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Islamic

Medical Ethics
Kassim
Baddarni
Al-Taj Organization
Arraba, Galilee, Israel
altaj@013.net

1
Islam is the
Youngest
2nd Largest Religion
Every 5th person
worldwide

Judais Hinduis Buddhis Christiani Isla


m m m ty
m

2000 BC 1000 563 33 610 AD 200


BC BC AD 2 8
Spiritual
Religion Care

Muslim
Patient

Values Belief
s 3
Islamic Law and
Rules
The Holy Book Quran
(Hadith), words or
Sunnah
actions of the
prophet Consensu
(Ijma) of the Clerics
s
(Ijtihad) personal
Wisdom
study 4
Values: Regulates:
Honor parents Marriage
Be kind to neighbors Divorce
Protect the weak Inheritance
Give to the poor Business

The
Quran
Forbids: Condemns:
Gambling Murder
Pork Stealing
Alcohol Lying
Prostitution Adultery
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Oneness of God
All can, no body or sex

Life after Death Angels of God


Sorting to Hill or Paradise From light to serve God

Intern
al Prophets of God
Day of Judgment From Adam to Mohammed (25
Rise of humanity Beliefs
Books of God
Divine Decree Of Abraham, David,
Fate set in advance Moses, Jesus, Mohammed
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Health, Religion &
Ethics

Contraception Brain Death


Fertility Organ
Cloning Donation
Medications Euthanasia
Resuscitation Death
Life after
Death 7
The Sharia Law
System
Category Arabi Do it Not do it
c
Obligatory Fard
Wajeb Reward Punishment
(Prescribed)
Recommend Mustaha
ed bMandu Reward No
b Punishment
(Desirable)
Permitted Mubah
Halal No Reward No
(Allowed) Punishment
Discouraged Makruh
Manboth No Reward
(Disliked) Punishment 8
Forbidde
n
Enforcing
Doing
of not
Maslow
Discoura
ged
Urging of not
Way
Doing

Permitted
Choice of Doing

Recommended
Urging of Doing

Obligatory
Enforcing of Doing
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Obligatory

10
Recommended

Blood and organ donation. (giving and


receiving).
Circumcision of male infants (7th day).
Controversy of female circumcision.
Breast feeding (two years).
Human skin bank: lawful for medical grafting
and unlawful for cosmetics and misleading others.

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Permitted
Autopsy: if for medically or by law indicated.
Reconstructive Surgery (post mastectomy).
Do Not Resuscitate order: when the
treatment becomes futile.
Withdrawal or withheld therapy is permitted
in brain death.
Genetic Engineering: to alter or cure diseased
genes.
Abortion: pregnancy that risk the mothers
health, physically or mentally. 12
Permitted
Contraception: Islam approves all methods of
contraception between husband and wife which are
not harmful, are reversible and are not causing
abortion.
Artificial insemination: when using the
husbands sperm and the wifes ovaries and uterus.
Death of one of the spouse terminates the
marriage contract on earth, thus frozen sperm
from husband can not be used.
13
Discourage

Forced feeding the sick.


Smoking
Divorce
Elective abortion before age 120
days (some sects before 40 days).

