Sunday, August 28, 2005

End-of-Life: the Islamic View

This week's Lancet has a viewpoint article--End-of-life: the Islamic View. Below is pretty much how it concludes, but having read the article a couple of times it's not clear to me how these conclusions are based in Islamic law. This suggests to me that besides a prohibition against suicide & euthanasia Islamic end of life ethics/law are not surprisingly just as plural, conflicted, and idiosyncratic as Jewish or Christian. Insofar as death is plural, conflicted, and idiosyncratic (& awfully hard to choreograph) this seems somehow right to me.

"Withdrawal of life-sustaining treatments in such instances is seen as allowing death to take its natural course. Notwithstanding a fine line between having and not having an intention to cause death in such instances, Islamic law permits withdrawal of futile and disproportionate treatment on the basis of the consent of the immediate family members who act on the professional advice of the physician in charge of the case. Some Muslim jurists recognise as legal a competent patient's informed refusal of treatment or a living will, which allows a person to die under circumstances in which there are no medical reasons to continue treatment. However, even in such rare recognition of the patient's autonomy in Muslim culture, the law takes into consideration the patient's long-term treatment relationship with a physician whose opinion, in the final assessment, serves as the grounds for turning off the respirator, for example. In this instance, death is recorded as caused by the person's underlying disease rather than the intentional act of turning off the respirator; a fact recognised by the Shari'ah."

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