Iranian Journal of Medical Ethics and History of Medicine

Deciding on whether to continue life-prolonging treatments for terminal patients is a major challenge in healthcare. Advance directive emerges as a proposed solution to this issue in the world. The patients record their preferences regarding the continuation of life-prolonging treatments while they still are able to make decisions. Although advance directive is morally justifiable from the perspective of principlism, respecting the patient’s right to autonomy and assessing the benefits and drawbacks of providing such services, the religious beliefs of patients, their families, and healthcare providers always exert a significant influence on this matter. In Islam, preserving human life heavily affects these decisions. Several juridical and legal rules can culminate in different decisions on the continuation or termination of life-prolonging treatments including the absolute legal power of the owner to exercise dominion^[1] or control over property and permission of intervention in their body^[2], the rules of prohibition on causing the death^[3], the sanctity of human killing^[4], the rule of prohibition of detriment^[5], the concept of unstable life^[6] in Article 372 of the Islamic Penal Code and the rules of preventing losses^[7], and the rule of sanctity of idle^[8]. Nevertheless, given various types of will in Islamic Jurisprudence and according to the contract of agreement^[9], it is possible to record the patient’s request regarding how to continue the treatment. This study indicated that implementing advance directives in Iran’s health system requires a more accurate analysis of moral, legal, and jurisprudential foundations.