Euthanasia -- Fatemeh Mirzaei

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Euthanasia -- Fatemeh Mirzaei ﻣﺠﻠﻪ ﺍﻳﺮﺍﻧﻲ ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﻜﻲ، ﺷﻬﺮﻳﻮﺭ ١٣٩٥، ﺩﻭﺭ ﻩﻱ ﻧﻬﻢ، ﺷﻤﺎﺭ ﻩﻱ ٣، ﺹ ٢٢-١ Abstract ürefü ﻣﺮوري ﻗﺮآ نﻣﺤﻮر ﺑﺮ دﯾﺪﮔﺎ ه اﺳﻼم در ﻣﻮرد ﻣﺮاﺣﻞ ﻣﺮگ و اﺛﺮﮔﺬاري آن در اراﺋ ﻪي ﻣﺮاﻗﺒ ﺖﻫﺎي ﻣﻌﻨﻮي ﭘﺎﯾﺎن ﺣﯿﺎت ١ *٢ ٣ ٤ ٥ ٦ ﻓﺎﻃﻤﻪ ﻣﻴﺮﺯﺍﻳﻲ (ﻟﻄﻔﻲ ﺁﺫﺭ) ، ﺳﻤﺎﻧﻪ ﺗﻴﺮﮔﺮ ، ﻓﺮﺯﺍﻧﻪ ﺯﺍﻫﺪﻱ ، ﺳﻮﺩﻩ ﺗﻴﺮﮔﺮ ، ﻓﺮﻳﺪﻩ ﺷﺮﻳﻌﺘﻲ ، ﺑﺎﻗﺮ ﻻﺭﻳﺠﺎﻧﻲ ﺗﺎرﯾﺦ درﯾﺎﻓﺖ: 19/3/95 ﺗﺎرﯾﺦ ﭘﺬﯾﺮش: 21/6/95 ﺗﺎرﯾﺦ اﻧﺘﺸﺎر: 95/7/17 ﻣﻘﺎﻟ ﻪﻱ ﻣﺮﻭﺭﻱ ﭼﻜﻴﺪﻩ ﺑﺎ ﻭﺟﻮﺩ ﭘﻴﺸﺮﻓﺖ ﻋﻠﻢ ﭘﺰﺷﮑﻲ ﻭ ﺗﮑﻨﻮﻟﻮﮊﻱ ﻫﺎﻱ ﻣﺮﺗﺒﻂ، ﺷﻨﺎﺧﺖ ﻣﺎﻫﻴﺖ ﻭ ﭼﮕﻮﻧﮕﻲ ﻣﺮﮒ، ﻫﻢﭼﻨﺎﻥ ﺩﺭ ﻫﺎﻟﻪ ﺍﻱ ﺍﺯ ﺍﺑﻬﺎﻡ ﺍﺳﺖ. ﺷﺎﻳﺪ ﭼﻨﻴﻦ ﺑﺘﻮﺍﻥ ﮔﻔﺖ ﮐﻪ ﭼﻮﻥ ﻣﺮﮒ، ﭘﺪﻳ ﺪﻩﺍﻱ ﺩﻭ ﻭﺟﻬﻲ ﺍﺳﺖ ﻭ ﻳﮏﺭﻭﻱ ﺁﻥ ﺟﺴﻤﺎﻧﻲ ﻭ ﺭﻭﻱ ﺩﻳﮕﺮ، ﻧﻔﺴﺎﻧﻲ ﻭ ﺭﻭﺣﺎﻧﻲ ﺍﺳﺖ، ﺷﻨﺎﺧﺖ ﺁﻥ، ﺗﻨﻬﺎ ﺩﺭ ﺣﻴ ﻄﻪﻱ ﻋﻠﻢ ﭘﺰﺷﮑﻲ ﻧﻴﺴﺖ، ﺑﻠﮑﻪ ﺗﻼﺵ ﻭ ﻫﻤﮑﺎﺭﻱ ﺍﻧﺪﻳﺸﻤﻨﺪﺍﻥ ﺣﻮﺯﻩ ﻫﺎﻱ ﺩﻳﮕﺮﻱ ﭼﻮﻥ ﻋﻠﻮﻡ ﻗﺮﺁﻧﻲ، ﻋﻠﻮﻡ ﺍﻧﺴـﺎﻧﻲ، ﻓﻠﺴـﻔﻪ ﻭ ﻣﺎﻧﻨﺪ ﺁﻥ ﻧﻴﺰ ﺑﺮﺍﻱ ﮔﺸﻮﺩﻥ ﻗﻔﻞﻫﺎﻱ ﺑﺴﺘ ﻪﻱ ﺁﻥ ﺿﺮﻭﺭﻱ ﺑﻪﻧﻈﺮ ﻣﻲﺭﺳﺪ. ﭼﻨﻴﻦ ﻫﻢﻓﮑﺮ ﻱﻫﺎﻳﻲ ﻣﻲﺗﻮﺍﻧﺪ ﺑﺎ ﺗﻮﺻﻴﻒ ﺁﻧﭽﻪ ﺑﺮ ﻧﻔﺲ ﺩﺭ ﺁﺳﺘﺎﻧﻪ ﻭ ﻫﻨﮕﺎﻡ ﻣﺮﮒ ﻣﻲﮔﺬﺭﺩ، ﺩﻳﺪﮔﺎﻩ ﺩﺍﻧﺸﻤﻨﺪﺍﻥ ﻋﻠﻮﻡ ﭘﺰﺷﮑﻲ ﺭﺍ ﮐﻪ ﺑﻪﺣﻖ، ﻣﻔﺴﺮﺍﻥ ﺧﻮﺑﻲ ﺑﺮﺍﻱ ﺗﻐﻴﻴﺮﺍﺕ ﺟﺴﻤﺎﻧﻲﹺ ﺯﻣﺎﻥ ﻣﺮﮒ ﻫﺴﺘﻨﺪ، ﻭﺳﻌﺖ ﻭ ﻋﻤﻖ ﺑﻴ ﺶﺗﺮﻱ ﺑﺨﺸﺪ. ﺑﻲﺷﮏ، ﭼﻨﻴﻦ ﻧﮕﺮﺷﻲ ﻣﻲﺗﻮﺍﻧﺪ ﺩﺭ ﮔﺮﻓﺘﻦ ﺗﺼﻤﻴ ﻢﻫﺎﻱ ﺍﺧﻼﻗﻲ ﭘﺎﻳﺎﻥ ﺣﻴﺎﺕ ﻭ ﻧﻴﺰ ﺍﺭﺍﺋ ﻪﻱ ﻣﺮﺍﻗﺒ ﺖﻫﺎﻱ ﻣﻌﻨﻮﻱ ﺩﺭ ﺍﻳﻦ ﻟﺤﻈﺎﺕ، ﺗﺤﻮﻝ ﺁﻓﺮﻳﻦ ﺑﺎﺷﺪ. ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻱ ﻣﺮﻭﺭﻱ ﺑﻪﺭﻭﺵ ﮐﺘﺎﺑﺨﺎﻧ ﻪﺍﻱ، ﺍﺑﺘﺪﺍ ﺗﻮﺻﻴﻔﻲ ﺍﺯ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺩﺭ ﻧﮕـﺎﻩ ﻋﻠـﻢ ﭘﺰﺷـﮑﻲ ﺩﺍﺭﺩ ﻭ ﺳﭙﺲ ﺑﺎ ﮐﻨﮑﺎﺷﻲ ﻗﺮﺁ ﻥﻣﺤﻮﺭ ﺩﺭ ﻣﻨﺎﺑﻊ ﺍﺳﻼﻣﻲ ﻭ ﺑﺎ ﺗﻤﺮﮐﺰ ﺑﺮ ﺁﻳﺎﺗﻲ ﮐﻪ ﺻﺮﺍﺣﺘﺎﹰ ﺩﻻﻟﺖ ﺑﺮ ﺯﻣﺎﻥ ﻣـﺮﮒ ﺩﺍﺭﻧـﺪ، ﺗﻮﺻـﻴﻒ ﻗﺮﺁﻧـﻲ ﺍﺯ ﺑﺮﺧـﻲ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺍﺭﺍﺋﻪ ﻣﻲ ﺩﻫﺪ. ﺳﺮﺍﻧﺠﺎﻡ ﺩﺭ ﺑﺤﺚ ﻧﻬﺎﻳﻲ، ﺑﺮﺧﻲ ﺷﺒﺎﻫ ﺖﻫﺎ ﻭ ﺗﻔﺎﻭ ﺕﻫﺎﻱ ﺩﻳﺪﮔﺎ ﻩﻫﺎ ﺭﺍ ﺑﻴﺎﻥ ﻭ ﺳﺆﺍﻻﺕ ﻣﻬﻤﻲ ﺭﺍ ﺩﺭ ﺍﻳﻦ ﺣﻴﻄـﻪ ﻣﻄﺮﺡ ﻣﻲ ﮐﻨﺪ ﮐﻪ ﻋﻤﺪﺗﺎﹰ ﺑﺮﺍﻱ ﺍﺭﺍﺋ ﻪﻱ ﻣﺮﺍﻗﺒﺖ ﻫﺎﻱ ﻣﻌﻨﻮﻱ ﺩﺭ ﻟﺤﻈﺎﺕ ﭘﺎﻳﺎﻧﻲ ﺣﻴـﺎﺕ ﺩﺭ ﺧـﻮﺭ ﺍﻫﻤﻴـﺖ ﻓـﺮﺍﻭﺍﻥ ﻫﺴـﺘﻨﺪ . ﺍﻣﻴـﺪ ﺍﺳـﺖ ﺑـﺎ ﭘﮋﻭﻫﺶ ﻫﺎﻱ ﻣﺘﻤﺮﮐﺰ ﺁﻳﻨﺪﻩ ﮐﻪ ﺩﺭ ﺟﻬﺖ ﭘﺎﺳﺦ ﺑﻪ ﺳﺆﺍﻻﺕ ﺍﺻﻠﻲ ﺍﻳﺠﺎﺩﺷﺪﻩ ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺧﻮﺍﻫﻨﺪ ﺑﻮﺩ، ﺭﺍﻩ ﺑـﺮﺍﻱ ﺍﺭﺍﺋـﻪ ﻱ ﻣﺮﺍﻗﺒـﺖ ﻫـﺎﻱ ﻣﻌﻨﻮﻱ ﻭ ﻗﺮ ﺁﻥﻣﺤﻮﺭ، ﺑﻴﺶ ﺍﺯ ﭘﻴﺶ ﺗﺴﻬﻴﻞ ﻭ ﻋﻤﻠﻴﺎﺗﻲ ﺷﻮﺩ. ﻭﺍﮊﮔﺎﻥ ﮐﻠﻴﺪﻱ: ﻣﺮﺍﻗﺒ ﺖﻫﺎﻱ ﻣﻌﻨﻮﻱ، ﭼﺎﻟ ﺶﻫﺎﻱ ﺍﺧﻼﻗﻲ ﭘﺎﻳﺎﻥ ﺣﻴﺎﺕ، ﻣﺮﮒ، ﺍﺳﻼﻡ، ﺍﺧﻼﻕ ﭘﺰﺷﮑﻲ، ﻗﺮﺁﻥ ١ Email: elmi.myy@ gmail.com ﭘﮋﻭﻫﺸﮕﺮ ﻭ ﺍﺳﺘﺎﺩ ﻋﻠﻮﻡ ﻗﺮﺁﻧﻲ ﻭ ﺍﺳﻼﻣﻲ ٢ ﭘﺰﺷﮏ ﻋﻤﻮﻣﻲ، ﻣﺮﮐﺰ ﺗﺤﻘﻴﻘﺎﺕ ﻏﺪﺩ ﻭ ﻣﺘﺎﺑﻮﻟﻴﺴﻢ، ﭘﮋﻭﻫﺸﮑﺪﻩ ﻋﻠﻮﻡ ﺑﺎﻟﻴﻨﻲ ﻏﺪﺩ ﻭ ﻣﺘﺎﺑﻮﻟﻴﺴﻢ، ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﮑﻲ ﺗﻬﺮﺍﻥ، ﺗﻬﺮﺍﻥ، ﺍﻳﺮﺍﻥ Email: s-tirgar@ farabi.tums.ac.ir ٣ ﭘﺰﺷﮏ، ﮔﺮﻭﻩ ﺍﺧﻼﻕ ﭘﺰﺷﮑﻲ، ﻣﺮﮐﺰ ﺗﺤﻘﻴﻘﺎﺕ ﻏﺪﺩ ﻭ ﻣﺘﺎﺑﻮﻟﻴﺴﻢ، ﭘﮋﻭﻫﺸﮑﺪﻩ ﻋﻠﻮﻡ ﺑﺎﻟﻴﻨﻲ ﻏﺪﺩ ﻭ ﻣﺘﺎﺑﻮﻟﻴﺴﻢ، ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﮑﻲ ﺗﻬﺮﺍﻥ، ﺗﻬﺮﺍﻥ، ﺍﻳﺮﺍﻥ Email: fzahedi@ tums.ac.ir ٤ Email: sude1432@ gmail.com ﺩﺍﻧﺸﺠﻮﻱ ﮐﺎﺭﺷﻨﺎﺳﻲ ﺍﺭﺷﺪ ﻋﻠﻮﻡ ﻗﺮﺁﻧﻲ ﻭ ﺣﺪﻳﺚ، ﺩﺍﻧﺸﮕﺎﻩ ﻗﺮﺁﻥ ﻭ ﺣﺪﻳﺚ، ﭘﺮﺩﻳﺲ ﺗﻬﺮﺍﻥ، ﺷﻬﺮﺭﻱ، ﺗﻬﺮﺍﻥ، ﺍﻳﺮﺍﻥ 5 Email: m_yaghesh@ yahoo.com ﮐﺎﺭﺷﻨﺎﺱ ﺭﺷﺘﻪ ﻱ ﻓﻘﻪ ﻭ ﺍﺻﻮﻝ، ﺩﺍﻧﺸﮕﺎﻩ ﺍﻣﺎﻡ ﺻﺎﺩ ﻕ (ﻉ)، ﺗﻬﺮﺍﻥ، ﺍﻳﺮﺍﻥ ٦ ﺍﺳﺘﺎﺩ، ﻣﺮﮐﺰ ﺗﺤﻘﻴﻘﺎﺕ ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﮑﻲ، ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﮑﻲ ﺗﻬﺮﺍﻥ، ﺗﻬﺮﺍﻥ، ﺍﻳﺮﺍﻥ Email: emrc@ tums.ac.ir * ﻧﺸﺎﻧﻲ: ﺗﻬﺮﺍﻥ، ﺧﻴﺎﺑﺎﻥ ﮐﺎﺭﮔﺮ ﺷﻤﺎﻟﻲ، ﻧﺮﺳﻴﺪﻩ ﺑﻪ ﺟﻼﻝ ﺁﻝ ﺍﺣﻤﺪ، ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺩﮐﺘﺮ ﺷﺮﻳﻌﺘﻲ، ﻃﺒﻘ ﻪﻱ ﭘﻨﺠﻢ، ﭘﮋﻭﻫﺸﮕﺎﻩ ﻋﻠﻮﻡ ﻏﺪﺩ ﻭ ﻣﺘﺎﺑﻮﻟﻴﺴﻢ، ﮔﺮﻭﻩ ﺍﺧﻼﻕ ﭘﺰﺷﮑﻲ، ﺗﻠﻔﻦ: Email: s-tirgar@ farabi.tums.ac.ir ،۰۲۱-۸۸۲۲۰۰۳۷ 2 ﻓﺎﻃﻤﻪ ﻣﻴﺮﺯﺍﻳﻲ (ﻟﻄﻔﻲ ﺁﺫﺭ) ﻭ ﻫﻤﻜﺎﺭﺍﻥ: ﻣﺮﻭﺭﻱ ﻗﺮﺁ ﻥﻣﺤﻮﺭ ﺑﺮ ﺩﻳﺪﮔﺎﻩ ﺍﺳﻼﻡ ﺩﺭ ﻣﻮﺭﺩ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﻭ ﺍﺛﺮﺍﮔﺬﺍﺭﻱ ﺁﻥ ... ﻣﻘﺪﻣﻪ ﻫﻢﭼﻨﻴﻦ، ﺑﺎ ﺍﻳﻦ ﻧﮕﺮﺵ، ﺗﻌﺮﻳﻒ ﻭ ﻧﺤ ﻮﻩﻱ ﺍﺭﺍﺋ ﻪﻱ ﻣﺮﺍﻗﺒ ﺖﻫﺎﻱ ٢ ﻣﺴﺄ ﻟﻪﻱ ﻣﺮﮒ ﺍﻣﺮﻱ ﭘﻴﭽﻴﺪﻩ ﻭ ﭼﻨﺪﺑﻌﺪﻱ ﺍﺳﺖ ﻭ ﺷﻨﺎﺧﺖ ﻣﻌﻨﻮﻱ ، ﺑﻪﻧﺤﻮ ﻣﻨﻄﻘ ﻲﺗﺮ ﻭ ﺟﺎ ﻣﻊﺗﺮﻱ ﻗﺎﺑﻞ ﻭﺻﻮﻝ ﺧﻮﺍﻫﺪ ﺑﻮﺩ. ٣ ﺁﻥ ﻣﻨﺤﺼـﺮﺍ ﺟﻨﺒ ﻪﻱ ﻣﺎﺩﻱ ﻧﺪﺍﺭﺩ، ﭼﺮﺍﮐﻪ ﻣﻄﺎﺑﻖ ﻣﺘﻮﻥ ﺍﺳﻼﻣﻲ ﻭ ﻣﺮﺍﻗﺒﺖ ﻣﻌﻨﻮﻱ، ﻳﮑﻲ ﺍﺯ ﺍﺑﻌﺎﺩ ﻣﺮﺍﻗﺒﺖ ﮐﻠ ﻲﻧﮕﺮ ﻭ ﺍﺯ ﺍﺭﮐﺎﻥ ﻧﻴﺰ ﺩﻳﺪﮔﺎﻩ ﻣﺘﺨﺼﺼﺎﻥ ﻋﻠﻮﻡ ﭘﺰﺷﮑﻲ، ﺍﺳﺎﺳﺎﹰ ﭘﺪﻳﺪ ﻩﺍﻱ ﺍﺻﻠﻲ ﻣﺮﺍﻗﺒ ﺖﻫﺎﻱ ﭘﺎﻳﺎﻥ ﺣﻴﺎﺕ ﺍﺳﺖ (۴) ﻭ ﻣﻨﻈﻮﺭ ﺍﺯ ﺁﻥ، ﺩﺭ ﻓﺮﺍﺟﺴﻤﺎﻧﻲ ﺍﺳﺖ ﮐﻪ ﺍﻟﺒﺘﻪ ﻇﻬﻮﺭﺍﺕ ﺟﺴﻤﺎﻧﻲ ﺩﺍﺭﺩ (۲ ، ۱). ﻋﻠﻢ ﻧﻈﺮ ﺩﺍﺷﺘﻦ ﻧﻴﺎﺯﻫﺎﻱ ﻣﻌﻨﻮﻱ ﻓﺮﺩ ﺩﺭ ﺍﺛﻨﺎﻱ ﺍﺭﺍﺋ ﻪﻱ ﻣﺮﺍﻗﺒ ﺖﻫﺎﻱ ﭘﺰﺷﮑﻲ ﺑﺎ ﺟﺰﺋﻴﺎﺕ، ﻣﺮﺍﺣﻞ ﻓﻴﺰﻳﻮﻟﻮﮊﻳﮏ ﻣﺮﮒ ﺭﺍ ﺗﻮﺻﻴﻒ ﮐﺮ ﺩﻩ ﺣﻴﺎﺗﻲ ﺍﺳﺖ (۵). ٤ ﻭ ﺁﻥ ﺭﺍ ﺗﺤﺖ ﻋﻨﺎﻭﻳﻦ ﻣﺮﮒ ﺳﻠﻮﻟﻲ ﻭ ﻣﺮﮒ ﮐﻞ ﺍﺭﮔﺎﻧﻴﺴﻢ ﺷﺮﺡ ﺗﻮﺻﻴﻒ ﻣﺮﺍﺣﻞ ﻧﻔﺴﺎﻧﻲ ﻣﺮﮒ ﺑﻪﻧﺤﻮ ﺟﺎﻟﺐ ﺗﻮﺟﻬﻲ ﺩﺭ ﺩﺍﺩﻩ ﺍﺳﺖ، ﺍﻣﺮﻱ ﮐﻪ ﺩﺍﻧﺶ ﻧﺴﺒﺖ ﺑﻪ ﺁﻥ ﺑﺮﺍﻱ ﮔﺮﻭﻩ ﭘﺰﺷﮑﻲ ﻗﺮ ﺁﻥﮐﺮﻳﻢ ﺁﻣﺪ ﻩﺍﺳﺖ ﻭ ﭘﮋﻭﻫﺸﻲ ﻗﺮ ﺁﻥﻣﺤﻮﺭ ﺑﺎ ﺗﻤﺮﮐﺰ ﺑﺮ ﺍﻳﻦ ﺿﺮﻭﺭﺗﻲ ﻏﻴﺮ ﻗﺎﺑﻞ ﺍﻧﮑﺎﺭ ﺩﺍﺭﺩ، ﺯﻳﺮﺍ ﻳﮑﻲ ﺍﺯ ﻣﻮﺿﻮﻋﺎﺕ ﺍﺻﻠﻲ ﻣﻮﺿﻮﻉ ﻣﻲﺗﻮﺍﻧﺪ ﺟﻬﺖ ﻧﺰﺩﻳ ﮏﺷﺪﻥ ﺑﻪ ﺍﻫﺪﺍﻑ ﻳﺎﺩﺷﺪﻩ، ﻧﻘﺸﻲ ﺩﺭ ﭘﺰﺷﮑﻲ، ﺣﻔﻆ ﺣﻴﺎﺕ، ﻣﻮﺍﺟﻬﻪ ﺑﺎ ﺑﻴﻤﺎﺭﺍﻥ ﺩﺭ ﺣﺎﻝ ﻣﺮﮒ ﻭ ﺑﺴﺰﺍ ﺩﺍﺷﺘﻪ ﺑﺎﺷﺪ. ﺍﺯ ﺁﻥﺟﺎ ﮐﻪ ﺩﺭ ﺣﺎﻝ ﺣﺎﺿﺮ، ﺩﺭ ﻣﺒﺎﺣﺚ ﺍﺗﺨﺎﺫ ﺗﺼﻤﻴﻤﺎﺕ ﺩﺭﻣﺎﻧﻲ ﻭ ﺍﺧﻼﻗﻲ ﺩﺭ ﺍﻳﻦ ﺧﺼﻮﺹ ﺍﺳﺖ. ﺁﻣﻮﺯﺷﻲ ﻣﺮﺑﻮﻁ ﺑﻪ ﺩﻭ ﺭﻩﻱ ﺗﺮﺑﻴﺖ ﭘﺰﺷﮑﺎﻥ ﻋﻤﻮﻣﻲ، ﻭﺍﺣﺪﻫﺎﻱ ﻫﻢﭼﻨﻴﻦ، ﺣﻞ ﺑﺴﻴﺎﺭﻱ ﺍﺯ ﭼﺎﻟ ﺶﻫﺎﻱ ﺍﺧﻼ ﻕﺯﻳﺴﺘﻲ ﺩﺭ ﻣﺴﺎﺋﻞ ﺩﺭﺳﻲ ﺑﺎ ﻣﻮﺿﻮﻋﺎﺕ ﻣﻴﺎ ﻥﺭﺷﺘ ﻪﺍﻱ ﻣﺎﻧﻨﺪ ﻓﻠﺴﻔ ﻪﻱ ﭘﺰﺷﮑﻲ، ﻣﺮﺑﻮﻁ ﺑﻪ ﭘﺎﻳﺎﻥ ﺣﻴﺎﺕ ﺍﺯ ﺟﻤﻠﻪ ﺍﺗﺎﻧﺎﺯﻱ، ﺩﺭﻣﺎﻥ ﺑﻴﻬﻮﺩﻩ، ﻣﺮﮒ ﺑﻪﻧﺪﺭﺕ ﺩﻳﺪﻩ ﻣﻲﺷﻮﺩ، ﻟﺬﺍ ﭘﺮﺩﺍﺧﺘﻦ ﺑﻪ ﻣﻮﺿﻮﻋﺎﺗﻲ ﺍﺯ ﻗﺒﻴﻞ ﻣﻐﺰﻱ ﻭ ﭘﻴﻮﻧﺪ ﺍﻋﻀﺎ، ﺩﺭ ﮔﺮﻭ ﺷﻨﺎﺧﺘﻲ ﺟﺎﻣﻊ ﻭ ﺭﻭﺷﻦ ﺍﺯ ﻣﺮﮒ ﻣﻔﻬﻮ ﻡﺷﻨﺎﺳﻲ ﻣﺮﮒ ﻭ ﻧﻴﺰ ﺗﺤﻮﻻﺕ ﻧﻔﺲ ﺩﺭ ﺯﻣﺎﻥ ﻣﺮﮒ ﺩﺭ ﮐﻨﺎﺭ ﺍﺳﺖ. ﺩﺭ ﺍﻳﻦ ﺯﻣﻴﻨﻪ ﻳﮑﻲ ﺍﺯ ﻣﻬ ﻢﺗﺮﻳﻦ ﻣﺒﺎﺣﺜﻲ ﮐﻪ ﺑﻪﻧﻈﺮ ﺗﻐﻴﻴﺮﺍﺕ ﺟﺴﻤﺎﻧﻲ ﺩﺭ ﺯﻣﺎﻥ ﻣﺮﮒ ﮐﻪ ﺟﺰﻭﻱ ﺍﺯ ﺩﺍﻧﺴﺘ ﻪﻫﺎﻱ ﻳﮏ . ﺿﺮﻭﺭﻱ ﻣﻲﺭﺳﺪ ﺁﻥ ﺍﺳﺖ ﮐﻪ ﮔﺮﻭﻩ ﭘﺰﺷﮑﻲ ﺑﻪ ﺑﻴﻤﺎﺭ ﺩﺭ ﺣﺎﻝ ﭘﺰﺷﮏ ﺍﺳﺖ، ﺑﺮﺍﻱ ﭘﺰﺷﮑﺎﻥ ﺳﻮﺩﻣﻨﺪ ﺧﻮﺍﻫﺪ ﺑﻮﺩ ﺑﺮ ﺍﻳﻦ ﻣﺮﮒ ﺗﻨﻬﺎ ﺍﺯ ﺟﻬﺖ ﺗﻐﻴﻴﺮﺍﺕ ﻇﺎﻫﺮﻱ ﻭ ﻣﺎﺩﻱ – ﮐﻪ ﻋﻠﻢ ﺍﺳﺎﺱ، ﺑﺮ ﺁﻥ ﺷﺪﻳﻢ ﺗﺎ ﺩﺭ ﭘﮋﻭﻫﺸﻲ ﻗﺮ ﺁﻥﻣﺤﻮﺭ ﺑﺎ ﻣﻮﺿﻮﻉ ﭘﺰﺷﮑﻲ، ﺗﻮﺻﻴ ﻒﮐﻨﻨ ﺪﻩﻱ ﺁﻥ ﺍﺳﺖ- ﻧﮕﺎﻩ ﻧﮑﻨﻨﺪ، ﺑﻠﮑﻪ ﺑﻪ ﺑﺮﺭﺳﻲ ﺗﺤﻮﻻﺕ ﻧﻔﺲ ﺩﺭ ﺁﺳﺘﺎﻧﻪ ﻭ ﺯﻣﺎﻥ ﻣﺮﮒ، ﺩﺭﻳﭽ ﻪﺍﻱ ﺩﺭ ١ ﺗﻐﻴﻴﺮﺍﺗﻲ ﮐﻪ ﺩﺭ ﺍﻳﻦ ﺣﺎﻟﺖ ﺩﺭ ﻧﻔﺲ ﺑﻴﻤﺎﺭﺍﻥ ﺩﺭ ﺣﺎﻝ ﺭ ﺥﺩﺍﺩﻥ ﻣﺴﻴﺮ ﺭﻭ ﺷﻦﺗﺮ ﺷﺪﻥ ﺍﻓ ﻖﻫﺎﻱ ﻓﺮﺍﺟﺴﻤﺎﻧﻲ، ﻓﺮﺍﺳﻮﻱ ﺩﻳﺪ ﺍﺳﺖ ﻧﻴﺰ ﺗﻮﺟﻪ ﻭﻳﮋﻩ ﺩﺍﺷﺘﻪ ﺑﺎﺷﻨﺪ. ﭼﺮﺍﮐﻪ ﻣﻄﺎﺑﻖ ﻣﺘﻮﻥ ﺍﺳﻼﻣﻲ، ﺟﺎﻣﻌ ﻪﻱ ﭘﺰﺷﮑﻲ ﺑﮕﺸﺎﻳﻴﻢ. ﺁﻧﭽﻪ ﭘﺰﺷﮑﺎﻥ ﺩﺭ ﺑﺎﻟﻴﻦ ﺑﻴﻤﺎﺭﺍﻥ ﺩﺭ ﺣﺎﻝ ﻣﺮﮒ ﻣﺸﺎﻫﺪﻩ ﻣﻲﮐﻨﻨﺪ، ﺑﺮ ﺍﺳﺎﺱ ﺟﺴ ﺖﻭﺟﻮﻱ ﺍﻭﻟﻴ ﻪﻱ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺩﺭ ﭘﺎﻳﮕﺎ ﻩﻫﺎﻱ SID, IranMedex, Pubmed ﮔﺮﭼﻪ ﻋﻤﺪﺗﺎ ﺗﻐﻴﻴﺮﺍﺗﻲ ﺩﺭ ﺭﻓﻠﮑ ﺲﻫﺎﻱ ﻋﺼﺒﻲ، ﻋﻼﻳﻢ ﺣﻴﺎﺗﻲ ﻭ ﻭ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﮐﻠﻤﺎﺕ ﮐﻠﻴﺪﻱ: ﺑﻪﻃﻮﺭ ﮐﻠﻲ ﺟﺴﻢ ﺍﺳﺖ، ﺍﺳﺎﺳﺎ ﺭﻳﺸﻪ ﺩﺭ ﺗﺤﻮﻻﺕ ﻧﻔـﺲ ﺁﺩﻣﻲ ﻣﺮﮒ، ﺍﺳﻼﻡ، ﻗﺮﺁﻥ، ﺍﺧﻼﻕ، ﻧﻔﺲ، ﺭﻭﺡ، ﺟﺎﻥ ﮐﻨﺪﻥ، ﺃﺟﻞ، Death, Islam, ﺩﺍﺭﺩ (۳). ﺷﻨﺎﺧﺖ ﺍﻳﻦ ﺗﺤﻮﻻﺕ ﻣﻲﺗﻮﺍﻧﺪ ﺑﻴﻨﺶ ﺟﺎﻣ ﻊﺗﺮ ﻭ ﻣﻮﺕ، ﻓﻮﺕ، ﻭﻓﺎﺕ، ﻧﺰﻉ، ﺳﮑﺮﺍﺕ، ﻏﻤﺮﺍﺕ، ethic, quran, agony swoon, soul,throes, rapture, ﻋﻤﻴ ﻖﺗﺮﻱ ﺭﺍ ﺑﺮﺍﻱ ﭘﺰﺷﮑﺎﻥ ﺑﻪ ﺍﺭﻣﻐﺎﻥ ﺁﻭﺭﺩ ﻭ ﺩﺭﻳﭽ ﻪﻱ ﻗﻀﺎﻭﺕ ﺍﻳﺸﺎﻥ ﺭﺍ ﮔﺴﺘﺮﺩ ﻩﺗﺮ ﻭ ﻋﻤﻴ ﻖﺗﺮ ﺳﺎﺯﺩ ﺗﺎ ﺑﺮﺍﻱ ﺗﺼﻤﻴ ﻢﮔﻴﺮ ﻱﻫﺎﻱ Spiritual care 2 3 Holistic care ﺍﺧﻼﻗﻲ ﺩﺭ ﻣﻮﺭﺩ ﺑﻴﻤﺎﺭﺍﻥ ﺩﺭ ﺣﺎﻝ ﻣﺮﮒ ﮐﺎﻣﻴﺎﺑﻲ ﺑﻴ ﺶﺗﺮﻱ ﺑﻴﺎﺑﻨﺪ. 4 ﻣﻨﻈﻮر از ﻣﺮاﺣﻞ ﻧﻔﺴﺎﻧﯽ ﻣﺮگ در اﯾﻦ ﻧﻮﺷﺘﺎر، ﺣﺎﻻت و وﻗﺎﯾﻌﯽ اﺳﺖ ﮐﻪ ﺑﺮ ﻧﻔﺲ در آﺳﺘﺎﻧﻪ و ﻫﻨﮕﺎم ﻣﺮگ ﻣﯽ ﮔﺬرد و ﻣﯽﺗﻮاﻧﺪ آن را از ﻧﻔﺴﯽ - 1 ﻣﻨﻈﻮر از ﻧﻔﺲ در اﯾﻦ ﻧﻮﺷﺘﺎر، ﻧﻔﺲ ﻧﺎﻃﻘﻪ اﺳﺖ ﮐﻪ ﺑﻪ ﮔﻔ ﺘﻪي ﻣﻼﺻﺪرا، ﺟﺴ ﻢﮔﺮا ﮐﻪ ﻋﻤﺪ هي ﺗﻮﺟﻬﺎﺗﺶ ﺑﻪ ﺟﺴﻢ و ﻣﺘﻌﻠﻘﺎت آن اﺳﺖ- ﺑﻪ ﻧﻔﺴﯽ واﺳﻄ ﻪاي اﺳﺖ ﺑﺮاي رﺳﺎﻧﺪن ﻓﯿﺾ رب از روح ﺑﻪ ﺟﺴﻢ. (ﺻﺪراﻟﻤﺘﺄﻟﻬﯿﻦ. رو حﮔﺮا – ﮐﻪ ﺑﯿﺶ ﺗﺮ، وﺟﻬﻪ ي آن ﺑﻪ روح و ﺣﻘﯿﻘﺖ ﻫﺴﺘﯽ اﺳﺖ- ﺗﺒﺪﯾﻞ ﺳﻪ رﺳﺎﺋﻞ ﻓﻠﺴﻔﻰ. ﻗﻢ: دﻓﺘﺮ ﺗﺒﻠﯿﻐﺎت اﺳﻼم؛ 1387، ص: 50) ﺳﺎزد ﮐﻪ آﺛﺎر ﺟﺴﻤﺎﻧﯽ اﯾﻦ ﺗﺤﻮﻻت، ﻗﺎﺑﻞ رؤﯾﺖ ﻫﺴﺘﻨﺪ. Website: http://ijme.tums.ac.ir ﻣﺠﻠﻪ ﺍﻳﺮﺍﻧﻲ ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﻜﻲ، ﺷﻬﺮﻳﻮﺭ ١٣٩٥، ﺩﻭﺭ ﻩﻱ ﻧﻬﻢ، ﺷﻤﺎﺭ ﻩﻱ ٣، ﺹ ٢٢-١ 3 drunkenness، ﻣﻘﺎﻟ ﻪ ﻱ ﻣﺸﺎﺑﻬﻲ ﺑﺎ ﺗﻤﺮﮐﺰ ﺑﺮ ﻣﻮﺿﻮﻉ ﺑﺮﺭﺳﻲ ﻗﺮﺁﻧﻲ ﻣﻮﺭﺩ ﺟﺴ ﺖﻭﺟﻮ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ. ﭘﺲ ﺍﺯ ﺁﻥ، ﺁﻳﺎﺕ ﻣﺮﺗﺒﻂ، ﻧﻔﺲ ﺩﺭ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻗﺮﺁﻥ ﻳﺎﻓﺖ ﻧﺸﺪ. ﺍﻟﺒﺘﻪ ﺗﺎﮐﻨﻮﻥ ﻋﻨﻮ ﺍﻥﺑﻨﺪﻱ ﻭ ﺩﺳﺘ ﻪﺑﻨﺪﻱ ﻣﻮﺿﻮﻋﻲ ﻭ ﺳﺎﻳﺮ ﮐﻠﻤﺎﺕ ﺁﻳﺎﺕ ﻣﻮﺭﺩ ﺩﺭ ﺑﺮﺧﻲ ﻣﻄﺎﻟﻌﺎﺕ ﺑﻪ ﻭﺍ ﮊﻩﻫﺎﻱ ﻗﺮﺁﻧﻲ ﻭ ﮔﺎﻫﺎ ﺁﺛﺎﺭ ﻣﺮﺑﻮﻁ ﺑﻪ ﻧﻈﺮ ﻭ ﺩﻳﮕﺮ ﻣﻌﺎﻧﻲ ﻭ ﻣﻮﺍﺭﺩ ﺍﺳﺘﻌﻤﺎﻝ ﺁﻥ ﮐﻠﻤﺎﺕ ﺩﺭ ﻗﺮﺁﻥ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺩﺭ ﻗﺮﺁﻥ ﺍﺷﺎﺭﺍﺗﻲ ﺷﺪﻩ ﺍﺳﺖ. ﺑﻪﻋﻨﻮﺍﻥ ﻧﻤﻮﻧﻪ، ﺟﺴ ﺖﻭﺟﻮ ﺷﺪﻧﺪ. ﻫﻢﺯﻣﺎﻥ، ﺗﻔﺎﺳﻴﺮ ﻭ ﺗﺄﻭﻳﻼﺕ ﺁﻳﺎﺕ ﻣﻨﺘﺨﺐ ﻃﺒﺎﻃﺒﺎﻳﻲ ﺩﺭ ﻣﻘﺎﻟ ﻪﻱ ﺧﻮﺩ ﺍﺯ ﺳﮑﺮﺍﺕ، ﻏﻤﺮﺍﺕ ﻭ ﻏﺸﻴ ﻪﻱ ﻣﻮﺕ ﺩﺭ ﮐﺘﺐ ﺗﻔﺴﻴﺮﻱ ﻣﻌﺘﺒﺮ ﻋﻤﺪﺗﺎﹰ ﺷﻴﻌﻲ ﻭ ﻧﻴﺰ ﺑﺮﺧﻲ ﮐﺘﺐ ﺭﻭﺍﻳﻲ ﻧﺎﻡ ﺑﺮ ﺩﻩﺍﺳﺖ. ﺑﻪﻧﻈﺮ ﺍﻳﺸﺎﻥ ﻫﺮ ﻳﮏ ﺍﺯ ﺍﻳﻦ ﻣﻮﺍﺭﺩ ﻣﻲﺗﻮﺍﻧﺪ ﺑﺎ ﻣﻮﺭﺩ ﺑﺮﺭﺳﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ. ﺩﺭ ﻧﻬﺎﻳﺖ، ﺷﻤﻪﺍﻱ ﺍﺯ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺯﻭﺍﻝ ﻗﻮ ﻩﻱ ﻋﻘﻼﻧﻲ ﻭ ﺑﻲﺣﺮﮐﺘﻲ ﮐﺎﻣﻞ ﻫﻤﺮﺍﻩ ﺑﺎﺷﺪ (۶). ﺩﺭ ﻗﺮﺁﻥ ﺍﺳﺘﺨﺮﺍﺝ ﺷﺪ. ﺩﺭ ﺍﻳﻦ ﻣﻴﺎﻥ، ﺗﻔﮑﻴﮑﻲ ﻫﻢ ﺑﻴﻦ ﺁﻳﺎﺗﻲ ﮐﻪ ﺍﻳﻤﺎﻧ ﻲﻓﺮ ﻭ ﻫﻤﮑﺎﺭﺍﻥ، ﺑﻪﻋﺒﺎﺭﺕ ﻗﺮﺁﻧﻲ «ﻏﻤﺮﺍﺕ ﻣﻮﺕ» ﺑﺎ ﻋﻨﻮﺍﻥ ﺻﺮﻳﺤﺎ ﺩﺭ ﻣﻮﺭﺩ ﻣﺮﮒ ﻫﺴﺘﻨﺪ ﺑﺎ ﺁﻳﺎﺗﻲ ﮐﻪ ﮐﻨﺎﻳﻪ ﺍﺯ ﻣﺮﮒ ﺩﺍﺭﻧﺪ ﺷﺪﺍﻳﺪ ﻭ ﺳﺨﺘ ﻲﻫﺎﻱ ﻣﺮﮒ ﺍﺷﺎﺭ ﻩﺍﻱ ﮐﺮ ﺩﻩﺍﻧﺪ (۷). ﺯﺭﺩﺍﺩﻱ، ﺍﻧﺠﺎﻡ ﺷﺪ ﻭ ﺗﻤﺮﮐﺰ ﺍﻳﻦ ﻣﻘﺎﻟﻪ ﺑﻪ ﺁﻳﺎﺕ ﺻﺮﻳﺢ ﺍﺧﺘﺼﺎﺹ ﺩﺍﺩﻩ ﺑﺮﺧﻲ ﺍﺯ ﺣﻮﺍﺩﺛﻲ ﺭﺍ ﮐﻪ ﺩﺭ ﺁﺳﺘﺎﻧ ﻪﻱ ﻣﺮﮒ ﺑﺮﺍﻱ ﻫﺮ ﺷﺨﺼﻲ ﺭﺥ ﺷﺪ. ﺑﻪﻋﻼﻭﻩ، ﺗﻼﺵ ﺑﺮ ﺁﻥ ﺑﻮﺩ ﮐﻪ ﺩﺭ ﺗﺮﺳﻴﻢ ﺩﻳﺪﮔﺎﻩ ﻗﺮﺁﻥ ﺩﺭ ﻣﻲﺩﻫﺪ، ﭼﻨﻴﻦ ﺑﺮ ﻣﻲﺷﻤﺮﺩ: ﺗﻤ ﺜﹼﻞ ﻣﺎﻝ، ﻫﻤﺴﺮ ﻭ ﻓﺮﺯﻧﺪﺍﻥ، ﻣﻮﺭﺩ ﻣﺮﺍﺣﻞ ﻣﺮﮒ، ﺍﺳﺎﺳﺎ ﺑﻪ ﺣﻘﻴﻘﺖ ﺍﻳﻦ ﻣﺮﺍﺣﻞ ﺗﻮﺟﻪ ﺷﻮﺩ ﻭ ﺣﻀﻮﺭ ﺷﻴﻄﺎﻥ ﻭ ﻭﺳﻮﺳ ﻪﻱ ﺍﻭ، ﻭ ﺭﺅﻳﺖ ﺣﻀﺮﺍﺕ ﻣﻌﺼﻮﻣﻴﻦ ﺣﺘ ﻲﺍﻻﻣﮑﺎﻥ، ﻭﺟﻪ ﺳﻌﺎﺩﺕ ﻳﺎ ﺷﻘﺎﻭﺕ ﻣﺮﮒ ﮐﻢﺭﻧﮓ ﺩﻳﺪﻩ ﺷﻮﺩ، (ﻉ) ﻭ ﻣﺸﺎﻫﺪ ﻩﻱ ﻋﻴﻨﻲ ﺍﻋﻤﺎﻝ ﻭ ﺍﻳﺠﺎﺩ ﺣﺴﺮﺕ، ﺍﺩﺭﺍﮎ ﺑﻲﺛﺒﺎﺗﻲ ﻫﺮ ﭼﻨﺪ ﺩﺭ ﺑﺮﺧﻲ ﻣﻮﺍﺭﺩ، ﺫﮐﺮ ﺁﻥ ﮔﺮﻳﺰﻧﺎﭘﺬﻳﺮ ﻣﻲﻧﻤﻮﺩ . ﺿﻤﻨﺎ ﺍﻳﻦ ﻋﺎﻟﻢ ﻭ ﺩﺭ ﻣﻘﺎﺑﻞ، ﺩﺭﮎ ﺣﻘﺎﻳﻖ ﺍﺧﺮﻭﻱ (۸). ﺳﻌﻲ ﺑﺮ ﺁﻥ ﺑﻮﺩ ﮐﻪ ﺩﺭ ﺗﻮﺻﻴﻒ ﻫﺮ ﻣﺮﺣﻠﻪ، ﺁﺛﺎﺭﻱ ﮐﻪ ﺩﺭ ﺟﺴﻢ ﺳﻠﻤﺎ ﻥﭘﻮﺭ ﻭ ﺍﻳﻤﺎﻧ ﻲﻓﺮ ﺑﻪ ﺷﺮﺡ ﻣﺨﺘﺼﺮﻱ ﺍﺯ ﻏﻤﺮﺍﺕ، ﺗﻮﻓﹼﻲ ﻇﺎﻫﺮ ﻣﻲﺷﻮﺩ ﻧﻴﺰ ﺟﺴ ﺖﻭﺟﻮ ﻭ ﺑﻴﺎﻥ ﺷﻮﻧﺪ. ﻫﻢﭼﻨﻴﻦ، ﺗﻌﺮﻳﻒ ﻭ ﻭ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺩﺭ ﻣﺆﻣﻨﺎﻥ ﻭ ﮐﺎﻓﺮﺍﻥ ﭘﺮﺩﺍﺧﺘ ﻪﺍﻧﺪ (۹). ﮔﻮﻫﺮﻱ ﺩﺭ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﭘﺰﺷﮑﻲ ﺩﺭ ﻣﻨﺎﺑﻊ ﺍﻃﻼﻋﺎﺗﻲ ﺍﺯ ﻗﺒﻴﻞ ﻣﻄﺎﻟﻌ ﻪﻱ ﺧﻮﺩ، ﺍﺣﺘﻀﺎﺭ، ﺳﮑﺮﺍﺕ ﻭ ﻏﻤﺮﺍﺕ ﺭﺍ ﺑﻪ ﻳﮏ ﻣﻌﻨﻲ Pubmed,Scopus, Science Direct ﺟﺴ ﺖﻭﺟﻮ ﺷﺪ. ﺩﺍﻧﺴﺘﻪ ﻭ ﻭﻗﺎﻳﻊ ﺯﻣﺎﻥ ﺍﺣﺘﻀﺎﺭ ﺭﺍ ﺑﺮﺍﻱ ﺩﻭ ﮔﺮﻭﻩ ﻣﺆﻣﻨﺎﻥ ﻭ ﮐﻔﺎﺭ ﺷﺎﻳﺎﻥ ﺫﮐﺮ ﺍﺳﺖ ﮐﻪ ﻫﺪﻑ ﺍﺯ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮﺭﺳﻲ ﺗﻄﺒﻴﻘﻲ ﺗﻮﺻﻴﻒ ﮐﺮﺩ ﻩﺍﺳﺖ (۱۰). ﻫﻢﭼﻨﻴﻦ، ﺍﻭ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺭﺍ ﺗﻨﻬﺎ ﺩﻭ ﻣﺮﺍﺣﻞ ﻣﺮﮒ ﺩﺭ ﭘﺰﺷﮑﻲ ﻭ ﻗﺮﺁﻥ ﻧﺒﻮﺩ ﻩﺍﺳﺖ، ﺑﻠﮑﻪ ﻧﮕﺎﻫﻲ ﺍﺯ ﺩﻭ ﻣﺮﺣ ﻠﻪﻱ ﺍﺣﺘﻀﺎﺭ ﻭ ﻗﺒﺾ ﺭﻭﺡ ﻣﻌﺮﻓﻲ ﮐﺮﺩﻩ ﺍﺳﺖ (۱۰).
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