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首页> 美国卫生研究院文献>Journal of Medical Ethics and History of Medicine >End-of-life care ethical decision-making: Shiite scholars’ views
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End-of-life care ethical decision-making: Shiite scholars’ views

机译：临终关怀伦理决策：什叶派学者的观点

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Recent advances in life-sustaining treatments and technologies, have given rise to newly-emerged, critical and sometimes, controversial questions regarding different aspects of end-of-life decision-making and care. Since religious values are among the most influential factors in these decisions, the present study aimed to examine the Islamic scholars’ views on end-of-life care.A structured interview based on six main questions on ethical decision-making in end-of-life care was conducted with eight Shiite experts in Islamic studies, and was analyzed through deductive content analysis.Analysis revealed certain points in Islamic views on the definition of death and the persons making decisions about end-of-life care. According to the participants, in addition to conventional criteria (‘urf) such as absence of heartbeat and respiration, the irreversible cessation of human voluntary acts (as a sign that the soul has control over the body and the faculty of thinking) are considered to be the criteria in establishing death. The participants also recognized physicians as the main authorities in verifying signs of death. Furthermore, it was emphasized that life preservation and continuation of care must be sensible, and the patient can request not to have death-prolonging procedures started or continued.In the view of participants, patient’s autonomy cannot be the sole basis for all measures, but Islamic ethical and jurisprudential principles should be relied upon to make correct and sensible decisions whether to continue or stop terminal patients’ care. Final decisions should be made by a team of experts, and physicians must be at the center of such a team. Finally, we suggest that a guideline in keeping with Islamic norms on human life and death, purpose of life, God’s will, boundaries of man’s authority, and the physician’s ethical duties and obligations should be developed.
机译：在生命维持治疗和技术方面的最新进展引起了关于生命终止决策和护理各个方面的新出现的，关键的，有时甚至是有争议的问题。由于宗教价值观是这些决定中最有影响力的因素之一，因此本研究旨在考察伊斯兰学者对临终关怀的看法。基于六个主要问题的结构化访谈，对临终关怀的伦理决策生命护理由八名什叶派伊斯兰研究专家进行，并通过演绎内容分析进行了分析。分析揭示了伊斯兰观点中有关死亡定义和生命终止决定者的某些观点。参加者认为，除了常规标准（'urf），例如没有心跳和呼吸外，人类自愿行为的不可逆转的停止（作为灵魂控制身体和思维能力的标志）被认为是是确定死亡的标准。参加者还承认医师是核实死亡迹象的主要机构。此外，还强调了生命的保存和继续护理必须是明智的，患者可以要求不要开始或继续延长死亡的程序。在参与者看来，患者的自主性不是所有措施的唯一基础，但是应该依靠伊斯兰的道德和法学原则来做出正确和明智的决定，是继续还是停止对最终患者的护理。最终决定应由一个专家团队来决定，而医生必须处于这样一个团队的中心。最后，我们建议应制定有关人类生死，生活目的，上帝的旨意，人的权威界限以及医师的道德义务和义务的伊斯兰准则。

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