anticipated to prevent the conflict of the rights of these two groups and the unequivocal predominance of one on another.
 

Suffering from Illness and Euthanasia sentence
Seyyed Abdol Rahim Hosseini, Davoud Zareian,
Volume 13, Issue 0 (3-2020)
Abstract
Perhaps, the most appropriate translation proposed for euthanasia is the painless and piteous killing. According to the existence of effective components in committing a crime, it is considered as complicity in murder and the consent of victim does not affect the nature of criminal act and the criminal liability of person depriving the life. One of issues related to this killing which is disagreed is the edict that person who is obliged to save life related to passive type of euthanasia does not perform this killing and there must be difference among its different types and conditions. The primary reasoning of the edicts indicate that duties whether difficulty or not must be done but, according to the rule of negation of difficulty and hardship, obligation to these edicts in cases of hardship is cancelled. The articles of this rule include obligatory duties to disuse. However, from the view of jurists, it is not general that euthanasia corresponds to some juridical sub-principles indicating the permission of suicide in some conditions, although this is criticized and rejected. Two rules of hardship and beneficence are those believed to help prove the hypothesis by attaching to the rule of negation of hardship and difficulty. But, it is clear that it is not so. In feasibility study of this rule with the rule of no harm, they are proved by the murder illegality and the mentioned rules cannot govern the primary reasoning of depriving the life Therefore, euthanasia is not allowed at all.

Ethical Challenges of Restrictions on Citizens’ Health choices by the Government
Seyed Ahmad Habibnejhad, Vahid Moazzen,
Volume 13, Issue 0 (3-2020)
Abstract
In recent decades, the concepts of healthy lifestyle and healthcare choices have been the subject of focus by healthcare policymakers. Together with financial, mental, and ethical reasons for citizens to have a free hand as far as their healthcare, numerous arguments based on the social aspects of healthcare have also been made by proponents of the necessity to limit these options by government, believing that in addition to personal consequences, an individual's healthcare choices have social ramifications as well. On the other hand, the definitions of the concept of freedom along with the impressionability factor of the individual's healthcare choices to government and society are other parameters that affect government policy in this area. By looking at the meaning of freedom from both the functional and opportunity creating standpoints, we have attempted to demonstrate that the optimal definition of freedom in the healthcare system is a responsibility based freedom in which it is although limited by the government, a person still maintains his individuality. According to the findings of this study, without establishing the necessary prerequisites by government and society, the freedom and equality of individuals in healthcare choices is meaningless. In this context, the special role of government is to create a balance between the individual rights and public interest as well as to cultivate responsible and well-informed citizens to protect themselves and others, building a society that would not allow the withdrawal or disregards of the right to freedom.

Evaluating the Level of Ethical Decision Making of Nurses and Its Relationship with the Attitudes of End-Of-Life Care of Patients with COVID-19
Mohammad Torabi, Mahsa Eslamipanah,
Volume 14, Issue 0 (3-2021)
Abstract
Nurses are among the members of the treatment team who have the most contact with Corona Virus Disease- 2019 (COVID-19) patients and their ethical decision-making is inevitable during patient care. On the other hand, nurses' motivation to implement end-of-life care is influenced by their attitude, awareness, and moral reasoning. The aim of this study was to investigate the level of ethical decision making of nurses and its relationship with the attitudes of end-of-life care of patients with COVID-19 in hospitals affiliated to Hamadan University of Medical Sciences in 2021. In this study, 180 nurses working in hospitals affiliated to Hamadan University of Medical Sciences were selected by convenience sampling method. Data collection tools included: demographic Information questionnaire, Nursing Dilemma Test (NDT) questionnaire, and Frommelt Attitudes towards End-of-Life Care questionnaire. According to the results, there is a direct relationship between nurses' ethical decisions and the attitude of end-of-life care (<0.05, r=0.819). The mean score of nurses' ethical decision-making indicates the low level of ethical decision-making (39.19 (5.3)) and the mean score of nurses' practical considerations (20.62(4.2)) showed that the process of nurses' ethical decision-making is relatively influenced by environmental factors. Also, the average score of nurses' exposure to moral challenges indicates that nurses are familiar with similar situations. The mean score of nurses' attitudes toward end-of-life care was reported at an undesirable level (81.58(7.8)). According to the results, by identifying the factors affecting nurses' ethical decision-making and educational planning to improve their decision-making level, it is possible to improve the quality of patients care while improving nurses' attitudes toward end-of-life care.

