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 NATURE OF KNOWLEDGE, tabi’at al ma’rifat
1.1 DESCRIPTION OF KNOWLEDGE
The Qur’anic terms for knowledge are: ‘ilm, ma’arifat, hikmat, basiirat, ra’ay, dhann, yaqeen, tadhkirat, shu’ur, lubb, naba’, burhan, dirayat, haqq, and tasawwur. The terms for lack of knowledge are: jahl, raib, shakk, dhann, and ghalabat al dhann. Grades of knowledge are ‘ilm al yaqeen, ‘ayn al yaqeen, and haqq al yaqeen. Knowledge is correlated with iman, ‘aql, qalb, and taqwah. Knowledge must be evidence-based knowledge, hujjiyat al burhan. The seat of knowledge is the ‘aql, and qalb. Allah’s knowledge is limitless but human knowledge is limited. Humans vary in knowledge. Knowledge is public property that cannot be hidden or monopolized. Humans, angels, jinn, and other living things have varying amounts of knowledge. Islamic epistemology, nadhariyyat ma’rifiyyat Islamiyyat, is Qur’ an-based within the tauhidi paradigm and is guided by objectivity, istiqamat. Knowledge can be absolute for example revealed knowledge. Other types of knowledge are relative, nisbiyat al haqiqat. The probabilistic nature of knowledge arises out of limitations of human observation and interpretation of physical phenomena.
1.2 HISTORY OF HUMAN KNOWLEDGE, tarikh al ma’rifat al insaniyat
Adam was the first human to learn actively when he was taught the names. Human knowledge after that grew by empirical trial and error or through revelations. Development of language and writing played a big role in knowledge development. Publication and telecommunication are responsible for the current knowledge revolution.
1.3 SOURCES OF KNOWLEDGE, masadir al ma’arifat:
All knowledge is from Allah. Humans can get it in a passive way from revelations or in an active way by empirical observation and experimentation. Whatever knowledge they get is ultimately from Allah. Knowledge may be innate of acquired. Humans have knowledge of the creator even before birth. Some human knowledge is instinct. Most human knowledge is learned as observation, ‘ilm tajriibi; transmission, 'ilm naqli; or analysis and understanding, 'ilm 'aqli. Seeking to know is an inner human need that satisfies curiosity. Revelation, wahy, inference, ‘aql, and empirical observation of the universe, kaun, are major sources of acquired knowledge accepted by believers. In terms of quantity, empirical knowledge, ‘ilm tajriibi, comes first. In terms of quality revealed knowledge, ‘ilm al wahy, comes first. There is close interaction and inter-dependence between revelation, inference, and empirical observation. ‘Aql is needed to understand wahy and reach conclusions from empirical observations. Wahy protects ‘aql from mistakes and provides it with information about the unseen. ‘Aql cannot, unaided, fully understand the empirical world. There is lack of unanimity on the following as additional sources of knowledge: ‘ilm laduniy; inspiration, ilham; intuition, hadas; instinct, jabillat; geomancy, firasat; dreams, ru’uyat; and kashf. The controversy is not whether they are sources of knowledge but whether they are sources independent of the three mentioned before. Magic & sorcery, sihr; astrology, tanjiim; foretelling, kahanat & tatayur; and other forms of superstition are not sources of true knowledge. They may lead to correct and verifiable facts but only by chance and coincidence. They most often lead to wrong and misguiding facts.
1.4 CLASSIFICATION OF KNOWLEDGE, tasnif al marifat
Knowledge can be innate of acquired. It can be ‘aqli and naqli. It can be knowledge of the seen, ‘ilm al shahadat, and knowledge of the unseen, ‘ilm al ghaib. The unseen can be absolute, ghaib mutlaq, or relative, ghaib nisbi. Some knowledge is individually obligatory, fard ‘ain, whereas other knowledge is collectively obligatory, fard kifayat.Knowledge can be useful, nafiu. Knowledge can be basic or applied. There are many different disciplines of knowledge.
