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Presented at the Kulliyah of Medicine Universiti, Antarabangsa, Kuantan, Malaysia; on 14th November 2008. By Professor Omar Hasan Kasule, Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Islamic Medicine at the Institute of Medicine Universiti Brunei Darussalam. WEB: http://omarkasule.tripod.com
ABSTRACT
This paper describes the crisis in education because of the dichotomy between traditional and modern forms of education. The dichotomy is a contributing factor to the weakness of the ummah. It provides an example in medical education in which an attempt is made to resolve the crisis.
1.0 DESCRIPTION OF THE CRISIS
1.1 MANIFESTATIONS OF THE CRISIS
There is pervasive ignorance of uluum al diin and uluum al dunia. There is little respect for scholarship. Wealth and power are considered more important than scholarship. There is neglect of the empirical sciences. There is a dichotomy in the education system: traditional Islamic vs. imported European, ulum al diin vs. ulum al dunia. Integration of the 2 systems has failed or has been difficult because it has been mechanical and not conceptual. The process of secularization in education has removed the moral dimension from the education and violated the aim of Islamic education to produce an integrated and perfect individual, insan kaamil. The brain drain from Muslim countries has compounded the educational crisis.
1.2 UMMATIC MALAISE DUE TO THE KNOWLEDGE CRISES
Knowledge deficiency and intellectual weakness are the most significant manifestation of ummat’s decadence. The intellectual crisis of the ummat is worsened by copying and using poorly digested alien ideas and concepts. The prophet warned the ummat about the lizard-hole phenomenon in which the ummat in later times would follow its enemies unquestionably like the lizard running into its hole. Among the manifestations of the ummatic malaise are dependence in science and technology.
1.3 KNOWLEDGE, A PRE REQUISITE FOR TAJDID
Reform and revival of the ummat will occur through educational and knowledge reform. Tajdid is a recurring phenomenon in the ummat and is a sign of its health and dynamism. It is a basic characteristic of the ummat that periods of reform/revival alternate with periods of decay and return to jahiliyyat. Tajdid requires knowledge, ideas and action related by the following mathematical equation: tajdid = idea + action. Action without knowledge and guiding ideas will not lead to true change. Ideas without action are not change at all. Tajdid requires and is preceded by a reform in knowledge to provide ideas and motivation on which to build. All successful societal reform starts with change in knowledge. The ideal society cannot be created without a knowledge base. That knowledge base must be correct, relevant, and useful. Successful revival movements throughout Muslim history have always been led by scholars.
1.4 KNOWLEDGE: STRATEGY, OBLIGATIONS, AND ETIQUETTE
The Muslim ummat is a potential economic and political bloc whose potential is not yet realized. The contemporary tajdid movement has a lot of strengths but also has basic deficiencies that must be corrected. The knowledge and intellectual crises are still a barrier. Reform movements unguided by correct knowledge and understanding will falter and fail or will be deviated from their paths. Social change requires change in attitudes, values, convictions and behavior of a critical mass of the population. Attitudes, values, convictions, and behaviors are determined by the knowledge base. The vision of the knowledge strategy is an upright balanced person who understands the creator, knows his place, his roles, his rights, and his responsibilities in the cosmic order. The mission of the knowledge strategy is conceptual transformation of the education system from kindergarten to post graduate studies to reflect tauhid, positive moral values, objectivity, universality, and serving the larger causes of humanity.
2.0 AN ISLAMIC INPUT INTO THE MEDICAL CURRICULUM: A SOUTH-EAST ASIAN EXPERIENCE
2.1 Introduction to the Islamic Input Curriculum
The main motive of IIMC is to resolve the crisis of duality or dichotomy manifesting as teaching Islamic sciences separately from medical disciplines by different teachers and in different institutions. IIMC resolves the crisis of duality by insisting that Islamic concepts should be taught by the same people who teach medical disciplines. All lecturers in the Kulliyah of Medicine go through a Diploma in Islamic Studies (DIS) whose modules are exactly the same as the modules of IIMC. This prepares them to be effective teachers of IIMC.
The teaching material of IIMC has been prepared and tested over the past 7 years. Synopses of all lectures for years 1 -5 are available at http://omarkasule.tripod.com.
Since the start of the Kulliyah in 1997, we have worked towards integrating Islamic values and concepts in the teaching and examination of basic and clinical medical sciences. The expectation is that our graduates will be able to integrate Islamic moral and legal values in their practice of medicine because they went through an integrated education system.
