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Submitted: 31 Oct 2020
Accepted: 02 Nov 2020
ePublished: 17 Nov 2020
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  Abstract View: 13

Epidemiology and the Burden of Diseases in Health Care System

Original Article

Occurrence of Congenital Anomalies in Iran and Implications of ‘No Hardship and Negation of Distress and Constriction’ Principal in Shia Fiqh

saeed dastgiri* ORCID logo, Abdolhassan Kazemi 2 ORCID logo, Mohammad heidarzadeh 3 ORCID logo, Morteza Alian 4, Bahram Samadi 5 ORCID logo, Ali Seif-farshad 6, Foroogh Sadat Sayyah Melli 7, Hossein Mirzajanzadeh6 8, Mariam Beigom Yasini 9

Abstract

Background and Objectives The aim of this study was to discuss the implications of ‘no hardship and negation of distress and constriction’ principle in Shia fiqh in terms of the therapeutic termination of pregnancies diagnosed for congenital anomalies.
Material and Methods: Data for occurrence of congenital anomalies were derived from two major regional and national epidemiological studies based on 6,465,849 births in the country. A comprehensive review of literature was carried out on the details of ‘no hardship’ principle. The details of medical termination of pregnancies diagnosed for congenital anomalies and the role of ‘no hardship and negation of distress and constriction’ principle in the prevention of birth defects were explored in several Focused Group Discussions formed by peditricians, geneticists, psychiatrists, neotatalogists and expert jurisprudents.
Results: The statistical estimates indicate that there are now nearly 100,000 births with one of the birth defects occurring every year in the country. The total prevalence of the anomalies has more than tripled in the last 18 years.
Conclusion: The occurrence of congenital anomalies and genetic disorders will undermine the gene pool of the population if preventive measures are not properly implemented in the community genetics services to control those disorders. According to the current law on therapeutic abortion, disorders that lead to the hardships of father, mother, family, community, as well as future generations may be diagnosed by the three specialists (before the 16th week of pregnancy, the time of onsetting the soul). They can then be referred for medical abortion. A minimum of 70,000 birth defects may be avoided using the therapeutic termination of pregnancies diagnosed for congenital anomalies if the ‘no hardship and negation of distress and constriction’ principle is suitably explored in maternal, pediatric, neonatal settings and for public health authorities
Keywords: Congenital Anomalies Birth Defects, Genetic Disorders, Prevention, Control Epidemiology, Negation of Distress and Constriction
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