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Background material for workshop on the Islamic Input in the Medical Curriculum by Professor Dr Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) WEB: http://omarkasule.tripod.com
1.0 ISLAM, IMAN, & IHSAN
1.1 FUNDAMENTALS OF THE DIIN:
The three fundamentals of ddiin, usul al ddiin, are: Islam, Iman, and Ihsan. These three concepts taken together constitute the creed of Islam, al aqidat al Islamiyyat. There is a gradation. Islam is the beginning. Iman is a higher level. Ihsan is the highest level. Islam is outward manifestation, dhaahir. Iman is in the heart, baatin. Ihsan applies to both Islam and iman. Every muhsin is a mu umin. Every mu umin is a Muslim. Not every mu umin is a muhsin. Not every Muslim is a mu umin. Iman is a higher level of spiritual progress than Islam. Islam is a pre-requisite for iman. You can not have iman without having Islam. It is however possible to be a Muslim who has not yet attained the level of a mu’umin. Iman is knowledge, ‘ilm; testament, qawl; and action, ‘amal. It is acceptance in the heart, tasdiiq bi al qalb; affirmation by the tongue, iqraar bi al lisaan; and work performance by the body, ‘amal bi al jawarih. Ihsan is excellence and is the highest level of din. Ihsan was defined in the sunnat as perfection of action. It represents perfection in both Islam and Iman. It is excellence in worship, work, and in any social action. It is worship of Allah in the full knowledge that He is seeing you even if you cannot see Him. No activity goes by without being observed by Allah. The concept of excellence extends from prescribed acts of ibadat to all human endeavors and activities.
1.2 BASIC CHARACTERISTICS OF ISLAM
Islam is built on 5 pillars: shahadat, salat, zakat, saum Ramadhan, and hajj. Islam is oral testament, belief, performance of righteous acts, and following the straight path. A person becomes a Muslim by testifying that there is only one creator and that Muhammad is His messenger. Carrying out the four prescribed duties of worship mentioned above is a practical manifestation of the 2 testaments. A person does not cease to be a Muslim because of a sin as long he does not dispute that his action is a sin. A sinner remains a Muslim but of weak faith. Faith is removed from him for the duration of committing the sin. Those who commit major sins will be punished in hell for a time and will be forgiven to go to paradise because Allah forgives everything except polytheism. Islam is comprehensive, unitary, indivisible, action-orientation, easy to practice, universal, and is final message. It is rational and understandable. It establishes freedom of belief and freedom of thought. It is societal, reformist, and revivalistic. It is a ddiin of equilibrium, balance, and moderation between divinity & humanity, spirituality & materialism, revelation & intellect, the afterlife & the earthly, individualism & communalism, ideal & reality, past & future, responsibility & freedom, following & innovation, duties & rights, stability & change, knowledge & belief, right & might, ‘aqiidat & action, ddiin & state, control by faith & control by authority, material innovations & moral ascendancy, military power & morale.
1.3 THE SOCIAL CULTURE OF ISLAM
Imaam al Nawawi listed 23 hadiths that he called madaar al Islam because they define the social culture of Islam. They can be considered under groups: aqidat, personal conduct, and social intercourse. The fundamentals of the ddiin, usul al ddiin, are Islam, iman, and ihsan. A Muslim rejects Innovation in religion, upholds certainty, rejects doubt, believes in qadar, relies on Allah, and repents from sins. Muslim personal conduct is characterized by purity of intention, good conduct, modesty, following the right path, observing rules of halaal and haram, renouncing materialism, consulting his conscience, quality work performance, starting with the most important work, and fulfilling the 5 pillars of Islam. In dealing with others the Muslim leaves alone what does not concern him, loves good for the others, hurts nobody, sincere advice for others, calling to Islam, honoring the neighbor and the guest, suppressing anger, and respecting the sanctity of human life. Misunderstanding of Islam arises due to deliberate distortion by enemies of Muslims or by misbehavior by Muslims ignorant of their religion.
