Medical Istifta’aat (2)

SHAFAQNA- Question: Bismehi Ta’aala, After praise to Allah, the Wise, and His most gracious Messenger Muhammad Mustapha and his pure family, I give my greetings to Seyyed Ali Khamene’i.

I seek guidance regarding some medical issues surrounding end of life care: 
Occasionally, a patient is deemed to have an illness that is not curable by current medical practices. Sometimes, a patient has suffered such significant damage to the brain or other organs, say, from a severe care accident or drowning, that he could not live on his own. 
Let us say that a patient has terminal illness, or is severely brain damaged, is no longer conscious, is on a ventilator to breathe, is dependent on food through a tube to keep from starving, and may need antibiotics periodically for infections. 
Is a distinction in Islam made between withholding care and withdrawing it IF IT IS DEEMED FUTILE CARE? For example, a patient on a ventilator will need to have food given through a tube to keep from starving. Withholding care would be to not begin to feed the patient knowing that they cannot be cured or their suffering alleviated. Withdrawing care would be to stop feeding them after you had begun it because, say, you were not certain if it would help them or not, and now you have determined that it will not. 
Is either of these actions considered as euthanasia or murder? Is either one of them permissible in Islam under any circumstances? Finally, if the patient in concern is a child, may the guardian agree to stop treatments or prevent them from starting in the first place?

Answer: Bismihi Ta`ala. It is obligatory to save the life of another Muslim even if it depends upon preparing or using equipment such as ventilators, etc. or feeding and giving that person medicine – this is regardless of the fact that these things may only delay his death. Moreover, once beginning the treatment for this Muslim (i.e. using medical equipment or administering medicine, etc.), if stopping or withholding the treatment is a factor leading to his death then it is considered murder, which is prohibited by law. Hence, it is not allowed to withhold or stop treatment until it is certain that that Muslim’s life has expired or that one is certain that stopping treatment will not result in the death of that Muslim. Thus, it is mandatory, based upon the obligation of saving another Muslim’s life not to withhold the treatment even if the sick person himself or his guardian gave the permission to do so, because it is prohibited, since it is murder. Wallahul`Alim.

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