Showing 97 results for Medical Ethics
Mostafa Moallemi, Morteza Darabinia,
Volume 13, Issue 0 (3-2020)
Abstract
This study seeks to identify one of the pioneers of traditional clinical medicine named Abdullah Azdi and his medical dictionary. This research is an analytical study. The focus of the search was on two keywords, Abdullah Azdi and Kitab al-Ma'ma, but the scope of the search included all appropriate terms such as: medicine, Bu Ali Sina, traditional medicine, medical dictionary, ethics, and medical law. Data were collected and analyzed using comprehensive library software (version one), Islamic History Library, Islamic Iran History and reputable national and international centers. The main purpose of the forthcoming research, on the one hand, is to identify and introduce points about life and beliefs, as well as Abdullah Azdi's specialized knowledge in the field of medicine, and on the other hand, to introduce his book, which is in fact a dictionary called "Kitab al-Ma'a". The researches of this research show that Abdullah Azdi was one of the students of Ibn Sina and the companion of Abu Rihan al-Biruni. In addition of being expert in clinical medicine, he was an ethical and professional physician and in every part of his book, he observes the Shari'a. The use of specialized medical terms indicates that he was surrounded by medical knowledge.
Mohammad Kiasalar, Hamidreza Namazi,
Volume 13, Issue 0 (3-2020)
Abstract
The National Medical Ethics Film & Photo Festival was held in February 2020 and ended with the registration of 487 works which 80 films and 36 photographs of them were finally selected and peer reviewed. The present article focuses on the films of this festival and tries to explain the experience of attracting, selecting, and judging films through the design and holding a festival by using action research method. The article, also, tries to analyze the selected films (50 documentaries, 20 short films, and 10 unspecified films) from medical ethics point of view. In this way, the thematic adaptation of the selected films with 16 topics declared by the festival has been used. One of the obvious findings of this study is the difference between the views of filmmakers and experts on medical ethics. This difference becomes more significant when we see that the number of films related to the 16 topics declared by the experts is one less than the number of the films that the filmmakers made and submitted to the festival on the 7 topics neglected in the text of the call. It seems that the camera of filmmakers in the field of medical ethics mainly focuses on the commitment of professionals and the vulnerability of patients. On the other hand, considering the number and variety of films in the festival, another finding of this study can be considered as the possibility of using short and documentary films to teach some concepts of medical ethics to medical students.
Farzad Zakian Khoramabadi, Alireza Parsapour, Bagher Larijani, Amirhossein Takian, Ehsan Shamsi Gooshki,
Volume 16, Issue 0 (11-2023)
Abstract
The right to access health services as a part of fundamental human rights, affected by the conditions and facilities of governments and the international status, has always faced challenges. Despite the clarity of the general policies and upstream documents in the Iranian health system regarding the need to provide immigrants and refugees with health services and Iran’s membership in the relevant conventions, the implementation of the provisions of these documents is not consistent and complete for various reasons, including the inadequacy of laws related to immigrants and refugees and the incorrect implementation of some existing laws. The first draft of the ethical guidelines for providing health services to immigrants was prepared by the research team using the results of a review of relevant documents as well as a qualitative study and finalized according to the opinions of the participants in a panel of experts. In this draft, after explaining the values and ethical principles governing the provision of services to Afghan immigrants, the suggested guidelines and assignments were presented to the main stakeholders involved, including the policymakers and macro planners of the health system, institutions and centers providing health services, professionals and health service providers, professional organizations, civil society activists, media and non-governmental organizations, and medical research and education authorities and researchers.
Mojtaba Norouzi , Ali Akbar Haghdoost , Mina Mobasher,
Volume 16, Issue 1 (3-2023)
Abstract
Scientists now believe that precision medicine, which employs complicated technology and information derived from omics, can treat complex diseases and provide justice in health. Implementation of precision medicine will face new ethical challenges, considering the principles of medical ethics. With respect to philosophical principles, this study addressed the issue of justice and some ethical challenges of precision medicine. Because, in order to gain the benefits of precision medicine, a proper ethical framework must be developed while considering the challenges. The manner in which precision medicine information is shared and accessed can have an impact on people’s future careers, marriage choices, and type of health insurance. Furthermore, preserving people’s privacy and autonomy are important ethical concerns in precision medicine since there will be no perfect guarantee about data security and access. Although in the short and medium term, due to the design of studies and expensive and complex technologies, precision medicine will be limited to certain groups and will intensify the inequality in justice, in the long run, with the easy access and inexpensive cost of precision medicine technologies, the accumulation of medical expenses will decrease throughout life, and justice will be established between and within countries.
Mojtaba Parsa,
Volume 16, Issue 1 (3-2023)
Abstract
Physician self-referral is the referral of a patient to a medical facility in which the referring physician has a financial interest. This can take two forms: internal referrals within the same office and external referrals, often involving joint ventures. Many claims, positive or negative, have been made regarding self-referral. Proponents claim that self referral causes, reduction of costs by fostering a competitive environment, encourage investment in health facilities particularly in underserved areas, financial benefits for both the doctor and the patient via cost reduction, and inhance the quality and accessibility of health services. Conversly, opponents, citing multiple studies, argue that self- referral may result in excessive and unnecessary utilization of healthcare services, leading to increased healthcare costs, low quality of services provided, and jeopardise patient safety. In certain countries, such as the United States and the Islamic Republic of Iran, ethical codes address self-referral. These guidelines either deem it unethical or require disclosure, accompnied by regulations to govern this practice.
Saeed Biroudian,
Volume 17, Issue 0 (12-2024)
Abstract
Conflicts of interest, particularly financial ones, pose a significant ethical challenge in the medical field. They can compromise clinical decision-making, erode patient trust, and ultimately diminish the quality of healthcare. This study reviewed ethical documents and guidelines published by the Medical Council of the Islamic Republic of Iran, including the Charter of Rights for the Medical Community. A comprehensive review of relevant scientific literature on conflicts of interest in healthcare was also conducted. The analysis revealed that financial relationships between physicians and external entities, such as pharmaceutical companies, can create conflicts of interest that negatively impact patient care. These conflicts can erode patient trust and lead to suboptimal clinical decisions. The Medical Council's ethical guidelines address these concerns by emphasizing the importance of transparency regarding financial ties and relationships. They advocate for the disclosure of such relationships to patients and the implementation of educational programs to enhance physician awareness of ethical principles and conflict-of-interest management strategies. Adherence to the ethical guidelines established by the Medical Council of Iran is crucial for effectively managing conflicts of interest in the physician-patient relationship. By prioritizing transparency, disclosure, and ongoing education, healthcare professionals can mitigate potential conflicts and maintain the highest standards of ethical conduct in patient care.
Mojtaba Parsa,
Volume 17, Issue 0 (12-2024)
Abstract
"Under-the-table payment" refers to money a physician demands and receives from a patient, in addition to the established and approved medical tariff, typically for medical services such as surgical operations. This study aims to examine the ethical, legal, and juridical aspects of this phenomenon, which has become common among many physicians. This qualitative study is based on semi-structured interviews with 17 experts from various fields, including Islamic jurisprudence, law, professional ethics, philosophy of ethics, medical ethics, health economics, and social psychology. The interviews were analyzed using the conventional content analysis method. Additionally, the opinions (fatwas) of 11 Shia Grand Ayatollahs on under-the-table payments were obtained by posing a specific question to them. The findings from the expert interviews revealed several concerns regarding under-the-table payments, including:
· Disregard for patients' best interests, particularly causing harm to poor patients;
· Undermining trust between doctors and patients;
· Violations of national laws and public policies;
· Promotion of lawlessness;
· Breaches of medical and ethical obligations by physicians;
· Coercion or undue pressure on patients to pay such fees.
Experts emphasized that medicine is a profession in which patients' interests should take precedence over those of doctors, and in this practice, this fundamental principle is violated. Furthermore, in the fatwas issued by the majority of Shia Grand Ayatollahs - particularly those with governmental perspectives - nearly all deemed this practice impermissible, with some explicitly declaring it forbidden (haram). Receiving under-the-table payments is ethically, legally, and juridically problematic, and in some cases, is considered impermissible, particularly for the physicians involved. However, it is generally not considered problematic for patients who are coerced into making such payments.
