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Background reading material for medicine & fiqh panel discussion held on 8th April 2000 at the Kulliyah of Medicine, International Islamic University, Kuantan, MALAYSIA by Professor Omar Hasan Kasule Sr.
OUTLINE
14.2.1 DISTURBANCE OF CONSCIOUSNESS
A. Ibadat:
B. Aadaat
C. Munakahat
D. Muamalat
E. Al Qadha
14.2.2 PSYCHIATRIC CONDITIONS
A. Personality Disorders
B. Neurotic And Psychotic Disorders
C. Sexual Disorders
D. Stress Disorders
E. Other Psychiatric Disorders
14.2.3 DEGENERATIVE CONDITIONS
A. Epilepsy
B. Parkinsonism
C. Dementia, Amnesia
D.
E.
14.4.4 NEUROLOGICAL CONDITIONS
A. Classification
B. Ibadat
C. Munakahaat
D. Muamalaat
E. Qadha
14.2.5 OTHERS
A.
B.
C.
D.
E.
14.2.1 DISTURBANCE OF CONSCIOUSNESS
A. IBADAT:
DISTURBED STATE OF CONSCIOUSNESS:
COMA, SEMI-COMA
Causes of coma: Trauma, Infection, poison, psychiatric, shock, alcohol, epilepsy, increased intra-cranial pressure, opiates, uremic/metabolic
BRAIN DEATH & VEGETATIVE STATE - SALAT, HAJJ
SALAT
Forgetfulness in salat, al sahawu fi al salat (KS 321)
If salat is forgotten it is offered when remembered, idha nasiya al salat yuswaliha ‘insa ma yadhkurha (KS 315)
Doubts in salat, al shakk fi al salat (KS 321)
Salat in terminal illness, al salat fi maradh al mawt (KS 349)
Salat in coma or unconsciousness, salat al mughma ‘alayhi (KS 506)
Salat in semi-coma
Salat in syncope
Salat with stroke
Salat and dozing: if a person dozes he should stop salat, sleep and resume only when conscious of what he is reading (KS 315)
Salat while asleep, al salat naiman (KS 311: Nisai K20 B21; Ahmad 4:435, 442, 443; Ahmad 6:56, 202, 205, 259, 268; Tayalisi H2645)
Shortening salat when frightened, qasr al salat fi haalat al khawf
SAUM
Forgetting in saum, al nisyaan fi al saum (KS 333: Musnad Zaid H237 & 241)
Saum with syncope
Saum with stroke
B. AADAAT
Forced feeding of a semi-conscious person
C. MUNAKAHAT
Sexual relations with semi-conscious spouse
Psycho-social stress as a cause of divorce or khulu’u
Marriage/divorce of the semi-conscious
D. MUAMALAT
Transactions under duress, an nahyu ‘an bay’I al mudhtarr (KS 128)
Contracts by or on behalf of the semi-conscious
E. AL QADHA
Testimony by and on behalf of the semi-conscious
Legal liability for crimes under the influence of ordinary psychiatric medication
Legal liability for crimes committed under the influence of alcohol or drugs
14.2.2 PSYCHIATRIC CONDITIONS
A. PERSONALITY DISORDERS
DESCRIPTION
The common personality disorders are: paranoid, schizoid, compulsive, hysterical, narcissist, avoidant, and dependent, passive-aggressive, anti-social, borderline. Their underlying causes may be biological organic brain syndromes, genetic, developmental, social (psychodynamic, learned behavior, environment), and biochemical. The precipitating causes are: stress, psychological disorders in medical/surgical disorders affecting both the patient and the family.
IBADAT
Personality disorders not accompanied by cognitive effects have no impact on ibadat.
Severe personality disorders may be reason for not performing hajj because the stress could precipitate a crisis
Saum and hunger could be a stressful condition precipitating a crisis
AADAAT
MUNAKAHAAT
Severe personality disorders as contra-indication for marriage
MUAMALAAT
Legality of contracts by persons with personality disorders that affect free will
QADHA
Crime due to underlying and perhaps genetically-determined personality disorder
B. NEUROTIC and PSYCHOTIC DISORDERS
Neurotic disorders are anxiety, fear, compulsive-obsessive behavior etc. Psychotic disorders: schizophrenia, paranoid, mood disorders( depression, suicide, mania, bipolar disease)
IBADAT
Salat in cases of anxiety
Lack of concentration in salat, ishtighaal al fikr fi al salat (KS 310: Bukhari K21 B18)
Compulsive-obsessive behavior and flatus
Compulsive-obsessive behavior and forgetfulness in salat
AADAAT
MUNAKAHAAT
Marriage of a spouse with madness, man tazawwaja imra at wa biha junuun (KS 550)
Marriage and divorce of a schizophrenic
MUAMALAAT
Contracts by a schizophrenic
Contracts in mood disorders clouding thinking
QADHA
Evidence by a schizophrenic
Assessment of evidence taking mood into account
C. SEXUAL DISORDERS
The common sex related disorders are: paraphilias (exhibitionism, transvetism, voyeurism, pedophilia), incest, bestiality, sadism, masochism, bondage, and necrophilia. Problems of gender identity could lead to trans-sexuality, bisexuality, and homosexuality. Psycho-sexual dysfunction includes: impotence, ejaculation disorders, vaginismus, frigidity, and lack of libido.
