Religious, Ethical, and Spiritual Considerations in Individuals Who Attempt Suicide by Intentional Poisoning: A Narrative Review Publisher

Summary: How should poisoning care address faith and ethics? A review urges clear distinctions between self-harm and treatment refusal, alongside evidence-based care and follow-up. #Bioethics #Toxicology

Zoofaghari S
Source: International Journal of Medical Toxicology and Forensic Medicine Published:2026

Abstract

Background: Intentional self-poisoning is a clinical toxicology emergency that may also raise questions about 16 suicide risk, capacity, ethics, law, spirituality, family context, and prevention after survival. The primary objective of this research is to integrate perspectives from clinical toxicology, medical ethics, law, philosophy, religion, spirituality, psychology, public health, and social-familial domains regarding individuals who attempt suicide through intentional poisoning (an interdisciplinary study). Methods: A narrative review was conducted using the article's original literature base (1999–2025). The search strategy covered PubMed/MEDLINE, Google Scholar, ScienceDirect, SpringerLink, SID, Magiran, and NoorMags, supplemented by official primary-authority sources from Shi'a maraji', Sunni fatwa institutions, the Vatican/USCCB, the World Medical Association, WHO, and NICE. Search concepts combined suicide/self-harm, intentional self-poisoning/poisoning, medical ethics, treatment refusal, decision-making capacity, confidentiality, spiritual care, Islamic ethics, Shi'a jurisprudence, Sunni jurisprudence, euthanasia, and physician-assisted suicide. Sources were screened for relevance, traceability, authority, and direct applicability to the review question. Results: The evidence supports a consistent clinical principle across contemporary guidance: patients who self-poison should receive appropriate medical treatment, privacy, non-punitive care, and timely psychosocial assessment. Religious sources examined here generally prohibit intentional self-killing, but they differ in terminology, jurisprudential reasoning, and treatment of responsibility, especially where severe psychological disturbance may affect responsibility. Contemporary bioethics distinguishes suicide attempts from capacitated treatment refusal and from euthanasia or physician-assisted suicide. These distinctions are essential in poisoning emergencies. Conclusion: Religious and ethical perspectives should inform, but not replace, evidence-based toxicological and psychosocial care. An interdisciplinary, patient-centered continuum from acute poisoning treatment through structured follow-up may support the prevention of recurrent intentional self-poisoning. Copyright © 2026 The Author(s); This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0: https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.