Saeed Biroudian,
Volume 17, Issue 0 (12-2024)
Abstract
Effective oversight of scientific research is essential for ensuring adherence to ethical and legal principles, particularly in medicine and health sciences. This oversight plays a crucial role in maintaining research validity and safeguarding human health. As knowledge-based and technological projects continue to expand, the responsibilities of ethics committees become increasingly significant. Recognized as independent and credible entities, these committees conduct rigorous reviews of research initiatives. This article critically examines the significance, methodologies, and impact of ethics committee oversight on the quality and credibility of scientific research in knowledge-based projects. This study employs a review methodology, synthesizing data from established guidelines and regulatory frameworks governing ethics in biomedical research, as outlined by the National Committee on Ethics in Research of the Ministry of Health and Medical Education. Additionally, a comprehensive review of relevant scientific literature and empirical studies was conducted, focusing on the oversight of approved projects from reputable contemporary sources. The analysis indicates that knowledge-based projects require heightened ethical scrutiny compared to other research initiatives. This necessity arises from the imperative to adhere strictly to ethical standards outlined in research proposals. Rigorous oversight significantly enhances research quality while mitigating ethical violations. Furthermore, active engagement by ethics committees fosters a stronger commitment among researchers to uphold ethical principles. By offering targeted guidance and training, these committees contribute to the development of high-quality research proposals. Effective oversight by ethics committees is instrumental in enhancing the quality and credibility of scientific research, particularly in emerging technologies and knowledge-based projects. This oversight not only reduces ethical infractions but also strengthens public trust in research findings. Therefore, continuous advancements in ethical training and researcher awareness are imperative. Improving oversight mechanisms will further elevate ethical standards and reinforce responsible research practices within this domain.
Fatemeh Rahimi,
Volume 17, Issue 0 (12-2024)
Abstract
Televisits offer significant potential for enhancing healthcare accessibility, reducing costs, and improving patient satisfaction. However, their effective implementation requires careful consideration of ethical principles to ensure patient safety, privacy, and quality of care. This paper examines key ethical considerations for televisit implementation across three stages: pre-visit, during-visit, and post-visit. Pre-visit considerations include careful patient selection to ensure suitability for remote care, establishing a strong physician-patient relationship based on trust and obtaining informed consent, and demonstrating cultural sensitivity and inter-professional coordination. During the televisit, optimal technical conditions are critical, including reliable internet connectivity, high-quality audio-visual equipment, and a conducive physical environment. Comprehensive and transparent documentation of the televisit encounter is essential. Post-visit considerations include evaluating patient experiences, addressing any identified issues, and ensuring timely follow-up for continuous quality improvement. Ethical considerations extend beyond the clinical encounter. Addressing technical challenges such as data security, privacy breaches, and equitable access for all populations, including those with disabilities, is crucial. Transparent reimbursement mechanisms and ongoing education for both patients and healthcare providers are essential for successful televisit integration. The successful implementation of televisits requires a multi-faceted approach that addresses ethical considerations at all stages. Developing comprehensive guidelines, adhering to international standards, and establishing robust oversight mechanisms are essential for ensuring the safe, effective, and equitable utilization of this innovative technology in healthcare delivery.