Nurses’ Attitudes About Euthanasia: A Systematic Review
Shabnam Rasoulpoor, Reza Nematollahi Maleki, Neda Tagizadeh,
Volume 17, Issue 0 (12-2024)
Abstract
Euthanasia, defined as the intentional ending of a patient's life to relieve intractable suffering, presents complex ethical, legal, and emotional challenges for healthcare professionals, particularly nurses. Nurses play a pivotal role in end-of-life care, making their attitudes toward euthanasia crucial for understanding its implications in clinical practice. This review aims to synthesize existing literature on nurses' attitudes about euthanasia to identify key influencing factors and areas requiring further exploration. This study was conducted using the PRISMA 2020 guideline with no time limitation (by December 2024). Eligible articles were selected following a search in various databases (Scopus, Web of Science, PubMed, ScienceDirect, Embase, and Google Scholar) using keywords and operators of “AND” & “OR.” The search strategy included “Perceptions” OR “Attitudes” OR “Nurse” AND “Euthanasia.” Data extraction and risk-of-bias assessment were performed independently by two reviewers (SR and NT). Studies were evaluated with the Appraisal Tool for Cross-Sectional Studies (AXIS Tool). A total of 21 studies were included in the review. The review revealed that nurses’ attitudes toward euthanasia vary widely depending on legal frameworks, cultural norms, religious beliefs, and personal values. In countries where euthanasia is legalized, such as Belgium and the Netherlands, nurses often report greater acceptance and willingness to participate in the process, emphasizing their role in ensuring patient autonomy and dignity. Conversely, in regions where euthanasia is illegal, nurses frequently express ethical concerns, moral distress, and reluctance to support the practice. Common themes include the need for clear guidelines, ethical training, and emotional support systems for nurses dealing with euthanasia-related situations. Nurses’ attitudes about euthanasia are influenced by a complex interplay of cultural, legal, and personal factors. While some nurses view euthanasia as an extension of compassionate care, others experience ethical dilemmas and professional conflict. This highlights the need for robust ethical frameworks, specialized training, and supportive resources to help nurses navigate the challenges associated with euthanasia in their practice.

