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Presentation at the Spiritual
Support Conference held at the King Fahad Medical City Riyadh 1-3 January 2013
by Prof Omar Hasan Kasule Sr MB ChB (MUK), MPH (Harvard), DrPH (Harvard)
Department of bioethics Faculty of Medicine King Fahad Medical City, Riyadh
Saudi Arabia.
Life from the tauhidi-based holistic
integrative Islamic paradigm, shumuliyat al Islam, is a complex
phenomenon with biological, chemical, and spiritual components. The relations
among the components 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. They 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), is a
positive and holistic state of well-being and not mere absence of disease or
illness. It 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.
The soul, 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 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.
Spiritually patients should be supported to reach calmness
devoid of fear anxiety by accepting death as a transitional event from inferior
life temporary 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.
Psychologically, the patient
should be supported to ascend from the evil-inclined soul, nafs al ammarat,
through the self-conscious soul, nafs lawaamat, to the high levels of
the calm soul, nafs mutmainnat. At this level the patient bravely faces
the suffering and pain of illness.
Cognitively the patient should be supported to appreciate
illness as just one minor phenomenon in the wide and expanding spatio-temporal
dimension of the universe and 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.
Emotionally the patient’s self-worth, self-esteem, and
self-confidence to face the challenges of illness should be enhanced based on
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.
Socially 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.