1.5 LIMITATIONS OF HUMAN KNOWLEDGE, mahdudiyat al marifat al bashariyyat
The Qur'an in many verses has reminded humans that their knowledge in all spheres and disciplines of knowledge is limited. Human senses can be easily deceived. Human intellect has limitations in interpreting correct sensory perceptions. Humans cannot know the unseen, ghaib. Humans can operate in limited time frames. The past and the future are unknowable with certainty. Humans operate in a limited speed frame at both the conceptual and sensory levels. Ideas can not be digested and processed if they are generated too slowly or too quickly. Humans cannot visually perceive very slow or very rapid events. Very slow events like the revolution of the earth or its rotation are perceived as if they are not happening. Human memory is limited. Knowledge acquired decays or may be lost altogether. Humans would have been more knowledgeable if they had perfect memory.
2.0 CRISIS OF KNOWLEDGE, azmat al ma’arifat
2.1 MANIFESTATIONS OF THE CRISIS
There is pervasive ignorance of uluum al diin and uluum al dunia. There is little respect for scholarship. Wealth and power are considered more important than scholarship. There is neglect of the empirical sciences. There is a dichotomy in the education system: traditional Islamic vs. imported European, ulum al diin vs ulum al dunia. Integration of the 2 systems has failed or has been difficult because it has been mechanical and not conceptual. The process of secularization in education has removed the moral dimension from the education and violated the aim of Islamic education to produce an integrated and perfect individual, insan kaamil. The brain drain from Muslim countries has compounded the educational crisis.
2.2 UMMATIC MALAISE DUE TO THE KNOWLEDGE CRISES
Knowledge deficiency and intellectual weakness are the most significant manifestation of ummat’s decadence. The intellectual crisis of the ummat is worsened by copying and using poorly digested alien ideas and concepts. The prophet warned the ummat about the lizard-hole phenomenon in which the ummat in later times would follow its enemies unquestionably like the lizard running into its hole. Among the manifestations of the ummatic malaise are deficient ibadat, action deficiency, political weakness, economic dependency, military weakness, dependence in science and technology, and erosion of the Islamic identity in life-style.
2.3 HISTORICAL BACKGROUND
The generation of the Prophet (pbuh) was the best generation. The best teacher met the best students and excellent results were obtained. Companions had excellent knowledge and understanding. Seeds of the current crisis appeared towards the end of the khilafat rashidat... New social and political forces overthrew the khilafat rashidat and the ideals it represented were distorted or abolished. Then the authentic ‘ulama and opinion leaders who remained faithful to the ideals of Islam were marginalized and persecuted. Intellectual stagnation then ensued. The process of secularization of the Muslim state progressed. Widespread ignorance and illiteracy became common. Many non-Islamic ideas and facts without valid proof have found their way into the intellectual and religious heritage of the ummat making the existing intellectual crisis even worse.
2.4 KNOWLEDGE, A PRE REQUISITE FOR TAJDID
Reform and revival of the ummat will occur through educational and knowledge reform. Tajdid is a recurring phenomenon in the ummat and is a sign of its health and dynamism. It is a basic characteristic of the ummat that periods of reform/revival alternate with periods of decay and return to jahiliyyat. Tajdid requires knowledge, ideas and action related by the following mathematical equation: tajdid = idea + action. Action without knowledge and guiding ideas will not lead to true change. Ideas without action are not change at all. Tajdid requires and is preceded by a reform in knowledge to provide ideas and motivation on which to build. All successful societal reform starts with change in knowledge. The ideal society cannot be created without a knowledge base. That knowledge base must be correct, relevant, and useful. Successful revival movements throughout Muslim history have always been led by scholars.
