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PubMed2001

A critical approach to the current understanding of Islamic scholars on using cadaver organs without prior permission.

Chronic organ diseases and the increasing demand for organ transplantation have become an important health care problem within the last few decades. Campaigns and regulations to encourage people to donate organs after death have not met with much success. This article discusses the subject from an Islamic perspective. It beings with some basic information on how Muslims reach legal rulings on a particular issue, and goes on to debate contemporary thinking among Islamic scholars on the ethical-legal issues of organ donation and organ transplantation. It is shown that there are two groups of scholars, one allowing organ donation and organ transplantation, the other refusing it in any circumstances. Both groups agree that is is fundamentally wrong to harvest organs from cadavers without prior permission of the deceased or the relatives. This dogma is re-examined, and it is argued that, under the rule of necessity and the imperative to preserve life, there is enough moral and theological ground to allow the state to harvest organs from the deceased without prior permission.

Brain Death↗
PubMed2002

The core concepts of the 'four principles' of bioethics as found in Islamic tradition.

Ethics can be described as a sub-branch of applied philosophy that seeks 'what is the right and the wrong, the good and the bad set of behaviours in a given circumstance'. Bioethics, however, is a quasi-social science that offers solutions to the moral conflicts arising in medical and biological science practice. There have been different ethical approaches to the issues in the history of philosophy. Two American philosophers, Beauchamp and Childress, formulated some ethical principles namely 'respect to autonomy', 'justice', 'beneficence' and 'non-maleficence'. These 'Four Principles' which have almost always existed and govern the ethical behaviour of human societies, were presented by the authors as universal and applicable to any culture and society. These 'Four Principles' have been one of the most widely discussed issues in Biomedical Ethics with arguments for and against them. The authors' claim has been tested by research conducted in different cultures and societies. In this study we aim to explore the roots of the 'Four Principles' in Islamic tradition and culture, and show that this particular set of principles are not something new but only one of the latest formulations of age-old common sense principles. It is therefore concluded that these principles are already being applied in Islamic traditional and cultural societies.

Beneficence↗
PubMed1990

The rights debate.

To date, no proposal for systemic healthcare reform directly addresses whether healthcare is a right for all Americans. In fact, some proposals have avoided the issue altogether. Typically, proponents of reform have been more comfortable approaching healthcare services as something society has a moral obligation to provide rather than something individuals have a right to. Such an approach is consistent with the liberal democratic tradition's understanding of rights, which stresses individual freedom and autonomy. According to the Catholic social teaching of the past century, however, the right to participate in society takes precedence over the right to be free of governmental intrusions. From the Catholic perspective, furthermore, lack of access to healthcare is tantamount to being denied full involvement in social life. This tradition has stressed repeatedly that each individual achieves dignity and fulfillment only by being actively involved in the social world. In debates over systemic healthcare reform, it is imperative that advocates of the Catholic perspective recognize the difference between the meaning of "rights" as it has developed in their tradition and the meaning that has emerged from the context of the liberal democratic tradition. Their challenge will be to give the debate's key term a meaning that better reflects the tradition of Catholic social teaching.

Catholicism↗
PubMed1995

Ecumenical in spite of ourselves: a Protestant assessment of Roman Catholic, Eastern Orthodox, and Anglican Catholic approaches to bioethics.

A Christian approach to the issues that constitute bioethics is inevitable for us who cherish the truth of historic, creedal, trinitarian Christianity. Scripture teaches and the Greek and Latin Church Fathers as well as the Reformers aver that man, created in the image of God, has an inherent, if vestigial, sense of right and wrong and a conscience however marred by the fall and by rebellion. We must believe that we share this most basic ecumenism with all humanity, not because of rational observation and analysis of nature, but because Scripture reveals it. We who are convinced of the truth of historic, creedal, trinitarian Christianity have a high view of Scripture and hold it to be infallible and utterly trustworthy irrespective of the importance we assign to our specific post-biblical traditional distinctives. This is a narrower but much more vital ecumenism than the first. Faithful adherence to Scripture inevitably manifests itself in remarkably similar priorities and values, often, lamentably, not because of, but in spite of, ourselves.

Bioethics↗
PubMedDate not supplied

A better approach to care of the dying. Catholic healthcare and the Catholic community can present an alternative to physician-assisted suicide.

To combat physician-assisted suicide, Catholic healthcare and the Catholic community cannot solely focus on mounting campaigns and formulating policies. They must also demonstrate an alternative way to approach death and care of the dying, taking a leadership role in improving end-of-life care. To accomplish this, Catholic healthcare must foster a culture that recognizes death as the inevitable outcome of human life and makes care for the dying as important as care for those who may get well. The ministry must acknowledge the limits of human life, human abilities, human ingenuity, and medical technology; and respect decisions to forgo life-sustaining therapies. In addition, physicians must address advance directives with patients before hospitalization and must be willing to offer hospice care as an option to dying patients and their families. More effective pain management must be devised. Catholic facilities must develop palliative care policies and commit to ongoing education to provide such care. It is essential that they pay attention to the environment in which patients die; identify the physical, psychosocial, and spiritual needs of family members; and use prayer and rituals in meaningful ways. With a clear focus on improving end-of-life care, Catholic healthcare--in partnership with other denominations--can eliminate some of the factors that can make physician-assisted suicide seem appealing to suffering people.