Exploring Advance Directives and End-of-Life Preferences in Heart Failure Patients: A Systematic Review and Meta-Analysis
Aydin Feyzi, Amirali Soheili, Samira Chaibakhsh, Fidan Shabani, Shiva Khaleghparast,
Volume 17, Issue 0 (12-2024)
Abstract
Advance directives (ADs) are legal instruments that enable individuals to express their healthcare preferences in anticipation of a future loss of decision-making capacity. These directives are particularly important in the context of chronic conditions such as heart failure (HF), a disease marked by progressive functional decline and unpredictable medical crises. ADs help safeguard patient autonomy by ensuring that care aligns with personal values and preferences, especially at the end of life. This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines to examine the preferences of patients with heart failure regarding life-sustaining treatments and end-of-life decision-making. A comprehensive literature search was performed across PubMed, Scopus, and Web of Science databases, covering publications up to March 2024. Search terms included "advance directive," "advance care planning," "heart failure," and "end-of-life decision-making." Studies were included if they were original, peer-reviewed, full-text articles focusing on HF patients aged 18 and older. Non-peer-reviewed works and inaccessible full texts were excluded. A total of 25 eligible studies were identified and appraised using the NIH quality assessment tool. Extracted data included demographic characteristics, preferences for treatment, surrogate decision-making, and educational interventions. Findings from the reviewed literature reveal consistently low levels of awareness and completion of ADs among HF patients. Completion rates varied significantly across studies, reflecting potential cultural and systemic influences. Preferences for surrogate decision-makers overwhelmingly favored family members over healthcare professionals. A notable finding from Jawahri et al. (2016) indicated that patients who received video-based education were significantly less inclined to choose cardiopulmonary resuscitation (CPR) or mechanical ventilation compared to those receiving only verbal information. Additional qualitative insights, such as those from Formiga et al. (2004), showed that patients prioritized maintaining dignity, independence, and meaningful relationships over merely extending life. These patterns highlight the necessity of aligning care with patients’ broader goals and values. Across the 25 studies included, a total of 4,091 heart failure patients were analyzed, with a mean age of 68.22 years. Meta-analytic findings demonstrated diverse preferences regarding life-sustaining interventions: approximately 53.73% of patients favored such treatments, while 45.37% declined CPR. These statistics underscore a substantial variability in end-of-life preferences, further reinforcing the need for individualized care planning. In conclusion, patients with heart failure display heterogeneous preferences concerning end-of-life care, shaped by cultural context, personal values, and the type of information provided. Despite the established importance of ADs, significant deficits in awareness, understanding, and documentation persist. These findings point to a critical need for tailored educational interventions, improved provider-patient communication, and culturally sensitive approaches to advance care planning. Future research should focus on designing and integrating standardized AD facilitation tools into routine clinical practice to support truly patient-centered care.

Avoidable Suffering at the End of Life
Mamak Tahmasebi,
Volume 17, Issue 0 (12-2024)
Abstract
Avoidable suffering at the end of life refers to the unnecessary pain and distress experienced by individuals with terminal illnesses—pain that can often be alleviated through effective palliative care practices. Addressing this issue is critical for improving the quality of life for both patients and their families during this challenging period. The recognition of holistic care, which considers physical, emotional, spiritual, and social needs, has fueled efforts to enhance end-of-life care to reduce suffering and uphold patients' autonomy. Numerous studies indicate that many terminally ill patients endure avoidable physical and emotional pain as they approach death, highlighting gaps in healthcare delivery. For instance, research from the National Center for Health Statistics reveals that a significant number of hospice patients report unmanaged pain despite the availability of effective interventions. Psychological distress, including anxiety and depression, is also prevalent among terminally ill patients, underscoring the need for comprehensive care that integrates mental health support. Furthermore, neglecting spiritual and social needs can leave patients feeling isolated and despairing, exacerbating their suffering. Ethical considerations in pain management at the end of life remain a subject of debate, particularly concerning the principles of beneficence and non-maleficence. The principle of double effect, which permits actions to relieve suffering even if they may unintentionally hasten death, continues to spark controversy among healthcare providers, patients, and families. Additionally, ethical dilemmas arise in advanced care planning, particularly in respecting patient autonomy while navigating complex end-of-life decisions. Addressing avoidable suffering at the end of life requires a multidisciplinary approach that honors patients' values and preferences while striving to minimize unnecessary distress. As research and clinical practices advance, healthcare systems must prioritize strategies to reduce avoidable suffering and ensure patients' dignity during their final days.
 

