EUTHANASIA

Euthanasia gained a legal foothold in Holland. It went to the ballot box in two states in America but was defeated. Its lobby is getting more active. Islam has definite views on euthanasia.

HUMAN LIFE

The sanctity of human life is a basic value as decreed by God even before the times of Moses, Jesus and Mohammad. Commenting on the killing of Abel by his brother Caine (the two sons of Adam), God says in theQuran: "On that account We ordained for the children of Israel that if anyone slay a person -unless it be for murder or spreading mischief in the land- it would be as if he slew the whole people. And if anyone saved a life, it would be as if he saved the life of the whole people" (Quran 5:32). The Quran also says: "Take not life which Allah made sacred otherwise than in the course of justice" (Quran 6:151 and 17:33). The Shari'a went into great detail in defining the conditions where taking life is permissible whether in war or in peace (as an item of the criminal law), with rigorous prerequisites and precautions to minimize that event.

IS THERE A RIGHT TO SUICIDE?

Not in Islam. Since we did not create ourselves we do not own our bodies. We are entrusted with them for care, nurture and safe keeping. God is the owner and giver of life and His rights in giving and in taking are not to be violated. Attempting to kill oneself is a crime in Islam as wellas a grave sin. The Quran says: "Do not kill (or destroy) yourselves, for verily Allah has been to you most Merciful" (Quran 4:29). To warn against suicide prophet Mohammad said: "Whoever kills himself with an iron instrument will be carrying it forever in hell. Whoever takes poison and kills himself will forever keep sipping that poison in hell. Whoever jumps off a mountain and kills himself will forever keep falling down in the depths of hell."

EUTHANASIA - MERCY KILLING

The Shari'a ( Islamic Law) listed and specified the indications for taking life (ie. the exceptions to the general rule of sanctity of human life), and they do not include mercy killing or make allowance for it. Human life per se is a value to be respected unconditionally, irrespective of other circumstances. The concept of a life not worthy of living does not exist in Islam. Justification of taking life to escape suffering is not acceptable in Islam. Prophet Mohammad taught: "There was a man in older times who had an infliction that taxed his patience, so he took a knife, cut his wrist and bled to death. Upon this God said: My subject hastened his end, I deny him paradise." During one of the military campaigns one of the Muslims was killed and the companions of the prophet kept praising his gallantry and efficiency in fighting, but, to their surprise, the Prophet commented, "His lot is hell." Upon inquiry, the companions found out that the man had been seriously injured so he supported the handle of his sword on the ground and plunged his chest onto its tip, committing suicide. The Islamic Code of Medical Ethics endorsed by the First International Conference on Islamic Medicine (Islamic Organization of Medical Sciences, Kuwait, 1981, p.65) includes: "Mercy killing, like suicide, finds no support except in the atheistic way of thinking thatbelieves that our life on this earth is followed by void. The claim of killing for painful hopeless illness is also refuted, for there is no human pain that cannot be largely conquered by medication or by suitable neurosurgery...".

There is still another dimension to the question of pain and suffering. Patience and endurance are highly regarded and highly rewarded values in Islam. "Those who patiently preserve will truly receive a reward without measure" (Quran 39:10). "And bear in patience whatever (ill) maybe fall you: this, behold, is something to set one's heart upon" (Quran 31:17). Prophet Mohammad taught "When the believer is afflicted with pain, even that of a prick of a thorn or more, God forgives his sins, and his wrongdoings are discarded as a tree sheds off its leaves." When means of preventing or alleviating pain fall short, this spiritual dimension can be very effectively called upon to support the patient who believes that accepting and standing unavoidable pain will be to his/her credit in the hereafter, the real and enduring life. To a person who does not believe in a hereafter this might sound like nonsense, but to one who does, euthanasia is certainly nonsense.

THE FINANCIAL FACTOR

There is no disagreement that the financial cost of maintainingthe incurably ill and the senile is a growing concern, so much so thatsome groups have gone beyond the concept of the "right to die" to that ofthe "duty to die". They claim that when the human machine has outlived its productive span its maintenance is an unacceptable burden on the productive stratum of society, and it should be disposed of, and rather abruptly than allowing it to deteriorate gradually (Jacques Atalli: La medicine en accusation - in Michel Solomon 'L' avenir de la vie', Coll. Les visages de L'avenir. Ed. Seghers, Paris, 1981, p. 273-275).

This logic is completely alien to Islam. Values take priority overprices. The care for the week, old and helpless is a value in itself for which people are willing to sacrifice time, effort and money, and this starts, naturally with one's own parents "Your Lord decreed that you worship none but Him, and that you be kind to your parents. Whether one or both of them attain old age in your life, say not to them a word of contempt but address them in terms of honor. And lower to them the wing of humility out of compassion, and say: my Lord, bestow on them Your mercy even as they cherished me in childhood" (Quran 17:25- 25). Because such caring is a virtue ordained and rewarded by God in this world and in the hereafter, the believers don't take it as a debit but as an investment. In a materialistic dollar- centric community this logic is meaningless, but not so in the value-oriented God heeding community of the faithful.

When individual means cannot cover the needed care, it becomes, according to Islam, the collective responsibility of society, and financial priorities are reshuffled so that values take priority over pleasures, and people derive more pleasure from heeding values than from pursuing other pleasantries. A prerequisite of course is a complete moral and spiritual re-orientation of a society that does not hold to these premises.

CLINICAL SITUATIONS

In an Islamic setting the question of euthanasia usually does not arise, and if it does, it is dismissed as religiously unlawful. The patient should receive every possible psychological support and compassion from family and friends, including the patient's spiritual (religious) resources. The doctor also participates in this, as well, and provides the therapeutic measures for the relief of pain. A dilemma arises when the dose of the pain killer necessary to alleviate pain approximates or overlaps with the lethal dose that might bring about the patient's death.

Ingenuity on the part of the doctor is called upon to avoid thissituation, but from a religious point of view the critical issue is the doctor's intention: is it to kill or to alleviate? Intention is beyond verification by the law but according to Islam it cannot escape the ever watchful eye of God Who according to the Quran "knows the treachery of the eyes, and all that hearts conceal" (Quran 40:19). Sins that do not fulfil the criteria of a legal crime are beyond the domain of the judge but remain answerable to God.

The Islamic Code of Medical Ethics (1981 p.67), states: "In his/her defense of life, however, the Doctor is well advised to realize his limit and not transgress it. If it is scientifically certain that life cannot be restored, then it is futile to diligently keep the patient in a vegetative state by heroic means or to preserve the patient by deep freezing or other artificial methods. It is the process of life that the doctor aims to maintain and not the process of dying. In any case, the doctor shall not take a positive measure to terminate the patient's life".

The seeking of medical treatment from illness is mandatory in Islam, according to two sayings of the prophet: "Seek treatment, subjects of God, for to every illness God has made a cure", and "Your body has a right on you." But when the treatment holds no promise it ceases to be mandatory. This applies both to surgical and/or pharmaceutical measures, and, according to a majority of scholars, to artificial animation equipment. Ordinary life needs which are the right of every living person and which are not categorized as "treatment" are regarded differently.

These include food and drink and ordinary nursing care, and they are not to be withheld as long as the patient lives.