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Islamic bioethics, or Islamic medical ethics, (Arabic: الأخلاق الطبية al-akhlaq al-tibbiyyah) refers to Islamic guidance on ethical or moral issues relating to medical and scientific fields, in particular, those dealing with human life.[1][2]

Introduction Edit

In Islam, human life is regarded as an invaluable gift from God, and should therefore be both respected and protected.[3][4] This is evident in many Qur’anic verses or ayat, one of the most important being:

"if anyone slays a human being, unless it be [in punishment] for murder or spreading corruption on earth, it shall be as though he had slain all mankind; whereas, if anyone saves a life, it shall be as though he had saved the lives of all mankind."(Qur’an 5:32)

It is this verse which has ultimately fueled the interest in Islamic bioethics and within it exist two basic principles which ensure that the sanctity of human life is preserved:

  1. Saving a life is obligatory.
  2. Unjustified taking of a life is classified as murder and, thus, forbidden.

Though Muslims recognize and maintain that Allah is the ultimate source of life (Qur’an 2:258), the Qur’an illustrates that God has instilled in them reason, free will, the ability to distinguish between what is morally acceptable and what is unacceptable (Qur’an 91:8) while also supplying the provisions of nature (Qur’an 45:13).[1] With these things, Muslims are held responsible for maintaining health and preventing illness. In the event that illness occurs, Muslims are obliged to seek medical treatment in a manner which is Islamically appropriate and permissible.[4]

SourcesEdit

The fundamental basis of Islamic bioethics is that all rulings and actions must fall into accordance with Islamic law (shari’a) and Islamic ethics. By evaluating bioethical issues from and ethical and legal standpoint, jurists can issue decrees or fatwas regarding the permissibility of the pertaining subject. Any rule that has not been explicitly outlined in the religious texts or formulated from them by jurists is referred to as bid'ah (innovation) and, therefore, is haram (impermissible).[5] For this reason, all medical procedures and treatments, as well as conduct between patient and medical professional must be legitimized by the sources of Islamic law,

Classical medical ethicsEdit

See also: Bimaristan and Islamic medicine

One of the features in medieval Muslim hospitals that distinguished them from their contemporaries was their higher standards of medical ethics. Hospitals in the Islamic world treated patients of all religions, ethnicities, and backgrounds, while the hospitals themselves often employed staff from Christian, Jewish and other minority backgrounds. Muslim doctors and physicians were expected to have obligations towards their patients, regardless of their wealth or backgrounds. The ethical standards of Muslim physicians was first laid down in the 9th century by Ishaq bin Ali Rahawi, who wrote the Adab al-Tabib (Conduct of a Physician), the first treatise dedicated to medical ethics. He regarded physicians as "guardians of souls and bodies", and wrote twenty chapters on various topics related to medical ethics, including:[6][7]

  • What the physician must avoid and beware of
  • The manners of visitors
  • The care of Remedy|remedies by the physician
  • The dignity of the medical profession
  • The examination of physicians
  • The removal of corruption among physicians

On a professional level, al-Razi (Rhazes) introduced many practical, progressive, medical and psychological ideas in the 10th century. He attacked charlatans and fake doctors who roamed the cities and countryside selling their nostrums and 'cures'. At the same time, he warned that even highly educated doctors did not have the answers to all medical problems and could not cure all sicknesses or heal every disease, which was humanly speaking impossible. To become more useful in their services and truer to their calling, Razi advised practitioners to keep up with advanced knowledge by continually studying medical books and exposing themselves to new information. He made a distinction between curable and incurable diseases. Pertaining to the latter, he commented that in the case of advanced cases of cancer and leprosy the physician should not be blamed when he could not cure them. Razi felt great pity for physicians who took care for the well-being of princes, nobility, and women, because they did not obey the doctor's orders to restrict their diet or get medical treatment, thus making it most difficult being their physician. He also wrote the following on medical ethics:

"The doctor's aim is to do good, even to our enemies, so much more to our friends, and my profession forbids us to do harm to our kindred, as it is instituted for the benefit and welfare of the human race, and God imposed on physicians the oath not to compose mortiferous remedies."[7]

DrugsEdit

The earliest known prohibition of illegal drugs occurred under Islamic law, which prohibited the use of Hashish, a preparation of cannabis, as a recreational drug. Classical jurists in medieval Islamic jurisprudence, however, accepted the use of the Hashish drug for medicinal and therapeutic purposes, and agreed that its "medical use, even if it leads to mental derangement, remains exempt" from punishment. In the 14th century, the Islamic scholar Az-Zarkashi spoke of "the permissibility of its use for medical purposes if it is established that it is beneficial."[8]

According to Mary Lynn Mathre, with "this legal distinction between the intoxicant and the medical uses of cannabis, medieval Muslim theologians were far ahead of present-day American law."[9]