IBADAT
AADAAT
MUNAKAHAAT
Divorce on basis of sexual disorder such as sadism, masochism
Divorce on basis of transsexual behavior
Divorce on basis of male impotence or female vaginismus/frigidity
Marriage contract in established lack of libido
Divorce/khuluu on basis of lack of libido
MUAMALAAT
QADHA
D. STRESS DISORDERS
Stress and its control: causes, reactions, manifestations, external control, internal control (solat, dhikr, itikaaf)
Salat while under stress
Hajj while under stress
Saum while under stress
E. OTHER PSYCHIARIC DISORDERS
SLEEP DISORDERS
Dreams: process, significance, interpretation, good and bad dreams
14.2.3 DEGENERATIVE CONDITIONS
A. EPILEPSY
Salat of the epileptic
Hajj of the epileptic
B. PARKINSONISM
Salat
Hajj
Unintentional injury
C. DEMENTIA, AMNESIA
Salat: validity of imaamat
Hajj: obligation
Court evidence: evaluation of court testimony by the elderly in view of incipient dementia
leadership
14.4.4 NEUROLOGICAL CONDITIONS
A. CLASSIFICATION
NMJ DISEASE:
Myasthenia gravis and salat
NEUROPATHIES
Types: mono-neuropathy and polyneuropathy. Peripheral nerves can be injured by (a) entrapment neuropathy like the carpal tunnel syndrome and the ulnar entrapment (b) peripheral nerve tumors. Neuropathies may be due to disease, metabolic disorders, or toxins.
HEAD INJURY
Open or closed. Focal or diffuse. Focal can be hematoma (epidural, subdural, intra-cerebral). Post concussion syndrome
VESTIBULAR DISTURBANCES
Standing up in salat may be difficult
Tawaaf in hajj may be difficult without support
BRAIN TUMORS
Both benign and malignant tumors have pressure effects. They are gliomas, meningiomas, pituitary adenomas, cranipharyngiomas, neurinomas. Intra-cranial vascular tumors are: aneurysms, A-V malformations, intra-cerebral hemorrhage, sub-arachnoid hemorrhage. Symptoms of increased intra-cranial pressure are: headache, nausea, vomiting, personality changes, loss of consciousness
B. IBADAT
Vestibular disturbances and salat or hajj
C. MUNAKAHAAT
D. MUAMALAAT
E. QADHA
14.2.5 OTHERS
APHASIA, DYSPHASIA: marriage, witnessing, public duty
INFECTIONS: brain abscess, cysticercosis, AIDS
CRANIAL STENOSIS
CRANIAL NEURALGIA
SPINAL CORD INJURIES.
Cervical injuries lead to quadriplegia
Thoracic injuries
Lumbar injuries lead to paraplegia
DISCUSSION
DISTURBANCE OF CONSCIOUSNESS
The concept of dhimmat for the brain-dead
Legal liabilities and obligations for the brain dead
Forgetfulness or absent-mindedness in salat
Salat in a semi-conscious state
Ruling on dozing in salat
Salat and stroke
Forgetfulness in saum
Forced feeding of a semi-conscious or unconscious person
Sexual relations with a semi-conscious spouse
Marriage or divorce of the semi-conscious
Contracts by and on behalf of the semi-conscious person
Court testimony by a semi-conscious person
Legal liability for crimes and contracts under the influence of ordinary psycho-active medications
Legal liability for crimes and contracts under the influence of alcohol and non-medicinal drugs
PSYCHIATRIC CONDITIONS
Obligation of hajj on person with borderline personality who could break down under stress
Saum for a borderline person as a stressor that could precipitate a crisis
Refusal of marriage for person with severe personality disorders
Legality of contracts or court testimony by person with personality disorders that affect free will
Liability for crimes in a person with underlying personality disorders that are genetically-determined
Salat in a state of fear or anxiety
Absent-mindedness in salat
Compulsive-obsessive disorder and doubt about nullification of wudhu by flatus
Compulsive-obsessive disorder and forgetfulness in salat
Discovery of severe psychiatric condition in a spouse after marriage
Marriage and divorce of a schizophrenic
Contracts by a schizophrenic
Contracts in mood disorders that affect free will and clear thinking
Court testimony by a schizophrenic
Assessment of evidence taking mood into consideration
Divorce of the basis of a sexual disorder such as sadism, masochism
Divorce on the basis of trans-sexual behavior
Divorce on the basis of male impotence or female vaginismus/fridigity
Validity of marriage contract concluded with knowledge of established lack of libido
Divorce/khulu on the basis of lack of libido
Salat while under stress
DEGENERATIVE DISORDERS
Obligation of congregational salat for an epileptic at risk of epileptic attacks
Obligation of hajj for an epileptic at risk of attacks
Legal liability of injury caused by a patient with Parkinson's disease
Validity of imaamat for a person with dementia and amnesia
Evaluation of court testimony by the elderly in view of incipient dementia leading to amnesia
NEUROLOGICAL DISORDERS
Vestibular disturbances and salat/hajj
Marriage contracts in cases of dysphasia and aphasia
Salat for the quadriplegicx
Hajj for the quadriplegic