God, Allaah says (which means): “Whosoever saves a human life saves the life of the whole mankind.” The Holy Quran, 6:32
Prophet Muhammad: “There is no disease that God has created, except that He also has created its treatment.” (Book of Al- Bukhari)
Islam considers access to health care as a fundamental right of the individual. In medicine, there are sometimes difficult decision-making options for the patient’s care. Thus, a physician at times has to decide for his /her patient in light of available knowledge, his/her experience, his/her peers and consensus of the community.
In addition, a Muslim physician derives his /her conclusion from rules of Islamic laws (Shari`ah) and Islamic medical ethics:
The first main principle of Islamic Medicine is the emphasis on the sanctity of human life which derives from al-Qur’an: “Whosoever saves a human life saves the life of the whole mankind.”
The second main principle is the emphasis on seeking a cure. This derives from a saying of Prophet Muhammad: “There is no disease that God has created, except that He also has created its treatment.”
Prophet Muhammad, in another narration, is also reported to have said: “Seek treatment, for God the Exalted did not create a disease for which He did not create a treatment, except senility. This is further emphasized by the fact that three of the “Goals of the Islamic Shari`ah” are the protection and preservation of life, intellect, and progeny. The other two are the protection of propertyand religion.
Some of the rules of Islamic medical ethics are:
1) Necessity overrides prohibition; that is, if there are certain items which are islamically prohibited, under dire necessity they can become permissible. 2)Harm has to be removed at every cost if possible. 3) Accept the lesser of the two harms if both can not be avoided. 4) Public interest overrides the individual interest.
Islamic Medical Ethics also upholds the four basic principles of biomedical ethics. These are 1) Respect for the autonomy of the patient, 2) Beneficence, 3) Nonmaleficence, and 4) Distributive JusticeThus, when a Muslim physician is making a decision about patient care, that decision should be in the best interest of the patient Muslim physicians, have dire need for recommendations from the guiding principles of the Glorious Qur’an, the tradition of Prophet Muhammad and opinions of past and contemporary Muslim scholars.
The Qur’an says: “It is not fitting for a believer, man or woman, when a matter has been decided by God, and His messenger, to have any option about their decision. If any one disobeys God and His messenger, he is indeed on a clearly wrong path.)
A: care for Amuslim patient
1. Muslim patients should be identified-if possible-as Muslim (or with the religion Islam) in the registration information so as to prevent any mistakes happening unintentionally in terms of violating dietary rules or privacy. 2. Their care providers should respect their modesty and privacy. Muslim patients, particularly women, may need a special gown to cover the whole body in order to avoid unnecessary exposure during physical examination. Some examinations may be done over the gown. 3. Provide Muslim patient’s islamically slaughtered (Dhabiha) meat. Muslim patients should not be served any pork, pork products or alcohol in their meals. A Muslim patient’s family may bePage 4 allowed bringing food from home, as long as it is meeting the patient’s dietary restrictions. 4. Make it easy for Muslim patients to perform Islamic prayers if they can. 5. Inform them of their rights as a patient and encourage an Islamic living will. A sample of a living will is included. (See Section E) 6. Take time to explain test procedures and treatment. Some of the more recently immigrated Muslims may have a language problem. Muslim women can give consent for any treatment or procedure. 7. Allow their Imam (religious teacher) to visit them and pray for them. Clerics of other faith traditions can pray for or with Muslim patients with their permission, using non denominational words like God. 8. Autopsy is permitted if medically indicated or required by law. 9. Organ donation is permitted with some guidelines and is encouraged. 10. Always examine a female patient in the presence of another female (chaperon) or a female relative (except in medical emergencies). Especially for labor and delivery, if the patient’s obstetrician is unavailable and upon her request, provide a female healthcare provider, if feasible. Her husband is encouraged to be present during the delivery. 11. After the death of a Muslim patient in a health care facility, allow the family and Imam to arrange for preparing the dead body for burial under Islamic guidelines. A corpse should be given the same respect and privacy as he/she was receiving while alive. Muslim relatives and friends of the dead are encouraged to stay in the room where the dead body is kept to recite Qur’an. Muslim corpses are not embalmed.
(B) Definition of Life and the Responsibility of Muslim Physicians towards Human Life
Muslims believe that God is the Creator of life and life is a gift from Him. Muslims believe that all life is sacred and must be protected. The respect for life in Islam is common for all humans, irrespective of gender, age, race, color, faith, ethnic origin or financial status. IMANA holds the position that biological life begins at conception while human life begins when ensoulment takes place. A verse from the Qur’an reads: Man We did create from a quintessence (of clay); Then We placed him as (a drop of) sperm in a place of rest, firmly fixed; Then We made the sperm into a clot of congealed blood; then of that clot We made a (fetus) lump; then we made out of that lump bones and clothed the bones with flesh; then we developed out of it another creature. So blessed be God, the best to create!. Ensoulment is believed to occur at 40 or 120 days after fertilization, according to different schools of thought. (see Section I) The right of the human fetus in Islam is similar to the rights of a mature human being, including the right to life, the right to inheritance, the right of compensation when injured by willful acts and the right to penalize assailants. IMANA extends the principles of medical ethics to the patient in a vegetative state. Until the death has been declared, the patient in a vegetative state is considered a living person and has all the rights of a living person.
(C) Definition of Death
The definition of the end of human life from the Islamic point of view has been previously discussed. When diagnosed by a physician or a team of physicians, is considered death. The concept of brain death is necessitated when artificial means to maintain cardiopulmonary function are employed. In those situations, cortical and brain stem death, as established by specialist(s) using appropriate investigations can be used. It is the attending physician who should be responsible for making the diagnosis of death.
Thus a person is considered dead when the conditions given below are met.
1. The physician has determined that after a standard examination, a person’s cardiopulmonary function has come to a permanent stop. 2. A specialist physician (or physicians) has determined that after standard examination, the function of the brain, including the brain stem, has come to a permanent stop, even if some other organs may continue to show spontaneous activity.
(D) Mechanical Life Support in Terminally Ill Patients or Those in Persistent Vegetative State and Euthanasia.
The following verses in the Glorious Qur’an are some of the verses which address issues of life and death.
“It is He who gives life and death and when He decides upon an affair, He says to it: Be and it is”.