Attitude to Death↗
PubMed2002

The 'four principles of bioethics' as found in 13th century Muslim scholar Mawlana's teachings.

BACKGROUND: There have been different ethical approaches to the issues in the history of philosophy. Two American philosophers Beachump and Childress formulated some ethical principles namely 'respect to autonomy', 'justice', 'beneficence' and 'non-maleficence'. These 'four principles' were presented by the authors as universal and applicable to any culture and society. Mawlana, a great figure in Sufi tradition, had written many books which not only guide people how to worship God to be close to Him, but also advise people how to lead a good life to enrich their personality, as well as to create a harmonious society and a peaceful world. METHODS: In this study we examined the major works of Mawlana to find out which of these 'four principles of bioethics' exist in Mawlana's ethical understanding. RESULTS: We have found in our study that all these principles exist in Mawlana's writings and philosophy in one form or another. CONCLUSIONS: We have concluded that, further to Beachump and Childress' claim that these principles are universal and applicable to any culture and society, these principles have always existed in different moral traditions in different ways, of which Mawlana's teaching might be presented as a good example.

Beneficence↗
PubMed1993

A qualified bioethic: particularity in James Gustafson and Stanley Hauerwas.

Most theoretical approaches in bioethics begin with a theory that articulates and defends basic principles or rules that are more or less systematically related and that seek to yield more or less precise conclusions with regard to specific acts, cases, or policies. Concerns about the agent and descriptions of the context of action stand on the margins of the theory. This is ironic, given the overwhelming importance and impact the training of health care professionals has upon them and upon the practice of health care as a whole, and given the fact that many advocates of the theories themselves concede that one's beliefs and how one describes a situation and weighs "facts" and values relevant to the case strongly determine one's conclusions. While morality may not lead ineluctably to religion, as Kant believed, bioethics does appear inevitably to involve particularity. I examine the work of James M. Gustafson and Stanley Hauerwas to analyze two views of the role of particularity in bioethics. I then show the relevance of their work for addressing some problems with the practicality and concreteness of current models in bioethics.

Bioethics↗
PubMedDate not supplied

Danger signs. Coalition points to causes and consequences of inadequate care of the dying.

Dying patients and their families repeatedly express their need for supports based on compassion and caring, yet healthcare efforts focus on often ineffective technological interventions and procedures. Professional healthcare schools provide little or no formal training in pain and palliative symptom management or in the multidimensional approach to care of the dying. And the pace of change in healthcare leaves little time for communication between the patient, family, and caring team. Physician denial of death and dying has a significant impact on clinical decision making and misleads healthcare administrators about priorities. Even when clinicians want to practice holistic supportive care, they are often unable to because of competing productivity demands and lack of reimbursement. Inappropriate therapies may be initiated to justify continued care in acute and skilled nursing environments. Because healthcare professionals may not inform families about what can be done in the way of supportive care, they may choose to ¿do everything,¿ which often means using inappropriate treatments. Supportive Care of the Dying: A Coalition for Compassionate Care is a unique collaborative effort to help change the culture of dying in healthcare and to help Catholic and other organizations offer appropriate care based on respect for the sanctity of life, regard for human dignity, and a commitment to stewardship. The coalition intends to develop a comprehensive supportive care model built on Catholic values and tradition.

Attitude to Death↗
PubMed1991

Social justice in a time of crisis. Catholic tradition offers creative ideas for solving the problems of healthcare costs and access.

In this moment of crisis, Catholic healthcare leaders must seek root causes and thorough solutions to the pressures of rising costs and the grave question of access to healthcare. The first question is whether the system can be fixed or if a more radical approach is needed. To reach a solution, government, business, hospitals, and physicians must sit down at a common table to debate the issue. In 1981 the bishops outlined a series of values or principles that should characterize the U.S. healthcare system, including treating the whole person and providing access for all. These values have characterized Catholic healthcare facilities in the past decades and should not be lost in the present crisis and in the decisions being made for the future. Today, Catholic healthcare leaders have a broadened understanding of Catholic identity and the need to continually probe what that means. They realize Catholic identity is more than a few moral codes; it is a broader concern about the way in which healing takes place. Another gain is the development of lay vocations, but these are often restricted and should be more fully developed. In conjunction with this concept, we need to see hospitals as belonging to the whole Church in terms of its mission and thus the responsibility of the entire body of believers. Finally, a new image is needed concerning how care is provided. We need to bring prevention and care closer together, preventing duplication of major services and making certain basic services available to all.