2.5 KNOWLEDGE: STRATEGY, OBLIGATIONS, AND ETIQUETTE
The Muslim ummat is a potential economic and political bloc whose potential is not yet realized. The contemporary tajdid movement has a lot of strengths but also has basic deficiencies that must be corrected. The knowledge and intellectual crises are still a barrier. Reform movements unguided by correct knowledge and understanding will falter and fail or will be deviated from their paths. Social change requires change in attitudes, values, convictions and behavior of a critical mass of the population. Attitudes, values, convictions, and behaviors are determined by the knowledge base. The vision of the knowledge strategy is an upright balanced person who understands the creator, knows his place, his roles, his rights, and his responsibilities in the cosmic order. The mission of the knowledge strategy is conceptual transformation of the education system from kindergarten to post graduate studies to reflect tauhid, positive moral values, objectivity, universality, and serving the larger causes of humanity.
3.0 METHODOLOGY OF KNOWLEDGE, manhaj al ma’arifat
3.1 CONCEPTS
Methodology started with Adam naming and classifying all things followed by trial and error discoveries and later by systematic methodological investigation. Inspired by the Qur’an, Muslims developed the empirical scientific methodology that triggered the European reformation, renaissance, and scientific and technological revolution starting in the early 16th century CE. Francis Bacon (1561-1626) knew Arabic, learned from Muslims, and was the first European to write about the empirical methodology. Europeans copied the empirical methodology without its tauhidi context, rejected wahy as a source of knowledge, and later imposed badly-copied secularized science on the Muslim world. Ancient Muslim scientists had shown that wahy, ‘aql, and empiricism were compatible and had used methodological tools from the Qur’an to correct deficiencies and improve Greek science before passing it on to Europeans. They replaced Aristotelian deductive logic and definitions with an Islamic inductive logic inspired by the Qur’an.
3.2 METHODOLOGY FROM THE QURAN, manhaj qur’ani
The Qur’anic provides general guiding principles and is not a substitute for empirical research. It enjoins empirical observation; liberates the mind from superstition, blind following, intellectual dependency, and whims. Its tauhidi paradigm is the basis for causality, rationality, order, predictability, innovation, objectivity, and natural laws. Laws can be known through wahy, empirical observation and experimentation. The Qur’anic teaches the inductive methodology, empirical observation, nadhar and tabassur; interpretation, tadabbur, tafakkur, i’itibaar & tafaquhu; and evidential knowledge, bayyinat and burhan. It condemns blind following, taqliid, conjecture, dhann; and personal whims, hiwa al nafs. The Qur’anic concept of istiqamat calls for valid and un-biased knowledge. The Qur’anic concepts of istikhlaf, taskhir, and isti’imar are a basis for technology. The concept of ‘ilm nafei underlies the imperative to transform basic knowledge into useful technology.
3.3 METHODOLOGY FROM THE CLASSICAL ISLAMIC SCIENCES
Classical sciences and their concepts are applicable to S&T. Tafsir ‘ilmi and tafsir mawdhu’e parallel data interpretation in empirical research. ‘Ilm al nasakh explains how new data updates old theories without making them complety useless. ‘Ilm al rijaalcan ascertain the trustworthiness of researchers. ‘Ilm naqd al hadith can inculcate attitudes of critical reading of scientific literature. Qiyaas is analogical reasoning. Istihbaab is continued application of a hypothesis or scientific laws until disproved. Istihsan is comparable to clinical intuition. Istislah is use of public interest to select among options for example medical technologies. Ijma is consensus-building among empirical researchers. Maqasid al shariat are conceptual tools for balanced use of S&T. Qawaid al shariat are axioms that simplify complex logical operations by using established axioms without going through detailed derivations.
3.4 ISLAMIC CRITIQUE OF THE EMPIRICAL METHOD, naqd al manhaj al tajribi
Using methodological tools from the Qur’an and classical Islamic sciences, Muslims developed a new empirical and inductive methodology in the form of qiyaas usuuli and also pioneered the empirical methods by experimentation and observation in a systematic way as illustrated by the work on Ibn Hazm on optics. They criticize ancient Greek methodology as conjectural, hypothetical, despising perceptual knowledge, and based on deductive logic. They accept the European scientific method of formulating and testing hypothesis but reject its philosophical presumptions: materialism, pragmatism, atheism, rejection of wahy as a source of knowledge, lack of balance, rejection of the duality between matter and spirit, lack of human purpose, lacks of an integrating paradigm like tauhid, and being Euro-centric and not universal. European claims to being open-minded, methodological, accurate, precise, objective, and morally neutral have been observed not to hold in practice. In its arrogance it treats as absolute probabilistic and relativistic empirical knowledge based fallible human observation and interpretation.
