Medical Figh

Since the onset of the scientific and industrial transformation in Europe, it was widely assumed that the ever-expanding branches of human knowledge, on the one hand, and the impossibility of mastering all of them, on the other, would inevitably lead to the separation of different fields of science. Consequently, the humanities gradually diverged from the natural sciences and engineering disciplines, while each of the latter also pursued its own distinct path. Yet, as this separation continued over time, the need for greater interconnectedness among the sciences became increasingly apparent. After all, the entirety of human knowledge either serves humanity or seeks to understand it; therefore, no field of knowledge can be meaningfully discussed without reference to human beings and human considerations.

This need, and the perspective that emerged from it, gradually elevated the significance of interdisciplinary studies, providing scholars with opportunities to examine a subject or problem from multiple perspectives and through diverse methodological approaches.

Medicine is undoubtedly among the most interdisciplinary of sciences. Owing to its multifaceted epistemological dimensions, it draws upon a wide range of fields of knowledge. Through a dynamic and reciprocal interaction between medicine and other disciplines, new areas of inquiry have emerged, including medical sociology, medical law, and medical ethics.

Although Islamic jurisprudence (fiqh) concerns itself with the acts of legally responsible individuals (mukallafūn) and the five normative rulings-obligation, prohibition, reprehensibility, recommendation, and permissibility-while medicine focuses on the human body and its health, an interdisciplinary domain emerges whenever a Muslim individual becomes involved in the therapeutic process, whether as a patient receiving treatment or as a physician providing it. In such circumstances, medical actions become subject not only to the five legal rulings but also to legal status rulings (aḥkām waḍʿiyyah), thereby giving rise to the field of Medical Fiqh.

Medical Fiqh has thus established its place as an interdisciplinary field situated between the humanities and the medical sciences. Medical phenomena are closely intertwined with the teachings of Islamic jurisprudence, and from their interaction emerge practical guidelines governing the conduct of both patients and physicians. For example, a mother's illness and her inability to continue a pregnancy constitute a medical issue whose diagnosis falls within the physician's expertise. However, the implications of that diagnosis may lead to specific legal obligations and rulings affecting both the patient and the physician.

Engaging Islamic jurisprudence with emerging medical issues and striving to provide religious and legal responses to them is a demanding task. The medical community is not generally accustomed to such a specialized interaction with a non-empirical field such as the humanities, and religious scholars (fuqahāʾ) likewise often lack sufficient experience in formulating realistic responses to novel medical challenges. Such responses require not only a thorough understanding of juristic principles and methods of legal deduction but also an accurate and comprehensive understanding of the medical subject itself. This challenge has become one of the most significant issues confronting contemporary jurists.

Although the juristic engagement with medical issues may appear to be relatively recent, a careful examination of the primary sources of Islamic law reveals that Muslim jurists, in accordance with the circumstances of their respective times and places, have consistently sought to address such issues and derive their legal rulings from the four recognized sources of Islamic jurisprudence.

It is hoped that the publication of scholarly research in the Journal of Medical Fiqh will contribute meaningfully to the advancement of interdisciplinary scholarship and foster deeper engagement with the issues and challenges arising within the field of medicine.

Background and Aim: The rule of “prohibition of two seminal fluids in one uterus” plays a critical role in analyzing jurisprudential rulings related to modern medical technologies, particularly in fertility treatments and infertility solutions. This article examines the application of this rule to resolve novel medical dilemmas, aiming to clarify its implications for contemporary ethical and legal challenges.

Materials and Methods: In this descriptive-analytical article, first, we examine the sources and jurisprudential texts, and then, by analyzing practical and applied examples, we attempt to explain the role of the rule "prohibition of two seminal fluids in one uterus" in solving emerging medical problems.

Conclusion: When modern fertility technologies result in the mixing of two seminal fluids, the prohibition derived from the rule “prohibition of two seminal fluids in one uterus” extends to such practices. This prohibition applies to three key domains: 1) Assisted Reproductive Technologies (ART): Case 1: Using sperm from a unrelated male (Namahram) to impregnate a woman whose husband is infertile. Case 2: Surrogacy involving a married woman’s uterus. 2) Genetic Editing: Utilizing sperm from another male in genetic modification procedures. 3) Multiple Embryo Implantations: Implanting a second embryo into a pregnant woman, particularly when the embryo belongs to another couple (known as “double pregnancy”). In all these cases, “prohibition of two seminal fluids in one uterus” rule serves as a jurisprudential framework to address ethical complexities in modern medicine.

