Friday, April 27, 2012

Fiqh Medic Part 2






Date        : 14th April 2012
Time        : 8.00am - 1.00pm
Place       : Lecture Theatre 2, IMU
Speaker  : Ustaz Ismat Nazirin bin Mat Isa 


This time, Ustaz will mostly discuss real cases from the website (www.e-fatwa.gov.my/). 

Q: What is the hukm of using ‘Maggot Debridement Therapy’ for patient with a chronic wound? (especially diabetic ulcer)
A: The Prophet Muhammad (salallahu alaihi wasallam) was once asked about the advisability of medical treatment. He replied, "Make use of medical treatment for Allah has not made a disease without making a cure for it, with the exception of one disease, namely old age." [Sunan of Abu Dawood, Hadith 1755] 

Hardship begets facility. Thus, this case falls under the category of Ja’iz or Mubah (Harus). The obedient act such as ablution and Salah performed by this patient while on treatment is valid. 

Q: Euthanasia or Mercy Killing. What is the hukm? 
A: Euthanasia is the act of intentional killing by act or omission of a dependent human being for his or her alleged benefit. Therefore its main hukm is Haram (prohibited or forbidden). A Muslim should never give up in seeking a method of recovery for his other brother; all means and methods that does not go against Syariah should be tried before giving up. Nevertheless, if a person is declared to be brain or any other organ failure (example: heart) and he/she has to be fully dependent on a machine to stay alive; all other doctors could not find other alternative treatment nor is there any hope for a living, then euthanasia is permissible by ceasing the lifeline with the machine. In order to do this, the doctor has to be fully competent and is confident without doubt of the decision he makes. 

“It is not for a believer to kill a believer unless (it be) by mistake. He who hath killed a believer by mistake must set free a believing slave, and pay the blood-money to the family of the slain, unless they remit it as a charity. If he (the victim) be of a people hostile unto you, and he is a believer, then (the penance is) to set free a believing slave. And if he cometh of a folk between whom and you there is a covenant, then the blood-money must be paid unto his folk and (also) a believing slave must be set free. And whoso hath not the wherewithal must fast two consecutive months. A penance from Allah. Allah is Knower, Wise.” 
(An-Nisa’: 92)

Anas (b. Malik) reported Allah's Messenger (may peace be upon him) as saying. None of you should make a request for death because of the trouble in which he is involved, but if there is no other help to it, then say: O Allah, keep me alive as long as there is goodness in life for me and bring death to me when there is goodness in death for me.
(Muslim :: Book 35 : Hadith 6480)

Q: What is the hukm of eating gecko-gecko lizard (Tokay) for the purpose of medicinal therapy? 
A: Haram because of the nature of the animal itself which is khabis (or abhorrence) and it may be poisonous. This lizard has not yet been scientifically proven to be of benefit to health. Once there are hard evidence based on research regarding the health benefit this lizard carries and then only the hukm would fall under Ja’iz or Mubah (Harus). 

Q: What is the hukm of donating an organ? 
A: Organ donation is permissible for a Muslim; though it is preferred that only the important organs (eg; liver, marrow, kidney) are to be donated and in any single body, it is advisable to take only one organ. The procedure is preferred to be handled by a Muslim doctor. Nonetheless, it is haram for a living Muslim to donate an organ whilst still alive and he/she actually requires that organ to live. There are exceptions to this case (for example in liver donation), as long as after the donation the donor must not suffer any chronic side effects that could cause death. 

Q: Can a Muslim donate his whole body after death for the purpose of research/study? 
A: Haram because there are lots of other death that can be used as research purposes instead. 

Q: Is autopsy allowed in Islam? 
A: Haram. Nevertheless, it is allowed in certain emergency (Dharurat) conditions and there is a need to ensure that the real cause of suspicious death can be brought to justice. This falls under the importance of the protection of life. 

Q: Can a male doctor attend to a woman in labour? 
A: The hukm is Ja’iz or Mubah (Harus) when it is an emergency situation. 

Q: Is In-Vitro Fertilization (IVF) allowed in Islam? 
A: The procedure is permissible as long as both the egg and sperm comes from legally married couple. 

Q: Is surrogacy allowed? 
A: Haram, as it might cause confusion in the lineage. 

Q: Is abortion of a disabled foetus allowed? (eg: Down Syndrome, congenital physical defect) 
A: Haram as the disability is a fitrah (disposition). 

