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Presented at Bandung Islamic Hospital June 2008 by Dr Omar Hasan Kasule Professor of Epidemiology and Islamic Medicine at the University of Brunei. WEB: http://omarkasule.tripod.com
1.0 PURPOSES AND PRINCIPLES USED IN THIS ANALYSIS
1.1 The Purpose of Protection of life, maqsad hifdh al nafs
1.2 The Purpose of Protection of resources, maqsad hifdh al maal
1.3 The Principle of Certainty, qa’idat al yaqeen
1.4 The Principle of custom/precedent, qa’idat al ‘aadat.
2.0 RULINGS ON LEGAL DEATH
2.1 Brain stem death = legal death accordinh to principle of custom, aadat
2.2 Persistent vegetative state (PVS) is not legal death?
2.3 Decision to withdrawal life support based on certainty of death, doctrine of futility, or financial / resource considerations
2.4 Role of the Qadhi / ulama /jurist
3.0 THE BASIS FOR THE LEGAL RULINGS
3.1 Preservation of life, maqsad hifdh al nafs, but not futile or heroic measures
3.2 Life vs resources. Certainty of death is defined by custom.
3.3 Futile treatment is waste, israaf
3.4 Qadhi is involved because of vested interests (family and physician)
3.5 Withholding life support = withdrawal but is psychologically easier
3.6 Do not start at all if it is futile.
3.7 Continuation is excused where commencing is not, yughtafar fi al baqa ma la yughtafar fi al ibtidaa
3.8 Continuation is easier that starting, al baqau ashal min al ibtidaa.
4.0 ROLE OF THE KADHI
4.1 Ulama in each city with special training on issues of determining death
4.2 Ulama involvement is sadd al dhari’at
4.3 Ulama guided by (a) brain stem death (b) futility doctrine
4.4 Family should not be forced into debt because of life support
4.5 Inheritance rights of family affected by involvement in decisions to withdraw life support