An Islamic perspective on end of life issues

Report
Compiled by Tehseen Lazzouni
Islamic Speakers Bureau of San Diego
Based on Works by the Islamic Medical Association of North
America (IMANA), Dr. Gamal Badawi, Dr. Saleem Saiyad,
and the Islamic Networks Group
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Islam: “Peace through Submission to God”
Muslim: “One who Submits to God”
Monotheistic Faith following the Abrahamic
tradition
Worldwide Muslim Population: > 1.6 Billion
U.S. Muslim Population: ~7 Million
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God
Angels
Prophets
Holy Books
Day of Judgment
Will of God
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Based on Islamic laws—the Shari’ah—in place
to benefit humans
Major goals of Shari’ah—protection and
preservation of:
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Life
Intellect
Progeny
Property
Religion
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First Principle (from the Qur’an): “Whosoever
saves a human life, saves the life of the whole
mankind.”
Second Principle (from the Hadith): “There is
no disease that God has created, except that He
also has created its treatment.”
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Necessity overrides prohibition
Harm must be removed at every cost if
possible
Accepting the lesser of two harms if both
cannot be avoided
Public interest overrides individual interest
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Muslim patients should be identified as
Muslim
Respect for modesty and privacy
No pork or alcohol
Facilitate daily prayers if possible
Inform patients of their rights; encourage
living will
Explanation of test procedures and treatment
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Allow Imam to visit and pray for patient
Autopsy permitted if necessary
Organ donation permitted within guidelines
Female patient exam in presence of another
female
After death, allow arrangements for Islamic
burial
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The human body is a trust
Obligation to seek a cure
Suicide and active euthanasia prohibited
Patient’s right to know (unless abdicated)
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When death is inevitable, as determined by a
team of physicians, patient should be allowed
to die without unnecessary procedures.
Ongoing medical treatments can be continued.
Mechanical support can be withdrawn.
Patient should be treated with full respect,
comfort measures, and pain control. No
attempt to withhold nutrition & hydration.
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Family should be contacted
Common to have many visitors, even nonrelatives
Qur’anic recitation desired
Muslim patient asked to reaffirm their cardinal
beliefs
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Two Different Views:
Person considered alive; withdrawal of life support
forbidden if endangers life of patient (ING View)
• Should not prolong misery of dying patients; imam
should be included in decision-making process
(IMANA View)
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Death an event under complete control of God
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“No soul can die except by Allah’s permission.”
According to Shari’ah, person considered dead
when either of the following two signs is noted:
Heartbeat and breathing stop completely; doctors
decide these cannot be restarted
• All the functions of brain stop completely; doctors
and specialists confirm this is irreversible and brain
has started to disintegrate
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General consensus on DNRs in Islamic community
is still evolving; decision of medical futility to be
determined by doctors on the case.
In the absence of terminal illness or futile care
situations, the Muslim patient should seek medical
treatment, including resuscitation, until recovery
or stage of terminal illness or vegetative state is
reached.
Encouraged to have a written living will and to be
“full code”—agreement to use all recognized
therapies, given reasonable chance of recovery.
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Patient’s eyes to be closed
Body to be covered
Family may ask for body to be turned so patient can
face Mecca, if possible
Body washed and wrapped in a white cloth before
burial
Burial to take place quickly—no cremation or
embalming
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Two contrasting opinions on organ donation:
• 1. Not allowed—we do not own our bodies
• 2. Allowed and encouraged—great act of charity
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IMANA takes the second opinion: organ donation
allowed under the following conditions:
• If specifically indicated by the deceased in a will or on
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driver’s license
For purpose of saving life
No financial incentive
No cost to donor’s family
No donation of reproductive organs
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