Love and medical ethics in Iran

- Alizhera Bagheri, M.D.
Center for Medical Ethics, Tehran, IRAN
Mail address: No. 16, 4th Alley, Nemati St., Dolat Ave,
Pasdaran 19396, Tehran, IRAN
Email: bagheria@yahoo.com
Eubios Journal of Asian and International Bioethics 9 (1999), 43-44.


Introduction

Love is a concept that humankind has always been aware of in all periods of the history of humanity. Throughout human history, this concept has been used among various nations and religions with slight differences in meaning. It can be claimed that in addition to worship, the concept of love has been a motivating factor in creating a common sense among different nations.

In this paper, I will try first to deal with the role of love in Islamic mysticism and literature then with the status of medical ethics in Iran and the impact of love on it.

Firstly, I have two problems: one is to put lofty concepts into language and words, and the other is the problem of rendering such concepts into another language.

As Sohravardi defined love, "When affection reaches its highest point, it is called love. Love is more specific than affection because any love is affection as well, but every affection is not love."

Love is not material. We can experience love. We experience love through benevolence, forgiveness, relationship with God, mercy, compassion, peace, happiness, sincerity and intimacy. Love is the unending bless of God and the fact of life. Awareness of love and experiencing it in relation to others is the true meaning of life. Love is entrusted in human beings. No one can remove it but they can only conceal it. Today, a few people can experience love in their life since the world has changed in such a way that people take heed of love little.

Unfortunately, our children, too, will grow up in such a world. Isn't it true that most part of world news is nothing but news on anger, violence, violation of human rights, invasion against other nations, and aggression against nature and environment. The violence in human beings should be polished and cleaned with love to attain its balance and become a factor of coordination and coexistence rather than a factor of disobedience and aggression.

When this God-created being forgot love and forgot to smile to life, a world full of illusions and satanic temptations has emerged. This was a time of turning to fear and dominance of violence and separation of the human being from his Creator.

When we give priority to love, we have indeed actualized God's power. Because our power and ability is derived from Him. Love should be given and taken. God the Almighty loves human beings as well. If it were not so, He would not grant human beings the power to perceive love.

Islamic mystics use poetry in a symbolic way to express their mystical concepts of love. In the symbolic use of poetry, words have two dimensions of meaning: superficial and deep. People of the superficial life understand it as its form and those of inner life understand its deep meaning. Hence, mystics believe that the language of love is not a straightforward explicit one; it is a symbolic language. Mowlavi says,"When you hear a word or a point from a mystic you should not take its surface meaning."

Love in the view point of Hafiz

Features of love, as Hafiz believes, are as follows:

  1. Love is a means of understanding the truth.
  2. Love is the source of creating the human being and the first element created by God the Glorious.
  3. Love is a factor in giving up selfishness and refraining from selfishness is the basic principle of ethics.
  4. Love is the factor in refraining from hostilities and bringing about peace and friendship.

According to Hafiz, love distinguishes the human being from other beings. He considers love as an alchemy that can change the copper of human existence into gold. Thus, he says, "From the copper of existence, like men of (mystical) path, thy hand wash, So that love's alchemy, thou mayst obtain; and gold thou mayst be."

Also he considers love as an art and believes that a person without love is a person without art. Thus, he says, "Khwaja! Strive portionless of love be not; For none buyeth the slave with the defect of being void of art."

The relationship between intellect and love

One of the issues sometimes discussed among philosophers and mystics is the relationship between intellect and love. The Islamic mystics believe that there are two ways to reach the truth: one is the way of intellect and the other is the way of love, out of which, the mystics prefer the way of love because, in their opinion, the intellect is a conservative faculty but love is a revolutionary power. That is, the intellect has the mission to 'preserve' the human being. The wise human always wants to preserve himself and takes caution. He wants everything for himself and this is the way much emphasized by philosophers. On the contrary, love is a power that wants to come out of itself: whether in the Absolute Truth, in God the Almighty, that wants to manifest itself or in the created beings that wants to fly towards Almighty God. Thus, the mystics emphasize on the power of love that is revolutionary, rather than on the faculty of intellect or reason that is conservative.

The mystics maintain that love has created the world. Thus, Hafiz says, "In eternity without beginning, of glory, the splendor-ray of thy beauty boasted. Revealed became love; and, upon old world fire dashed." That is, when Your Being wanted to manifest, love appeared (the manifestation of God the Glorious caused the emergence of love) and made every being your lover. Again Hafiz says, "Thy face displayed splendour; beheld the angel had no love. From this jealousy, it became the essence of fire; and Adam dashed."

