| Guest Name | Dr. Maher Hathout |
| Profession | Senior Advisor: Muslim Public Affairs Council (MPAC) |
| Subject | Right to Live or Die: Who Decides? |
| Date | Wednesday,Mar 30 ,2005 |
| Time |
| Name |
imad - United States |
| Profession | physician |
| Question | ASWAWB what is islam stand on the removal of a feeding tube or respiratory mechanical support from a person in a vegitative state or terminal illness,since in both situations we are prolonging life artificialy. Jazakum Allah |
| Answer | The Islamic stand as determined by the conferences of medical doctors and Shair'ah scholars held in Cairo, Jeddah, Kuwait, and Jordan, recommended that death is identified by complete brain death. Prior to that the patient is considered alive and the essentials of life including water and food should be supplied. In case the patient is artificially living in state imitating life, then we may then pull the plug. If a patient is determined by the current medical knowledge that he or she is having irreversible terminal disease, life support measures may not be started. However, food and water should be supplied. |
| Name |
Dakota - |
| Profession | |
| Question | Have you versed yourself on the details of the Terri Shiavo case and what do you think of the case? Should Mr. Shiavo be allowed to be judge, jury and executioner or do you think Terri's parents should be granted gaurdianship of her? |
| Answer | In our opinion, based on the information available, she is alive and neither the husband not the parents has the right to terminate her life through starvation. We do not see any logic that the husband who came to the life of this patient when she was 22 years old have more say in the matter than the parents who took care of her since her life began. |
| Name |
Salma - United Kingdom |
| Profession | |
| Question | Dear Dr. Hathout, Assalamu alaikum. My question is this: if a person is affected with a life-threatening disease such as end-stage cancer, and the doctors have informed him that there is not much they can do for him, but they can try to prolong his life a little bit by trying chemotherapy for example. But the person's condition is that there are metastases in the liver and bones. This person does not want to go through the agony of chemotherapy at the end of his life, which appears to be coming soon because of this condition, and would prefer to die peacefully at home among his family without going through chemotherapy. Is it the right of the person to refuse such treatment in a case like this? My personal feeling is that if I am at the end of my life, I would not want to be in a hospital which is impersonal and go through more pain than I am already going through. And that if the person with cancer decides instead to die at home and to try to make sure that during the process he takes necessary nutrition, and perhaps honey and black seed, in addition to praying to Allah, then that is the decision of the patient and it is his right. Do we have to force western medicine on a person in this kind of situation? Thank you. |
| Answer | If this is as we said diagnosed by qualified doctors as irreversible terminal disease, nobody can enforce any treatment on this patient and the patient may choose whatever makes him or her more comfortable at their terminal stage, short of committing suicide. So if the person wants to stay home and comfort himself or herself in whichever ways that alleviate the suffering, that is well and good. |
| Name |
Stephanie - United States |
| Profession | |
| Question | I heard a local imam say on NPR that there is disagreement amongst the scholars on the definition of life, & that Mrs. Schiavo would be considered as dead by some scholars who see life as related to consciousness. Can you comment on this? |
| Answer | I refer to the medical and fiqh councils, the last one took place in Cairo on December 2004, which I attended and the agreement there was full brain death which means a straight line on the electro-encephalo-graph is a sure sign of death and organs can be taken and donated at this stage. The proceedings of this conference can be obtained from the Organization of Islamic Medicine, Kuwait. |
| Name |
Mohamad - Canada |
| Profession | |
| Question | Salamualaikum, Is it halal to use a ventilator in Islam for a case lying in a vegetative state? Who decides when it is time to remove the ventilator? And what situation would its removal be correct from a medical and Islamic point of view? Is it right to prolong the life of a person this way when he isn't really living? Jazakummallah khairan |
| Answer | This has been answered before. The brain might be dead while other organs are still functioning. In that case, we can stop the ventilator. But if the brain is not dead we have to be humble enough not to sentence a patient to death because we, with out limited knowledge, decided that there is no hope. So the whole thing again depends on brain death. |
