Presented via online at the Postgraduate Program organized by Prime Institute of Public Health (PIPH) held in Peshawar, Pakistan on 02 February 2016 by Professor Omar Hasan Kasule Sr.
Introduction:
- This paper presents a system of ethical theories and ethical
principles developed and used in West Asia, South East Asia and other
parts of the Muslim world over the past 17 years.
- A basic premise of this framework is that ethics is embraced fully
within the ambit of the Law since Islamic law contains both positive law
and moral law.
- Under Islamic law the legal and the moral are perfectly
equivalent; every moral is legal and vice versa and every immoral is
illegal and vice versa.
Methods:
- The study aimed at discovering ethical theories and ethical
principles in Islamic Law to compare with generally accepted theories and
principles.
- Results first presented at the Scientific Conference of the
Jordanian Islamic Medical Association in Amman in 2004 and have been
presented at many conferences in other countries.
- Two sources of Islamic Law were used: (a) The purposes of the Law
(maqasid al shari’at) developed starting in the 5th
Islamic century as the basis for an Islamic ethical theory and (b)
Principles of the Law (qawa’id al fiqh), as the basis for ethical
principles.
Purposes of the Law (maqasid al shari’at) 1: early beginnings
- The Law has 5 governing higher purposes that are its legal theory;
they govern all details and branches of the Law.
- Development of this legal theory can be traced to the 5th
Islamic century and the pioneers were Shaikh al Haramain al Juwayni and
his student Hujjat al Islam Abu Hamid AlGhazzali. Contributions were made
2 centuries later by Shaikh al Islam Ibn Taymiyah and his student Abu
Qayyim al Jawziyat.
Purposes of the Law (maqasid al shari’at) 2: later development
- The theory was formulated systematically in the form it is used
today by the Spanish Andalusian scholar of the Maliki School of Law, Abu
Ishaq AlShatibi in his 8th century legal manual Almuwafaqaat
fi usuul al shari’at.
- The theory was not used a lot in the past 7 centuries because the
legal dilemmas that arose were simple and could be resolved by existing
legal texts and precedents.
- Modern medical technology has given rise to many legal and ethical
dilemmas that can be resolved only by reference directly to the legal
theory.
The 5 Purposes of the Law = ethical theory
- For an act to be considered ethical, it must conform to or not
violate one of the 5 major purposes of the Law.
- The advantage is that one internally consistent legal or ethical
theory is applied to various situations.
- The 5 purposes aim at protecting (hifdh), preserving (ibqaa),
and promoting (tatwiir) of 5 entities that among them cover all
aspects of human endeavor and medical treatment.
- Morality/religion, hifdh al ddiin;
- Life and health, hifdh al nafs;
- Progeny, hifdh al nafs;
- Intellect, hifdh al ‘aq
- Resources, hifdh al maal.
- The principles were developed by legal scholars from basic sources
of the Law by inductive reasoning. They provide quick tools for reasoning
out complex cases.
- They were formulated in a systematic way in the 19th
Gregorian century in the Turkish Ottoman Legal gazette called Majallat
al Ahkaam Aladliyyat.
- These principles were detailed for commercial transactions; the
challenge today it to develop them in detail for medical application.
- The principles help in resolving ethical dilemmas in which the
purposes may be apparently contradictory such as prolongation of life in
the intensive care unit (protection of health) that is prohibitively
expensive ((protection of resources).
- They also provide more detailed and specific guidelines on matters
covered in general by the Purposes.
- Each of these principles has many sub-principles that cover the
whole spectrum of ethical dilemmas.
The 5 Principles of the Law = Islamic ethical principles 1
- Under the principle of certainty of intention (qa’idat al qasd)
actions are judged by their inner intentions and motivations and not by
their external manifestations.
- Under the principle of certainty (qa’idat al yaqeen)
decisions must be evidence-based.
- Under the principle of injury (qa’idat al dharar) the
benefits (maslahat) of an action must out-weight its harm (mafsadat)
and if the two are of equal worth the action is not taken.
The 5 Principles of the Law = Islamic ethical principles 2
- Under the principle of hardship (qa’idat al mashaqqat)
legal prohibitions are temporarily set aside in order to undertake actions
that will preserve life.
- Under the principle of custom (qa’idat al ‘aadat) existing
consensus guidelines a standard operating principles should be followed
because they have the force of Law.
The 4 ethical principles vs the Islamic ethical principles
- The 4 principles of Beaumont and Childress are subsumed under one
Islamic principle of preventing injury (qa’idat al dharar).
- AUTONOMY: The patient has
the right of autonomy because she/he has his best interests at heart and
cannot willfully and knowingly take a harmful decision.
- BENEFICENCE / NONMALEFACENCE: Robust rules for balance of injury and benefit in cases of
ethical dilemmas.
- JUSTICE: Assurance of
justice prevents harm due to injustice.
- Islamic Law has formulations comparable to international
formulations that adequately cover the needs of ethical theory and
principles in ethical analysis.
- Ethical analysis in Muslim countries / communities will be easier
and more acceptable if approached from Islamic Law.