Advance medical directives: a proposed new approach and terminology from an Islamic perspective

Abstract

Advance directives are specific competent consumers' wishes about future medical plans in the event that they become incompetent. Awareness of a patient's autonomy particularly, in relation to their right to refuse or withdraw treatment, a right for the patient to die from natural causes and interest in end of life issues were among the main reasons for developing and legalizing advance medical directives in developed countries. However, in many circumstances cultural and religious aspects are among many factors that can hamper implementation of advance directives. Islam and Muslims in general have a good understanding of death and dying. Islam allows the withholding or withdrawal of treatments in some cases where the intervention is considered futile. However, there is lack of literature and debate about such issues from an Islamic point of view. This article provides the Islamic perspective with regards to advance medical directive with the hope that it will generate more thoughts and evoke further discussion on this important topic.

Critical care nurses' attitude towards life-sustaining treatments in South East Iran

“…[31] In Islamic countries such as Iran, there is no advance directives regarding end of life medical decisions. [32] Based on Islamic law, "decisions about life belong to Allah, not to the person himself and documents to preserve or end personal life are not recognized" (Babgi, 2009). Of course, Islamic idea of humanity provides a provisional framework in which advance directive can generally be considered legitimate.…”

Supporting Muslim Patients During Advanced Illness

“…Furthermore, Muslims are permitted to refuse treatment in the context of incurable diseases and to not have undesired treatments given to them. 43…”

Advance directive preferences of patients with chronic and terminal illness towards end of life decisions: a sample from Saudi Arabia

“…Although the concept of advance directives is deeprooted in Islamic teaching, it is seldom practised in the setting of end of life health care planning among Arab patients, or even among other Muslims (5). Among Saudi citizens there is a strong belief that open discussion of serious illness may cause unnecessary depression or anxiety to the patient (2,3).…”

“…Physicians often utilize technical terms to minimize or obscure the seriousness of the disease and its prognosis (4,5). Some investigators concluded that implementing a programme to increase physician opportunity to discuss end of life care with their patients, and improve residents' confidence in leading discussions regarding advance care directives, led to more patients expressing interest in talking about their wishes (9).…”

“…Saudi Arabian family members, particularly parents, feel that they are responsible for their relatives' welfare and may request extraordinary measures, even if the situation is futile (4,5). Such decisions taken on behalf of the patient may subject them to overzealous use of life-sustaining procedures that prolong suffering Research article and compromise both dignity and quality of life.…”