Saeedeh Saeedi Tehrani1, Mansoureh Madani,
Volume 7, Issue 6 (3-2015)
Abstract
Medical futility refers to diagnostic, treatment, and rehabilitation interventions that are unlikely to produce any positive outcome for patients. Doctors should beware of such actions due to their professional commitments. There are ambiguities in the definition of futility that have been the subject of many studies. In this paper, relevant literature was reviewed to find a definition for futility from the perspective of the four bioethical principles.Determining the futility of an action, whether it is the request of the patient, their family or service providers, is a highly sensitive matter that can lead to unethical decisions in the medical profession.Autonomy is a concept that is related to the diverse views on treatment objectives. In this paper we investigated the issues of physician and patient autonomy, and the differences between the values of the people involved. We have also discussed the concept of palliative care with an attempt to clarify the difference between this type of care and futile care, and to determine the boundaries. Another focus of our study was situations where physicians and other health care providers deliver futile treatment for various purposes. Such cases involve factors that may influence the judgment of physicians, and some of them are unethical due to incentives such as financial gain.Finally, ethical decision-making in this area is only possible through clarification of the different aspects of the issue and prioritization by experts and professionals. In order to do so, all circumstances need to be taken into account, including allocation of scarce resources within the health care system and fairness. Moreover, medical staff should have access to the necessary information so that they can make ethical decisions in different situations.
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.