Islamic Considerations on the Application of Patient’s Autonomy in End-of-Life Decision

Abstract

In end-of-life situation, the need for patient's preference comes into the picture with the intention of guiding physicians in the direction of patient care. Preference in medical directive is made by a person with full mental capacity outlining what actions should be taken for his health should he loses his competency. This is based on the reality of universal paradigm in medical practice that emphasises patient's autonomy. A specific directive is produced according to a patient's wish that might include some ethically and religiously controversial directives such as mercy killing, physician-assisted suicide, forgoing life-supporting treatments and do-not-resuscitate. In the future, patient autonomy is expected to become prevalent. The extent of patient autonomy has not been widely discussed among Muslim scholars. In Islam, there are certain considerations that must be adhered to.

The Islamic perspective on physician-assisted suicide and euthanasia

“…To overcome these limitations, a secondary search strategy was performed as follows. The references listed in the 46 selected articles 1,3,5,6,[8][9][10][11][12][13][15][16][17][20][21][22][23][24][25][26]29,30,32,33,36,[40][41][42][43][44]46,[48][49][50][51][52][53][54][55][56][57]59,66,[71][72][73] were checked for further relevant references, and religious books (Quran and hadith) and legal codes of selected countries were also consulted from websites. The secondary search strategy resulted in an additional 30 references, which we included in this review.…”

“…16 Non-voluntary euthanasia refers to the termination of life without explicit request and is typically practiced on patients who lack decisional capacity. 4,10 The practice which is against the patient's will or interest despite the presence of decisional capacity is known as involuntary euthanasia. 4,10 The term passive euthanasia is used when death is brought up by withholding or withdrawing life-maintaining treatment, such as ventilators.…”

“…4,10 The practice which is against the patient's will or interest despite the presence of decisional capacity is known as involuntary euthanasia. 4,10 The term passive euthanasia is used when death is brought up by withholding or withdrawing life-maintaining treatment, such as ventilators. 4,10 The definitions described (Table 2) are derived from Western bioethics.…”

“…4,10 The term passive euthanasia is used when death is brought up by withholding or withdrawing life-maintaining treatment, such as ventilators. 4,10 The definitions described (Table 2) are derived from Western bioethics. However, these terms often appear in Islamic writings and regulations on bioethical issues.…”

“…8 Therefore, hastening death is considered to be a sin and this is explicitly stated in the Quran. 8,10 Euthanasia is etymologically derived from two Greek words, eu means easy or good, and thanatos means death. Thus, the meaning translates to an 'easy death' or a 'good death'.…”