Catholicism↗
PubMed1988

Two ethical approaches to research on human beings.

Since World War II the Catholic Church and national and international study groups have issued separate sets of statements regarding the ethics of research involving human subjects. The Church and the study groups agree on several points, including the following: Research on human subjects is a vital part of scientific medicine. Ethical research requires the informed consent of the subject or proxy. Research on human subjects is therapeutic or nontherapeutic. The risk of harm involved in research must be considered in regard to the potential benefit. Research on human beings should be allowed only after appropriate research on animals. Researchers should practice equity in selecting subjects and scientific problems to be studied. The human subject or proxy should be free to withdraw from the research program at any time. The two sets of statements generally disagree about nontherapeutic research on embryos and about genetic research. They also disagree on the use of in vitro fertilization and embryo transplants to initiate pregnancy. The disagreements are due to dissimilar ethical systems. The Church bases ethical analysis on a study of the effect an action has on basic human goods. As a result of this analysis, the Church maintains that some human actions are good or evil in themselves. If the action is evil insofar as the natural needs and functions of a person are concerned, it is not ethically good simply because it results in a good outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Advisory Committees↗
PubMedDate not supplied

Balancing benefit and burden. Merely avoiding harm does not carry out the intent of the Hippocratic Oath.

Healthcare providers often seek to benefit their patients through the avoidance of harm. This approach to benefit is rooted in the common understanding of the Hippocratic oath as primum non nocere--first, do no harm. A need exists in medical-ethical decision making to rediscover the principle of benefit per se, independent of the principle of avoiding harm. In healthcare the invasive, painful, costly, or repugnant nature of the treatment reflects the burden. Benefit, on the other hand, is personal. Rev. Gerald Kelly, SJ, moved away from considering objective burdens as the principal factor in determining the ethical status of a treatment and toward the presence or absence of some benefit. He also gave insight into the nature of this benefit: The treatment being considered should have a reasonable chance of offering a "remedial" effect. Recent literature has considered the "extent" of improvement as an important element in determining whether a treatment is of benefit. Not just any improvement justifies the treatment, but an improvement that fulfills the patient's reasonable expectations. The Declaration on Euthanasia states that if a treatment will or does fall short of expectations, it may be withheld or withdrawn on the grounds that the burdens involved are disproportionate. To understand a treatment as having proportionate value, one must also take into account that aspect of benefit which has not resulted.

Beneficence↗
PubMed1996

Abortions in Byzantine times (325-1453 AD).

The legislation and the texts of the most important medical writers of Byzantine times have been studied with reference to abortions, the ethical aspect of this social and medico-legal problem, the theological and the scientific approach. The theoretical basis of the permanent and absolute condemnation of all kinds of abortions except those permitted for medical reasons, is greatly influenced by the spirit of Christianity. In fact, religion supported the view that the reception of the seed in the uterus and the conception of the embryo means the beginning of life and accepted that the foetus is already a living creature. All legislation of Byzantium from the earliest times also condemned abortions. Consequently, foeticide was considered equal to murder and infanticide and the result was severe punishments for all persons who participated in an abortive technique reliant on drugs or other methods. The punishments could extend to exile, confiscation of property and death. The physicians followed the tradition of Ancient Greece, incorporated in the Hippocratic Oath, representative of the ideas of previous philosophers. According to this famous document, it is forbidden them to give a woman "an abortive suppository". The Orthodox faith reinforced this attitute, protective of every human life. On the other hand, the Church and the State accepted selective abortion based on medical data, such as prevention of dangerous conditions in pregnancy or anatomical difficulties involved. In conclusion, science, church and legislation had a common attitude to matters concerning abortion and this fact reveals an effort to apply a fair policy for the rights of the embryo and the protection of human life in Byzantine society.

Abortion, Spontaneous↗
PubMed2003

"Inappropriate" treatment near the end of life: conflict between religious convictions and clinical judgment.

Not infrequently, Christian patients and families provide religious justifications for an insistence on aggressive medical care near the end of life. Four commonly invoked reasons are (1). hope for a miracle, (2). refusal to give up on the God of faith, (3). a conviction that every moment of life is a gift from God and is worth preserving at any cost, and (4). a belief that suffering can have redemptive value. For each of these 4 reasons, however, there are alternative Christian interpretations that point in the direction of limiting medical intervention under certain circumstances. When clinicians believe that an intervention is medically inappropriate or inhumane, they are not necessarily obligated to provide it simply because it is demanded on religious grounds. Instead, clinicians-preferably assisted by chaplains or clergy-should discuss alternative religious interpretations with the patient or family, and should attempt to reach a consensus on the appropriate limits to life-sustaining treatment.

Aged↗