The Islamic Mystics believe that if instead of searching for the secrets of the world, the human being looks for, or tries to approach, the Truth itself, the secrets of the world will also be revealed to him.

Medical ethics in Iran and the impact of love on it

The second part of this paper will be divided into two sections: a) ethics among Iranian physicians, b) resolving the ethical problems in medicine.

a. Ethics among Iranian physicians

The Islamic ethics is one of the principles of Islamic teachings. Here, it can be claimed that fortunately Iranian physicians satisfactorily observe principles of ethics and set their relations with their patients on the basis of Islamic ethics.

In Iran, the medical job is based on love of life and affection and altruism for human beings. The Iranian physicians have learned that they indeed deal with sick people rather than with various diseases and disorders. On this basis, the correct treatment depends on establishing an appropriate relationship between the physician and the patient. Such a relationship that is based on benevolence, affection, altruism and mutual trust is considered as the central focus of medical work in Iran.

Of course, it is necessary to note that in countries which are not themselves producers of technology and they are only its consumers, the traditional patterns of ethical relations are more subject to unpleasant changes. Thus, it is necessary to make more attempts in the field of bioethics to observe ethical considerations in such countries. Here the ethical systems must consolidate their position against the ruling of medical technopoly so that they can respond to the ethical questions raised by technology because the unilateral growth of medical technopoly can be dreadful without development of ethical systems.

In Iran, the patient's autonomy is recognized as a principle by physicians. On the other hand, patients, too, have realized traditionally that the physician is a benevolent person. On the basis of such benevolence, physicians perform whatever is good for the patient and attempt is made to prevent the patient's autonomy from hurting himself.

When there is a contradiction between what the patient wants and what the physician considers right for the patient, physicians try to follow the principle of benevolence without violating the patient's autonomy by giving sufficient information to make the patient aware of what is suitable for him or her, and hence they help the patient to decide in a way to prevent from hurting himself or herself.

Of course, the patient has always the right to consult with other physicians and choose his or her physician freely. Therefore, it is very important that the patient's autonomy should not cause any damage to himself or herself due to lack of knowledge.

In Islam, it is an inappropriate objective for physicians to charge bills for their services. Rather physicians should have a humane attitude towards the patient and their objective in treating patients should be to help preserve a human's life as an ethical value; the physician should have the intention of approaching God the Almighty in his job of treating sick people.

b. Resolving the ethical problems in medicine

Unfortunately academic departments of medical ethics have not been established in medical faculties in Iran. However, some physicians who are interested in this field do researches at the Center for Studies and Researches on Medical Ethics that was founded in 1992 in Tehran. Also the fields of philosophy and ethics are taught in universities, and distinguished scholars are educated in these centers as well as in theological schools.

Thus, at present medical specialists, scholars of philosophy and ethics, and religious scholars cooperate in order to survey and respond to the ethical questions in medicine, like abortion, the brain death, and Euthanasia. A proper activity has started since last year to formulate ethical codes to be observed in the researches on human subjects. I have the honor to work as its executive manager. However, it does not mean that ethical codes have been ignored in research plans; rather on the basis of Helsinki codes and cultural and religious issues, these plans have been reviewed. We have tried to make those codes comprehensive and incorporate further legal instruments to prevent their probable abuse, and to standardize them. Following this activity, we have recently been able to activate the National Ethical Review Committee in the Ministry of Health.

Finally, ladies and gentlemen, I would like to add one more point: with the attempts of the World Health Organization, the hygienic indexes have been so much improved that the Organization can even hope to eradicate infectious diseases as it managed to uproot small pox in 1980. Every year, the World Health Organization declares a slogan as its objective and tries to achieve it. Here I would like to suggest that the ground should be provided so that the World Health Organization announce an ethical value in medicine as its yearly slogan. For example, Observe ethical codes in your researches on human subjects

or Distribute hygienic facilities justly. Then, the Organization can ask the member countries to try to follow them on the basis of their national standards.

Conclusion

On the whole it seems impossible to actualize the world slogan, "health for all" unless the basic principles of bioethics, like justice and macroallocation, are consolidated in the world. Let's undertake this common responsibility and realize that the best strategy to consolidate the principles of bioethics is to propagate 'love for life'. What makes us hopeful is the love given by people of the world to the world: this gift granted to us human beings by God Almighty who has encouraged us to preserve and improve it.


Go back to EJAIB 9(2) March 1999
Bioethics is Love of Life An alternative textbook on cross-cultural ethics by Darryl Macer
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