Saeed Nazari Tavakkoli, Saeed Ghadirzadeh Toosi,
Volume 17, Issue 1 (3-2024)
Abstract
Treating patients whose lives are in danger or threatened by irreparable harm, is an obligatory act. However, sometimes, due to old age, the severity of the disease, or the lack of definitive treatment, the patient faces a situation where, according to the diagnosis of the medical staff, starting or continuing the treatment has no effect on patient recovery, or the effect is so insignificant that is ignored in medical practice. This study was conducted using a descriptive and analytical method based on library resources to compare “futile treatment” in medical ethics with “Israf” (extravagance) in Islamic jurisprudence so as to indicate the level of conceptual compatibility between these two concepts. Moreover, considering the illegitimacy of extravagance in jurisprudential teachings, it was attempted to explore whether it is illegitimate, according to Islamic rules, to perform futile treatment. To do so, first, futile treatment and its characteristics in medical texts were defined. Second, the ethical considerations of performing such treatment were explained based on the teachings of medical ethics. Third, extravagance was analyzed in terms of concept, topic, and sentence by referring to valid lexical, jurisprudential, narrative, and interpretative resources. Finally, based on a comparative study, the level of compatibility of futile treatment with extravagance was investigated. The findings of this study showed futile treatment is an example of extravagance as it causes the waste of personal or public property, lacks rational purpose, and does not lead to patient recovery or promotion of health status. Therefore, futile treatment is not considered an obligatory act but even an illegitimate one as it is a clear example of extravagance. In addition to punishment in the afterlife, it entails civil liability as it results in the loss of others’ property.
Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
Defensive medicine refers to actions taken by doctors and other medical professionals to protect themselves against potential threats and risks, particularly to prevent patient complaints or convictions in court, which is carried out in various forms including positive and negative defensive medicine. Since the primary motivation behind such actions, often viewed as morally unjustified, is to avoid legal proceedings and lawsuits, court rulings against doctors can intensify these behaviors. Reports of criminal sentences against some doctors in Iran and reactions from professional associations highlight the significance of this issue. This study examined the effects of such sentences on the healthcare system by referring to available documents and data on the widespread prevalence of defensive medicine in Iran, offering some suggestions for managing the issue. The objective of the study was to emphasize the importance of acknowledging the defensive motivations of doctors in healthcare and its influential factors, particularly the fear of criminal convictions, which can increase defensive behaviors among doctors and amplify their negative impacts on the healthcare system.
Hosein Fasihi, Dr. Syyed Ahmad Fazeli,
Volume 17, Issue 1 (3-2024)
Abstract
In the realm of philosophy, numerous thinkers have offered profound, and at times amazing, insights into the nature of existence. Among them, Spinoza stands out with his unique perspective, establishing a deep connection between ethics, religion, and the divine nature. Spinoza posits that religious texts, beyond their religious teachings, serve a motivational role in inspiring moral behavior. He locates the foundation of virtue within human nature and essence, arguing that the moral quality of actions is not inherent but is derived from God as the ultimate source of good and evil. Ultimately, adhering to the principle of universal necessity, Spinoza extends this concept to ethics, viewing it as an expression of divine nature. This perspective implies that morality and all human actions unfold within the framework of natural and divine necessity. An examination of Spinoza's views reveals a profound unity between humanity and the divine, characterized by a harmonious and interactive relationship between religion and ethics. Within Spinoza's philosophical system, these two categories are aligned, guiding individuals toward happiness and virtue. This innovative approach not only enriches our understanding of Spinoza's thought but also, by bridging religion, reason, and health, opens avenues for reconsidering medical ethics and spirituality in the contemporary world. This study, through a critical analysis of Spinoza's views, lays the groundwork for future investigations into moral philosophy, religion, and medical ethics, fostering a constructive dialogue between tradition and modernity.
Farshid Mohammadmousaei, Zeinab Raiesifar, Seyed Ali Mousavi, Nastaran Khorsandi Bahar, Fatemeh Esmaelzadeh,
Volume 18, Issue 1 (3-2025)
Abstract
Maintaining patient privacy is a fundamental right of patients and an ethical duty of healthcare professionals. The present descriptive, cross-sectional study was conducted in 2022 to compare the perspectives of patients and staff in obstetrics and gynecology operating rooms in Mashhad, Iran, on the extent to which patient privacy was preserved. Patients were selected using random sampling in the operating rooms of hospitals affiliated with Mashhad University of Medical Sciences. Data were collected through a demographic information form and a standardized questionnaire to assess hospitalized patients’ privacy. Data were analyzed via SPSS-22, utilizing descriptive and inferential statistics, with a significance level of P<0.05. The mean ages of patients and staff participating in this study were 39.07±12.56 and 31.65±8.42 years, respectively. The mean score of preserving privacy from the patients' perspective was 38.92±22.41, whereas from the staff's perspective, it was 64.26±8.02, and the difference was statistically significant (p=0.0001). The lowest scores in both groups for personal privacy were 4.97±8.77 for patients and 13.37±2.66 for staff. Results indicated that the staff perceived the level of preserving patient privacy to be above average, while patients considered it below average. Therefore, given the patients’ specific conditions, high stress levels, and physical and mental limitations to support themselves, it is essential to implement targeted training and take necessary measures to encourage the staff to pay more attention to patient privacy and raise patient awareness in this regard.