IIMC follows the Islamic paradigm of reading 2 books, the book of revelation, kitaab al wahy, and the book of empirical science, kitaab al kawn. Both books contain signs of Allah, ayaat al llaah, and must be read together. It is a mistake to read one of the books and neglect the other. The solution to the crisis of duality in the ummah starts from joint reading of the 2 books, al jam ‘u baina al qira atain. Thus medical scientists who are involved in IIMC read the signs in both books.
The vision of IIC has two separate but closely related components: Islamization and legal medicine. Islamization deals with putting medicine in an Islamic context in terms of epistemology, values, and attitudes. Legal medicine deals with issues of application of the Law (fiqh) from a medical perspective.
IIMC has 5 main objectives: (a) Introduction of Islamic paradigms and concepts in general as they relate to medicine, mafahiim Islamiyat fi al Tibb. (b) Strengthening faith, iman, through study of Allah’s sign in the human body. (c) Appreciating and understanding the juridical, fiqh, aspects of health and disease, al fiqh al tibbi. (d) Understanding the social issues in medical practice and research and (e) Professional etiquette, adab al tabiib, from the Islamic perspective.
We feel that IIC helps the future physician prepare for the heavy trust, the amanat of being professionally competent. He must be highly motivated. He must have personal, professional, intellectual, and spiritual development programs. He must know the proper etiquette of dealing with patients and colleagues. He also must know and avoid professional malpractice. He needs to be equipped with leadership and managerial skills to be able to function properly as a head of a medical team.
2.2 Derivation of Medical Ethics from the Maqasid Al Shari’at
In my view the most significant aspect of IIMC is the derivation of medical ethics from Islamic sources as al alternative to western sources. The full impact of this will be appreciated in due course when these ideas become widely adopted.
Secularized European law denied moral considerations associated with ‘religion’ and therefore failed to solve issues in modern medicine requiring moral considerations. This led to the birth of the discipline of medical ethics that is neither law enforceable by government nor morality enforceable by conscience. On the other hand, Islamic Law is comprehensive and encompasses moral principles directly applicable to medicine.
The theory of medical ethics in Islam should be based on the 5 purposes of the Law, maqasid al shari’at, that are also considered the 5 purposes of medicine, maqasid al tibb. The 5 purposes are preservation of religion and morality, hifdh al diin; preservation of life and health, hifdh al nafs; preservation of progeny, hifdh al nasl; preservation of intellect, hifdh al ‘aql; and preservation of wealth, hifdh al maal. Any medical action must fulfill one of the above purposes if it is to be considered ethical. If any medical procedure violates any of the 5 purposes it is deemed unethical.
In practical detailed situations, legal axioms called Principles of the Law or qawa’id al shari’at need to be used to resolve mostly situations of apparent conflict between maqasid or to assist logical reasoning. Principles of the Law, qawa’id al shari’at, when applied to the medical area can also be referred to as Ethical Principles of Medicine, qawa’id al tibb. The basic ethical principles of Islam relevant to medical practice be derived from the 5 principles of the Law, qawa’id al shari’at, that are: intention, qasd; certainty, yaqeen; injury, dharar; hardship, mashaqqat; and custom or precedent, ‘aadat. The maqasid and qawa’id are used in a synergistic way. The basic purpose of qawa’id is to provide robust rules for resolving situations of conflict between or among different maqasid.
The challenge before Muslim physicians is to liberate themselves from confusing and inconsistent European ethical theories and principles and instead to work hard to develop specific regulations for various medical interventions, dhawaabit al tibaabat, by a renewal of ijtihad. This ijtihad will be based on primary sources of the Law (Qur’an and sunnat), secondary sources of the Law based on transmission, masaadir naqliyyat (ijma and qiyaas); secondary sources of the Law based on reason, masaadir ‘aqliyyat (istishaab, istihsaan, & istilaah); the purposes of the Law, maqasid al shari’at; principles of the Law, qawa’id al fiqh; as well as regulations of the Law, dhawaabit al fiqh.
In the early period of medical jurisprudence (0-1400 H) most issues could be resolved by direct reference to the primary sources. In the middle period (1401 – 1420 H) issues were resolved by using ijma, qiyaas, istishaab, istihsaan, & istilaah. In the modern period (1420 - ) medical technology is creating so many issues whose resolution will require a broad bird’s eye-view approach that can only be found in the theory of maqasid al shari’at.