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Islamic Perspectives on Clinical Intervention Near the End of Life: We Can but Must We?

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Death and Dying

Part of the book series: Comparative Philosophy of Religion ((COPR,volume 2))

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Abstract

The ever-increasing technological advances of modern medicine have increased physicians’ capacity to carry out a wide array of clinical interventions near the end of life. These new procedures have resulted in new “types” of living where a patient’s cognitive functions are severely diminished although many physiological functions remain active. In this biomedical context, patients, surrogate decision-makers, and clinicians all struggle with decisions about what clinical interventions to pursue and when therapeutic intent should be replaced with palliative goals of care. For some patients and clinicians, religious teachings about the duty to seek medical care and the care of the dying offer ethical guidance when faced with such choices. Accordingly, this paper argues that traditional Sunni Islamic ethico-legal views on the obligation to seek medical care and Islamic theological concepts of human dignity (karāmah) and inviolability (ḥurmah) provide the ethical grounds for non-intervention at the end of life and can help calibrate goals of care discussions for Muslim patients. In closing, the paper highlights the pressing need to develop a holistic ethics of healthcare of the dying from an Islamic perspective that brings together multiple genres of the Islamic intellectual tradition so that it can meet the needs of the patients, clinicians, and Muslim religious leaders interacting with the healthcare system.

First published through Springer Nature in 2016. In Medicine, Health Care, and Philosophy. doi:10.1007/s11019-016-9729-y. Thanks to Springer for the right to reuse.

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Notes

  1. 1.

    We adopt Prof. Mohamed Fadel’s usage of the English term moral theology to refer to the Islamic science of uṣūl al-fiqh (Fadel 2008). As Prof. Fadel notes, insofar as uṣūl al-fiqh is concerned with the scriptural sources of moral obligation, the processes of moral assessment, and moral epistemology, it is a moral science. And since uṣūl al-fiqh is primarily concerned with how God judges human acts and strives to reach the truth regarding moral propositions, it is a theological discipline. Consequently, the mapping of terms is apropos even if not precise. I use the terms “Islamic ethico-legal tradition” and “Islamic law” to refer to the notions of fiqh and aḥkām taklīfiyya interchangeably.

  2. 2.

    This gradient ranges from obligatory (farḍ or wājib) to recommended (mandūb or mustaḥab) to permitted (mubāḥ) to discouraged (makrūḥ) and, finally, to prohibited (ḥarām).

  3. 3.

    For a classification schema of the different types of fatāwā, see Skovgaard-Petersen (2015), and for insights into legal manuals used for seminary instruction in Islamic law, see Fadel (1996).

  4. 4.

    Acknowledgements: AIP’s time-effort and research support for OQ was supported by a grant from the John Templeton Foundation (#39623) entitled “Scientific Discoveries & Theological Realities—Exploring the Intersection of Islam and the Human Sciences.” Additional time-effort funding for AIP and symposium support was provided by the Doha International Center for Interfaith Dialogue. This paper was presented in partial form at Bayan Claremont College at a symposium entitled “Dignity and Healthcare at the End-of-Life: Abrahamic Faiths in a Bioethics Conversation.” The authors acknowledge the support of Dr. Muhammed Volkan Stodolsky who researched Ḥanafī sources. We would also like to thank Drs. Ahsan Arozullah, Faisal Qazi, and Katherine Klima, and Shaykh Mohammad Amin Kholwadia and Jihad Hashim-Brown who were key interlocutors and partners in the working group project that motivated some of the work presented herein.

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Padela, A.I., Qureshi, O. (2019). Islamic Perspectives on Clinical Intervention Near the End of Life: We Can but Must We?. In: Knepper, T.D., Bregman, L., Gottschalk, M. (eds) Death and Dying. Comparative Philosophy of Religion, vol 2. Springer, Cham. https://doi.org/10.1007/978-3-030-19300-3_13

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