Should a Doctor Treat or Not? Which Is a Crime?

From Zeynab Soleimani’s case to laws on acts and omissions: how should a doctor choose between the duty to save a patient’s life and the risk of security prosecution?

Has a doctor who saves an injured person’s life fulfilled their duty, or committed a crime? And if they refuse to treat that same injured person and the patient dies, what does the law say about them? These questions have taken on new meaning with the news about the situation of Zeynab Soleimani, a paediatrician in Isfahan.

According to reports published on 9 Aban 1405, Zeynab Soleimani, who helped treat injured people and remove pellets and bullets from their bodies during the Dey 1404 protests, has been held at Dowlatabad Prison in Isfahan since Farvardin. According to sources cited in these reports, she spent most of her detention in solitary confinement, was transferred to Farabi Psychiatric Hospital three times, and has not yet been tried. The official charge against her has also not been made publicly clear. It is therefore necessary to distinguish between reports about the reason for her detention and a charge that the judicial authorities have not yet officially substantiated.

Now suppose someone is brought to A&E in torn clothes, wearing only their underwear or under-trousers, bloodied and unconscious. They have no identification with them. Perhaps they are a protester, perhaps a Basij or IRGC member, perhaps a passer-by caught in a shooting. How is a doctor supposed to tell? Should they wait for the patient to regain consciousness and explain their political affiliations? Seek permission from the security forces? Or treat their physical condition immediately?

The answer can be found in Iran’s own laws. Article 2 of the Medical Council’s disciplinary regulations requires practitioners in the medical professions to make every possible effort within the scope of their professional duties, without regard to their patients’ social or political status. For a doctor, an injured Basij member and a protester have the same right to receive care.

The law does not merely offer ethical support for treatment; it also provides for liability for refusing to help. The 1975 Law on Refusal to Assist the Injured stipulates punishment, in certain circumstances, for anyone who can help a person whose life is in danger without putting themselves at risk, but refuses to do so. Article 295 of the Islamic Penal Code, adopted in 2013, explicitly mentions doctors and nurses: if they fail to perform a legal duty despite being able to do so, and a criminal injury results from that omission, they may be held liable. However, the duty, the ability to act and the causal link must be established; not every adverse outcome automatically constitutes a crime by the doctor.

So if this same unconscious patient dies because of an unjustified refusal to help, the treating professional may face prosecution. But if they are treated and it later emerges that they took part in the protests, why should the act of treating them itself put the doctor at risk of security-related repercussions?

This question applies to both sides of the conflict. On 13 Bahman 1404, Salar Velayatmadar, the representative for Qazvin, said that a doctor who, he alleged, had refused to operate on an injured Basij member in uniform had been arrested, although, he added, the doctor was later released and was not convicted. This statement is not evidence of a conviction for failure to act, but it shows that, even in the account of a government official, refusing treatment on the basis of a patient’s identity was met with action. Is the same principle upheld in reverse? Is treating an injured protester equally protected from security-force interference?

The figures suggest that healthcare workers’ concerns are not merely hypothetical. In Bahman 1401, the Center for Human Rights in Iran reported recording the arrests of at least 81 doctors, healthcare workers and medical students during those protests. Yaser Rahmani-Rad, Behnam Ohadi and Homayoun Eftekhariannia were arrested while travelling to Mahabad to provide aid. The deaths of Aida Rostami and Parisa Bahmani, two female doctors, have also been accompanied by uncertainty and conflicting accounts in human rights reports.

In Ordibehesht 1405, IranWire reported the arrests of at least 83 healthcare workers in 33 cities in connection with the Dey protests; the list included 37 doctors and 9 nurses. Let us not even assume that all of them were arrested solely for providing treatment. Nevertheless, in Esfand 1404, Iran International reported, citing witnesses, that at Tehran’s Rajaei Heart Hospital two female nurses were killed while providing emergency assistance, five people were arrested, and two of those detained were raped and tortured. The victims’ names and independent medical or judicial confirmation of these allegations have not been made public, but the gravity of the allegations does not remove the need for an independent investigation. Of course, the presence of security forces in hospitals and medical centres, and the intimidation and threats directed at healthcare workers, are no longer hidden from anyone, given the videos and evidence.

In response to these reports, the Judiciary and the head of the Medical Council have said that no doctor has been arrested solely for providing medical services. If that is the case, publishing the legal grounds for the arrests and clarifying the charges against Zeynab Soleimani should be the first step towards resolving the uncertainty.

There is an old story about a man with two daughters: one was married to a farmer and wanted rain for his fields; the other was married to a potter, and rain would ruin the pots that had not yet dried. The father said that whether it rained or not, one of them would be in trouble. The predicament of a healthcare worker caught between the risks of treating a patient and liability for failing to treat them recalls that story—with one difference: no one controls the rain, but the government controls the enforcement of the law.

Ultimately, we must ask: when an injured person lies unconscious on an A&E bed, should the doctor be thinking about saving their life, or worrying that tomorrow it may become known whom they saved? If the law treats all patients equally, why should the professional safety of the person who upholds that law not be guaranteed?