Ethical dilemmas in the era of COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic placed an extraordinary demand on health systems and healthcare providers all over the world. The pandemic presented a number of unprecedented challenging ethical issues. Across the globe, hospitals are being challenged by a large number of patients presenting to the emergency room for treatment, creating scarcities of critical care resources, and uncovering the need for formal crisis standards of care. Difficult life and death decisions, which may create severe moral distress to the physicians, have to be made in emergency rooms and intensive care units. Other ethical issues, such as that related to conducting clinical trials during the pandemic, and the increase in domestic violence during the quarantine period, will be also discussed.

Doctor-patient relationship. Islamic perspective.

The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor's instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients.

Ethical considerations in the prevention and management of genetic disorders with special emphasis on religious considerations.

Genetic diseases include not only single gene disorders, but multifactorial, somatic cell genetic disorders, mitochondrial and even chromosomal. One in 4 adults will suffer from a multifactorial or a somatic cell genetic disease. The common diseases in the community have a hereditary component namely diabetes mellitus, hypertension, ischemic heart diseases and many types of cancer. Even monogenic diseases which affect a small number of the newborns (2%-3%), have a greater impact on childhood diseases up to age 15 years. Therefore, it is imperative to scrutinize the available methods of prevention and management of genetic disorders, their ethical implications, and since east Mediterranean region is mainly occupied by Arabs and muslims, religious considerations become of paramount importance. Islam differs from many other religions in providing a complete code of life, which encompasses the secular with spiritual, the mundane with the celestial and hence forms the basis of the ethical, moral and even juridical attitudes and laws towards any problem or situation. Islamic teachings carry a great deal of instructions for health promotion and disease prevention including hereditary and genetic disorders. This review discusses how the Islamic teachings play an important role in the prevention and management of genetic disorders and the type of ethical implications involved in such management namely premarital medical examination, the question of consanguinity, the genetic counseling, the question of preimplantation diagnosis, the question of abortion and the offering of alternative ways of reproduction.