RESUMEN
Profound ethical challenges have been generated by the emergence of the COVID-19 pandemic. The unprecedented plights that have arisen have led nations to devise ethical roadmaps for handling their finite resources. Muslim countries are no exception and must continue to endure the effects of the pandemic, as more waves of infections from new strains are being reported. Given the scarcity of resources available to some countries, it is critical to adopt a roadmap to prioritize these limited resources based on ethical guidelines that are acceptable to Muslim communities. This work describes the concept of "ijtihad", a process frequently used by Muslim scholars to develop novel solutions to deal with unprecedented events, such as the recent pandemic. In this manuscript, Islamic perspectives were discussed on social justice and equality and how limited resources can be used in a way consistent with such perspectives. Relying on previous experiences of the Muslim community, such as the plague of Amwas, in which social distancing and quarantine strategies were used effectively to control the disease, and utilizing available guidelines such as "Al-Qawaid Al-Fiqhiyyah" and "Fiqh Al-Nawazel", we propose a practical protocol and roadmap that can be applied in the current crisis. Managing and prioritizing limited medical resources requires a just and ethically acceptable system. Islamic leaders should immediately develop a roadmap that emphasizes ethical values such as ihsan and altruism to help Muslim countries prioritize the limited medical resources available to medical staff to guarantee the sustainability of health services.
Asunto(s)
COVID-19 , Pandemias , Humanos , Islamismo , Pandemias/prevención & control , Cuarentena , SARS-CoV-2RESUMEN
BACKGROUND: Defensive medicine (DM) practice refers to the ordering or prescription of unnecessary treatments or tests while avoiding risky procedures for critically ill patients with the aim to alleviate the physician's legal responsibility and preserve reputation. Although DM practice is recognized, its dimensions are still uncertain. The subject has been highly investigated in developed countries, but unfortunately, many developing countries are unable to investigate it properly. DM has many serious ramifications, exemplified by the increase in treatment costs for patients and health systems, patients' exposure to risks, and negative effects on the psychological health of both health providers and recipients. Ultimately, the most serious consequence is the ethical consequences. METHODS: This work is based on a review of the literature related to DM worldwide and a comparison with the available knowledge found in Jordan. It is qualitative with a descriptive nature, aiming to diagnose the current DM practice in Jordan. RESULTS: This is the first published article that discusses DM in Jordan by diagnosing its ethical and economic consequences for the health system as well as for patients. Despite the knowledge of the reasons that support its practice, little is being done to solve this issue. The absence of agreeable medical malpractice law, the dearth of unified medical protocols, the overwhelming pressure imposed by patients on medical staff, and the deteriorating patient-physician relationship are some of the causes of DM practice. Surely, the solution to these issues is to focus on fortifying the ethical and humanitarian aspects on the side of both the physician and the patient to ensure positive collaboration. The ethical aim of the physician to treat the patient faithfully and do what is possible to help combined with the appreciation of the physician's efforts and the choice to not take advantage of the physician through litigation could be the most reasonable solution in the near future. CONCLUSION: Jordan is suffering from DM due to the limited financial expenditure on the health sector and the impracticality of medical malpractice law. The authors highlight that the cardinal step in solving this dilemma is restoring the ethical dimension of the patient-physician relationship.
Asunto(s)
Mala Praxis , Médicos , Medicina Defensiva , Humanos , Jordania , Relaciones Médico-PacienteRESUMEN
In light of the development of "CRISPR" technology, new promising advances in therapeutic and preventive approaches have become a reality. However, with it came many ethical challenges. The most recent worldwide condemnation of the first use of CRISPR to genetically modify a human embryo is the latest example of ethically questionable use of this new and emerging field. Monotheistic religions are very conservative about such changes to the human genome and can be considered an interference with God's creation. Moreover, these changes could cause perpetual changes to future generations. The Muslim scholars establish their decisions by addressing five foundations of Islamic law i.e. "maqasid al shariÌ`a"; the purposes of the law. These are dinÌ (religion), nafs (life), nasl (progeny), `aql (intellect) and mal (wealth). To achieve this, the five principles should all be met before approval of an experiment like the Chinese embryo modifications; Qasd (intention) which is achieved in this case as it aims to protect the embryo from HIV. YaqinÌ (certainty) and Darar (injury) were not satisfied as they require strong scientific certainty of the procedures, and evidence of safety. Darura (necessity) by which the alternatives being compared; in this case more established and proven safe alternatives to protect the HIV transmission from the father are available, so this principle is not met. The final principle is `Urf (custom), by which the social context of using any contemporary technology should be taken in consideration, and clearly this was not achieved. Collectively, germline changes are rejected from an Islamic perspective until the five principles are fulfilled. In the Chinese Twins gene editing case, there was clearly no justification or support for it according to the Muslim Jurisprudence laws. These laws and approaches can serve as an ethical checklist for such controversial research, especially in early stages of the research.