Q: Are Muslims allowed to take medications, food, drinks, or use perfumes which contain alcohol? 
A: First of all, we have to bear in mind that all liquor is made from alcohol but not all alcohol is made into liquor. An alcohol is considered as haram as long as these two conditions is fulfilled:
i)   The level of alcohol is more than 0.5% 
ii)  The process of making the alcohol is from ensiled fruits. 
iii) The alcohol made is intended to cause a person to be drunk. 

In medication and perfumes, the alcohol used is mainly intended to be a solvent so that the whole formula is well incorporated. Therefore, it is not considered to be impure and it falls under the hukm of Ja’iz or Mubah (Harus). 

Q: Is the gelatin used in medication safe for Muslims to consume? 
A: The gelatin may come from many different resources such as bovine (cow), porcine (pig) or even avian (ducks). Therefore, only medication that has gelatin made from resources such as porcine is considered haram. Nevertheless, in times of emergency (Dharurat) and there are certainly no other medication left, then it is permissible or Ja’iz or Mubah (Harus) for a Muslim to consume it. 

Each hospital in Malaysia has its own responsibility to ensure that the medication that they ordered has to be free from any suspicious materials used and patient has the full right for information regarding the medication that they are taking. 

Q: What is the hukm of using highly purified insulin coming from a porcine source? 
A: In a critical diabetic emergency (Dharurat) case, it falls under the hukm of Ja’iz or Mubah (Harus). Nevertheless, a Muslim is obligated (Wajib and Fardh) to continue to search for other insulin medication that does not have any haram source in them. 




Ramadhan Guidelines for Patients 

Jau’f is defined as a passage that can transfer food or drinks (or any material that may nullify the fast) into the “al-mi’dah” (a reservoir or stomach) as that is the designated place where food substances is processed into products which benefits the body. In other words, it can also be denoted as inserting any items that can nullify the fast through a passage or cavity into the body. 


Acts which nullify the fast (for patient): 

1. Injecting substances which are considered as “food material” into the body. (eg: Glucose) 
2. Inserting any material through a passage into a cavity in the body (Jau’f) 


Acts which do not nullify the fast: 

1. Eye or nose drop (for medication purposes) 
2. Using an instrument to look into the throat provided that no “fluid” enters with it. 
3. Placing a medication underneath the toungue (eg: GTN for angina patient) 
4. Placing a medical instrument into the womb for the purposes of inspection or 
    treatment of a condition. 
5. Placing a medical instrument into the bladder for the purpose of treatment. 
6. Placing a medical instrument into the intestine for the purpose of inspection and 
    treatment (eg: colonoscopy provided that no “fluid” is entered into the site) 
7. Dental treatment (eg: removing tooth, plastering or cleaning) provided that no “fluid” is
    swallowed. 
8. Mouthwashing or spraying any medication into the mouth provided that no “fluid” is
    swallowed. 
9. Injection of intravascular (IV), intramuscular (IM) or subcutaneous (SC)medication is 
    allowed. 
10. Oxygen mask and nebulizer is allowed. For the usage of inhaler; there are two 
      schools of thought. Firstly, the act falls under the hukm of nullifying the fast because 
      some of the medication enters into the stomach and to certain extend can give 
      energy to the body. Secondly, the act does not fall under the hukm of nullifying the fast 
      because the main purpose of taking an inhaler medication is so that the medication
      would  majorly enter into the lung (with proper usage technique) and the minute 
      amount of medication which enters into the stomach does not provide the body
      energy during fasting. An individual is allowed to hold on to any one school of thought
      as both are generally accepted according to one’s preference and confidence. 
11. Anesthetic is allowed. 
12. Any medication/ creams / patches that are able to be absorbed into the skin is 
      allowed. 
13. Contrast material for angiogram purposes 
14. Biopsy provided that no “fluid” is entered into the site. 
15. Epidural injection (into the spinal cord) is allowed. 
16. Vomiting accidently does not nullify the fast. 
17. Hemodialysis does not nullify the fast. 


References

1.   Notes and Presentation prepared by Ustaz Ismat Nazirin bin Mat Isa 
2.   Al-Maqasid Al-Shari’ah (The Objectives of Islamic Law) wriiten by Mohammed 
      Hashim Kamali (a Professor of Law at the International Islamic University Malaysia) 
3.   Qawa’id Al-Fiqh (The Legal Maxims of Islamic Law) wriiten by Mohammed Hashim
      Kamali (a Professor of Law at the International Islamic University Malaysia)


Prepared by,
Saifullah
IMU Fiqh Medic 2012

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