Darurah (Necessity) and Its Application in Islamic Ethical Assessment of Medical Applications: A Review on Malaysian Fatwa

Abstract

The discovery and invention of new medical applications may be considered blessings to humankind. However, some applications which might be the only remedy for certain diseases may contain ingredients or involve methods that are not in harmony with certain cultural and religious perspectives. These situations have raised important questions in medical ethics; are these applications completely prohibited according to these perspectives, and is there any room for mitigation? This paper explores the concept of darurah (necessity) and its deliberation in the formulation of fatwas on medicine issued by the National Fatwa Council of Malaysia. Darurah has explicitly been taken into consideration in the formulation of 14 out of 45 fatwas on medicine thus far, including one of the latest fatwas regarding uterine donation and transplantation. These fatwas are not only limited to the issues regarding the use of unlawful things as remedies. They include issues pertaining to organ transplantation, management of the corpse and treatment of brain dead patients. While deliberation of darurah in medicine may vary from issue to issue, darurah applies in a dire situation in which there are no lawful means to prevent harm that may be inflicted upon human life. Nevertheless, other aspects must also be taken into the deliberation. For example, consent must be obtained from the donor or his next of kin (after his death) to conduct a cadaveric organ transplantation.

Jewish, Christian and Muslim theological perspectives about xenotransplantation

“…50,51 The ethico-legal concept of ḍarūrah is invoked to overturn a normatively prohibition when a life threat or similar hardship exists, there is no alternative solution, and the proposed solution does not directly entail harms that outweigh the benefit. [52][53][54] In the case of XTx, some jurists restrict their permissibility to cases where a non-porcine animal is used. 50,51 Others invoke ḍarūrah as the basis for permitting porcine-based XTx.…”

Patients attitude towards an alcohol content and halalness of cough medicines

“…Seperti misalnya cangkang kapsul yang berasal dari gelatin babi dan insulin yang berasal dari babi untuk penderita diabetes. Penggunaan obat dengan campuran bahan haram diperbolehkan karena alasan darurah sampai pada akhirnya ditemukan alternatif bahan yang halal (Isa 2016).…”

The ethics of organ donation, donation after circulatory determination of death, and xenotransplantation from an Islamic perspective

“…35 Dire necessity is often referred to in Islamic bioethics discourse, for example, many fatwas argue that the use of porcine-based vaccinations and the practice of sterilization are permitted when a life threat exists. [36][37][38] Importantly, several conditions must be met to apply ḍarūra to a case, including the existence of a credible life threat, relative certainty the current circumstances will result in said threat (as opposed to mere suspicion) and the unavailability of alternatives to the proposed action. 21 Furthermore, the permission is granted so long as the enabling circumstances exist, and thus, permission is revoked when the threat subsides (eg, by eating a minimal amount of pork) or alternative actions present (eg, vaccines without porcine).…”