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Forbidden
Surgical contraception: (Sterilization: Vasectomy
& tubal ligation). Permitted for mentally sick or
when another pregnancy risks mothers life.
Sperm or ova donation.
Fetal Sex Determination.
Elective abortion in a healthy mother 120 days
after fertilization.
Human milk bank.
Human cloning (permitted for tissues and organs).
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Forbidden
Surrogacy Uterus: Surrogacy involving a third
person is not permissible. (even if the woman
involved is another wife of the husband).
Sex: Oral sex, homosexual and gay/lesbian relation,
prostitution and sex outside marriage.
Cosmetic surgery: Changing the creation of Allah.
Food: not Halal meat, of pork or dead animal/bird.
Drink: alcohol.
Others: interest, theft, gambling and drugs.
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Forbidden
Active Euthanasia: voluntary, non-voluntary
and Involuntary are not permissible under any
circumstances.
Passive euthanasia: treatment is not obligatory
when there is no hope of survival (brain death).
Patient should be provided with food, drink,
nursing, and relief from pain until death.
Suicide: include assisted suicide and physicians
assisted suicide.
Murder. "take not life which Allah has made sacred"
Quran 6:151. 17
Principles of Medical
Ethics
Necessity overrides prohibition (insulin
from pork, medications with alcohol).
Remove harm at every cost if possible
(quit smoking, risk factors, disease therapy).
Accept the lesser of two harms if both
cannot be avoided (abortion in risk to the
pregnant woman).
Public interest overrides individual
interest (blood and organ donation). 18
Female
Modesty
Dress: Provide a long-sleeved gown or allow to
wear her own cloths.
Examination: exposure of the patients body
parts should be limited to the minimum necessary.
Sex: sensitivity when asking a single, widow or a
divorced about sexual habits.
Respect privacy and do not touch while talking.
Should not be placed in mixed rooms.
Avoid eye contact and shaking hands to
prevent unnecessary embarrassment. 19
Cancer
Result of Divine Will or a spiritual trial (not a
product of a carcinogen or risk behavior).
Cancer is often referred to as that disease
followed by God keep it away.
Cancer kept confidential, fear that it may affect
their daughters marriage.
Pain: analgesic to prevent suffering include
morphine is allowed and recommended. Suffering
delete sins.
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Palliative
Care
When death is inevitable, Islam directs that the
patient be allowed to die without heroic
measures.
Muslims disapprove of any medical care that may
hasten the death of a patient.
Muslims prefer to die at home if possible with the
family providing comprehensive physical and
spiritual support.
Death is not prepared for with prior funeral
arrangements and viewed as an interference in
Gods will. 21
Death
Death definition: when spirit leaves the body.
Death is Inevitable: Every soul shall have a taste of
death: In the end to Us shall you be brought back." Quran 29:57

The dying person: should sit up or lie with their


face towards Mecca. Ideally one should die with
the Declaration of Faith on the lips (Shahada).
When death occur: eyes should be closed; all
connected tubes removed; all limbs flexed and
the body straightened.
22
After Death
Washing and burying the body as soon as possible
(same day). On the right side, facing Mecca.
Respect for the body and prayers over the dead.
Recitation of the whole Quran if possible.
Mourning should not be excessive, as this would
disturb the dead as well as show lack of
acceptance of Gods will and purpose regarding
death.

23
Funeral &
Mourning
Period
Funeral is simple and every human is equal.
Deceased buried in a white shroud (men 3 pieces,
women 5 pieces) without a coffin. Islam forbids
cremation.
Women are not allowed to attend the funeral,
non-Muslim men may attend.
Mourning period 3 days. Wife mourn her
husband 4 months and 10 days. She is not to
remarry, leave her home, or wear decorative
clothing. Pregnant widow may remarry 42 days
after childbirth. 24
Life After Death
Angels visit the dead in grave during the first night.
Believers are comfortable waiting till judgment day.
Judgement Day: resurrection of bodies. The good
cross to Paradise, The bad fall off into Hell.
Child is regarded sinless until the age of maturity. The
soul /spirit of the child is automatically transferred to
paradise.

25
Family Duties
After Death
Payment of Funeral expenses.
Payment of his/her debts.
Execution of his/her will.
Distribution of the remaining
estate.

26
Spiritual
History
Ask: About life & death meaning.
Observe: Dressing, praying, reading
Listen: Reactions, answers, remarks

27
Barriers of Spiritual
History and Therapy
Lack of time.
Lack of training.
Discomfort with the subject.
Fear of activity outside area of
expertise.
Lack of interest or awareness.

28
Final Words
Listen to patient and family.
Demonstrate sensitivity.
Respect Patients Values and Beliefs.
Remain Flexible.
Avoid Speculation.
Respond to Who, What, Where,
When?
Provide Reassurance.

29
Al-Taj for Health and
Heritage
Mission: health promotion by
raising awareness for
prevention, early detection
and improve management and
outcome of cancer and
diabetes in the Arab sector,
Tel/Fax +972-4-6747737
Israel
altaj@013.net

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Some
Projects
Palliative
Care
Manual

Diabetes
Mellitus the
Era Plague

31
Some
Projects
Breast
Cancer
lecture

Palliative Care
conference

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