Background and Aim: In recent years, the world has witnessed the emergence of CRISPR/Cas-9, a low-cost, accessible, and precise gene-editing biotechnology that can target and modify specific segments of DNA responsible for particular traits or disorders without harming other regions. Unlike genetically modified organisms (GMOs), this technology avoids many of their potential ethical and biological challenges. Its ability to revolutionize agricultural practices-by improving crop yields and quality through targeted genetic modifications-necessitates a jurisprudential analysis to establish ethical and legal frameworks governing its application within domestic contexts.

Materials and Methods: This research is an interdisciplinary study in the fields of biotechnology and Islamic jurisprudence, employing a descriptive-analytical methodology. By reviewing the latest scholarly articles and existing knowledge on CRISPR, it investigates the jurisprudential legitimacy of utilizing this technology to enhance food security in agricultural products.

Conclusion: The utilization of CRISPR technology in agriculture does not conflict with the divine purpose of creation and holds the jurisprudential ruling of permissibility among the fivefold Islamic legal classification (aḥkām khamsah taklīfiyyah). Furthermore, it carries the applied ruling of legality. By analyzing principles such as the prohibition of wastefulness (isrāf)-given CRISPR’s role in preventing resource depletion-and its alignment with "strengthening the Islamic system", alongside evaluating arguments from proponents and opponents, this study concludes that its use is permissible and lawful under normal circumstances. In cases of necessity or emergency, however, jurisprudential evidence-such as the obligation to preserve life (ḥifẓ al-nafs), protect societal integrity (ḥifẓ kiyān), and the Quranic injunction "And prepare against them whatever you are able" (Quran 8:60)-as well as the rational precedent of preventive measures, render its application obligatory and legally binding. Therefore, formulating laws and standards for CRISPR must be integrated into the national legislative framework.

Background and Aim: The non-payment of a wife’s medical expenses as part of spousal alimony (nafaqa) represents an undeniable necessity within Iran's jurisprudential criminal justice system, due to its connection to public order and the protection of marital rights for women. This has led to the criminalization of spousal abandonment (tark-e enfāq) under certain conditions. However, disregarding the origin of the wife’s illness within this criminal imperative not only conflicts with the phrase "payment of alimony commensurate and proportional to the wife's circumstances" in Article 1107 of the amended Civil Code (1381/2002), but also fails to align with principles of equity and judicial justice. The question thus arises: In what criminal position does the husband stand when failing to pay the medical expenses of his wife who is afflicted with various diseases that prevent her from fulfilling specific marital obligations towards him?

Materials and Methods: The present study, drawing on authentic jurisprudential and legal sources and employing a descriptive-analytical method, examines jurisprudential and legal perspectives on the impact of the state of affliction and the origin of diseases preventing a wife's specific marital compliance (tamkin-e khaas) on the realization of the crime of spousal abandonment (tark-e nafaqa) by the husband.

Conclusion: The findings indicate that by invoking the principles of barā'at (presumption of innocence), tasbīb (causal liability), and iqdām (voluntary action) – which are more compatible with judicial equity and justice – it is possible to remove the criminal characterization of 'abandoning spousal maintenance (nafaqa) from certain cases of non-payment of a wife's medical expenses, thereby preventing the husband's conviction for this criminal offense.

Background and Aim: The liability of a non-culpable, authorized physician in the event of injury to a patient is one of the controversial issues proposed among Imamiyyah scholars. Jurisprudential disagreement on this matter has led to the adoption of various approaches throughout the legislative period following the victory of the Islamic Revolution. Specifically, until the adoption of the Islamic Penal Code in 1392 SH, following the majority opinion of jurists, the theory of the physician's absolute liability was accepted. However, despite this theory being accepted in the judiciary's draft of the Penal Code and also in the initial bill passed by the Islamic Consultative Assembly (Majlis), the Guardian Council deemed this perspective flawed. Consequently, in order to resolve this flaw, the Majlis, by adding a note, approved the less prevalent view, namely the theory of the physician’s fault-based liability. The legislation of this less prevalent view, after three decades of the dominance of the theory of the physician's absolute liability, raises the question: what is the basis for the legislator's deviation from this theory?

