Ethics guidelines for palliative care of terminally ill patients in Islamic Republic of Iran

Background: There have been many challenges with clinical interventions and policy decisions to enhance the quality of life and care for patients facing life-threatening illnesses, thus highlighting the need for ethical considerations and guidelines for palliative care of terminally ill patients. Aim: To document the development of guidelines for addressing ethical concerns in the palliative care of terminally ill patients in Islamic Republic of Iran. Methods: The guidelines were developed in 4 phases: a scoping review of existing palliative care guidelines on PubMed, Scopus, Web of Science, Google Scholar, and 2 Persian databases; focus group discussions to improve the drafts guidelines; online opinion poll of 32 experts, including ethicists, religious scholars, psychologists, palliative care specialists, and sociologists; and a national workshop to produce the final guidelines for government approval. Results: We published the “National palliative care ethical guidelines and regulations for terminally ill patients” in Islamic Republic of Iran after endorsement and approval by the High Council of Medical Ethics. The guidelines provides recommendations on 5 main aspects of palliative care: structure, composition and qualification of interdisciplinary teams; the roles and responsibilities of ethics advisors; general ethical principles governing palliative care practice; specific guidelines for psychological, spiritual and religious support; and protocols for ethical decision-making in end-of-life care. Conclusion: Considering the challenges associated with palliative care, it is necessary to provide ethical guidelines specific to the needs of terminally ill patients. These guidelines will serve as a steppingstone towards integrating palliative care into the national healthcare services in Islamic Republic of Iran.