231103P - SHARIAH COMPLIANT HOSPITAL: VALUE ADDITION TO HEALTHCARE

Presented at a special workshop with top management, consultants, specialists, heads of department, and coordinators of units at Kuantan by Prof Omar Hasan K Kasule MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Chairman of the Research and Medical Ethics committees at the King Abdullah ibn Abdulaziz University Hospital, Riyadh Saudi Arabia.

 

1.0 INTRODUCTION

1.1 Concept of Shari’at Compliance

• The term shari’at relating to hospitals should be used in its original wider sense of a general guide and way for all Muslim activities and not the limited sense today that confines it to ‘ibadat and some mu’amalaat.
• Shari’at is a wide path - المائدة ٤٨ لِكُلٍّ جَعَلْنَا مِنكُمْ شِرْعَةً وَمِنْهَاجًا ۚ. The term shari’at started as both ‘aqidah and fiqh. Then ‘aqidah was separated. Then muamalat (politics, economy, business, health care) were separated leaving ‘ibadaat, ‘aadaat, munakahaat and mawariith. Munakahaat and mawariith have been separated in several countries leaving ibaadaat and aadaat.
• The term Shar'iah compliance is a return to the original holistic understanding that conforms to the Islamic worldview. This is a reform and in a way a revolution in understanding and practice. What distinguishes a Muslim hospital is not the architecture or the types of medical procedures but the Islamic paradigms, values, ethics, and culture of the health professionals, other workers, and patients. 
• Shariah compliance is not starting a new medical science or practice. All existing and useful knowledge and technology used in the hospital can be used but within the Islamic moral, ethical, and legal context, a process called Islamization. 

 

1.2 The Basic Guiding Paradigms to be Considered in the Planning of the Hospital

• Integration (deriving from tauhid): spirit (nafs) and body (jasad). ‘Ilm naqli and ‘ilm ‘aqli. Duniya and akhirat. Shahadat and ghaib.
• Cure has one source from Allah, it is both spiritual and physical. وَإِذَا مَرِضْتُ فَهُوَ يَشْفِيْنِ.الشعراء ٨٠
• Balance (tawazun), equilibrium (e’itidaal), and feedback (tadafu’u)
• Quality work (ihsan and itqan)
• Justice (‘adl): social class, race, religion, gender.

 

1.3 The Hospital Should fulfill the 5 Main Purposes of the Shari’at (Maqasid Al Shari’at)

• Preservation, protection, and promotion of diin  حفظ الدين.
• life حفظ النفس.
• Progenyحفظ النفس .
• Human intellectحفظ العقل .
• Resourcesحفظ المال . 

 

1.4 Recognition and Certification

• The concept of Shar'iah-compliant hospital started with the ibadat-friendly hospital,
• The concept of shari’ah-compliant hospitals was promoted further by official recognition when shari’ah standard operating procedures and standards were recognized in Malaysia (SIRIM) and Indonesia.
• This recognition further stimulated public demand for ibadah-friendly hospitals with the Malaysian Ministry of Health taking the lead in responding to this demand and making its hospitals ibadah-friendly.
• The shari’at-compliant hospitals have asserted themselves further by forming coalitions and associations that represent their interests.
• Hospitals are expanding the concept of Shar'iah compliance beyond being ibadah friendly.

 

1.5 Process of compliance: Revolution vs evolution

• واللَّهِ لَيَتِمَّنَّ هذا الأمْرُ، حتَّى يَسِيرَ الرَّاكِبُ مِن صَنْعاءَ إلى حَضْرَمَوْتَ، لا يَخافُ إلَّا اللَّهَ، والذِّئْبَ علَى غَنَمِهِ، ولَكِنَّكُمْ تَسْتَعْجِلُونَ. صحيح البخاري.

• Implementation of a Shari’at-compliant hospital will fail if initiated in a revolutionary way. 
• The process should be evolutionary starting with what exists, making changes as we go along, and learning from experiences both positive and negative.  
• We keep the mind open to new ideas even apparently strange or wrong ones thinks about them before discarding them.
• We started with the ‘ibadat friendly hospital and succeeded. Now we are poised to move towards management, financing, etc.…
• The most strategic move in the whole process is the Islamic training of the professionals and workers in the hospital to reflect the basic Islamic culture.
• The most important outcome is a work culture that reflects Islamic values.

