Abstract
In Islam, issues and concerns that arise in Muslim societies are addressed and often resolved by issuing fatāwā, or religious rulings, derived from the ‘ulamā's reasonings that are based on the Qur'ān and the Sunnah. In Brunei Darussalam, its State Mufti provides religious verdicts on various issues, including healthcare. Thus, this chapter seeks to analyse whether Brunei Darussalam's health professionals handle medical ethical cases in a manner that is congruent to the State Mufti's fatāwā. There are many issues pertaining to ethics in medical healthcare, however, only three contentious ones will be discussed: euthanasia, organ transplantation, and abortion. A semi-structured e-mail interview was sent to several hospital nurses under relevant departments. The findings demonstrate a certain degree of congruity, with the exception of abortion cases. The State Mufti declared that abortion in rape cases is not sinful, but legally, it would still be considered as a crime, as the Brunei law states that abortion is permissible only if the pregnancy is detrimental to the mother's health.
TopIntroduction
Today, one of the most pressing controversial debates pertains to the ethics surrounding the medical field. Due to the effervescent technological advancement, the lines between what is ethical and unethical are obscured. Thus, there is a necessity to draw a fine line between what is deemed ethical and unethical. In Muslim societies, any issues or concerns, including those relating to medical ethics, are addressed, and often resolved by issuing fatāwā (religious rulings), derived from the learned Muslim scholars’ ijtihad (reasonings). These ijtihād stemmed from two principal knowledge sources, the Qur’ān and the Sunnah of Prophet Muhammadﷺ. To clarify, medical ethical issues are essentially concerns faced in the medical field in general; however, they are discussed from an Islamic perspective in this chapter. The question that poses itself now is: what exactly is Islamic medical ethics? More specifically, how does it differ from the Western opinion of medical ethics? To grasp the difference between Western and Islamic ethics, particularly in a medical environment, it is important to understand that the connotation of ethics and law in the West is distinctive than that of ethics and law in Islam. What is generally meant by ethics here, according to the Oxford English Dictionary, is a set of rules that governs a person’s behaviour, or conduct, activity, or action, based on his moral values. From a Western perspective, medical ethics are moral principles that apply values and judgements to the field of medicine, including clinical practice and scientific research (Beauchamp & James, 2013).
Medical ethics in the West functions as a guideline for medical professionals and scientists towards protecting and defending human dignity and rights of the patients (World Medical Association Declaration on the Right of the Patient, 1981), whereas for Muslims, both practitioners and patients are obligated to adhere to medical ethics as defined by Islam. Simply put, there are specific guidelines on how a Muslim should behave and what he should undertake for certain duties in a personal or medical situation. For example, it is imperative for a Muslim patient in a critical condition to practise patience, or ṣabr, and contentment, or riḍā, (two ethical manners encouraged by Islam), and to pronounce the shahādah prior to death. Thus, the moral principles of medical ethics in Islam are based on the Sharī’ah. Furthermore, what may seem like a moral issue in the West may actually be ethical and legal issues in Islam. For example, in cases of induced abortion. In some Western societies, a non-Muslim woman may have a right to abort her foetus without facing legal consequences. However, if a Muslim woman aborted her foetus, then such an act is illegal under the Sharī’ah, as agreed upon by the International Islamic Fiqh Academy. Therefore, the Sharī’ah sets ethical principles by which Muslim medical practitioners, researchers, as well as, patients, are guided by. In essence, what makes medical ethics “Islamic” is that these ethics are based on Islamic principles. These medical ethics and principles are extracted from the Qur’ān and the Sunnah, explained as well by the contemporary fatāwā, particularly for the purposes of this research, those issued by Brunei Darussalam’s State Mufti.
Key Terms in this Chapter
‘Aurah: Parts of a body required to be covered by clothing in the presence of a non- ma?ram (a person to whom marriage is permissible).
Fatawa (sing. Fatwa): Religious rulings that pertain to matters of the Shari ’ ah .
Abortion: An intentional act of eliminating an embryo or foetus, thus terminating the pregnancy.
Shari’ah: Translates to “the way” in English. It is the Islamic Law that is derived from the Qur’an and the Sunnah (Prophet Muhammad ? ’s actions, sayings, and tacit approval).
Islamic Medical Ethics: When Islamic principles are applied as a guidance for ethical or moral behaviour in the medical and scientific fields that especially involve human life.
Shahadah: Translates to “testimony” or “witness” in English. It is the first of the five pillars of Islam and is divided into two parts: ashadu ‘alla ilaha illal’Lah (I testify that there is no god except Allah), and wa ashadu ‘anna Mu?ammadan rasulul-Lah (and I testify that Muhammad ? is the Messenger of Allah).
Ijtihad: The reasonings, or opinions, or interpretations of a Muslim based on his or her understanding of the Shari ’ ah .
Organ Transplantation: A surgical procedure of removing a deceased patient’s organ and that organ is placed in the living beneficiary’s body as a replacement for the beneficiary’s damaged or missing organ.
Far?hu kifayah: Obligations to reach social sufficiency in an Islamic society. Failure to fulfil these social obligations would place the society under a huge sin.
Euthanasia: An act of ending a patient’s life, either by injecting lethal solutions or depriving the patient of necessary treatments and/or nutrients.