Islamic Medical Ethics

Kassim Baddarni
Al-Taj Organization Arraba, Galilee, Israel

altaj@013.net

Religion

Spiritual Care

Patient

Values

Beliefs

Values:
Honor parents Be kind to neighbors Protect the weak Give to the poor

Regulates:
Marriage Divorce Inheritance Business

The Quran
Forbids:
Gambling Pork Alcohol Prostitution

Condemns:
Murder Stealing Lying Adultery

Oneness of God
All can, no body or sex

Life after Death

Sorting to Hill or Paradise

Angels of God
From light to serve God

Internal Prophets of God Beliefs Day of Judgment From Adam to Mohammed (25)
Rise of humanity

Divine Decree
Fate set in advance

Books of God
Of Abraham, David, Moses, Jesus, Mohammed

Health, Religion & Ethics

Contraception Brain Death Organ Donation Euthanasia Death Life after Death

Fertility
Cloning Medications Resuscitation

The Sharia Law System

Category
Obligatory (Prescribed)

Arabic
Fard Wajeb

Do it
Reward
Reward No Reward No Punishment Punishment

Not do it
Punishment
No Punishment No Punishment Reward No Reward

Recommended (Desirable) Permitted (Allowed)

Discouraged (Disliked) Forbidden (Prohibited)

Mustahab Mandub Mubah Halal

Makruh Manboth Haraam Mahdur

Obligatory = Wajib
5 5 Pillars Pillars
1-9 1-9

Pilgrimage Pilgrimage
Hajj Hajj

Testimony Testimony of of Faith Faith

Shahadah Shahadah

Charity Charity
Zakat Zakat

External Beliefs
(Ibada)

Prayer Prayer
Salat Salat

Fasting Fasting
Sawm Sawm
Copyright 1995 Prentice Hall

Recommended = Sunnah
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.

Permitted = Halal
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.
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Permitted = Halal
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.
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Discourage = Makruh
Forced feeding the sick.

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

Forbidden = Halal
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 = Halal
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.

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).

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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.

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.

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.

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.

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.

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.

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.

Family Duties After Death

Payment of Funeral expenses.
Payment of his/her debts. Execution of his/her will. Distribution of the remaining estate.

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

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.

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.

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, Israel

Tel/Fax +972-4-6747737 altaj@013.net

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Some Projects
Palliative Care Manual

Diabetes Mellitus the Era Plague

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Some Projects
Breast Cancer lecture

Palliative Care conference

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