| Name |
Ramadhan - Kenya |
| Profession | Youth co-ordinator |
| Question | We have the Schiavo story that is unfolding in USA.But also in the same country they have the issue of embryos being grown for the sole purpose of treatment and not full growth.What does Islam say about this issue? |
| Answer | If you mean the issue of stem cell research to obtain certain living cells which can be used to treat certain diseases, I feel that if the cells can be obtained without deliberately killing a fetus, it is Ok. There are fertilized eggs which are left over after a process of artificial insemination from the husband to treat cases of being infertility. So rather than throwing these eggs away, it can be developed in a test-tube and the stem cells can be taken to treat patient. I feel nothing wrong with that (and God knows Best). |
| Name |
John - United States |
| Profession | |
| Question | Hello, I am interested in learning what the Islamic stance is on a case like Terri Schiavo. Would it be Islamically correct to remove her nutrition tube? Who would be her legal guardian according to Islam, the parents or the husband? Who would make life and death decisions for her? Thanks |
| Answer | In the case of Terri, she is alive because she is not brain dead. And in that particular case, neither the husband nor the parents has the right to terminate her life. We said before that parents are closer and have more right over the person than a spouse. |
| Name |
Rasha - Egypt |
| Profession | |
| Question | Salam Doctor, Does a Muslim have a right to write a legal statement during his life asking that in the case of hospitalization and that if the only way he could be kept alive is thru an artificial respirator, that this not be done to him and that he be left to die? Jazak Allah khair |
| Answer | The patient has the right to write a will indicating that he or she does not want to be kept artificially alive. This is different from writing a will to say if he is i a coma they can terminate his life, because this will be considered suicide, which is absolutely haram in Islam. |
| Name |
Aisha - |
| Profession | |
| Question | How long a person should be under life support? What is the percentage he will get back to life? If by taking life support this person will die, why using it in the first place? Terri lived under life support for 15 years....should we wait 15 more until she recovers or save this money to save millions of children who die because of poverty in Africa and in other parts of the world? |
| Answer | I consider this as a very dangerous argument because it is putting a price tag on human life. We don't know how Terri is feeling; she might be clinging to life or afraid to die, and we don't have the right to say that in amount of dollars her life is not worthy. If we really want to save money to protect the lives of millions of children that we are talking about, then let us get this money from the industry of death or making very expensive, sophisticated weapons or get the money spent on cosmetics, fancy cars, unneeded food, and liquor, in order to save the lives of the needy and let Terri have her decision by the Merciful God who created her. |
| Name |
Hadi - |
| Profession | |
| Question | What determines death? If the heart stops but the brain does not die, is the person considered dead? |
| Answer | If the person is in a hospital setting, the death of the heart is not enough because it is reversible. Certainly if does not reverse, the brain will die within minutes because of the lack of blood supply. Gut if he is not in a hospital setting, like a person who dies at home, death is known by cessation of all vital signs which include breathing, heart beating, movement, and reflexives, etc. In that case the person is considered dead even without checking on the brain wave. |
| Name |
Lamis - |
| Profession | |
| Question | Do Muslim women have the right to choose which kind of medication or treatment they will receive if they are ill (terminally ill)? Or can the husband override their choice? For example, if a woman wishes to be treated with holistic treatment and the husband insists on chemical therapy….. |
| Answer | The husband does not own his wife! She is not his property. God gave her full right equal to him, and she can make her choice. Of course it is preferable to be through mutual counseling and agreement, but he does not have the right to overrule her decision. |
| Name |
Mehdi - Germany |
| Profession | Computer scientist |
| Question | Assalamu aleikom dear Dr. Hathout, what is the Islamic standpoint on cases such as the one of Mrs. Shiavo? I assume I know the answer but would be interested in the full causal analysis. Jezekom Allahu khair. Wasselam. |
