Ethics and etiquette of human research

ABSTRACT

Medical research is a form of ijtihad inspired by the teaching of the prophet that there is a cure for every disease that must be searched for. The Islamic ethical theory on research is based on the 5 purposes of the Law, maqasid al shari'at [religion, life, progeny, the mind, and wealth]. If any of the five is at risk permission is given to undertake human experiments that Would otherwise be legally prohibited. Therapeutic research fulfills the purpose of protecting health and life. Infertility research fulfils the purpose of protecting progeny. Psychiatric research fulfills the purpose of protecting the mind The search for cheaper treatments fulfills the purpose of protecting wealth. The 5 principles of the Law, qawa 'id al shari 'at. resolve conflicts between and among the maqasid. Under the principle of intention, qa'idat al qasd, research is judged by its underlying and not expressed intentions. Under the principle of certainty, qa'idat al yaqeen, research on new treatment modalities is permitted if there are doubts about existing modalities. Under the principle of injury, qa 'idat aldharar, research is allowed if benefit expected from the experimental therapy outweighs the potential risks. The principle of custom, qa'idat al 'aadat, is used to define stamdards of good clinical practice [GCP] as what the majority of reasonable physicians consider as reasonable.Under the doctrine of istishaab, an existing treatment is continued until there is evidence to the contrary. Under the doctrine of istihsaan a physician can ignore results of a new experiment because of some inclination in his mind based on clinical intuition. Under the doctrine of istislaah medical research can be carried out in the public interest although it causes inconvenience to individuals.Informed consent by a legally competent research subject is mandatory for research. Informed consent is based on the principle of intention. Of all thepersons involved in research, the research subject who consents has the purest intentions because he is at risk. Others involved in the research may have selfish motives that are not in the best interests of the research subject. Informed consent does not legalize risky non-therapeutic research with no potential benefit. It is illegal to force participation, of the weak [prisoners, children, the ignorant, mentally incapacitated, and the poor] in research even if they sign informed consent forms.Findings of research should be widely disseminated either by teaching or by publication for universal benefit. Islam enjoins dissemination of knowledge and prohibits hiding or monopolizing knowledge