Islam - Bioethics

BIOETHICSContraception

AbortionIVF

SurrogacyGenetic EngineeringStem Cell ResearchOrgan transplants

Euthanasia

Infacticide

Bioethics is the study of ethical issues arising from human involvement with life

Bioethical QuestionsWhen does life begin?

What constitutes death?

Who is the mother of a child produced by surrogacy?

Can parents select the sex of their child?

Should a smoker receive a new organ?

What about genetic engineering?

Bioethical considerations

the emphasis is always on prevention

the patient must be treated with respect and compassion at all times

the physical, mental and spiritual dimensions of the illness experience must be taken into account.

Islamic Code of Medical Ethics - 1981

“Life is sacred: every moment of life has great value, even if it is poor quality. The saving of life is a duty, and the unwarranted taking of life is a grave sin.”

The physician understands that they have a duty to try to heal and acknowledges God as the ultimate healer.

Islamic bioethics teaches that the patient must be treated with respect and compassion and that the physical, mental and spiritual dimensions must be taken into account.

FAMILY PLANNINGContraception

Al Ghazali (12th c.) contraception was permissible if performed to preserve a woman’s health or save a life, to avoid financial hardship or to avoid domestic problems caused by a large family

It is never permissible to avoid the birth of a female child.

Some believe that contraception for the fear of poverty represents a lack of trust in God’s promise that every child born will be provided for by divine providence.

al-Ghazali - c. 1058-1111 in Ihya Ulum-id-Din

Abortion is a crime against an existing being. Existence has stages. The first stages of existence are the settling of the semen in the womb and its mixing with the secretions of the woman. It is then ready to receive life. Disturbing it is a crime. When it develops further and becomes a lump, aborting it is a greater crime. When it acquires a soul and its creation is completed, the crime become more grievous. The crime reaches a maximum seriousness when it is committed

after it (foetus) is separated (from the mother) alive.’

ABORTION

There are different Islamic views on abortion.

some ban it completely eg in Indonesia

others up to the time of ‘ensoulment’ 120 days of pregnancy

some up to 40 days, others 80 days

Social or financial reasons do not provide reason for an abortion.

Sura 17:31 “Do not kill your children out of fear of poverty; we shall provide for them and for you. Truly the killing of them is a great sin.”

This is interpreted to apply to unborn children as well.

In all cases one must weigh up sympathies for the patient and sympathies for the unborn foetus

The question is, how are these sympathies to be harmonised

Coming to a decision requires a combination of principles, duties and rights, accompanied by a call to virtue.

both revelation and tradition form the basis of Islam’s ethical framework

Muslim scholars believe that this gives Islam the flexibility to respond to new biomedical technologies.

Schools of Jurisprudence

The fours schools within Sunni Islam:

The Hanafi

The Maliki

The Shafi’i

The Hanbali

Shi’a Muslims have developed their own interpretations based on their own systems, methodologies and authority

Their decisions are very similar to Sunnis.

Those who make the final ethical pronouncements are scholars of religious law who will declare something forbidden (haram), discouraged, neutral, recommended or obligatory.

Inevitably there will be a diversity of views which arise from the different schools of jurisprudence, sects, cultural backgrounds and different levels of religious observance.

Differing views include:

The sin of abortion before 120 days is not as bad as after 120 days which is regarded as murder of a human being.(Maliki, some Shafi’i and Hanbali and Shi’a)

ie it is never permissible after 120 days. Some Hanafi jurists go so far as to say it is not permissible even if the mother’s life is at risk.

IVF

There is no objection to the insemination of a wife with her husbands sperm, but donor sperm is tantamount to adultery.

SURROGACY

Reasons for condemnation:

it tampers with the normal process of procreation

biologically it divides motherhood and confuses the issue of who is the mother

when reduced to a price it is exploitation.

EUTHANASIA and END of LIFE ISSUES

Life and death are exclusively in God’s hands.

Human’s have no right to intervene.

SUICIDEThe Qur’an says: ‘not to kill yourself; indeed, God is merciful to you’ (Sura 4:29)

“The Prophet Muhammad (PBUH) said: ‘In the time before you a man was wounded. His wounds troubled him so much that he took a knife and cut his writs and bled to death. Thereupon God said: ‘My servant hurried in the matter of his life.’ Therefore he is deprived of the Garden (Hadith: Bukhari 8:603)

Therefore suicide is not permissible

it destroys what does not belong to that person

and the community (Umma) has failed in its responsibility to meet the needs of that person.

remember - keeping of an optimistic attitude is a duty

nor may anyone assist them.

EUTHANASIA

Questions:

When can care ethically be terminated?

What is the difference between removing life support and prolonging life?

What constitutes death - brain death or the cessation of heart and respiration?

When can organs be removed for transplant?

Only God can decide on time of death: ‘Nor can a person die except by God’s leave, the term being fixed as by waiting (Sura 3:145)

SUFFERING

Suffering should be eased, but this time is regarded as a time of spiritual growth for the person concerned and the people around them.

SUSPENSION OF MEDICAL TREATMENT

The physician can stop medication for the sake of the patient’s comfort and the relief of their family

ORGAN DONATION

If a person has been pronounced brain dead then switching off life support may be permissible.

This may only take place after consultation and only if the machine is considered of no further use to the patient.