Indian Journal of Medical Ethics and bioethics from an 'axis of evil'
This month's issue has an eye-opening article on abortion practices and policy in Iran. According to the authors Larijani and Zahedi, Iranian abortion policy is based on Islamic conceptions of fetal development, more specifically the notion of 'ensoulment', the point 120 days after conception that the fetus becomes a full human being. Before that, abortion may be permitted under certain conditions: to save the life of the mother or if the fetus has a serious pathology. Interestingly, the Iranian government no longer requires the consent of the father for a woman to have an abortion under these conditions, and even when women have an illegal abortion, they can count on care within Iran's private or public hospitals. The emergency contraception is also available in family planning clinics. Even more interestingly, perhaps, is that the same conception of ensoulment that supports limited forms of abortion seems to allow for embryonic stem cell research and therapeutic cloning.
This nuanced policy and the lucid prose in which it is expressed does not jive with the current image of Iran and Iranians as 'hardline Muslims with missiles.' In the current geopolitical climate, one is less likely to find much discussion of bioethics from Muslim nations in any mainstream American or European journal, though Cambridge Quarterly of Healthcare Ethics (subscription required) did publish an article in 2005 with the rather off-putting title 'Pakistan and biomedical ethics: report from a Muslim country', and The American Academy of Pediatrics put out a fascinating primer on Islamic biomedical ethics for pediatricians, alas, just before the 9/11 attacks. The journal Developing World Bioethics, as usual, makes no bones about publishing articles from countries deeply out of favor with US foreign policymakers, having issued another piece co-authored by Larijani and Zahedi in 2006 (free access to low income countries via HINARI) on establishing medical ethics programs within the Iranian national health care system.
The richer countries continue to dominate the bioethics scene, but it is good to see a glimpse, through the prism the IJME, of what the other 80% are doing.