Supported Decision Making in Healthcare: Integrating the Principles of Sy?r?, Hifz al-Nafs, and Patient Legal Protection
DOI:
https://doi.org/10.59261/jlsp.v4i4.163Keywords:
Hifz al-Nafs, Informed Consent, Patient Legal Protection, Supported Decision Making, Sy?r? Supported Decision MakingAbstract
Background: Medical consent may be formally valid while still failing to demonstrate patient understanding, voluntariness, and meaningful participation.
Objective: This conceptual article examines supported decision-making as a model of legal protection for patients through the integration of sy?r? and hifz al-nafs.
Methods: This literature-based conceptual paper uses a narrative-integrative synthesis of primary legal materials and scholarly literature on health law, informed consent, autonomy, supported decision-making, and Islamic bioethics.
Results: The synthesis constructs a five-element model: patient primacy, understandable information, a patient-approved companion or facilitator, protection against domination or substitution of the patient’s will, and documentation of the decision-making process. Sy?r? functions as the deliberative procedure through which patients, families, and healthcare professionals clarify options without displacing the patient’s will; hifz al-nafs functions as the normative orientation toward life, safety, dignity, welfare, and harm prevention.
Conclusion: The model reconstructs the procedural implementation of informed consent rather than replacing its legal doctrine. It provides a conceptual basis for process-based legal protection, while its practical effects require future empirical and normative validation.
References
Akhtar, M. U., Bhatti, M. E., & Fredericks, S. (2024). What factors influence patient autonomy in healthcare decision-making? A systematic review of studies from the Global South. Nursing Ethics, 32, 875–891. https://doi.org/10.1177/09697330241272794
Alfahmi, M. Z. (2022). Justification for requiring disclosure of diagnoses and prognoses to dying patients in saudi medical settings?: a Maqasid Al ? Shariah ? based Islamic bioethics approach. BMC Medical Ethics, 23(72), 1–9. https://doi.org/10.1186/s12910-022-00808-6
Allen, J. W., Levy, N., & Wilkinson, D. (2025). Empowering Patient Autonomy?: The Role of Large Language Models ( LLMs ) in Scaffolding Informed Consent in Medical Practice. Bioethics, 40, 183–193. https://doi.org/10.1111/bioe.70030
Appelbaum, P. S., & Trachsel, M. (2021). The Doctrine of Informed Consent Doesn’t Need Modification for Supported Decision Making. The American Journal of Bioethics, 21(11), 27–29. https://doi.org/10.1080/15265161.2021.1980143
Dennstädt, F., Putora, P. M., Iseli, T., Treffers, T., Panje, C., & Fischer, G. F. (2024). Patient autonomy and shared decision?making in the context of clinical trial participation. European Journal of Clinical Investigation, 54. https://doi.org/10.1111/eci.14291
Donnell, D. O., Davies, C., Christophers, L., Shé, É. N., Donnelly, S., & Kroll, T. (2023). An examination of relational dynamics of power in the context of supported ( assisted ) decision ? making with older people and those with disabilities in an acute healthcare setting. Health Expectations?: An International Journal of Public Participation in Health Care and Health Policy, 26, 1339–1348. https://doi.org/10.1111/hex.13750
Idris, I. B., Hamis, A. A., Bukhori, A. B. M., Hoong, D. C. C., Yusop, H., Shaharuddin, M. A., Fauzi, N. A. F. A., & Kandayah, T. (2023). Women ’ s autonomy in healthcare decision making?: a systematic review. BMC Women’s Health, 23(643), 1–10. https://doi.org/10.1186/s12905-023-02792-4
Jaakkola, E. (2020). Designing conceptual articles?: four approaches. AMS Review, 10, 18–26. https://doi.org/10.1007/s13162-020-00161-0
Koch, V. G. (2024). Reforming Informed Consent to Include Comprehension: A Proposal to Promote Equity in Medical Decision-Making. SSRN Electronic Journal, 8–16. https://doi.org/10.2139/ssrn.4741975
Kuosmanen, L., Hupli, M., Ahtiluoto, S., & Haavisto, E. (2021). Patient participation in shared decision- making in palliative care – an integrative review. Journal of Clinical Nursing, March, 3415–3428. https://doi.org/10.1111/jocn.15866
Le, T. D., Lin, S.-C., Huang, M.-C., Fan, S.-Y., & Kao, C.-Y. (2023). Factors impacting the demonstration of relational autonomy in medical decision-making: A meta-synthesis. Nursing Ethics, 31. https://doi.org/10.1177/09697330231200570
Lewis, J. (2023). Respect for autonomy?: Consent doesn’t cut it. Clinical Ethics, 18(2), 139–141. https://doi.org/10.1177/14777509231173572
Masyuri, R. I., Setioboedi, D., Mashdurohatun, A., Kadarmo, D. A., & Fareha, N. (2024). Towards Equitable Healthcare?: Redesigning Informed Consent Regulations. Journal of Ecohumanism, 6798, 8518–8524. https://doi.org/https://doi.org/10.62754/joe.v3i8.5447
Muhsin, S. M., Hashi, A. A., Gounjaria, N., Alashaikh, M. H., & Chin, A. H. B. (2025). Can Global Bioethics Benefit From Islamic Jurisprudential Principles? Bioethics, 35–44. https://doi.org/10.1111/bioe.70035
Nurhasanah, N. (2018). Metodologi Studi Islam. Amzah.
Padela, A. I. (2022). Maq??id? Models for an “ Islamic ” Medical Ethics?: Problem-Solving or Confusing at the Bedside?? American Journal of Islam and Society, 72–114. https://doi.org/10.35632/ajis.v39i1-2.3069
Pichlak, M., Kaleta, K. J., & Nawacka, A. (2025). Systematic Literature Review Method in Legal Research. Law and Method, 1–23. https://doi.org/10.5553/REM/.000085
Rahman, M. F. A., Rofiah, N., & Nurbaiti, N. (2025). Islamic Bioethics Construction. Journal of Comprehensive Science, 4(3), 1163–1176. https://doi.org/10.59188/jcs.v4i3.3091
Thomas, E. C., Bass, S. B., & Siminoff, L. A. (2021). Beyond Rationality: Expanding the Practice of Shared Decision Making in Modern Medicine. Social Science & Medicine, 215, 1–14. https://doi.org/10.1016/j.socscimed.2021.113900.
Wendler, D., & Kim, S. Y. (2022). Implementing supported decision making in clinical research. International Journal of Geriatric Psychiatry, 38(1). https://doi.org/10.1002/gps.5860
Wied, T. S., Haberstroh, J., Gather, J., Karakaya, T., Oswald, F., Qubad, M., Scholten, M., Vollmann, J., & Pantel, J. (2021). Supported Decision-Making in Persons With Dementia?: Development of an Enhanced Consent Procedure for Lumbar Puncture. Frontiers in Psychiatry, 12(November), 1–7. https://doi.org/10.3389/fpsyt.2021.780276
Wilkinson, D., & Levy, N. (2024). Scaffolding informed consent. Journal of Medical Ethics, 1–8. https://doi.org/10.1136/jme-2024-110105
Yeoran, Y., & Hyuna, B. (2024). Shared Decision-Making and Informed Consent Legislation in Clinical Decision Making. Korean Journal Medical Ethics, 27(2), 71–87. https://doi.org/10.35301/ksme.2024.27.2.71
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