Medical ethics
Objectives of tissue grafting
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- Bu səhifədəki naviqasiya:
- Transplant of one testicle from a donor
- Ethics of Medical Examination of the Opposite Sex
- Ethical issues of plastic and cosmetic surgery
- In his hadith, the Prophet (peace and blessings be upon him) is reported to have cursed
- The Ethical issues related to treatment of patients suffering from infections like HIV/ AIDS, Hepatitis and other dangerous infections
- “And do not cast yourselves into destruction by your own hands” Qur’an- 2:196.
- You should hurry up in burying your dead persons {Bukhari and Muslim}
Objectives of tissue grafting If the reason is a physical or psychological need it is permissible. If it is for the purpose of eluding the law, it would not be so, and the majority opinion is that it would not be allowed for cosmetic purposes. Transplantation could be done for cosmetic reasons such as adjusting nose or chin size or enhancing one's looks. It could be done to change the identity by criminals or fugitives running from the law. These do not apply to brain or nervous system transplant because of their special role in giving a person his human qualities. Their transplantation must only be allowed for genuine psychological or physiological reasons of restoring health and normality to the body and psychological balance to the person. Thus, such transplantation is permissible within the conditions outlined earlier and when a good chance of recovery exists. If the patient's life is in danger, the transplant, under the above conditions, would be obligatory and the medical team would be rewarded. If the condition is not critical, the operation would be commendable in Allah's eyes, as long as the surgeon does it for the sake of pleasing Almighty Allah. Transplant of one testicle from a donor: Though the testis are paired organ and one testis can easily be removed or harvested from live donor without much physical and mental disability or from a cadaver. This is complex situation as regards Islamic fiqah. The opinion of Muslim scholars is divided on these issues as being a reproductive organ this organ carry especial considerations and can not be treated at par with other organs of the body. Very few Muslim scholars still permit such type of transplantation but vast majority of Muslim scholars believe that “just as it should not be allowed to transplant an ovary, it is not allowed to transplant a testicle. Since successful transplantation means that organ donated is functional. Will the sperm produce be genetically those of the donor? If so than the situation akin to in insemination from a donor (as discussed in details above). The offspring would be illegitimate if doubts are correct. But there is question of adultery. There fore it is not allowed to carry out transplant of an ovary or testicle. Ethics of Medical Examination of the Opposite Sex Distinct behavior in male and female sex is a known phenomenon. While it is not universally possible to get all possible medical care, through health care professional of similar sex. The patients' attitudes toward their physicians are usually ones of trust. The physicians to the best of their professional capabilities try their level best to stand fast by the trust endured upon them. This attitude develops due to awareness that the motivation, training, and discipline of medical students are directed toward helping those who are ill. A medical students soon become aware of this sense of trust, not only by the readiness of patients to expose the nakedness of their bodies for examination, but often to expose their innermost private thoughts unrelated to their physical problems. The importance of this trust and intimate relationship must be constantly stressed during the students' training. One should always aware that examining a patient and specially of an opposite sex carry very important responsibility and very strong ethical bindings are required to avoid physical, emotional and spiritual insult on patient while carrying out necessary medical examination. Preferably all these examinations to be performed by a physician/ health care provider of the similar sex. Majority of the time even in Muslim countries it is not possible to get physicians of the similar sex thus compelling a patient to be examined by the physician of an opposite sex. Islam plays a significant role in satisfying our physical as well as spiritual needs. Islam teaches us, a code of behavior, and conservation of social values and gives us a meaning for our existence. It helps in toleration and developing adaptive capacities for stressful events of life. It gives us a sense of self-respect and teaches us about the virtues of family life and a cohesive society with a sense of brotherhood. Shall Muslim doctor while examining the patient needs to adhere with the Islamic principles and values? It is paramount that during practicing medicine a Muslim doctor must have essential Knowledge of his allowances, limitations and permits and not permits. History taking and physical examination of the patient is essential for diagnosis and carrying out management of the patient as hole. It is lawful for a medical member of one sex to look at the 'aura of member of the other sex in need for purposes of medical examination, treatment, and for the purpose of medical education. Exposition, however, should be limited to what the need calls for. A Muslim doctor must keep in mind that Ikhtalat ( mixing with the opposite sex in privacy) is not permissible Therefore examination of the opposite sex is allowed in the presence of a third person of the same sex as the patient. In case of a minor, one of the parent’s presences is desirable. Medical or nursing students may be allowed during examination of a female patient, but only with her prior consent and in the presence of a female nurse or relative. Only necessary examination needs to be done and only that part of the body to be exposed which deem required. One must be very careful in performing necessary examination of the patients always seek Allah’s guideless and remember and His divine guidance in every action. “Allah lets go astray those whom He wills, and guide to Himself those who turn to Him, Such are the ones who believe (in the massage of the Prophet) and those hearts find rest in the remembrance of Allah. Surely in Allah’s remembrance do hearts fin rest?” Qur’an- 13:27-28. Ethical issues of plastic and cosmetic surgery Advances in plastic and reconstructive surgery over the past three decades brought up the fictions into facts. Many disfigurements and defects have been successfully managed to normal or nearly normal. This branch of medicine has really helped very disappointed patients in not only correcting physical disfigurements and defects congenital in nature or caused by disease or trauma including disfiguring surgeries but also mental and emotional repairement of the patients. These advances also lead to cosmetically better outlook and even change of facial figures, cosmetic surgery of nose, surgery to correct the factors of aging. “Surgeries for beautification are in vogue today as the result of the materialistic pattern of Western civilization, whose main focus is the body and its desires. Men and women spend hundreds and thousands of dollars to reshape their noses or breasts, or whatever they consider defective. In his hadith, the Prophet (peace and blessings be upon him) is reported to have cursed “the tattooed and the person who is tattooed and the one who shortens the teeth and one whose teeth are shortened.” (Sahi’h Muslim). In another hadith, the Prophet (peace and blessings be upon him) is reported to have condemned those women who widen the gap between their teeth for the sake of beauty. Allah Almighty says: “(Satan said) “and shall lead them astray, and shall engross them in vain desires, and I shall command those [people] and they will cut off the ears of cattle, and I shall command them and they will disfigure Allah’s creation. He who took Satan rather than Allah for his guardian has indeed suffered a manifest loss” Qur’an- 4: 119” For this kind of surgery one must clearly understand what Allah Almighty says in the above verse, where one should not follow the desires of Satan and refrain from all sort of those procedures in surgical practice leading to such changes in body appearance. In summary it is allowed to resort to plastic surgery to remove some kind of disfigurement that causes the one physical, psychological or emotional problem. "Beautification which is used to reshape a deformed part of the body is generally recommended in Islam, as long as it is used for a valid reason. If a person has an unusual physical defect, which attracts the attention of others to the point of inflicting on him physical and psychological pain every time he meets people. In this case, he may treat the defect and thus alleviate the embarrassment that makes his life miserable. Allah, the Most Merciful, has imposed no hardship on us in religion. “There is no compulsion in religion. The right Way stands clearly distinguished from the wrong. Hence he who rejects the evil ones and believes in Allah has indeed taken hold of the firm, unbreakable handle and Allah is All –Hearing All knowing”. Qur’an-2256 Yet, Islam discourages and do not allow any unnecessary plastic surgery which is sought for the mere purpose of excessive beautification. This version have been supported by the Hadith cited above regarding prohibition of widen the gap between their teeth for the sake of beauty. There is no controversy among Islamic jurists regarding change of facial features for beatification is not allowed. The Ethical issues related to treatment of patients suffering from infections like HIV/ AIDS, Hepatitis and other dangerous infections Though HIV/AIDS is large scale issue in the western and African countries where free sexual contacts at the large scale. Muslim communities are having remarkably less number of patients with HIV positive or AIDS. But this phenomenon will not continue permanently due to free movements between all Muslims and non Muslim communities. This disease is plague of 21st century where one case is being reported every 14 minutes. 700,000 Americans carry the virus and CDC officially estimates that 1.5 million are infected. One do not need to have to be homosexual to get AIDS, through sexual transmission and sharing the needle in IV drug users is the main mode of transmission. The spread of AIDS is changing the sex life style of single women, and men. AIDS has been reported in 112 countries. Next to the USA, the highest numbers in the western countries are France, Germany and Britain. More over dreadful and potentially lethal diseases like Hepatitis B and C (HCV and HBV) are posing problem number one for health care providers in economically deprived countries. In Muslim and other developing countries HCV and HBV infections mainly spread through infected instruments, syringes and blood products. HBV and HCV is becoming large scale problem of the economically deprived countries where very large number of infected individuals is encountered. Islamic teachings are very clear for the prevention of disease and Islam Laid down basic principle for the prevention of the spread of