Thursday, October 04, 2012

Visual recording for biomedical purposes: Islamic perspectives

The Journal of Medical Ethics just came out with a short article on the Islamic perspective regarding  taking photographs or making video recordings of people's bodies for medical purposes. Not surprisingly, there are many similarities with 'conventional', non-Islamic ethical standards: informed consent is important, as well as respect for dignity, confidentiality and privacy. It matters how the images are to be used and how they are stored; the recording should also have a legitimate scientific purpose, which could not be realized by alternative, less infringing or less identifying means.

But there are some interesting differences: for medical recording to be ethical, the process of gaining and using the images has to adhere to (or at least not contradict) Shari'ah law. One important consideration is what part of the body is being photographed or video recorded. The concept of awrah refers to a body part that is forbidden to be shown to specific individuals, either in person or in photographs. While it is forbidden to record body parts considered awrah, there are rare exceptions: when a trustworthy Muslim specialist certifies that there is a necessity to store, use or view images involving awrah (such as reporting of sexual abuse), then this is justified and does not contravene Shari'ah law. Interestingly, there are strong gender differences in what is considered awrah. For men, awrah is the area between the navel and the knee. For women, awrah is the whole body except the hands and face, and in some circumstances the feet also fall into the category of the 'unrecordable.'

For an outsider, it seems strange that photographing a woman's elbow for medical purposes is considered as prima facie unethical as photographing her vagina for medical purposes. The discrepancy also seems to foster to gender inequity in health, given that recordings are commonly used in clinical care, biomedical research and medical education: I imagine that, given the strictures, most of these images are of male bodies. Whether or not you agree with them, these are considerations important to know when delivering care or conducting research with devout members of this faith.

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