3.5 TOWARDS AN ISLAMIC METHODOLOGY
A tauhidi universal, objective and unbiased methodology must replace the Euro-centric and philosophically biased context and not the practical experimental methods. The precepts of tauhidi science are: unity of knowledge, comprehensiveness; causality is the basis for human action, human knowledge is limited, investigation of causal relations is based on constant and fixed natural laws, harmony between the seen and the unseen, 3 sources of knowledge (wahy, aql & empirical observation); khilafat; moral accountability; creation and existence have a purpose, truth is both absolute and relative, human free will is the basis of accountability, and tawakkul.
4.0 TARBIYYAT ‘ILMIYYAT QUR’ANIYYAT
4.1 BASIC CONCEPTS
Basic concepts are the Qur’an, intellect, knowledge, fiqh, thinking, innovation and creativity. The Qur’an is not a textbook of science. It however contains many verses that train the mind to observe, analyze, think and act in a scientific manner. The Qur’anic stories have lessons, many scientific, for those who understand. Intellect is correlated with signs and with knowledge. Failure to use the intellect and blind following are condemned. Knowledge is supreme. It removes blind following. Human knowledge is limited. Knowledge is acquired by study. Humans were ordained to read. Knowledge by itself is not useful unless it is associated with work. The Qur’an has used the term fiqh to refer to understanding which is deeper than knowing. The Qur’an puts emphasis on thinking. Thinking is based on empirical observation. The Qur’an emphasizes freedom of thought in the form of freedom of belief. Innovations in religion are prohibited but creativity is encouraged.
4.2 DESCRIPTIVE KNOWLEDGE
The Qur’an described mountains, the barrier between two oceans, metal, the wind, plants, the sky, honey, and water. It described the motion of the earth, the boats, the sun, the moon, the water, and of the wind. It described processes such as making of iron, armor, dams, and boats. It described the creation of the human from dust. It describes the constant laws of nature, sunan al laah fi al kawn. The laws are fixed and stable and operate in various situations. Order is a law of nature. Recording of observations is emphasized.
4.3 ANALYTIC KNOWLEDGE
The Qur’an calls for evidence. It rejects false evidence and condemns non evidence-based knowledge such as sorcery, consulting fortune tellers, speculation or conjecture. Human thought is a tool and not an end in itself. It operates on the basis of empirical observations and revelation, both objective sources of information, Thought that is not based on an empirical basis or revelation is speculative and leads to wrong conclusions. The Qur’an calls for objectivity. It condemns following subjective feelings and turning away from the truth. Reliance is on observation and not speculation. The Qur’an calls upon humans to observe Allah’s signs in the universe and in humans. The Qur’an however made it clear that human senses have limitations. Rational thinking and logical operations were described. In many prohibitions the Qur’an provides logical reasons. The use of similitude, tashbiih, of two things and phenomena is seen several verses. The Qur’an also employed many examples, mithl, to illustrate concepts. Prudence in reaching conclusions is emphasized.
4.4 ETIQUETTE OF SCIENTIFIC DISCOURSE
Questions can be for finding out information. The opposing opinion should be respected. Differences on scientific matters can arise and are natural. Discussion and exchange of views is a necessity for humans. Discussion has its own etiquette. Truth must be revealed. Contradictions must be avoided. Arrogance is condemned. The following are attributes of good discussion: objectivity, truthfulness, asking for evidence, and knowledge. Purposeless disputation is frowned upon. False premises should be abandoned once discovered Fear of people should be no reason for not revealing the truth. Deception is condemned. The truth of any assertion must be checked. Yaqeen is the basis of ‘ilm but dhann is not.