An Islamic Bioethics Framework for Decision-Making on the Life Support of Periviable Newborns
Forouzan Akrami,
Volume 17, Issue 0 (12-2024)
Abstract
For many years, the question of whether or not to resuscitate periviable newborns has been a topic of debate among perinatologists, neonatologists, and ethicists. Unlike other studies that focus on the value and sanctity of human life during intrauterine development, the present study seeks to address the ethical question of what constitutes the right decision regarding life-support measures for newborns born at peri-viability ages, within the ethical norms of the Islamic tradition. This study assumes the inherent value of every moment of human life and acknowledges the human dignity of individuals from the time of conception. This multi-method study was conducted in three parts: (1) a review of the ethical frameworks presented for supporting the lives of periviable newborns, (2) an explanation of the principles of Islamic bioethics based on common Sunni and Shiite sources, and (3) the development of an Islamic bioethics framework. According to the ethical principles of the Islamic tradition—contrary to secular biomedical ethics—first and foremost, efforts should be made to preserve and prolong the life of periviable newborns regardless of their anticipated quality of life. Second, in decisions involving life and death, the priority is not the preferences of the infant's parents but rather the saving of the infant's life and its preservation by the physician and medical team. Nonetheless, parental participation in the decision-making process is essential. Preserving life, however, is not an absolute obligation; the aim of life-support measures is not merely to extend the infant's life for a short period but to do so in proportion to the prognosis and expected benefits. Specifically, these measures should be considered when there is a significant probability of the newborn’s survival. This requires a case-by-case assessment of risks, taking into account the newborn’s clinical condition, as well as regional resources and conditions. It is recommended to use the proposed Islamic bioethical framework to develop a clinical guideline that includes criteria for classifying infants born at the edge of viability based on their clinical condition. Ethical decisions to intervene should then be based on the infant's clinical state, probability of survival, and the resources available in the region.

Investigating the Ethical Challenges of Nurses in End-of-Life Care at Home for Elderly Patients: A Review Study
Nayereh Baghcheghi, Zahra Maddah,
Volume 17, Issue 0 (12-2024)
Abstract
With the increasing elderly population and the growing demand for home healthcare and end-of-life care services, nurses are facing expanded duties and responsibilities. This intensification of responsibilities can expose them to significant ethical challenges. This study aimed to investigate the ethical issues nurses encounter in providing end-of-life care at home for elderly patients. This review study involved a comprehensive search of databases including PubMed (Medline), Google Scholar, ISI Scopus, ProQuest, Science Direct, SID, IranDoc, IranMedex, and Magiran. The keywords used were: nursing ethics, ethical challenges, end-of-life care, and home care, along with their Persian equivalents. The search covered literature published between 2000 and 2024. The review identified several prominent ethical challenges faced by nurses in home-based end-of-life care, including: lack of attention to patients’ rights and independence, disrespect for the dignity of elderly patients, inadequate empathetic care, poor communication, and unsafe home environments for nurses. These challenges may lead to moral distress, as well as psychological and emotional consequences for both the care providers and the elderly patients. Given the serious ethical challenges nurses face in end-of-life home care for the elderly, it is essential for them to be well-versed in ethical principles relevant to this context. Enhancing awareness and competence in ethical practices can help nurses uphold patient rights, promote autonomy, and provide high-quality, compassionate care through effective communication and support.

A Critique of the Jurisprudential-Ethical Foundations of Applying the Term “Death” to the Vegetative State
Sayyed Mohammad Taghi Hosseini Vardaniani, Dr Ahmad Salami, Sayyed Morteza Hosseini, Jannat Mashayekhi,
Volume 18, Issue 1 (3-2025)
Abstract
The vegetative state is a condition in contemporary medicine that raises numerous ethical, jurisprudential, and legal challenges. The most fundamental question when confronting this condition concerns whether individuals in such a state are considered alive or deceased, as subsequent rulings and implications are typically contingent upon the answer to this question. Some contemporary Islamic jurists, drawing upon the jurisprudential division of life into “stable life” and “unstable life”, have deemed individuals in a vegetative state to be deceased, given their lack of volition and consciousness. This study argues that the concept of “unstable life” does not apply to these individuals, particularly in cases of persistent and chronic vegetative states where the possibility of regaining consciousness, however remote, exists. Furthermore, the continued function of the brainstem and the non-fulfillment of the medical and legal criteria for brain death in many systems affirm that the designation of “deceased” is incorrect. From an Islamic perspective, the definitive separation of the soul from the body, which is the condition for the occurrence of death, cannot be ascertained in the vegetative state. Ultimately, in circumstances of doubt regarding the life or death of a person in a vegetative state, this uncertainty constitutes a “case-specific doubt”, and by applying the legal principle of “presumption of continued life”, the individual must be deemed alive and all the corresponding legal and religious consequences of life must be accorded to them.

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