1.4 IMAN
Iman has 6 pillars: belief in Allah, belief in angels, as creations from light for the purpose of executing Allah’s commands; belief in the revelations, the major ones being the Qur’an, Injil, Zabuur, and Taurat; belief in messengers, from Adam to Muhammad (PBUH); belief in the last day, al iman bi yawm al qiyamat; and belief in qadar, and accepting Allah’s judgment whether perceived as favorable or favorable in the full belief that all is from Allah while at the same time basing human action on empirical evidence. Iman has many types and manifestations. There are over 72 types of iman. The highest grade of iman is the testament of la ilaaha illa al llaah and the lowest is removing an annoyance from a public road. Modesty is part of iman. Iman can be weak or strong. The prophet explained the characteristics of the weakest iman. Even the smallest amount of iman protects from hell-fire. Work is part of iman. Iman can increase or decrease according to whether the person is performing good or bad acts. Iman increases with performance of good work. It decreases with performance of bad work. Iman disappears completely for the duration of the period that a major sin like theft or adultery is being committed. It returns as soon as the sin is stopped. There are clear differences between iman and Islam. Iman manifests through practical actions because Islam is a practical religion that has to be lived in society. It is not in any way a metaphysical or esoteric experience. Iman manifests as good deeds, and worship of the creator. It also includes, inter alia, living in harmony with other humans as well as with the social and physical environment. Iman is an inner motivator of externally visible human action and behavior. True believers acquire some recognizable traits and characteristics described by the Qur’an. Iman is associated with excellence in many areas. It is associated with good performance. The believers are tested. Iman has many advantages for the human: honor, brotherhood, firmness, success, victory, rewards, light. Iman is associated with happiness because a believer knows himself, his position, his relation with the creator, his relation with the other humans and his relation with the physical environment. He can also situate himself in the time dimension; he knows where he came from and where he is going. This sense of firmness removes the normal tensions of uncertainty and anxiety that humans experience and leave the believer a happy and contented person.
1.5 IHSAN IS THE CULTURE OF ISLAM
Islam requires quality work and excellent performance. Allah accepts and rewards the best of work. He loves quality everything so Muslims must perfect their work. Humans in their earthly life are tested to see who performs the best. The Qur’an and sunnat have emphasized quality, ihsan, and quality performers, muhsinuun.
2.0 TAUHID
2.1 TAUHID al DDHHAAT, TAUHID al ASMAU & TAUHID al SIFAT
The essence of Allah is one. As humans we cannot reach or understand the essence of Allah. We can only deal with the names and attributes. Part of the creed is belief in the names and attributes of God. They testify to and help humans understand the power and majesty of the creator. Denial of any one name or attribute nullifies iman. All the 99 names of Allah are mentioned in the Qur’an. Allah has several attributes, sifaat, mentioned in the Qur'an. Like names, the sifaat help the human understand the majesty of Allah. A Muslim must belief in all the sifaat. This includes testifying that they are Allah's attributes and His alone. The human should however not delve into the details of the mechanisms, kaifa, because those are above human intellect and understanding. The sifaat can be anatomical features, actions or functions, or potential for action, or states of being. The names of Allah are to be used for Him and Him alone. Humans cannot attribute any of the names to themselves. This includes prophets and the righteous. The sifaat are for Allah alone and no human or any other creation can have the same attributes. It is a crime to think that Allah’s attributes are similar to human attributes. It is also a crime to deny them.
2.2 TAUHID AL RUBUBIYYAT
The concept of rubuubiyyat is the assertion that there is a creator and sustainer for the universe and all its contents. The creator cannot be created and has neither beginning nor end. The concept of auto-creation, existence without a creator, is untenable because it leads to the logical absurdity of an object 'existing' before it existed. Belief in the one-ness of the creator-God, tauhid al rubuubiyyat, is inborn. Any normal human being will innately and instinctively know that there is one creator for the universe. Tauhid al rubuubiyyat is a logical imperative. It is impossible for the harmonious and well-coordinated universe to have more than one creator. No two creators could agree so perfectly without any contradictions. Tauhid al rubuubiyat also explains the harmonious interactions in the eco system, the food chains and the food webs.
2.3 TAUHID AL ULUHIYYAT
Tauhid al uluuhiyyat implies worship of one God alone. Nothing else can be associated with Him in worship. The purpose of the creation of the universe is worship of God that is an expression of gratitude to the creator. All creations involuntarily worship God; it is only humans who sometimes disobey because they were given free will that is misused. Kufr, denial of God, is ungratefulness. Shirk, associating God with anything else in worship, is an unforgivable sin. Shirk is the cause of religious and social anarchy.