5.0 ISLAMIZATION OF KNOWLEDGE: CONCEPT & PRACTICE
5.1 THE CONCEPT OF ISLAMIZATION:
Islamization is a process of recasting the corpus of human knowledge to conform to the basic tenets of ‘aqidat al tauhid. The process of Islamization does not call for re-invention of the wheel of knowledge but calls for reform, correction, and re-orientation. It is evolutionary and not revolutionary. It is corrective and reformative. It is the first step in the islamization and reform of the education system as a prelude to islamization and reform of society.
5.2 HISTORY OF ISLAMIZATION
The 2-3rd centuries H witnessed a failed effort at Islamization of knowledge. Greek scientific knowledge was transferred to Muslims together with Greek philosophy and ideas that caused confusions in ‘aqiidat. Greek science depended more on philosophical deduction than experimentally-based induction. It discouraged the scientific tarbiyat of the Qur’an which emphasized observation of nature as a basis for conclusions. The recent Islamisation movement towards the close of the 14th century H aimed at de-europeanizing education systems and building an education system based on tauhid.
5.3 REFORM OF DISCIPLINES:
Islamization has to start with reforming the epistemology, methodology, and corpus of knowledge of each discipline. It must be pro-active, academic, methodological, objective, and practical. Its vision is objective, universal, and beneficial knowledge in the context of a harmonious interaction of humans with their physical, social, and spiritual environment. Its practical mission is transformation of the paradigms, methodologies, and uses of disciplines of knowledge to conform to tauhid. Its immediate goals are: (a) de-Europeanizing paradigms of existing disciplines to change them from parochiality to universal objectivity, (b) reconstruction of the paradigms using Islamic universal guidelines, (c) re-classifying disciplines to reflect universal tauhidi values, (d) reforming research methodology to become objective, purposeful, and comprehensive (e) growth of knowledge by research, and (f) inculcating morally correct application of knowledge. The Qur’an gives general principles that establish objectivity and protect against biased research methodology. It creates a world-view that encourages research to extend the frontiers of knowledge and its use for the benefit of the whole universe. Scientists are encouraged to work within these Qur’anic parameters to expand the frontiers of knowledge through research, basic and applied.
5.4 MISUNDERSTANDING THE REFORM PROCESS
Islamization has been misunderstood as rejection of the corpus of existing human knowledge and disciplines. It has been misunderstood as creation of knowledge exclusive to Muslims. It has been misconstrued as rewriting existing text-books to reflect Islamic themes without deep thought about the paradigms and methodology. It has also been confined to spiritual reform of the student, scholar, or researcher. The following superficial approaches to civilization have been tried and failed: ‘Insertion’ of Qur’anic verses and hadiths in an otherwise European piece of writing, searching for scientific facts in the Qur’an, searching for Qur’anic proof of scientific facts, establishing Qur’anic scientific miracles, searching for parallels between Islamic and European concepts, using Islamic in place of European terminologies, and adding supplementary ideas to the European corpus of knowledge.
5.5 PRACTICAL STEPS / TASKS OF THE REFORM PROCESS:
The first step is a good grounding in Islamic methodological sciences of of usul al fiqh, ‘uluum al Qur’an, ulum al hadith, and 'uluum al llughat. This is followed by reading the Qur’an and sunnat with understanding of the changing time-space dimensions. This is followed by clarification of basic epistemological issues and relations: wahy and aql, ghaib and shahada, ‘ilm and iman. This is followed by an Islamic critique of basic paradigms, basic assumptions, and basic concepts of various disciplines using criteria of Islamic methodology and Islamic epistemology. Islamic reviews of existing text-books and teaching materials are then undertaken to identify deviations from the tauhidi episteme and the Islamic methodology. The initial output of the islamization process will be Islamic introductions to disciplines, muqaddimat al ‘uluum, establishing basic Islamic principles and paradigms that determine and regulate the methodology, content, and teaching of disciplines. This parallels Ibn Khaldun’s Introduction to History, muqaddimat presented generalizing and methodological concepts on historical events. Publication and testing of new text-books and other teaching materials is a necessary step towards reform by putting into the hands of teachers and students reformed material. Developing applied knowledge in science and technology from basic knowledge will be the last stage of the reform process. This is because in the end it is science and technology that actually lead to changes in society.
