بِسۡمِ اللهِ الرَّحۡمٰنِ الرَّحِيۡمِ
It is imperative to recognize that the act of withdrawing or withholding medical treatment does not constitute physician-assisted suicide. Rather, when treatment is withheld or withdrawn, the patient succumbs to the underlying disease, devoid of any direct intervention by medical professionals. In matters concerning end-of-life care, it is crucial for treating physicians to consider the patient's religious beliefs and cultural background. A lack of understanding regarding these aspects can often
precipitate avoidable confusion and conflict.
Within the Muslim faith, life is regarded as a divine trust, with its duration predetermined and immutable by human intervention. Regarding the withholding and withdrawal of treatment, the following principles are to be adhered to:
1. Vital food and fluids must be administered as long as the patient remains alive unless such measures would inflict harm upon the patient at a certain stage.
2. If treatment typically leads to a cure, and non-treatment would result in significant harm or certain death, then treatment becomes obligatory, and life support cannot be terminated.
3. If treatment holds the potential for cure or is deemed probable, efforts should be made to administer treatment. However, if the physician and the patient's relatives, after informed and mutual deliberation, determine that treatment is not in the patient's best interest, then the withdrawal of treatment or life support is permissible.
4. If a cure is not realistically attainable, while it is permissible to attempt treatment, it is preferable for the patient to place trust in the Will of the Almighty.
5. If medical experts deem life-sustaining treatment to be futile, the continuation of life support becomes unnecessary and constitutes a misuse of resources.
Decisions regarding the withholding or withdrawal of treatment should be made in consultation with the patient's family and other members of the healthcare team. A fatwa issued by the Presidency of the Administration of Islāmic Research and Ifta (Riyadh) in 1988 stipulated that if three knowledgeable and trustworthy physicians concur that the patient's condition is beyond hope, life-supporting machines may be withheld or withdrawn. Family members' opinions are excluded from the decision-making process, as they lack the qualifications to make such determinations.
Dr. A. Hussain