2.4 ‘AQIDAT AL TAUHID & THE ISLAMIC WORLD-VIEW, TASAWWUR ISLAMI
Tauhid is oneness of the creator-God that implies oneness of the created universe. The testament of tauhid is 'there is no god but one God, la ilaha illa al llaahu, consists of a negation followed by an affirmation. Tauhid encapsulates the Islamic world-view and is the basis of Islamic culture and civilization. Tauhid is an intellectual challenge since the concept of one God above and beyond human and the whole universe is an intellectual and abstract reality that can be only grasped at the highest levels of intellectual competence. Tauhid provides an integrating framework for the whole universe in whose absence there would be irreconcilable contradictions. Tauhid is the basis for physical and social laws that govern science, technology and society. The perfection, order, and harmony of the universe and the human body are an empirical proof for oneness of the creator. Tauhid, as belief in one creator and sustainer gives purpose and a sense of direction to human civilization. Belief in tauhid guarantees eventual entry into paradise with a short stay in hell as punishment for un-forgiven major sins.
2.5 IMPLICATIONS OF TAUHID IN DAILY LIFE
Tauhid has implications for our daily life based on issuing from one creator: brotherhood and equality, physical laws of science and technology, social laws, economic organization, and political organization.
3.0 RISAALAT
3.1 BASIC ELEMENTS OF THE PROCESS OF REVELATION
Revelation has three essential components: angels, messengers, and the scriptures. Allah sent messages to humans as revelation, wahy. These revelations were conveyed from the heavens by angels to human messengers who are prophets chosen by Allah.
3.2 ANGELS
Belief in the revelation necessitates belief in the existence of the angels who conveyed that message. Angels undertake the following functions: carrying the throne of Allah, being sent on missions, conveying revelations; taking away the souls of the dying, recording human actions and behavior, intervention in some human actions at Allah’s command, executing Allah’s orders on punishing humans, working in jannat, putting disbelievers into jahannam, guarding jahannam, protecting humans, helping believers to victory, seeking forgiveness for humans, and intercession.
3.3 MESSENGERS:
Prophets are of two types: those with messages, nabi rusul, and those without messages, nabi. Twenty-five of the messengers are special: Adam, Idris, Nuh, Hud, Salih, Lut, Ibrahim, Ismail, Ishaq, Yaqub, Shuaib, Harun, Musa, Daud, Sulaiman, Ayub, Dhu al Kifli, Yunus, Ilyas, al Yas'a, Zakariyah, Yahya, Isa, and Muhammad. The first messenger was Nuh and the last was Muhammad. The religion of all the messengers is the same in essence and is Islam. A Muslim must believe in all messengers without any distinctions or discrimination. All messengers were human. It is against the Islamic creed to attribute any divine attribute to any prophet. Some messengers had physical miracles as proof that they were from Allah. Muhammad (PBUH)’s major miracle is the Qur’an which is an everlasting intellectual miracle. The main function of messengers was to convey messages. Muslims believe in the concept of finality of prophethood, khatm al nubuwat. Muhammad is the last of the prophets and messengers. Islam is therefore the final religion and the Qur’an is the final revelation.
3.4 REVEALED BOOKS
Revealed books are an authority and tell the truth. The books are the injil revealed to Isa, the taurat revealed to Musa, the suhf of Ibrahim, the zabuur revealed to Daud, and the Qur’an revealed to Muhammad. The Qur'an contains all the previous books. A Muslim must believe in the past revelations by believing in the Qur’an because they are all embraced within the Qur’an. Rejection of any part of the Qur'an is kufr. It is enough to believe in the Qur'an; it must be out into practice. Muslims are obliged to remember the Qur'an, contemplate its meanings, and convey its message to others. The Qur'an was first revealed on the night of power. It was revealed in bits and pieces over a period of 23 years. The prophet used to dictate the Qur'an to his companions to put each verse in the right surat. The Qur’an, being the last revelation, was scrupulously protected from any distortions. It was written down during the era of the prophet on various writing materials. Thousands of Muslims learn the Qur’an by heart in so many countries that it is impossible for it to be distorted or to disappear. The Qur’an has several names and attributes. The Qur’an is the word of Allah. It is a miracle. Muslims are obliged to read the Qur’an. The Qur'an clarifies ‘aqidat, is a spiritual guide, a source of Law, a source of information about past and future events, a basis for ummatic unity and helps resolve differences. Belief that the sunnat of the prophet is valid revelation is part of belief in the Qur’an. The sunnat is an extension and interpretation of the Qur’an.
