[Response to the questions sent by a student, this text is derived from the discourse of Javed Ahmed Ghamidi]
Question: If a person is suffering from an incurable and painful disease, can the treatment be discontinued to relieve him from the agony, consequently leading to death? In this situation, can the person themselves request to withdraw from the treatment? What guidance does Islamic Shariah provide on this matter?
Answer: In this matter, understand two things as principles.
Firstly, according to Islamic law, human life holds sanctity. It is a trust from Allah, given to humans for safekeeping. The Messenger of Allah (PBUH) stated, “Your body has a right over you,” and “Your life also has a right over you.” This means that just as others’ rights are obligatory on a person, the right to protect one’s own life is also obligatory. Therefore, one cannot harm their own life nor be harmful to the lives of other people.
The treatment and therapy originate from the same principle of the sanctity of life. Its primary purpose is the protection of life. Therefore, when a person becomes ill, they should make every possible effort to seek treatment. Negligence in this matter should never be adopted. This responsibility of seeking treatment applies to an individual regarding their own self, as well as concerning their family and dependents. There is no fundamental difference between the two situations. Both involve life, and both are entrusted with the responsibility of protection. Hence, in both cases, one must necessarily fulfill this responsibility.
Second, in Islamic law, obligations and duties are given precedence over optional and recommended acts and permissible and allowable actions. Thus, it is mandatory to fulfill obligations and duties. Deviation from them is tantamount to violating Islamic law. However, as far as optional acts (nawafil), recommended acts (mustahabbat), and permissible acts (mubah) are concerned, they are left to a person’s discretion. The protection of life and making arrangements for its treatment fall under the category of obligations; hence, avoiding them without a valid reason is prohibited. However, if the matter goes beyond treatment to merely maintaining breath or involves artificial measures rather than natural methods of treatment, it is up to the person to decide whether to accept them or to avoid them. Maintaining life through such methods is neither a religious nor a moral obligation.
In the light of these principles, it becomes clear that the protection of human life and providing medical treatment is a religious and moral responsibility. This responsibility applies to every individual not only for their own life but also for the lives of others. Every person is accountable and cannot overlook this obligation. However, if a disease is incurable and the pain exceeds the limit of endurance, then a person is no longer obligated to continue treatment. In such a situation, the matter shifts from being obligatory to being recommended or permissible, and continuing or abandoning the treatment becomes an optional matter.
The same principle applies to situations where the essential organs that guarantee human life become non-functional, but the opportunity arises to sustain life through mechanical devices or transplantation of organs from other humans or animals. In this situation too, the individual has both options: they can either rely on such means to continue the journey of life, or they can forgo these means and entrust their life to Allah. They are free to choose either option. In this regard, there is no religious or ethical obligation on them.
As for physicians and medical practitioners, they should also guide the patient in accordance with the aforementioned principles. If, at any point, they must make a decision on their own, they should consider the patient to be under their care and act accordingly. In other words, they should make decisions in the same manner as parents do for their children.
Question: According to Shariah, what is considered death, when does it occur, and how can it be determined? If a person experiences brain death but the heart continues to beat, or the heart stops but the brain is alive, or the person is in a permanent state of coma due to another reason, should treatment continue in such a case? According to Shariah, is it obligatory, recommended, or permissible to continue such treatment?
Answer: Determining the occurrence of death is not a subject of Shariah. It is based on people’s experience and observation. If there is any doubt, consultation with a medical professional is sought. The medical professional also forms an opinion with the help of their knowledge, experience, and available resources as to whether a person is alive or deceased. Sometimes, the decision is made by examining the eyes, sometimes by checking the pulse, conducting a test, listening to the heartbeat, or determining brain death. The objective is to be completely assured that death has occurred and there is no possibility of life remaining. In this matter, mistakes can sometimes happen, but despite this, we have to rely on our own knowledge and experience. Besides this, we have no other method to ascertain death.
In terms of medical treatment, it should be limited to preserving actual life and providing relief to the patient. Extending beyond this to merely maintaining physical existence, effectively turning a human into a living corpse, is not the intention of Shariah. In such situations, medication should be discontinued, and machines should be removed, waiting instead for Allah’s decree. Once God’s decision is made and death occurs in the conventional sense, burial should be conducted according to Shariah guidelines. There is no distinction of obligatory, recommended, or permissible in this matter. If life can be saved, every possible effort should be made to save it, as this is obligatory from a Shariah perspective. However, if life cannot be saved, it is better to leave the individual to Allah’s care.
Question: If a disease is treatable, but the patient and their family lack financial means, is it permissible to take a loan or seek assistance for treatment?
Answer: It is the duty of society and the state to provide for the basic necessities of life. The protection of life is the most fundamental need of humans. Society should make every possible effort to fulfill this need. If society fails to meet this requirement, then the responsibility falls on relatives and close kin. It is entirely permissible to seek help from others or to take a loan for medical treatment. The Shariah has not imposed any restriction on this. However, it is necessary that the loan is taken within one’s capacity to repay, ensuring that it is possible to return it.
It should be kept in mind that life and death are within the control of Allah. Means and resources are also subject to His power. We must make every effort to save lives according to our capacity and strength. After this, we must leave matters to Allah. If Allah wishes to sustain life, then the means for it will inevitably be created. However, if He has decreed death, then despite all available means, a person will not be able to survive.