In recent decades, great attention has been paid to ethical issues as an inevitable consequence of emerging biomedical advances. There have been ever-increasing discussions about ethical aspects of this new knowledge in different societies. Accordingly, the propensity in scientific society to look for legitimate solutions to moral dilemmas has led to the involvement of bioethics with the law. Some countries now have rulings and guidelines on bioethical concerns, although legislation in some challenging cases such as cloning has produced controversies.
The academic efforts of bioethicists to address these modern dilemmas has provided crucial assistance to both political and professional societal leaders. (1) Organizations such as WHO and the United Nations Educational, Scientific and Cultural Organization (UNESCO) have recognized the necessity for creating specific guidelines to protect human rights in health-care settings. The principal issue involved is the influence that various sociocultural and religious backgrounds exert in different countries. UNESCO's Global Ethics Observatory (GEObs) initiative is a resource of databases that encourage international collaboration and provide support to all interested parties. (2)
Bioethics empowerment and legislation have received special attention in the Islamic Republic of Iran. The most important recent efforts have been the enactment of regulations covering new fields of science and technology and the compilation of The ethical guidelines for biomedical research. We will review these endeavours and the legislative process. First, we intend to elucidate the religious background of our country, which is very important for understanding and practising bioethics in the Islamic Republic of Iran.
Values and principles
In the Islamic Republic of Iran, in which Shi'a Muslims are in the majority (80-90%), ethical issues are discussed among medical physicians and religious scholars. The main rules of activities consist of the holy Quran and principles of Islamic ethics; the religious opinions (Fatwa) of Islamic scholars on special issues; the national laws or ethics codes; international guidelines; and the norms of the society. Since minority groups such as Sunni Muslims and Armenians are represented in the parliament, their opinions are also considered in religious discussion. On account of the fact that there is a diversity of opinions among different religions, all Iranians, Muslim or non-Muslim, are permitted to follow their religious beliefs providing that they are not against the law. For example, concerning contradiction over cadaveric donation, brain-dead organs will be donated only if there is valid consent of the deceased and his/her family.
Although the main principles of "western" bioethics (autonomy, beneficence, non-maleficence and justice) are acceptable according to Islam, (3) interpretation of them can differ. For example, there is a limit on autonomy; sometimes the interest of the society is preferred to individual rights.
In Muslim countries, in any discussion on bioethics, there is a tendency to look towards religion. Islam is believed to be able to fully restore the harmony between religion and science. (4) The principles of bioethics and solutions to ethical problems are therefore derived from the Islamic legal rulings. The main principles of Islamic ethics are the respect for human dignity, eternity of life (immortal soul and lire after death), altruism, benevolence to fellow human beings, seeking perfection and eternal salvation, and association of a human being with God and the universe. It is noteworthy that there is a wide overlap between Islamic bioethics, the Islamic rulings (Fegh or Shari'a) and law, so that some religious principles such as eternity of life or seeking perfection could be very important in ethical decision-making in an Islamic setting. For instance, in the issue of the end of life, suffering a lot of pain cannot justify ending life in terminally-ill patients who believe in resurrection. …