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Lecture delivered to 1st year medical students at Kuantan, Pahang on October 25th 1997 by Prof Dr Omar Hasan Kasule, Sr. Deputy Dean for Research and Post-graduate Affairs, Kulliyah of Medicine IIUM
OUTLINE
1.0 DEFINITION OF LIFE
Biological
Chemical
Dynamic change
Spiritual
2.0 LEVELS OF LIFE
Ruh
Organism
Organ
Cell
Sub-cellular
3.0 START OF LIFE
Pre-conception
Conception
Nafakh al ruh
4.0 NATURE OF HUMAN LIFE
Gift of life
Ownership of life
Right to Life
Sanctity of Life
Protection of Life
Ajal
Love of Life
Test of Life
5.0 CRITERIA OF LIFE
Historical perspective
New Challenges
6.0 QUALITY OF LIFE
Physical
Mental
Spiritual
1.0 DEFINITION OF LIFE
Life can not be defined simply as the opposite of death. Life can be defined biologically, chemically, legally, and spiritually. It is not surprising that there is no one single definition of life; life is complex and its definition must be complex.
The biological definition is not straight-forward. Phenomena of death occur on a continuous basis. On a daily basis cells die and are replaced. Some organs can die while the rest of the organism is still living. Even in situations in which the whole organism is considered dead by ordinary criteria, some parts of it could maintain manifestations of life for a long time. Organs of dead persons stay alive for a long time in transplantees.
Life could also be defined in chemical terms as a series of chemical reactions in metabolism. These reactions are not much different from inorganic reactions that occur between elements.
One of the signs of life is dynamic change. There is growth and development. There is also degeneration and death. The elements that make up the human body are recycled. The degenerate cells and tissues whether in life or after death break up and become part of the earth. They are later incorporated into new cells as food, water or air that is breathed in.
Life could also be looked at in spiritual terms. Life without any spirituality is no life at all. Spiritual death could occur without biological death. Spiritual diseases could transform a human to be at the level of animals or even worse.
2.0 NATURE OF HUMAN LIFE
Life can be described at various levels: ruh, the whole living organism, the organ, the tissue or cell, the molecule, the atom. The highest level is that of the ruh about which we know very little. We however know that the ruh is the essence of human life and that it is eternal.
As far as we know human life exists only on our planet. The possibility of human life on other planets is possible and was referred to indirectly by the Qur’an (42:29). The details will have to be unraveled by scientific research and exploration.
It is pointless to try to define the exact moment when human life on earth is considered to start because of the concept of the continuum above. Such a definition would have legal implications in cases of abortion, inheritance, homicide etc. This matter will be discussed in due course in more detail.
Human life is a gift from Allah (ni’imat al hayat). Those who have life are a select few. A fertilized ovum that eventually grows into a human being is a very small statistical probability. One male ejaculate has millions of sperms and only one of them succeeds in fertilizing the female ovum. In many cases fertilized ova do not grow into fetii but are aborted early. Humans must be grateful to Allah for the gift of life by worshipping Him (ibadat).
Life belongs to Allah and not the human. Allah gives and takes away life (2:96, 3:156, 7:25, 7:158, 15:23, 23:80, 30:40, 40:43, 40:68, 45:26, 50:43, 44:53:44, 57:2, 67:2). Humans do not own their life but are temporary custodians of life. Humans have no control over life or death (25:3). Death and life are in Allah’s hands (p 382 25:3). Humans therefore have no right to destroy their life or that of any other human. Doing so is one of the greatest transgressions.
Each human has an inalienable right to life from Allah (haqq al hayat). This life can not be taken away or impaired by any human being except in cases of judicial execution after due process of the law.
Life is sacred. The sanctity of life (hurmat al hayat) is guaranteed by the Qur’an. The life of each single individual whatever be his or her age, social status or state of health is important and is as equally important as the life of any other human (5:32).
Protection of life (‘ismat al hayat/hifdh al nafs) is the second most important purpose of the shariat coming second only to the protection of the diin. It has priority over any other mindane consideration.
There is a continuum in human life. The start is the state on non-existence (azal). Allah then created the souls and took an undertaking from them to worship him (al ‘ahad). Starting with Adam (PBUH) Allah created a physical body to house those souls during life on earth (hayat al duniyat). The physical part of existence on earth ends with death and the souls continue into eternity. Life in the integerrum (hayat al barzakh) is an intermediate stage between life on earth and life in the hereafter (hayat al akhirat). In the hereafter human life will re-assume its physical form with the resurrection (al ba’ath). Life in the hereafter will be eternal. The fortunes of people will vary; some will be in jannat while others will be in hell being punished for their transgressions on earth.
Human life on earth has a definite time span (ajal) (p 763 6:2…13:38). No human endeavour including the most advanced medical procedures can shorten or extend this time span. The whole purpose of medicine is to exert maximum efforts to improve the quality of remaining life since the timing of the ajal is known by Allah alone.
Humans naturally want to live for long (2:96). This may be because they want to enjoy the earth as long as possible or for fear of the unknown after death. Some humans desire a long life to be able to make a maximum contribution to improving themselves and the earth on which they live.
Life can be a happy one (hayat said) or unhappy (hayat dhankat) (20:124). A good life is related to good deeds (p 382 16:97).
Life on earth is a test for humans (67:2). Those who pass the test succeed.
3.0 CRITERIA OF LIFE
The question whether life exists or has ceased to exist is a recent pre-occupation. For millenia humans did not bother to answer the question since the answer had no practical value. When a person was seriously ill all they did was to wait. If there was some life the patient could revive else he would not. Death was easily defined in terms of irreversibility.
Modern technology has complicated the picture by introducing methods of keeping some functions of life like breathing or blood circulation beyond the point at which traditionally people would have been considered in a state of irreversible decline to death. It is therefore now important be able to define the moment of death to guide decisions on whether to apply or stop the advanced technology life support. The criteria of death will be discussed in the section on death.
4.0 QUALITY OF LIFE
Human life must have some quality. It is not enough to eat and breathe or maintain the vegetative functions only. A human can not live like a plant or an animal. The quality of human life must include physical, mental, and spiritual dimensions. Physical: absence of disease, comfortable environment, basic necessities. Mental: calmness, absence of neurosis and anxiety, purposive life. Spiritual: correct relation with the creator.