When can Muslims withdraw or withhold life support? A narrative review of Islamic juridical rulings

Mohiuddin, Afshan; Suleman, Mehrunisha; Rasheed, Shoaib; Padela, Aasim I.

doi:10.1080/11287462.2020.1736243

Cited by 17 publications

(26 citation statements)

References 13 publications

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“…The spiritual, religious, and existential aspects of care constitute one of the major domains of the palliative care team [16]. Every culture and religion understands the events near the end of life and the appropriate rites to perform at that time [17], which are advantageous to integrate with advance directives. There are variations in end-of-life care decision-making by clinicians and patients based on their religious teachings and beliefs [16].…”

Section: Discussionmentioning

confidence: 99%

Together Till the End: Two Cases of Withdrawal of Life Support

Shalak¹,

Shariff²

2022

Cureus

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It's important to consider patients' wishes regarding treatment options, especially near the end of life to allow patients to die with dignity. Worldwide variability exists regarding the palliative extubation decision, which is performed to relieve suffering by the termination of mechanical ventilation and withdrawal of the breathing tube, consequently avoiding the prolongation of death. It is only performed when it is consistent with patients' values and prognosis. This variability is even more prominent in low-income and developing countries. We are presenting a case report of two patients, a husband and a wife, who underwent palliative extubation and withdrawal of life support on the same day.

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Section: Discussionmentioning

confidence: 99%

Together Till the End: Two Cases of Withdrawal of Life Support

Shalak¹,

Shariff²

2022

Cureus

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“…(Padela & Qureshi, 2017). There has also been a recent narrative review of Islamic juridical rulings concerning the question of whether it is ethically justifiable, according to the Islamic ethico-legal framework, to withdraw or withhold life-sustaining treatment (Mohiuddin et al, 2020). The authors reviewed a range of non-binding legal opinions (fatwās) from established Islamic jurists and juridical councils and found all the fatwās reviewed (n = 16) except one, allowed for treatment to be withdrawn or withheld in cases where the clinician prognosticates clinical futility, depressed neurological status, and compounding harms caused from continued treatment.…”

Section: Islamic Juridical Rulings Towards Withholding or Withdrawing End-of-life Treatmentmentioning

confidence: 99%

“…What that "harm" involves that compels clinicians to suggest it is worth stopping active treatment, can vary depending on many factors-including limited resource settings where another patient fighting for an intensive care bed has a better chance of survival and improved health outcomes. Also, the scope of what is understood as "harm" in the Islamic context is not clearly defined for end-of-life treatment (Mohiuddin et al, 2020). This is especially relevant during a pandemic where clinicians want to avoid unnecessary use of resources for patients where recovery is unlikely, but also more generally, in assessing whether the "harm" outweighs the expected benefit.…”

Section: Introductionmentioning

confidence: 99%

“…brain death or a persistent vegetative state, however it is not the focus of the article. There are other works such as Mohiuddin et al, (2020), that have analysed these deliberations for each type of situation where continued life support is potentially considered futile by clinicians. For this commentary, we are presenting the reasons for a psycho-spiritual orientation towards death in this context for Muslims.…”

Section: Introductionmentioning

confidence: 99%

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Death Be Not Proud: A Commentary on Muslim Acceptance of Death in the Intensive Care Unit

Khan

Saad²

2021

J Relig Health

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Technologies used in medicine have meant that treatments can keep people biologically alive but often fail to provide meaningful recovery and quality of life. Many of those from the Islamic faith have relied on these technologies for recovery on religious grounds, even when it may be against clinical advice. This commentary seeks to challenge this notion among many Muslims and suggests there is a psycho-spiritual motivation within the Islamic tradition in not pursuing intensive care treatment that is deemed futile by clinicians. A wish to embrace death in these situations should be expressed to loved ones, and the dying person’s loved ones should be encouraged to embrace death, in order to minimise harm from disagreements between clinical staff and family.

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“…It is clear from the previous discussion that Islam is of the view that in the event a patient is suffering from a terminal illness which will inevitably lead to death, medical treatment, including life support, can be discontinued. However, when CANH is discussed from an Islamic perspective, it should be differentiated from life-support because CANH is considered basic care, and it is similar to regular food and drinks ( 46 ). It is an obligation to feed patients who are no longer capable to feed themselves ( 24 ).…”

Section: Limitations On Patient’s Decision-making In Amdmentioning

confidence: 99%

Honouring Wishes of Patients: An Islamic View on the Implementation of the Advance Medical Directive in Malaysia

Malek¹,

Saifuddeen²,

Rahman

et al. 2021

MJMS

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An Advance Medical Directive (AMD) is a document in which competent patients express their wishes regarding their preferred choice of future medical plans in the event they become incompetent. AMD is important in relation to the patient’s right to refuse treatment. However, they must also consider cultural and religious values of different communities. In Islam, there are several concerns that need to be addressed, namely the validity of the AMD according to Islamic jurisprudence and patients’ right to end-of-life decision-making. To address these concerns, this article refers to multiple sources of Islamic jurisprudence, such as the Quran, the tradition of Prophet Muhammad and the works of Islamic scholars related to this topic. Based on the findings, Islam does not forbid the use of AMD as a method to honour patients’ wishes in their end-of-life care. Islamic jurisprudence emphasises on the importance of seeking patients’ consent before carrying out any medical procedures. However, several conditions need to be given due attention, such as: i) a patient’s cognitive capacity during the process of drawing up an AMD; ii) the professional views of medical experts; iii) the involvement of family members in end-of-life care and iv) the limitations of a patient’s decision-making in creating an AMD.

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When can Muslims withdraw or withhold life support? A narrative review of Islamic juridical rulings

Cited by 17 publications

References 13 publications

Together Till the End: Two Cases of Withdrawal of Life Support

Together Till the End: Two Cases of Withdrawal of Life Support

Death Be Not Proud: A Commentary on Muslim Acceptance of Death in the Intensive Care Unit

Honouring Wishes of Patients: An Islamic View on the Implementation of the Advance Medical Directive in Malaysia

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