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Islamic medical ethics in the 20th century.

While the practice of Western medicine is known today to doctors of all ethnic and religious groups, its standards are subject to the availability of resources. The medical ethics guiding each doctor is influenced by his/her religious or cultural background or affiliation, and that is where diversity exists. Much has been written about Jewish and Christian medical ethics. Islamic medical ethics has never been discussed as an independent field of ethics, although several selected topics, especially those concerning sexuality, birth control and abortions, have been more discussed than others. Islamic medical ethics in the 20th century will be characterised on the basis of Egyptian fatawa (legal opinions) issued by famous Muslim scholars and several doctors. Some of the issues discussed by Islamic medical ethics are universal: abortions, organ transplants, artificial insemination, cosmetic surgery, doctor-patient relations, etc. Other issues are typically Islamic, such as impediments to fasting in Ramadan, diseases and physical conditions that cause infringement of the state of purity, medicines containing alcohol, etc. Muslims' attitudes to both types of ethical issues often prove that pragmatism prevails and the aim is to seek a compromise between Islamic heritage and the achievements of modern medicine, as long as basic Islamic dogma is not violated.

Bioethical Issues

Medical ethics and the Islamic tradition.

After tracing the main features of the foundational ethical perspectives and their relationship to the rise of medical practice in early Islam, the paper focuses on the development of the moral concept of adab. This concept served as an important tool in defining and shaping an ethical tradition based on the integration of the Hippocratic tradition into Muslim medicine and its underlying moral values. The existence of plural therapeutic systems and their moral and theological sources are also noted and an attempt is made to show how all of these diverse modes co-existed through most of the pre-modern history of medicine among Muslims. The paper ends by outlining the impact the European colonial and cultural encounter with the World of Islam had, in creating a duality in medical practice, education and institutions, thus limiting sustained and meaningful discourse between modern medical science and the ethical values of Islam.

Cultural Diversity

[The importance of Islam religious philosophy for psychiatric practice].

Experience has shown that Muslim patients in psychiatry cause special problems. The article outlines the Islamic religion and demonstrates that Islam embraces all spheres of its follower's life. This causes many kinds of special behaviours and attitudes that have considerable consequences for psychiatric therapy. The consequences in the most important areas of therapy are illustrated, and this should enable the therapist to gain an adequate understanding of the world of his patients. However, if he works often with Muslim patients it will be essential for him to acquire a comprehensive knowledge of the religion on Islam.

Combined Modality Therapy

The health risks of occupational stress in islamic industrial workers during the Ramadan fasting period.

During Ramadan, Moslems are required strictly to avoid fluids and nourishment from dawn to sunset. Heat stress during such abstinence represents a substantial health hazard. In the Federal Republic of Germany (FRG) where numerous Moslems, particularly of Turkish origin, perform heat work and other heavy labour, we observed moderate to severe health disturbances in such labourers during Ramadan, e.g.: tachycardia, severe headaches, dizziness, nausea, vomiting and circulatory collapse. The severe dehydration of these workers was demonstrated by substantial increases in their hematocrit, serum protein, urea, creatinine, uric acid and electrolyte imbalance. Because of the evidence of the substantial health hazard to Islamic workers in such situations, we have strongly urged employers to refrain from assigning Islamic workers to heat work or heavy daytime work during Ramadan; we have therefore limited systematic studies of health problems during Ramadan to persons performing only moderate work. Even under these conditions signs of dehydration were found in the 32 labourers monitored. Some of these labourers also had to interrupt their observance of Ramadan due to health problems, e.g.: acute gout due to serum uric acid increase, or circulatory insufficiency. In light of the observed potentially harmful pathophysiological effects, the danger of dehydration of Islamic workers due to heat work during Ramadan should be taken very seriously.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Weight

A differential diagnosis of the inspirational spells of Muhammad the Prophet of Islam.

This paper reviews the spells of Muhammad, the Prophet of Islam. During these spells, Muhammad sensed the approach of a figure whom he thought to be the Angel Gabriel. The inspirational message transmitted to Muhammad during these spells helped form the religion of Islam. This is a review of the historical details of these spells and an attempt to reach a medical diagnosis. Although an unequivocal decision is not possible from existing knowledge, psychomotor or complex partial seizures of temporal lobe epilepsy would be the most tenable diagnosis. An examination of Western civilization's views of Muhammad's spells reveals historical and modern misconceptions about epilepsy.

Arabia

The Islamic psycho-social approach to alcoholism.

Alcoholism in Islamic countries has such a low incidence that it is not yet considered a serious public health problem of the Moslem states. The reason is that the precepts of Islam succeeded in reducing alcoholic dependence, and offer a unique example in prohibiting this social evil.

Aged

Islam and family planning acceptance in Bangladesh.

