Islamic Medical Ethics

Al-Taj Organization Arraba, Galilee, Israel

Kassim Baddarni

altaj@013.net
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Youngest 2nd Largest Religion

Every 5th person worldwide

Judais m

Hinduis m

Buddhis m

Christiani ty

Isla m

2000 BC

1000 BC

563 BC

33 AD

610 AD

200 2 8

Spiritual Religion Care

Muslim Patient

Values

Belief s

Islamic Law and Rules

The Holy Book (Hadith), words or actions of the prophet (Ijma) of the Clerics (Ijtihad) personal study

Quran Sunnah Consensu s Wisdom

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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
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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

Intern Prophets of God al From Adam to Mohammed (25 Day of Judgment Rise of humanity Beliefs
Divine Decree
Fate set in advance

Books of God
Of Abraham, David, Moses, Jesus, Mohammed
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Health, Religion & Ethics

Contracepti on Fertility Cloning Medications Resuscitatio n Brain Death Organ Donation Euthanasia Death Life after Death
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The Sharia Law System

Category Arabic
Obligatory (Prescribed)
Fard Wajeb

Do it
Reward Reward

Not do it
Punishment No Punishment

Recommende Mustahab Mandub d (Desirable) Permitted (Allowed) Discouraged (Disliked)

Mubah Halal Makruh Manboth

No Reward No Punishment

No Punishment Reward
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Forbidde n Enforcing of not Doing

Discoura ged Urging of not Doing

Maslow Way

Permitted
Choice of Doing

Recommended
Urging of Doing

Obligatory
Enforcing of Doing
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Obligatory
Pilgrimage Pilgrimage
Hajj Hajj

1Pillars Pillars 1
1-1 -1 1

Testimony Testimony of Faith of Faith

Shahadah Shahadah

Charity Charity
Zakat Zakat

External Beliefs
(Ibada)

Prayer Prayer
Salat Salat

Fasting Fasting
Sawm Sawm
Copyright 1111 Prentice Hall

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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
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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 13 sperm from husband can not be used.

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.
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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.
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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.

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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 18 interest (blood and organ donation).

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.
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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. 20 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 21

Death
Death definition: when spirit leaves the body. Death is Inevitable:
Every soul shall have a taste of
Quran 29:57

death: In the end to Us shall you be brought back."

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 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
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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 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

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Family Duties After Death

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

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Spiritual History
Ask: About life & death meaning. Observe: Dressing, praying, reading Listen: Reactions, answers, remarks
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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.
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Final Words
Listen to patient and family. Demonstrate sensitivity. Respect Patients Values and Beliefs. Remain Flexible. Avoid Speculation. Respond to Who, What, Where, When?
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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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