communicable disease in particular. Islamic teachings are for the prevention of the disease and after its occurrence treating it like any other disease, e.g. tuberculosis, syphilis, or small-pox etc. The lifestyle of patients is not questioned with other common diseases i.e. diabetes, hypertension, coronary heart disease in terms of discriminating them or restricting their care. AIDS may be "a wrath of Allah" because of certain lifestyle which should be discouraged but many "innocent" people are being affected without being their fault. Therefore, they should not be penalized. In each community every attempt should be made to prevent the spread of the disease but once it has affected an individual full attention and care be given to lessen his/her suffering and maintain the dignity and quality of life of all patients suffering from HIV or other infections. At the same time health care providers must take special measures dictated by scientific research and based on evidence, to prevent the disease from spread to them and others. Careless attitude leading to spread of the disease is not allowed as mentioned in Qur’an: “And do not cast yourselves into destruction by your own hands” Qur’an- 2:196. Postmortem and Anatomical dissection of cadavers for education purposes Post mortem of cadavers is being performed for two main reasons: Firstly as a part of forensic investigations and secondly for educational purposes, weather done in a hospital or in a dissecting room of an anatomy department. Most of these anatomical specimens are being further utilized for education purposes. All ethics codes serve an argumentative function to improve public opinion, avoid government regulation, and produce ethical behavior among doctors so that any thing which can create conflicts or confusion must be addressed before embarking in to medical practice of any sort. In medical practice nothing can be allowed without stringent regulations and sound ethical bindings can only ensure the safety of patients, society, and public and humanity at large scale. Medical Examination of the dead body including its dissection and analyzing its tissues is known as postmortem Postmortem frequently performed mainly for two reasons:
Anatomical dissections and study of morphology is carried in the dissection halls of all teaching institutions around the world. Great Muslim doctors like Abu Ali Ibne Sine and Al Zukharvi dissected cadavers and made the anatomy understood able for themselves and for generations of doctors to come after. Though in Islamic Sharia’h mutilation of dead human bodies is not allowed. Islamic teachings clearly describe the honour and respect of the deceased body. “We have honoured the progeny of Adam” Qur’an-17:70. Prophet of Islam said “breaking the bone of dead person is like breaking the bone in a living person.” {Muslim and Bukhari). More over our prophet ordered to burry the dead body of deceased as soon as it is possible without any delay “ You should hurry up in burying your dead persons {Bukhari and Muslim} Offering jinaza prayers is also mandatory for Muslim deceases. These Islamic rituals can not be performed if the dead bodies are lying in the dissecting rooms for months and even years in anatomical museum. Muslim scholars debated this issue over several years and there is no consensus of opinion regarding permission or non permission for dissection of human bodies. Some Muslim scholars do allow this practice until medical science come up with alternative solution of medical education following the notion that it for the service to humanity at large scale and following the rule of “Necessity overrides prohibition,” a few group of Muslim scholar prohibit this practice and do not allow this practice at all. A large group of Muslim scholars allow dissection of human bodies taking care of all human respect and honour. All Muslim scholars’ emphasis the invention and use of blue print fabrication of human bodies with correct replication at minute details and use it for teaching purposes. I am sure at this time even of very huge research work on human body lot more need to be known and true replication of human body is not possible at correct minute details. A lot more need to be known in the human body. Till we have sound alternate for anatomical dissection and research we have to accept this prohibition as lawful in the large interest of humanity. Selected References:
Should Know About It, Crescent International, Toronto, Nov. 1987.
Report 1987, Vol. 102 No. I Page 5-17. 98.Farmer, P.E. et al. (2001). ‘Community-based Approaches to HIV Treatment in Resource-poor Settings’. The Lancet, 358(9279): 404–9. 99. Gray, Peter B. (2004). ‘HIV and Islam: Is HIV Prevalence Lower among Muslims?’ Social Science and Medicine, 58: 1751–6. 100. Al Bar, Muhammad Ali. [Al Adwah Bayn al Tiobb WA Hadith al Mustafa Contagion between Medicine and the Hadith of the Prophet. 4th edition. Al Dar al Saudia li al Nashr WA al Tawzi'i. Jeddah 1981/1401 101. Basyuni, Abdul Hamid and Jundi, Rajai. (eds.): [Ibn Rushd: al Tabiib WA al Faqih, WA al Failasuf]. Ibn Rushd the physician, the jurist, and the philosopher. Islamic Medicine Organization. Kuwait. 1995 102. Muslim (2000). Sahih, trans. Abdul Hamid Siddiqi, 4 vols. New Delhi: Kitab Bhavan.Panos Institute (1990). Triple Jeopardy: Women and AIDS. London: Panos Publications.
Claims of HIV-Prevention’. The Lancet, 360: 78–80. 104.Conrad, L. I. (1995). The Arab-Islamic medical tradition. In L. I. Conrad et al.
105 Al-Mubarakpuri, S. (2002). The sealed Nectar: Biography of the noble prophet. Riyadh, Kingdom Of Saudi Arabia: Darussalam
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