Document Type : Review article
Authors
1
PhD student of Jurisprudence and principales of Law and Imam Khomeini's Thought, Islamic Azad University of Mashhad, Mashhad. Iran
2
Assistant Professor, Department of Jurisprudence and the Foundation of Islamic Law, Islamic Azad University of Mashhad, Mashhad. Iran.
3
Assistant Professor, Department of Jurisprudence and the Foundation of Islamic Law, Islamic Azad University of Torbat Heydarieh, Torbat Heydarieh, Iran.
4
Associate Professor, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/mjms.2026.94504.5231
Abstract
Adopting a jurisprudential–medical approach, this article examines, within Imami (Twelver) Shi‘i jurisprudence, the permissibility of foregoing treatment that is futile or disproportionate, and offers a principled defense of “passive euthanasia.” The study’s methodological contribution is that, rather than relying solely on the broad no-harm (la darar) and no-undue-hardship (la haraj) maxims, it articulates operational criteria for determining futility and disproportionality as a central component of specifying the operative subject matter of the ruling. By distinguishing between withdrawal of treatment and withdrawal of care, it treats the continuation of supportive and palliative care as necessary. It then analyzes the concept of tahlukah (self-destructive endangerment) alongside the criterion of customary (ʿurfi) attribution, arguing that foregoing treatment that lacks a reasonable prospect of rescue, or that imposes escalating harm and undue hardship, neither constitutes tahlukah nor amounts to aiding in killing; rather, it should be understood as lifting the obligation. The article also addresses common objections, such as an alleged conflict with the principle of preserving life, and cites—by way of corroborative support—Ayatollah Khamenei’s ruling that there is no obligation to keep a dying person alive or to delay death. Finally, the proposed framework can serve as a basis for drafting clinical guidelines, reducing conflict between healthcare teams and families, and structuring deliberations in medical ethics committees, without crossing the categorical boundary set by the prohibition of killing and the inviolability of human life.
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