3.5 SAHABAT and SALIHIIN
Sahabat or companions are defined as those who met the prophet and believed in him during his lifetime. They were just and truthful. We remember the good acts of the sahabat, talk only good of them, love all of them, and pray for them. Insulting, cursing, or despising any of the sahabat is forbidden. Hatred of the sahabat is kufr and nifaaq. We do not discuss the conflicts that occurred among the sahabat. The righteous, al salihiin, are men and women who lived exemplary lives. We believe that the salihiin or awliya have karaamaat (miracles from other than prophets). The salihiin do not deserve being worshipped in their life or after their death. Worshipping them in order to get nearer to Allah is like worshipping idols. They can be asked to make dua during their life but not after their death. It is forbidden to use the salihiin as intermediaries. It is also considered major shirk to ask them for help, to relieve hardships, or bring benefits.
4.0 AKHIRAT
4.1 STAGES OF HUMAN LIFE
The life-span, ajal, is fixed. Humans pass through 4 phases: non-existence, life on earth, life in the grave, the intermediate phase, and life in the hereafter. Islam does not accept the concept of re-incarnation. Each human has only one earthly life which ends on death. Death is a transitional event that occurs when the ruh is separated from the physical body. Death is in the hands of Allah. Humans do not know its appointed time. All humans will die and will have life after death. Life in the hereafter, hayat al akhirat, is a higher and better existence than the earthly life, hayat al duniyat. Life after death has two consecutive stages: life in the grave and in life after resurrection either in jahannam or in jannat. On resurrection the ruh will rejoin its physical body. Life in the hereafter whether in paradise or in hell is everlasting.
4.2 LIFE IN THE GRAVE, qabr
Burial in the grave is a respectful send-off unlike most animals that just abandon their dead. It is followed by questioning during which the ruh is returned temporarily to the body. The believers will answer correctly whereas the evil ones will not know the answers. Everyone will be told their fate, jannat or jahannam, while they are still in the qabr. There will be rewards and punishment in the qabr. Transitional life, hayat al barzakh, is between earthly life and life in the hereafter. Some authentic hadiths seem to indicate existence of some physiological functions in the deceased in the graves such as shouting, hearing. Ghosts do not exist. There is no direct between the dead in the qabr and living humans on earth. The dead cannot influence events on earth. The living cannot influence events in the qabr apart from dua. Dreams of the living about the dead are not a true form of communication between the living and the dead. Only dreams of prophets are true. Interpretation of dreams of ordinary humans is not a valid method of knowing anything about the dead.
4.3 THE LAST DAY, yawm al akhirat
Belief in the last day is a pillar of iman. Denial of the last day is unbelief, kufr. The knowledge of tlast day is with Allah alone. The pre-events of the last day will be social, physical, and special changes. The social changes will be: mothers enslaved by their children, living in sky scrapers, plenty of wealth, much fitnat, disappearance of trust, and disappearance of iman,. The physical events will be: rising of the sun from the west. The special events will be emergence of the false messiah; descent of Isa, and emergence of the daabat al ardh. This will be followed by the following events of the last day. The horn will be blown to herald resurrection. People will be gathered, their work record will be presented, accounts of their deeds will be made, the balance will be set up, and justice will be established. Intercession on the last day will be by Allah’s permission as mentioned in the Qur’an.
4.4 AFTER-LIFE: JANNAT and JAHANNAM
Jannat and jahannam were created by Allah before creation of humans. They exist today and are eternal. The jannat has many bounties and comforts that will be enjoyed in a physical form. People in jannat will enjoy these physical comforts without the biological and psychological stresses of life on earth. Jahannam is the abode of the unbelievers and wrong-doers. It is a place of punishment. The Qur’an has described life in hell as bad and frightening. There are many punishments one of which is physical burning. The physiological processes on earth will also occur in hell but will be a means of punishment and not satisfying physiological needs. The drink will not quench thirst. The food will not relieve hunger.
