Volume 20, Issue 61 (4-2026)
MLJ 2026, 20(61): 31-44 |
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Abdolahi M. Legal and Jurisprudential Analysis of Right to Refuse Treatment and Withdraw Life Sustaining Support in Irreversible Coma. MLJ 2026; 20 (61) :31-44
URL: http://ijmedicallaw.ir/article-1-2008-en.html
URL: http://ijmedicallaw.ir/article-1-2008-en.html
Department of Law, Dezful.C., Islamic Azad University, Dezful, Iran.
Abstract:
Background and Aim: Irreversible coma is a condition in which the patient’s level of consciousness on the Glasgow Coma Scale is below 6, with no cortical activity and no possibility of recovery. This state differs from brain death. Continuing treatment in such cases not only lacks medical benefit but also imposes additional costs and suffering. The aim of this study is to examine the jurisprudential and legal foundations of the patient’s right to refuse treatment in these circumstances, with emphasis on the principles of lā ḍarar (no harm), ʿusr wa ḥaraj (hardship), human dignity and informed consent.
Method: This research was conducted using a descriptive-analytical approach and data were collected through library-based sources.
Ethical Considerations: The study was carried out with adherence to ethical principles, honesty and integrity in citation of references.
Results: In irreversible coma, continuation of treatment is futile and its imposition causes harm and severe hardship. According to the principle of lā ḍarar, such treatment is not obligatory. Similarly, under the principle of ʿusr wa ḥaraj, burdensome obligations are invalid. The principle of human dignity rejects futile treatment, while informed consent affirms the patient’s autonomy. Article 3 of the Patient Rights Charter recognizes the patient’s right to accept or refuse treatment and Article 18 of the Medical Ethics Code exempts physicians from liability when discontinuing ineffective interventions.
Conclusion: The findings indicate that refusal of treatment in irreversible coma is consistent with jurisprudential, legal and ethical principles. Fatwas by leading scholars, including Ayatollah Makarem Shirazi, support this view. Therefore, the patient’s or family’s right to refuse treatment should be formally recognized. It is recommended that such rulings form the basis for legislative reform and that medical expert committees be established to systematize the process of identifying and discontinuing futile treatment.
Please cite this article as:
Abdolahi M. Legal and Jurisprudential Analysis of Right to Refuse Treatment and Withdraw Life Sustaining Support in Irreversible Coma. Medical Law Journal. 2026; 20: e3.
Method: This research was conducted using a descriptive-analytical approach and data were collected through library-based sources.
Ethical Considerations: The study was carried out with adherence to ethical principles, honesty and integrity in citation of references.
Results: In irreversible coma, continuation of treatment is futile and its imposition causes harm and severe hardship. According to the principle of lā ḍarar, such treatment is not obligatory. Similarly, under the principle of ʿusr wa ḥaraj, burdensome obligations are invalid. The principle of human dignity rejects futile treatment, while informed consent affirms the patient’s autonomy. Article 3 of the Patient Rights Charter recognizes the patient’s right to accept or refuse treatment and Article 18 of the Medical Ethics Code exempts physicians from liability when discontinuing ineffective interventions.
Conclusion: The findings indicate that refusal of treatment in irreversible coma is consistent with jurisprudential, legal and ethical principles. Fatwas by leading scholars, including Ayatollah Makarem Shirazi, support this view. Therefore, the patient’s or family’s right to refuse treatment should be formally recognized. It is recommended that such rulings form the basis for legislative reform and that medical expert committees be established to systematize the process of identifying and discontinuing futile treatment.
Please cite this article as:
Abdolahi M. Legal and Jurisprudential Analysis of Right to Refuse Treatment and Withdraw Life Sustaining Support in Irreversible Coma. Medical Law Journal. 2026; 20: e3.
Type of Study: Review Article |
Received: 2025/08/27 | Accepted: 2025/12/4
Received: 2025/08/27 | Accepted: 2025/12/4
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