Mojtaba Parsa, Soudabeh Mehdizadeh,
Volume 18, Issue 1 (3-2025)
Abstract
Domestic violence and abuse against women, particularly intimate partner violence, is a widespread public health problem. Domestic violence is associated with a wide range of physical and mental health issues and negatively impacts the health and well-being of the affected individual. Women who experience violence need support to mitigate the negative impacts of these violent acts. In this regard, health institutions play a critical role in providing comprehensive healthcare to women affected by domestic violence. Physicians' encounters with women experiencing domestic violence, especially in countries like Iran, where there are no clear guidelines on this matter, lead to challenges and ethical issues. This study explored some of these ethical issues and challenges by presenting a case study.
Davood Rasouli, Elham Ramezanpour, Sohrab Nosrati, Akram Zhianifard, Zahra Nouri Khaneghah,
Volume 18, Issue 1 (3-2025)
Abstract
Professional ethics, as a critical aspect of medical ethics, holds significant importance in healthcare professions that directly involve human lives. Accordingly, this study aimed to compare adherence to professional ethics principles among operating room (OR) students and staff in selected teaching hospitals affiliated with Iran University of Medical Sciences during 2021–2022. This cross-sectional descriptive study included 200 OR staff from six hospitals (selected via stratified quota sampling) and 60 OR students (recruited via convenience sampling). Data were collected using a demographic questionnaire and Kadushin’s Professional Ethics Questionnaire (2002) and analyzed in SPSS-24 using descriptive statistics (median and interquartile range) and inferential tests (Chi-square and Mann-Whitney U tests). Results indicated strong professional ethics in 98.4% of students and 75% of staff. Students scored significantly higher in loyalty and accountability (median score, P < 0.0001), while staff outperformed in honesty (median score, P = 0.003). No significant differences were observed in other dimensions. Overall, both groups demonstrated favorable professional ethics. These findings can guide educational interventions and developmental programs to further enhance professional ethics in these populations.
Zahra Khalilzadeh-Farsangi, Samaneh Fallah-Karimi,
Volume 18, Issue 1 (3-2025)
Abstract
With increasing life expectancy and a growing elderly population worldwide, elder care has become a major priority for health systems. These care services are accompanied by numerous ethical challenges, and neglecting them can negatively affect the dignity, rights, and quality of life of older adults. This study aimed to address the question: “What ethical challenges are faced in elder care?” Accordingly, a systematic review was conducted guided by PRISMA guidelines. To identify relevant studies, PubMed, Scopus, Web of Science, SID, and Google Scholar were searched for the period 2013–2025, using the keywords “Ethical Challenges”, “Elderly Care”, “Nursing”, and their Persian equivalents. Inclusion criteria were original articles (qualitative, quantitative, experimental, or quasi-experimental) with a direct focus on ethical challenges in elder care, written in Persian or English, and with full-text availability. Exclusion criteria included letters to the editor and conference abstracts. The quality of the studies was assessed using the appraisal tool proposed by Gifford. In total, 31 eligible articles were included in the final analysis. The results indicated that ethical challenges in elder care can be classified into four main categories, including autonomy, justice, beneficence, and non-maleficence. Subthemes included privacy preservation, shared decision-making, end-of-life care, equitable resource allocation, and the prevention of physical and psychological harm. The findings underscored the necessity of strengthening ethics education and informing policymaking in elder care.