Materials and Methods: The present research has been conducted using a descriptive-analytical method. The data was analyzed qualitatively by referring to documents and library resources.

Conclusion: The findings indicate that the legislator's deviation from the majority opinion of the jurists in the Islamic Penal Code adopted in 1392 SH was not due to the strength of the foundations of the less prevalent view. Rather it was a result of the incorrect interpretation of the majority opinion and the jurisprudential decree (fatwa) of Imam Khomeini (RA) during the stage of religious (Sharia) review of Article (495) of this law. The Guardian Council declared this article to be in contravention of Sharia, and consequently, the Parliament amended the approved bill in accordance with the less prevalent view in order to satisfy the Guardian Council's opinion. Therefore, considering the error that occurred during the religious review stage, and given the solidity of the evidence supporting the majority opinion, it is necessary to stablish the jurisprudential decree of the Supreme Leader (Vali-e Faqih) as the standard for state regulations, to resolve the ambiguities and contradictions present in the current article, to replace the text of Article (495) with the original draft from the Judiciary and the Parliament's initial bill and to remove note 1 (Tabsareh 1) of this article.

Background and Aim: The rule of qur‘a in Imami jurisprudence and the principle of lottery in biomedical ethics each provide a mechanism for dealing with situations in which no action can be decisively preferred over others, making decision-making difficult. The present study aims to examine the degree of conceptual compatibility and practical applicability of the juristic rule of qur‘a and the lottery principle in medical ethics, in order to utilize the potential of each in resolving clinical dilemmas.

Materials and Methods: This study used a descriptive–analytical, comparative approach. Drawing on Imami jurisprudential sources (the Qur’an, hadiths, jurisprudential rules and principles) and biomedical ethics literature related to theories of procedural justice, impartiality, and equality of opportunity, it investigates the issue of lottery from both jurisprudential and biomedical-ethical perspectives.

Conclusion: The findings indicate that the qur‘a in Imami jurisprudence—beyond its traditional application in deciding cases of uncertainty—can also be employed in situations involving conflicting rights. In biomedical ethics, although there are differing views on the fairness of using a lottery, this article, drawing on theories of procedural justice and impartiality, recognises the lottery as a legitimate method for allocating scarce healthcare resources. Therefore, there is no fundamental or significant conceptual or practical difference between the jurisprudential rule of qur‘a and the lottery principle in biomedical ethics.

Background and Aim: The civil legislator has provided specific rights for the wife in the event of the husband's impotence, sexual dysfunction, and sexually transmitted diseases. Article 1122 of the Civil Code grants the wife the right to divorce under certain conditions if the husband suffers from impotence or sexual dysfunction. Article 1127 recognizes also the wife’s right to prevent sexual intercourse in cases of the husband’s sexually transmitted diseases, while maintaining her financial support. Given that, on one hand, sexual satisfaction and its relation to marital satisfaction and mental health are among the most significant findings of psychological sciences regarding marital relationships, and on the other hand, the legislator's supportive approach towards the wife's sexual satisfaction as an important component of her sexual rights, along with the establishment of enforcement mechanisms, can prevent issues such as marital infidelity, the question arises as to how much attention the legislator has paid to the wife’s sexual satisfaction in formulating these articles.

Materials and Methods: This research employs a descriptive-analytical method to collect information through library resources using a note-taking approach.

Conclusion: Analyzing the jurisprudential texts related to Articles 1122 and 1127 of the Civil Code, as well as psychological findings on the importance of sexual satisfaction in marital life, it can be inferred that in cases of the husband’s impotence, the stipulation of “the occurrence of marital intercourse once” and in cases of penile amputation, the stipulation of “the husband’s ability to engage in marital intercourse” in waiving the wife's right to divorce does not align with the important factor of the wife’s sexual satisfaction and, consequently, her mental health. This study recommends amending the second and third clauses of Article 1122 of the Civil Code. In cases of the husband suffering from sexually transmitted diseases, it is necessary to recognize the right to request divorce in Article 1127 of the Civil Code, after the completion of the standard medical treatment period for the husband’s illness and failure to cure, in order to support the wife's sexual satisfaction.