4.5 NATURE OF THE AFTER-LIFE
Life after resurrection from the graves will be physical and not metaphysical or spiritual. We do not know whether it will be exactly like that on earth or there will be some differences. The Qur’an makes it clear that it will be physical life with physical bodies with physiological functions of that life that are similar to those on earth. The resurrected humans will experience all events of the hereafter as physical beings. There will be no more death after the last day. Those who enter paradise will stay there permanently. Hell will be permanent for certain categories of offenders. Those with minor offences will spend a time of punishment in hell and then be forgiven and enter paradise.
5.0 QADAR
5.1 DESCRIPTION
Everything is fixed and is under Allah's pre-determination. The two terms qadha and qadar mean different things. Qadar is pre-determination or pre-fixing of events before their occurrence. Qadha is a term used to refers to the empirical or practical occurrence of what was pre-determined by qadar. In the stage of qadar Allah knows what will happen but the human does not. The human has to struggle as best as he can to achieve a desired objective. In the stage of qadha the event has occurred, the human has to accept what happened because now he can do nothing to reverse the qadar of Allah. Allah’s knowledge and will are unrestricted. Humans have to surrender to Allah’s will. They cannot change established qadar except by dua. Belief in qadar is associated with contentment of the heart, avoidance of excessive joy and sadness, bravery and initiative, and lack of fear. There is no escape from qadar since it operates everywhere. Everything was pre-determined before the creation of the earth and the heavens and is recorded in Allah’s great record. All phenomena and events in the universe follow the program in the record. Ordinary humans have no way of knowing what is in the record. Qadar It is part of belief in the unseen because human intellect can not on its own logically work out all aspects of qadar.
5.2 WILL, iraadat, KNOWLEDGE, ‘ilm, and POWER, qudrat
Allah’s knowledge, will, and power are unlimited. Human will, knowledge, and power are limited. The limited human will can be misguided by shaitan. A human in the course of normal life gets good and bad experiences. A believing Muslim knows that all is part of qadar and says ‘praise be to Allah’, alhamdu li llaah, for both good and bad experiences. The terms good and bad in human experience and knowledge are relative. What may appear to be good may turn out to be bad. What may appear to be bad may turn out to be good.
5.3 HUMAN ACTION
All human actions were created by Allah. He knows the actions of humans in advance. Allah tries humans by letting them be free in the choice of their actions but He knows in advance what they will choose. Whatever choices the human makes Allah is forgiving and is kind. Free will entails responsibility and humans are responsible for their actions and are accountable for their choices. Humans should not give up struggling relying on qadar and arguing that everything is pre-determined. They have to make all the efforts that is humanly possible to achieve a good result. The laws of causality are fixed such that an action is inevitably followed by the predictable result unless there is special divine intervention. However despite all human effort the results turn out different from the expectation, the human must submit and accept the will of Allah. A human can be guided or misguided. Guidance in the long run is from Allah. Humans within their limited will can exert effort to be guided. All of the human’s life on earth is a great test of how well the free will is used.
5.4 CAUSALITY and CAUSAL RELATIONS
In most human situations phenomena follow the fixed causal laws ie action is followed by an effect. Each event has a cause, sabab. All causes are from Allah. The causal laws are called ‘sunan Allah fi al kawn’ in Qur’anic terminology. These laws are fixed and are stable. Allah is not bound to obey these laws because they are His laws. His will is above them and can alter them. Allah created the causes and the effects. Thus causes are part of qadar. Normally the cause is followed by the expected result. There are however situations such as prophetic miracles in which divine intervention breaks those physical laws known to humans. In such situations one qadar is reversing another qadar.
5.5 MISUNDERSTANDING OF QADAR
Correct understanding of qadar requires distinguishing tawakkul that is good from tawaakul that is bad. Tawakkul in relying on Allah after taking all the necessary measures to achieve an objective following the laws of causality. Tawaakul is giving up all effort and just wait for things to happen. 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 can not distinguish between curable and incurable disease. He therefore plays 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. Allah alone determines the life and death. No human can give life or take it away. The human can be involved as an agent but not as a cause. These are matters of qadar that the human intellect cannot understand fully. Trying to search into such matters leads to perdition. It is therefore advised not to go deep in matters of qadar.