such as "Introduction", "Conclusion"..etc
Tharwat Mohammed Halwani B.S. Law, M.S. public Law
Free lance Lawyer
King Fahad Medical City
Riyadh, Kingdom Saudi Arabia
The Internet Journal of Health 2008; Volume 7, Number 1. [Open Access]
Background: Autonomy is respected in all medical management. Competent patient my give informed consent, but incompetent patients like children or unconscious adult patients need the informed consent of their guardians or surrogate mangers.
A well in formed competent patient has decision-making capacity; it is generally, in all societies, has the right to refuse medical therapy, including treatment that will sustain life artificially. During critical illnesses and in case of sustained coma such decision would be taken on his behalf by physicians and or next of kin or a manger that are following his advance directive. If the patient has made a decision to receive life-sustaining therapy, or if circumstances have arisen in which such therapies were initiated, the patient is free, supposedly, at any time to decide whether to have such treatments continue or be withdrawn. There are legal, economical and ethical issues governing such decision, all physicians would support the right to live. But the right to die is not well defined or accepted in most societies. In Islamic societies euthanasia and assisted suicides are forbidden. But the wishes of patient not to have his dying prolonged artificially with the presence of hopeless prognosis are well preserved. Such wishes may be declared in advance directive or accepted standing Do Not Resuscitate (DNR) order in certain hopeless medical conditions. There is no relevant distinction between withholding and withdrawing life-sustaining treatment. In this paper summarized (ICU) current practice in intensive care unit regarding initiating DNR order and Islamic advance directive sample for managing dying process in dignity.
Setting: Literature review
Method: A search of regional and international literature documents regarding policy and procedures was conducted to elicit current practice medical and legal guidelines for DNR order practices in Arabic and Islamic ICU units in the last months of year 2007
Results: There were 138 books and articles dealing with the general key words Do Not Resuscitate order in Google scholar 32 were relevant to guidelines. 12 articles were dealing with research and one leading article death with the issue of no-code as guidelines incorporated in optimizing the use of ICU in Saudi Arabia.
Other guidelines by medical assembly of North America Ethical Committee addressed the issue in details and in suggestion way as such guidelines do not get the same weight of the fatwa or Verdict of religious scholar
Conclusion: The general consensus was that the issue of end of life in Muslim societies is still evolving. There is great respect to human life and the exciting civil forbids euthanasia or assisted suicide, in regards other issues like brain death and DNR. The Islamic Verdicts were facilitating the easy courses of medical futility decided by competent doctors.
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