One frequently cited barrier to more widespread adoption of family planning in Moslem countries is religious opposition. To examine the depth and extent of such opposition in Bangladesh, 106 men who had been identified by their wives as religiously opposed to family planning were interviewed. Unexpectedly, 26 percent of the "opposing" husbands reported that they were current users of a contraceptive and an additional 50 percent, although not practicing, said they were in favor of family planning. Of the alleged "opposers," only 23 percent said they opposed family planning on religious grounds. One-fourth of this last group were able to cite specific islamic injunctions against family planning. It appears on the basis of these data, which were collected in the religiously conservative area of Lakshimipur, that the perception of widespread Islamic-based resistance to contraception in Bangladesh is not founded in fact.

Bangladesh

The Islamic movement, development, and health education: recent changes in the health of rural women in central Sudan.

Follow-up research on women's work and health in two rural areas of Sudan in 1989 identified several areas of change since the 1970s. Health improvements due to better access to education and health services were noted. However, interethnic contacts have led to some experimentation with the severe form of female circumcision in one area while health education and the Islamic movement have contributed to a decline in popularity of it in another area. Further, the structure of agricultural development has resulted in changes in women's participation in agriculture and polygyny rates, which have had impacts on birth rates.

Agriculture

The influence of Islamic views on public attitudes towards kidney transplant donation in a Saudi Arabian community.

Public attitudes towards organ donation during life and at death were examined in a randomised survey of 850 individuals, both male and female, in a representative Saudi Arabian community in Riyadh. Demographic categories accounted were age, sex, marital status, cultural and ethnic background, educational level and occupation. Of the sampled population 87% were native Saudi and the mean age was 30.7 years. Students and teachers made up the largest occupational groups and only 8.1% were illiterate. Although only 10.1% of all subjects had signed a kidney donor card, a further 42.6% expressed willingness to do so. Acceptance of organ donation at death was highest amongst males and in the age group below 30 years (P less than 0.05). There was no differential effect of the various demographic sub-groups in willingness for kidney donation during life. Sixty-five per cent were ready to donate to a close relative and 9.3% were even prepared to do so to a non-related recipient. The Islamic view supporting concepts of transplantation provided the strongest positive influence for organ donation both during life and at death. Dread of mutilation and the fear that pre-consent may adversely affect treatment after serious injury proved potent negative influences.

Adult

Drugs and Iran after the Islamic revolution: prophesying the next quarter century.

Prior to the Islamic revolution of 1979, research on Iran's long-standing drug use patterns had begun in clinic settings, but there were few data available on countrywide use. Opium, the traditional drug used in social settings and produced in quantity in the east of the country, was the first target of fierce antidrug measures in 1979. The course of future drug cultivation, use, treatment and, therefore, research needed on the drug problem is closely linked to political developments in Iran. Much will depend on whether Iran maintains an independent stance or rejoins the international agencies' efforts.

Drug and Narcotic Control

Fasting in Islam.

Summarized are the significance of fasting in Islam, the rules and regulations of fasting, types of fasting, nullification of fasting, and food practices and habits of Muslims during the fasting month of Ramadan. Some problems pertaining to fasting and their solutions are also considered, and applications of fasting to America have been pointed out. It is hoped that this paper may bring a new dimension to the sphere of cultural nutrition and encourage partial fasting as a means of curbing inflation and helping the poor, the needy, and hungry all over the world.

Aged

[Infectious perforation of the terminal ileum. Apropos of 42 cases treated in the Islamic Republic of Mauritania].

The authors report 42 infectious perforations of terminal ileum operated at the National Hospital of Nouakchott (Islamic Republic of Mauritania) from 1985 to 1988. The main etiology is typhic (67 p.c.). The mortality is important (21 p.c.). The standardization of medico-surgical treatment and the use of cotromoxazole open the way to a better prognosis, but differed diagnosis and socio-economical conditions are some burdens, common to developing countries that have to be taken into consideration.

Abdominal Pain

Pediatric surgery in Islamic medicine from the Middle Ages to the Renaissance.

Albucasis lived throughout the tenth century, practicing medicine for more than 40 years in Zahra at the outskirts of Cordoba. This was the period of the greatest splendour of Arab domination of Spain. Albucasis taught medicine at the university of Cordoba and published an encyclopedia of medicine comprising 30 volumes, the last one dealing with surgery. This work was translated into all civilized languages and was the standard medical textbook right till the eighteenth century. This paper deals with many pediatric surgical conditions as described in Albucasis' 30th volume. The pathology and treatment of harelip, hydrocephalus, the adenoids, ranula, gynecomastia, imperforated external urinary meatus, circumcision, hermaphrodites, imperforate anus, and supernumerary and webbed finger were all described by Albucasis, and his remarks are discussed here in some detail.

General Surgery