NeuroethicsEdit

Main article: Islamic psychology

Most ancient and medieval societies believed that mental illness was caused by either demonic possession or as punishment from a god, which led to a negative attitude towards mental illness in Judeo-Christian and Greco-Roman societies. On the other hand, Islamic neuroethics and neurotheology held a more sympathetic attitude towards the mentally ill, as exemplified in Sura 4:5 of the Qur'an:[10]

"Do not give your property which God assigned you to manage to the insane: but feed and cloth the insane with this property and tell splendid words to him."[11]

This Qur'anic verse summarized Islam's attitudes towards the mentally ill, who were considered unfit to manage property but must be treated humanely and be kept under care by a guardian, according to Islamic law.[10] This positive neuroethical understanding of mental health consequently led to the establishment of the first psychiatric hospitals in the medieval Islamic world from the 8th century,[12] and an early scientific understanding of neuroscience and psychology by medieval Muslim physicians and psychologists, who discovered that mental disorders are caused by dysfunctions in the brain.[13]

Peer reviewEdit

The first documented description of a peer review process is found in the Ethics of the Physician written by Ishaq bin Ali al-Rahwi (854–931) of al-Raha, Syria, who describes the first medical peer review process. His work, as well as later Arabic medical manuals, state that a visiting physician must always make duplicate notes of a patient's condition on every visit. When the patient was cured or had died, the notes of the physician were examined by a local medical council of other physicians, who would review the practising physician's notes to decide whether his/her performance have met the required standards of medical care. If their reviews were negative, the practicing physician could face a lawsuit from a maltreated patient.[14]

Public health careEdit

Islamic cities also had an early public health care service. "The extraordinary provision of public bath-houses, complex sanitary systems of drainage (more extensive even than the famous Roman infrastructures), fresh water supplies, and the large and sophisticated urban hospitals, all contributed to the general health of the population." Competency tests were also carried out by medical authorities visiting hospitals and clinics "to regulate, in one way or another, the performance and competency of those providing medical care or active in the medical market-place."[15]

Contemporary bioethicsEdit

PrinciplesEdit

Principles of bioethics in the Western world were first developed and outlined by two American philosophers and bioethicists, Tom Beauchamp and James F. Childress, in their book, Principles of Biomedical Ethics. The concept of bioethical principles has since been regarded as a purely “Western” innovation which is absent in the Islamic health care system.[16] These bioethical principles: autonomy, beneficence, non-maleficence and justice have been legitimized by Muslims jurists as falling into the sphere of Islamic law and have also been supported by Qur’anic verses (Qur'an 3:104, 16:90 and 17:70). They have subsequently become the foundational spirit underlying the Oath of the Muslim Doctor [1] and, thus, dictate the conduct between a Muslim physician and his or her patient.[17]

AuthorityEdit

Formulations of rulings on bioethical issues in the Islamic context generally arise due to some form of deliberation between medical professionals and religious authority who have been recognized as most qualified individuals of location or time period.[18] After being approached by health care officials, a member of the religious authority (mufti) may then consult the religious texts and determine whether or not a specific issue is obligatory (wajib/fard), recommended (mustahabb), neutral (mubah), discouraged (makruh) or forbidden (haram).[19]

ModernityEdit

As health care and science have progressed over time, and the Muslim population has also increased to over one billion adherents over every continent on the globe, there have been increasingly prevalent circumstances for the evaluation of technological applications and bioethical issues to determine how they fit into the Islamic sphere. As a result, larger bodies of Islamic committees have been formed to address issues at hand. National Committees of Medical Ethics/Bioethics have been formed in many Islamic countries which work together with ulema to issue fatwas ensuring that neither the progress of medical science is hindered, nor the Islamic code of bioethics is jeopardized.[20] The importance of Islamic law (sharia’) is so heavily valued that each issue is looked at independently and subsequently deemed permissible or impermissible. Specific issues addressed in the modern scientific era include abortion, fertility treatments, family planning, euthanasia, genetic research, cloning, stem cell research among many other issues.[21][22][23]

Islamic Medical and Scientific Ethics ProjectEdit

The Islamic Medical and Scientific Ethics (IMSE) Project is a multinational effort to produce a comprehensive collection of Islamic bioethics resources.[24] Project staff members at two Georgetown University libraries, the Bioethics Research Library (Washington) and the School of Foreign Service-Qatar Library (Doha), have already compiled over 1,000 relevant written works into the IMSE Special Collection and have entered them into the searchable IMSE Database. The IMSE Project is funded by the Qatar National Research Fund (QNRF), a member of the Qatar Foundation for Education, Science and Community Development.[25]