| Answer | Matters of life and death cannot be taken casually!! The question has been answered before. Again, we are aware that God gives life and He is the only one who takes it back and the whole philosophy of terminating life because of suffering is based on three wrong assumptions: 1. That we are more merciful than God, and that is wrong. 2. That death ends suffering while we don't actually believe that death is the final chapter in life because there is life after death. 3. If the patient is unable to express himself or herself, we don't really have the right to assume that he wants to die. |
| Name |
Ihsaan Hendricks - South Africa |
| Profession | teacher |
| Question | To live or to die.plse explain to what extent should this qeustion be answered by the ulama and to what extent by the medical experts in the muslim community. |
| Answer | The decision of "to live or to die" is totally in the Hands of Almight God. Doctors and Ulama (scholars) should not decide whether a person should live or die, all what they can do is to determine to the best of their knowledge when life begins, which means the signs of life, when it ends, which means the signs of death. We do not make decisions; we try to find definitions. |
| Name |
Kahlid - |
| Profession | |
| Question | Dr. Maher I wonder how many cases went successful after using the life support? We always hear about people under life support and then die clinically and then the support is switched off, but other cases that were successful are not known? |
| Answer | It depends on the diagnosis made before starting the life support. If the disease is reversible and the patient needs the support until treatment takes over and controls the disease, then the success rate is quite substantial. However, I don’t have accurate statistics. If the diagnosis was of a terminal or a very advanced disease, the success rate is very low. The problem is we usually don't know accurately before we start the life support. For example, if I get a case of a car accident and the patient comes to me not breathing or the heart is not beating, I will not wait until I know the exact amount of damage; I may start the life support measures then get the different tests that might tell me that the damage is so horrendous or even irreversible like cases of brain damage. We have to remember that when brain cells die, they don't come back while in case of cells of other organs there may be a process of healing or regeneration. |
| Name |
rabab - |
| Profession | |
| Question | My child is under life support since 3 months. The Imam said we cannot pull it off unless the brain is dead but doctors say they cannot know because they are putting the child under anesthesia so he does not move? How can we know? |
| Answer | There is technology now to determine the electrical waves in the brain without the patient moving and they should do these kind of tests. Our hearts with you and we pray for God's mercy. |
| Name |
Editor - |
| Profession | |
| Answer | Finally, we would like to thank both Dr. Maher Hathout for taking the time to answer the questions of Islamonline viewers today, and we also thank all those who participated in this dialogue. We apologize for not being able to accommodate all the questions within the time allocated to this session. If you feel your question is very important, feel free to contact us at [EMAIL PROTECTED] and we will try our best to answer your question. We request our readers to join us in upcoming sessions. Yours, IslamOnline Live Dialogue Editing Desk |
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{Invite (mankind, O Muhammad ) to the Way of your Lord (i.e. Islam) with wisdom (i.e. with the Divine Inspiration and the Qur'an) and fair preaching, and argue with them in a way that is better. Truly, your Lord knows best who has gone astray from His Path, and He is the Best Aware of those who are guided.}
(Holy Quran-16:125)
{And who is better in speech than he who [says: "My Lord is Allah (believes in His Oneness)," and then stands straight (acts upon His Order), and] invites (men) to Allah's (Islamic Monotheism), and does righteous deeds, and says: "I am one of the Muslims."} (Holy Quran-41:33)
The prophet (peace and blessings of Allah be upon him) said: "By Allah, if Allah guides one person by you, it is better for you than the best types of camels." [al-Bukhaaree, Muslim]
The prophet (peace and blessings of Allah be upon him) also said, "Whoever calls to guidance will have a reward similar to the reward of the one who follows him, without the reward of either of them being lessened at all."
[Muslim, Ahmad, Aboo Daawood, an-Nasaa'ee, at-Tirmidhee, Ibn Maajah]
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