6.0 ISLAMIZATION OF MEDICAL SCIENCES
6.1 HISTORY OF MEDICINE, tarikh al tibb
Pre-Islamic roots of medicine are found in ancient Egyptian, Babylon, Chinese, Indian, Syriac, Persian, Arabian, and Greco-Roman civilizations. Medical knowledge in the early Islamic period (0 – 132 H) was based on traditional Arab medicine and medical teachings of the prophet. Medicine in the golden era of the Abassid period (132 – 656 H) started with translation of Greek and other medical texts. Muslims added the results of their observations and experimentation. Following the Tatar invasion and destruction of the capital of the khilafat in Baghdad, the Muslim world went into a period of decline. Medicine and medical knowledge also declined. Medical knowledge spread in Europe from Andalusia. Muslims made many contributions to basic sciences and the various clinical disciplines.
6.2 PROPHETIC MEDICINE, tibb nabawi
Tibb nabawi refers to words and actions of the Prophet with a bearing on disease, treatment of disease, and care of patients. The Prophet enunciated a basic principle in medicine that for every disease there is cure. The sources of tibb nabawi are revelation, empirical experience, and folk medicine of the Arabian Peninsula. Tibb nabawi can be spiritual, curative or preventive. Most of tibb nabawi is preventive medicine. Tibb nabawi is an authentic and valid medical system. The general principles of this system are applicable at all times and all places. The specific remedies taught by the Prophet (PBUH) are valid and useful. They however can not be used today without undertaking further empirical research because of changes in the human and physical environments.
6.3 ISLAMIC MEDICINE, mafhum al tibb al islami
Islamic Medicine is defined as medicine whose basic paradigms, concepts, values, and procedures conform to or to do not contradict the Qur’an and Sunnah. It is not specific medical procedures or therapeutic agents used in a particular place or a particular time. Islamic Medicine is universal, all-embracing, flexible, and allows for growth and development of various methods of investigating and treating diseases within the frame-work described above. This definition calls for basic transformation of current medical systems. Islamic Medicine thus becomes the result of an Islamic critique and reformulation of the basic paradigms, research methodology, teaching, and practice of medicine. This process is called Islamization of Medicine. The end-result of the Islamization process will not be a medical system for Muslims only but for the whole humanity because Islam is a set of universal and objective values.
6.4 ISLAMIZATION OF KNOWLEDGE IN MEDICINE, islamiyyat al tibb
Muslims failed to Islamize Greek medicine when they neglected the empirical scientific method of the Qur’an and adopted negative aspects of Greek philosophy that discouraged experimentation. Guided by empirical scientific spirit of the Qur’an, Muslims must be innovative, creative, and researchers in basic and applied medical sciences so that they may become leaders of the disciplines. A medical student starts by commitment to discipline reform process. He must master your discipline well. He should then get basics of Islamic methodology from usul al fiqh, ‘uluum al Qur’an and ‘uluum al hadith to be able to critique the basic paradigms of your discipline on the basis of tauhid and the universal and perennial values of Islam. This is followed by research, publishing, teaching, networking, and inspiring others.
6.5 THE ISLAMIC INPUT CURRICULUM
The vision of the curriculum has two closely related components: Islamization and legal medicine. Islamization deals with putting medicine in an Islamic context in terms of epistemology, values, and attitudes. Legal medicine deals with issues of application of the Law from a medical perspective. The curriculum has 5 objectives: (a) Introduction of Islamic paradigms and concepts in general and as they relate to medicine (b) strengthening iman through study of Allah’s sign in the human body (c) appreciating and understanding the juridical, fiqh, aspects of health and disease, al fiqh al tibbi (d) understanding the social issues in medical practice and research (e) professional etiquette, adab al tabiib.