Notes Edit

  1. 1.0 1.1 Shomali, Mohammad Ali. "Islamic Bioethics: A General Scheme." Journal of Medical Ethics and History of Medicine. 1.1 (2008): 3.
  2. Atighetchi, Darius. Islamic Bioethics: Problems and Perspectives. 31. Springer, 2007. 19.
  3. Shomali, Mohammad Ali. "Islamic Bioethics: A General Scheme." Journal of Medical Ethics and History of Medicine. 1.1 (2008): 1-2.
  4. 4.0 4.1 Younis, Huda. "Islamic Bioethics." O&G Magazine Winter 2008: 24.
  5. Atighetchi, Darius. Islamic Bioethics: Problems and Perspectives. 31. Springer, 2007. 14.
  6. Turner, Howard R. (1997), Science in Medieval Islam: An Illustrated Introduction, University of Texas Press, p. 134, ISBN 0292781490
  7. 7.0 7.1 Islamic Science, the Scholar and Ethics, Foundation for Science Technology and Civilisation
  8. Mathre, Mary Lynn (1997), Cannabis in Medical Practice: A Legal, Historical and Pharmacological Overview of the Therapeutic Use of Marijuana, McFarland, p. 40, ISBN 0786403616, OCLC 36598136
  9. Mathre, Mary Lynn (1997), Cannabis in Medical Practice: A Legal, Historical and Pharmacological Overview of the Therapeutic Use of Marijuana, McFarland, p. 41, ISBN 0786403616, OCLC 36598136
  10. 10.0 10.1 A. Vanzan Paladin (1998), "Ethics and neurology in the islamic world: Continuity and change", Italial Journal of Neurological Science 19: 255-258 [257], Springer-Verlag.
  11. Qur'an, Sura 4:5
  12. (Youssef, Youssef & Dening 1996, p. 57)
  13. (Youssef, Youssef & Dening 1996, p. 59)
  14. Spier, Ray (2002-08). "The History of the Peer-Review Process". Trends in Biotechnology 20 (8): 357–358. doi:10.1016/S0167-7799(02)01985-6. ISSN 0167-7799. 
    Al Kawi, M. Zuheir. "History of Medical Records and Peer Review". Annals of Saudi Medicine 17 (3): 277–278. 
  15. Savage-Smith, Emilie; Pormann, Peter E. (2007), Medieval Islamic Medicine, Edinburgh University Press, ISBN 1589011600, OCLC 71581787 232347381 71581787, http://muslimheritage.com/topics/default.cfm?TaxonomyTypeID=111&TaxonomySubTypeID=139&TaxonomyThirdLevelID=-1&ArticleID=676, retrieved 2008-01-29
  16. Atighetchi, Darius. Islamic Bioethics: Problems and Perspectives. 31. Springer, 2007. 21.
  17. Al-Hathery, Shabib. "The Muslim Doctor: Duties and Responsibilities." Islamic Medical Association Conference, Dammam, Saudi Arabia. Ed. Khan, Y. and H. Bouagada. 8.
  18. Atighetchi, Darius. Islamic Bioethics: Problems and Perspectives. 31. Springer, 2007. 13-14.
  19. Shomali, Mohammad Ali. "Islamic Bioethics: A General Scheme." Journal of Medical Ethics and History of Medicine. 1.1 (2008): 4.
  20. Atighetchi, Darius. Islamic Bioethics: Problems and Perspectives. 31. Springer, 2007. 15-16.
  21. Shomali, Mohammad Ali. "Islamic Bioethics: A General Scheme." Journal of Medical Ethics and History of Medicine. 1.1 (2008): 1-8.
  22. Younis, Huda. "Islamic Bioethics." O&G Magazine Winter 2008: 24-26.
  23. Atighetchi, Darius. Islamic Bioethics: Problems and Perspectives. 31. Springer, 2007. 13-29.
  24. http://bioethics.georgetown.edu/collections/islamic/index.html
  25. http://www.qnrf.org/nl/research_news/index.php?ELEMEID=1646

References Edit

Atighetchi, Darius (2007). Islamic Bioethics: Problems and Perspectives. Springer, 13–29. ISBN 978-1-4020-4961-3. 

Shomali, Mohammad Ali (October 2008), "Islamic Bioethics: A General Scheme", Journal of Medical Ethics and History of Medicine 1: 1–8

Younis, Huda (Winter 2008), "Islamic Bioethics", O&G Magazine 10: 24–26

Al-Hathery, Shabib; Yaqub Khan. "The Muslim Doctor: Duties and Responsibilities". Islamic Medical Association Conference. Saudi Arabia, Dammam. pp. 1–21.

Health, Ethics and Law (HEAL) - Online Radio Program, The World Association for Medical Law (WAML). "Islam and Medical Ethics, Interview with Prof. Abul Fadl Mohsin Ebrahim". Retrieved on 2 March 2011.

"Oath of a Muslim Doctor". Retrieved on 8 March 2010.

(1997) The Qur'an. Riyadh: Abulqasim Publishing House, 1–941. ISBN 9960-792-63-3. 

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