Background and Aim: In recent decades, significant advancements in medical science and the development of novel genetic technologies have created new possibilities for the early detection of genetic and chromosomal abnormalities and diseases during pregnancy. Among these, amniocentesis, as one of the most accurate and primary invasive methods for diagnosing fetal genetic abnormalities, has gained a special status. Despite the high medical, religious, and legal importance of amniocentesis, no independent research providing a jurisprudential examination and ijtihad-based analysis of this procedure has been published to date. This article seeks to explain and present a documented and reasoned perspective on the jurisprudential ruling of the widely used amniocentesis test; a perspective that can be utilized in individual and family decision-making, cultural and social policymaking, and especially in legislation "with religious backing."

Materials and Methods: Employing a descriptive-analytical methodology, this research draws upon authoritative medical and jurisprudential sources. It begins by outlining the medical procedure of amniocentesis and then critically examines the relevant jurisprudential evidence pertaining to its prohibition, obligation, or permissibility.

Findings: The examination and analysis of jurisprudential evidence indicate that the primary principle regarding medical procedures is permissibility, unless there is valid evidence for prohibition. Regarding amniocentesis, considering rational objectives such as preventing the birth of a child with severe and incurable abnormalities that cause extreme hardship (haraj) and distress for the family, and by relying on principles such as "the rule of la haraj" (no hardship) and "the obligation to repel probable harm," this test can be deemed permissible. This ruling is contingent upon observing conditions, including minimizing the risk of miscarriage as much as possible and using it only in cases of valid medical necessity.

Conclusion: A critical analysis of existing evidence shows that performing amniocentesis, both before and after the ensoulment of the fetus, is permissible, provided it is conducted for a rational purpose such as preventing "harm" or "hardship and distress."

Background and Aim: The rule of “Faragh and Tajawuz” is a recognized principle in Islamic jurisprudence established with the aim of freeing the obligated persons from a state of doubt and uncertainty regarding the performance or validity of their acts of worship. According to this rule, uncertainty about the execution or correctness of an action is ignored, and the individual is obligated to disregard these probabilities and consider their action as correct and completed. On the other hand, in psychology, doubt concerning the correctness of actions is examined under the pattern of Obsessive-Compulsive Disorder (OCD) (pathological doubt and checking compulsion); a condition in which individuals constantly doubt their actions and engage in checking and repeating them. Since the rule of Faragh and Tajawuz addresses a cognitive and behavioral state (doubt/skepticism), the present study seeks to answer the question: to what extent is this rule (which guides the thoughts and behaviors of obligated persons by confirming the validity of their past actions) compatible with psychological treatment methods for Obsessive-Compulsive Disorder?

Materials and Methods: This research was conducted using a descriptive-analytical method, relying on library resources, to present a psychological analysis of the rule of Faragh and Tajawuz. In this regard, the jurisprudential concept of doubt was juxtaposed against the doubt arising from Obsessive-Compulsive Disorder. Subsequently, in a comparative study, these two phenomena were compared in terms of their position, concept, therapeutic approach, and underlying basis, and their degree of convergence was evaluated.

Conclusion: The scope and position of the rule of Faragh and Tajawuz extend beyond the treatment methods for Obsessive-Compulsive Disorder; such that, in addition to its therapeutic aspect, it is also effective in preventing doubt-related disorders by strengthening the cognitive framework of obligated persons. Conceptually, psychological doubt (uncertainty about the correctness of past actions) perfectly aligns with jurisprudential doubt (a state of uncertainty regarding past acts of worship). Furthermore, Cognitive-Behavioral Therapy in the form of “Cognitive Restructuring and Exposure and Response Prevention (ERP)” is evaluated as equivalent to jurisprudential cognitive-behavioral correction (emphasizing a more accurate perception of the performed act and negating the necessity of repeating it). Moreover, anxiety, as the root cause of Obsessive-Compulsive Disorder, is considered parallel to satanic temptations or inner suggestions (Nafsani insinuations), which form the underlying basis for the legislation of the rule of Faragh and Tajawuz. Consequently, the application of the provisions of the rule of Faragh and Tajawuz, in addition to its jurisprudential implications, plays a significant role in promoting the mental health of obligated individuals.