Home 
Contact 
Profile 
Videos 
Presented at a workshop held in Mombasa, Kenya on Saturday, 29 February 2020. By Professor Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Bioethics Riyadh.
ISLAMIC ETHICS: GENERAL CHARACTERISTICS - 1:
} Morality and ethics
in Islam are absolute and of divine origin. Human consensus not deriving
from divine legislation cannot be a source of binding ethical guidelines. All
that humans do it to apply the legal and moral teachings of divine origin to
practical situations.
} The Law
automatically bans all immoral actions as haram and automatically
permits all that is moral as mubaah.
} Ethical guidelines
are both fixed and variable. The fixed moral and legal principles are broad
enough to encompass the needs of all times and places. The detailed
applications are variable and change with the growth of science and technology.
ISLAMIC
ETHICS: GENERAL CHARACTERISTICS - 2:
} The fixed principles
set the parameters beyond which it is absolutely immoral to operate. Within
these parameters, consensus can be reached on specific moral issues.
} Ethics cannot be
divorced from morality. Ethics can also not be divorced from Law. Islamic Law
is a compendium of ethics, morality, and legal rules.
} The purposes of
the Law, maqasid al shari’at, the principles of the Law, qawa’id al
fiqh, and the regulations of the Law, dhawaabit al fiqh, are
therefore the basis of ethics.
PURPOSES
of the LAW: Maqasid al shari’at:
} The first purpose
is protection of ddiin, hifdh al ddiin.
} The second purpose
is the protection of life, hifdh al nafs.
} The third purpose
is the protection of progeny, hifdh al nasl.
} The fourth purpose
is the protection of the mind, hifdh al ‘aql.
} The fifth purpose
is the protection of wealth, hifdh al maal.
PRINCIPLES
of MEDICINE: Qawai’d al shari’at:
} The first
principle is the principle of intention, qa’idat al qasd.
} The second
principle is the principle of certainty, qaidat al yaqeen.
} The third
principle is the principle of injury, qa’idat al dharar.
} The fourth
principle is the principle of hardship, q'aidat al mashaqqat.
} The fifth
principle is the principle of custom, qaidat alk urf / aadat.
The PRINCIPLE of INJURY, QAIDAT AL DHARAR in MEDICAL APPLICATIONS - 1:
} Medical
intervention is justified on the basic principle that injury if it occurs,
should be relieved, al dharar yuzaal.
} The physician
should however cause no harm in the course of his work according to the
principle of la dharara wa la dhirar.
} Injury should be
prevented or mitigated as much as is possible, al dharar yudfau bi qadr al
imkaan.
} When an injury is
found in a patient it is presumed to be of recent origin unless there is
evidence to the contrary, al dharar la yakuun qadiiman, and therefore
must be alleviated.
The
PRINCIPLE of INJURY, QAIDAT AL DHARAR in MEDICAL APPLICATIONS - 2:
} An injury should
not be relieved by a medical procedure that leads to an injury of the same
magnitude as a side effect, al dharar la yuzaal bi mithlihi.
} In a situation in
which the proposed medical intervention has side effects, we follow the
principle that prevention of a harm has priority over pursuit of a benefit of
equal worth, dariu an mafasid awla min jalbi al masaalih. If the benefit
has far more importance and worth than the harm, then the pursuit of the
benefit has priority.
The
PRINCIPLE of INJURY, QAIDAT AL DHARAR in MEDICAL APPLICATIONS - 3:
} Physicians
sometimes are confronted with medical interventions that are double-edged; they
have both prohibited and permitted effects. The guidance of the Law is that the
prohibited has priority of recognition over the permitted if the two occur
together and a choice has to be made, idha ijtama'a al halaal wa al haram
ghalaba al haraam al halaaal.
} If confronted with
2 medical situations both of which are harmful and there is no way but to
choose one of them, the lesser harm is committed, ikhtiyaar ahwan al
sharrain. A lesser harm is committed to preventing a bigger harm, al
dharar al ashadd yuzaalu bi al dharar al akhaff.
The
PRINCIPLE of INJURY, QAIDAT AL DHARAR in MEDICAL APPLICATIONS - 4:
} Medical
interventions that are in the public interest have priority over consideration of
individual interest, al maslahat al aamat muqaddamat ala al maslahat al
khaassat.
} The individual may
have to sustain harm in order to protect the public interest, yatahammalu al
dharar al khaas li dafu’i al dharar al aam.
} In the course of
combating communicable diseases, the state may have to restrict movements of a
citizen or even destroy his property.
} The state cannot
infringe on the rights of the public unless there is a public benefit to be
achieved, al tasarruf ala al ra'iyat manuutu bi al maslahat.
} Many situations,
the line between benefit and injury is so fine that salat al istikharat
is needed to reach a solution since no empirical methods can be used.
CASE
STUDIES OF THE PRINCIPLE OF INJURY IN MEDICAL APPLICATIONS:
} Case 1: Immediate surgery
in a case of spinal injury with a 10% chance of success and a 90% chance of
permanent paraplegia. If surgery is not carried out paraplegia will occur after
6 months.
} Case 2: Writing a
DO-NOT-RESISCITATE (DNR) order for a conscious patient with no hope of
recovery.
} Case 3: Abortion of a
fetus with a congenital abnormality incompatible with life
CASE
STUDIES OF THE PRINCIPLE OF INJURY IN SOCIAL INTERVENTIONS:
} Case 1: Family Formation and
higher professional education.
} Case 2: Premarital
screening for disease.
} Case 3: Marrying within vs
marrying outside the family circle.
} Case 4: Denying TV and
mobile from teenagers.
} Case 5: ostracizing or
otherwise punishing addicts.