Islamic Legal Ethics of Life-Sustaining Measures in End-of-Life Care and Terminal Illness
Maryam Sultan, M.D., Resident Physician, Physical Medicine & Rehabilitation, Baylor College of Medicine
Hatem al-Haj, M.D., PhD., Dean, College of Islamic Studies, English – Mishkah University
Cultural competency and patient-centered care is best achieved when a physician has some understanding of a patient’s beliefs and practices. The paucity of English-language literature on Islam’s perspectives of end-of-life care and life-sustaining measures in terminal illness makes caring for dying Muslim patients difficult.
Decisions made by scholars of Islamic legislative assemblies, in consultation with medical professionals, are used in decision-making for treating disease and employing life-sustaining measures in terminally ill patients. The goal of this paper is to present information to enhance the experience of the Muslim patient receiving treatment and the healthcare professionals providing care by facilitating an understanding of Islam’s teachings on medical treatment and end-of-life care.
Guided by the goal of limiting harm in Islamic jurisprudence, the decision to initiate artificial nutrition and hydration varies from obligatory to disliked depending on the specific situation of each patient, while the decision to withdraw such interventions is often more difficult to justify Islamically. In contrast to a terminally ill patient with a grim prognosis, a patient with severe cognitive deficits that limit his/her ability to survive independently, but who may survive indefinitely with artificial interventions, may be maintained on or withdrawn from such interventions at any point per the proxy’s informed and patient-centered decision. The physician’s role in explaining the patient’s prognosis and the benefits and harms of specific interventions is critical in allowing the patient, proxy or surrogate to make the most appropriate decision of care in accordance with their Islamic beliefs.
Hatem al-Haj, M.D., PhD., Dean, College of Islamic Studies, English – Mishkah University
Cultural competency and patient-centered care is best achieved when a physician has some understanding of a patient’s beliefs and practices. The paucity of English-language literature on Islam’s perspectives of end-of-life care and life-sustaining measures in terminal illness makes caring for dying Muslim patients difficult.
Decisions made by scholars of Islamic legislative assemblies, in consultation with medical professionals, are used in decision-making for treating disease and employing life-sustaining measures in terminally ill patients. The goal of this paper is to present information to enhance the experience of the Muslim patient receiving treatment and the healthcare professionals providing care by facilitating an understanding of Islam’s teachings on medical treatment and end-of-life care.
Guided by the goal of limiting harm in Islamic jurisprudence, the decision to initiate artificial nutrition and hydration varies from obligatory to disliked depending on the specific situation of each patient, while the decision to withdraw such interventions is often more difficult to justify Islamically. In contrast to a terminally ill patient with a grim prognosis, a patient with severe cognitive deficits that limit his/her ability to survive independently, but who may survive indefinitely with artificial interventions, may be maintained on or withdrawn from such interventions at any point per the proxy’s informed and patient-centered decision. The physician’s role in explaining the patient’s prognosis and the benefits and harms of specific interventions is critical in allowing the patient, proxy or surrogate to make the most appropriate decision of care in accordance with their Islamic beliefs.