Mohsen Shahriari, Maryam Sadat Hashemi, Arash Najimi, Mohammad Zare Reshkoieh,
Volume 18, Issue 1 (3-2025)
Abstract
The fundamental nature of nursing care lies in maintaining patients’ human dignity. Protecting the dignity and high value of humanity is the focus of the nursing profession. This study aimed to compare the effectiveness of mobile application-based and webinar-based professional ethics education on maintaining patient dignity among nursing students. This was a quasi-experimental study with a two-group pretest-posttest design involving 90 undergraduate nursing students. One group received professional ethics education via webinars, while the other received training through a mobile application-based program. Data were collected using a demographic information form and a questionnaire assessing nursing students’ views on maintaining patient dignity. The findings showed that before training, the mean total scores for human dignity were 99.96 ± 17.43 in the webinar group and 99.59 ± 16.28 in the mobile application group, with no statistically significant difference (p=0.62). After training, the mean human dignity score was significantly higher in the mobile application group (111.15±14.69) than in the webinar group (104.34 ± 15.38), and this difference was statistically significant (p=0.02). The findings indicated that professional ethics education delivered via a mobile application was associated with a greater improvement in nursing students’ views on patient dignity compared to webinar-based education. Mobile-based education offers a self-directed, flexible learning method, enabling students to have continuous access to educational content without time or place restrictions. It is recommended that medical universities in Iran consider developing and integrating educational applications into their curricula.
Akram Heidari, Morteza Heidari, Baqer Larijani, Professor Ali Mohammad Mosadeqrad,
Volume 18, Issue 1 (3-2025)
Abstract
Spiritual health refers to having purpose and meaning in life and a sense of belonging to something beyond the self, which strengthens inner peace, satisfaction, and happiness. This qualitative study was conducted in 2024 using an interpretive phenomenological approach. Through semi-structured interviews with 47 policymakers, managers, faculty members, staff, and students, a total of 183 benefits of spiritual health education in universities of medical sciences were identified. These benefits were categorized into six groups: benefits for faculty members, students, staff, patients, society, and the university. For faculty members, spirituality education leads to enhanced ethical awareness, increased motivation, job satisfaction, professional commitment, and improved quality of education. Students, by strengthening spirituality, gain greater communication and empathy skills, experience reduced stress and anxiety, and demonstrate improved professional competencies. Healthcare staff benefit from reduced medical errors, increased resilience, improved social relationships, and enhanced quality of care. Patients receiving spiritual care experience lower levels of stress and depression, improved mental health and quality of life, and a more rapid course of treatment and recovery. At the societal level, spiritual health education contributes to more positive social behaviors and the development of a healthier community. Furthermore, universities implementing such education can design more comprehensive curricula, promote interdisciplinary research, strengthen professional ethics, and train holistically oriented healthcare professionals, thereby increasing their credibility and productivity. Spiritual health education in Iranian universities of medical sciences, by exerting positive effects on faculty members, students, staff, patients, society, and the university itself, results in the improvement of psychological and professional well-being, the enhancement of educational quality, and the increased productivity and credibility of the higher education health system of the country.
Parsa Farmahin Farahany, Zahra Torkashvand,
Volume 18, Issue 1 (3-2025)
Abstract
One of the key ethical-legal concerns in the medical profession is patients’ trust in the quality of care and adherence to professional standards. This viewpoint explored the ethical-legal dimensions of using surveillance cameras in Intensive Care Units (ICUs), focusing on a specific legal-ethical case. In this scenario, the patients’ family caregivers express doubt about the quality of care and request access to recorded footage. From an ethical-legal perspective, documenting events by the medical team—provided that privacy, data protection regulations, and visual monitoring standards are respected—can help safeguard patients’ rights, clarify staff performance, and prevent legal misunderstandings. While acknowledging the potential benefits, this study also outlined legal considerations, such as patient notification, access limitations, and data management protocols. The key conclusion is that the use of cameras in ICUs, if aligned with legal and institutional requirements, can enhance trust, demonstrate ethical compliance, and reduce legal complaints.
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.
