End-of-life medical decision making presents a major challenge to patients and physicians alike. In order to determine whether it is ethically justifiable to forgo medical treatment in such scenarios, clinical data must be interpreted alongside patient values, as well as in light of the physician's ethical commitments. Though much has been written about this ethical issue from religious perspectives (especially Christian and Jewish), little work has been done from an Islamic point of view. To fill the gap in the literature around Islamic bioethical perspectives on the matter, we derive a theologically rooted rubric for goals of care. We use the Islamic obligation for Muslims to seek medical treatment as the foundation for determining the clinical conditions under which Muslim physicians have a duty to treat. We next link the theological concept of accountability before God (taklīf) to quality-of-life assessment. Using this construct, we suggest that a Muslim physician is not obligated to maintain or continue clinical treatment when patients who were formerly of, or had the potential to be, mukallaf (the term for a person who has taklīf), are now not expected to regain that status by means of continued clinical treatment.
Personal care products and facial cosmetics are commonly used by millions of consumers on a daily basis. Direct application of cosmetics on human skin makes it vulnerable to a wide variety of ingredients. Despite the protecting role of skin against exogenous contaminants, some of the ingredients in cosmetic products are able to penetrate the skin and to produce systemic exposure. Consumers' knowledge of the potential risks of the frequent application of cosmetic products should be improved. While regulations exist in most of the high-income countries, in low income countries there is a lack of similar standards. In most countries for which these legal regulations have been identified, restrictions on the permissible level of heavy metals are strict. There is a need for enforcement of existing rules, and rigorous assessment of the effectiveness of these regulations. The occurrence of metals in cosmetic products is of concern for three principal reasons: (i) the use of cosmetic products could represent a possible source of population-wide exposure daily, and often long-term exposure to metals in cosmetic products (ii) metals can accumulate in the body over time, and (iii) a number of them are known to exhibit different chronic health effects, such as cancer, contact dermatitis, developmental, neurological and reproductive disorders, brittle hair and hair loss. Some metals are potent endocrine disruptors and respiratory toxins. Moreover, some metals, such as Cd, As, Pb, Hg and Sb, are exceptionally toxic with a wide variety of chronic health effects, whereas Cr, Ni and Co are well known skin sensitizers. Since the issue of heavy metals as deliberate cosmetic ingredients has been addressed, attention is turned to the presence of these substances as impurities.
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