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Lecture for
3rd year medical students at the Faculty of Medicine King Fahad
Medical City Riyadh on May 29, 2013 by Prof
Omar Hasan Kasule Sr MB ChB (MUK), MPH (Harvard), DrPH (Harvard)
OBJECTIVES
·
Link the religious and
spiritual principles to medical practice
LECTURE OBJECTIVES
•
Describe the religious and
cultural practices of spiritual healing.
•
Describe the clinical
opportunities for applying spirituality.
•
Apply the concept of
spiritual support in clinical practice.
QADAR IN DISEASE
·
Human illness is part of qadar. Medical treatment is not denial
of or attempting to reverse qadar.
Both the disease and its treatment are part of Allah’s all-embracing qadar.
·
The human in his limited
knowledge cannot distinguish between curable and incurable disease. Human
experience has shown that diseases considered incurable a few years ago are now
curable.
·
It is therefore logical
that humans in ignorance of the true situation should play safe by treating all
diseases to the best of their ability being fully aware that this is an attempt
and leave the rest to Allah.
·
Immunization and other
preventive measures are treatment before disease and are not denial of qadar.
QADAR IN DEATH, al qadar fi al mawt:
·
Allah alone determines the
life and death of cells, tissues, organs, and the whole human organism. No
human can give life or take it away.
·
The human can be involved
as an agent but not as a cause.
·
This is a matter that King Nimrod
could not grasp in his arguments with Ibrahim (PBUH). Ibrahim told the King
that Allah gave and took away life. The King countered by killing one person
and sparing the life of another one[i].
The king either did not understand or chose to ignore the issue at stake,
creating life de novo.
LIFE, hayaat
·
Life, from the tauhidi-based
holistic integrative Islamic paradigm, shumuliyat al Islam, is a complex
phenomenon with biological, chemical, social, psychological, and spiritual
components.
·
The relations among the
components of life are governed by the physical laws, sunan al kawn, of balance,
mizan, equilibrium, i’itidaal, and reciprocal action-reaction, tadafu’u.
·
Humans share biological
life with plants and animals and share spiritual life with angels.
·
Humans are the only
creation to have both biological and spiritual life at the same time.
·
Human life devoid of
spirituality is like animal or plant life.
HEALTH, sihhat, raahat, ‘aafihat
·
Health is a positive and
holistic state of well-being and not mere absence of disease or illness.
·
Health includes spiritual, physical,
psychological, emotional, and psychological dimensions in holistic balance and
equilibrium.
·
The spiritual component is
the most important and its impairment adversely affects all the other
components.
·
Holistic measures of
quality of life and health must incorporate all the dimensions above.
SOUL, ruh
·
The ruh, the
permanent and eternal essence of each human life, was created before Adam.
·
Ensoulment, nafakh al
ruh, occurs in intra-uterine life. It is a spiritual event that also
sustains biological life; Desoulment, naza’u al ruh, is followed rapidly
by biological death.
·
The limited knowledge of
humans about the ruh is only from revelation, wahy.
·
The Qur’an used several
terms that seem to be referring to various manifestations of the same essence
of human life: ruh, nafs, aql, naasiyat, lubb, dhihn, fuad etc,
·
These terms can be mapped
by experts in tafsir al Qur’an to spiritual, psychological, cognitive,
emotional, and social modalities that professionals use in providing holistic spiritual
support to patients.
SPIRITUAL SUPPORT, al da’am
al ruhi
·
Patients should be supported
to reach calmness devoid of fear or anxiety by accepting death as a
transitional event
·
The transition is from inferior
and temporary life on earth, hayat al duniyat, through the interregnum, hayat
al barzakh, to the superior and eternal life in the hereafter, hayat al
akhirat.
·
Death is not a terminal
event and neither does it break the reassuring direct communication between the
human and the Creator.
·
Of all links and relations
that a human can have, it is only the link with Allah that persists after the
disappearance of parents, siblings, children, spouses, friends, and enemies
PSYCHOLOGICAL SUPPORT, al
da’am al nafsaani
·
The patient should
be supported to ascend from the lowest to the highest levels of the nafs
·
From the evil-inclined soul,
nafs al ammarat to the self-conscious soul, nafs lawaamat
·
From the self-conscious
soul, nafs lawaamat to the high levels of the calm soul, nafs
mutmainnat.
·
Nafs mutmainnat is
described as raadhiyat, mardhiyat, qanuu’at
·
At this level the patient
bravely faces the suffering and pain of illness.
COGNITIVE SUPPORT FOR THE
PATIENT, al da’am al ma’arifi/al fikri
·
The patient should
be supported to appreciate illness as just one minor phenomenon in the wide and
expanding spatio-temporal dimension of the universe ‘aalamiin
·
The patient should be
guided to appreciate that illness can have beneficial aspects such as
forgiveness of sins and bringing out the best in the human who can overcome
pain and suffering and stay calm and composed.
EMOTIONAL SUPPORT, al da’am
al ‘aatifi
·
The patient’s self-worth,
self-esteem, and self-confidence to face the challenges of illness should be
enhanced
·
The patient should be aware
of the superiority of human creation that overcomes innate weakness such as
evil-doing fisk, and spilling blood, safk al dima, to become a
vicegerent, khalifat, who with limited control of the universe, taskhiir,
is able to build a material civilization, imarat al ardh.
SOCIAL SUPPORT, al da’am al
ijtima’e
·
The patient should be given
support to live the remaining life with the highest quality of social relations
with the family and the wider community.
·
Members of the family
should be welcome as partners in patient care and should be treated as honored
guests of the hospital with all the rights of the visitor, huquuq al dhaif.
·
The patient should be
enabled to stay in contact with the outside community and not be confined to
the 4 walls of the hospital room: news, visits, participation in radio talks
etc
PHYSICAL SUPPORT, al da’am
al maadi
·
The spiritual support
professional cannot ignore the physical needs of the patient
·
The primary necessities, dharuraat,
are those needed to preserve life like basic staple food and water
·
The needs, haajiyaat,
bring emotional satisfaction like favorite dishes served in an attractive way
·
Embellishments, tahsiinaat,
and complementaries, mukamillaat, are what are beyond the necessities
and needs
SPIRITUAL HEALING
·
Dua, ruqyah, tawakkul, and
raja are spiritual treatments.
·
It is permitted to
slaughter on behalf of the sick taqarruban ila al llaah and to give the
poor.
·
HCWs must make dua for the patients because qadar can only be changed by dua.
·
HCWs can make ruqya for the
patients by reciting the two mu’awadhatain
or any other verses of the Qur’an.
·
Payment for ruqya is
allowed.
CONCLUSION
·
Islam has concepts of life
and health than can guide spiritual support for the patient
·
The multi-dimensional
manifestations of the ruh require that spiritual support consider
spiritual, psychological, emotional, social, and physical modalities of patient
welfare
·
Little research has been
carried out on spiritual support from the Islamic perspective
·
Because of its
multi-dimensional aspects, spiritual support should be recognized as a separate
profession that goes beyond religious guidance, irshaad diini.