 

2.0 BRANDING / TRADEMARK

2.1 What is a brand?

• Branding before was on animals to distinguish the cattle of one farmer from those of another one.
• Brands became logos and monetary value was attached to the brands.
• The brand increases the value of the hospital because of the perception.
• Brand equity and selling goodwill.
• Brand names and trademarks are important. Brand awareness and brand recognition are important for commercial ads that promote the brands.

 

2.2 Famous hospital brands

 

2.3 Brand of a Shari’at-compliant hospital

• The Shari'ah-compliant hospital must have its own brand that distinguishes it from others easily in the marketplace. We are not generic but are a brand. We must be very clear about how we are distinguished from others. Patients and others must be aware of our brand even unconsciously.
• We must work hard to define and actualize our brand within Malaysia and without. Brand recognition must be based on actual achievements and not propaganda or false claims.
• Our brand is the impression that our patients and families take away and tell others. Our hospital, our staff, and our satisfied patients are our best advertisement.
• A brand motivates hospital staff. They want to be associated with success.

 

3.0 BENCHMARKING

3.1 Overview

• We follow generally accepted benchmarking criteria such as health outcomes, financial indicators, overall productivity, quality of care, and management.
• We have additional benchmarks that add value to healthcare in the form of a holistic approach that takes care of the patient’s spiritual, physical, and fiqhi needs at a cost comparable to or below top performers in the industry.
• The cost savings vs quality can be offset by the higher productivity of Islamically-motivated healthcare providers.
• Select processes to benchmark, collect data, statistical analysis.
• Types of benchmarking: outcome benchmarking, productivity benchmarking, and patient satisfaction.

 

3.2 Catching up and rising higher

• The basis for benchmarking is itqaan and attempting to reach the highest frontier gradually up and never down.

• منِ استَوى يوماهُ فَهوَ مَغبونٌ ، ومن كانَ آخرُ يوميهِ شرًّا فَهوَ مَلعونٌ ، ومَن لم يَكُن في الزِّيادةِ فَهوَ في النُّقصانِ ، ومن كانَ في النُّقصانِ فالموتُ خيرٌ لَهُ ، ومَنِ اشتاقَ إلى الجنَّةِ سارعَ في الخَيراتِ. الراوي: علي بن ابي طالب. المحدث: السخاوي. المصدر: المقاصد الحسنة.
• من استوى يوماه فهو مغبونٌ ومن كان آخرُ يومِه شرًّا فهو ملعونٌ ومن لم يكن على الزيادةِ فهو في النقصانِ فالموتُ خيرٌ له ومن اشتاق إلى الجنةِ سارع إلى الخيراتِ ومن أشفق من النارِ لهيَ عن الشهواتِ ومن ترقَّبَ الموتَ هان عليه اللذاتُ ومن زهد في الدنيا هانت عليه المصيبات. الراي: لي بن ابي طالب. المحدث: الزركشي. المصدر: اللالي المنثور. 

 

3.3 Benchmarks

• Process variables: hospital stay as bed days, costs for diagnostic categories, bed ulcers.
• Productivity variables: number of outpatient visits, average waiting time, etc.
• Outcome variables: re-admission for the same condition, morbidity, mortality, patient satisfaction, and staff retention.
• Source of benchmark data: aim very high use international standards but do not self-blame. The standards are a challenge and not an indicator of failure.
• Who is the industry leader to benchmark against? We have few peers. Compare performance with local competitors but they are different from us.
• Joint audit unit for Islamic hospitals.

 

3.4 Methodology

• Consistent passive data collection- do not overstress staff.
• Data must be complete and accurate.
• Statistical summary of the data to derive statistics that compare with the benchmarks: means for continuous data and proportions for discrete data.
• Gap analysis.

 

3.5 Identifying an Industry leader-not easy

• Who is the industry leader to benchmark against? We have few peers.
• The best would be an Islamic hospital but there are few.
• For-profit hospitals.
• Not-for-profit hospitals.
• The best is to look for a leader for specific benchmarks.

 

4.0 MANAGING THE HUMAN RESOURCES BY TARBIYAH

4.1 Overview

• The main factor that will distinguish us from others is the way we select, train, and manage our human resources.
• Happy, well-trained, satisfied staff are our best asset.
• The prophetic guidance in dealing with our staff. We train them to be great men and women.
• Our staff are our brothers and sisters.
• The prophet is our model of leadership.
• We shall use only 2 models: Anas bin Malik and Usamah bin Zayd. The prophet trained and prepared them for great achievements.

 

4.2 Anas bin Malik: preparation

• Anas was from the Khazraj tribe of Madina given his mother to serve the prophet he was 10 years.
• The prophet prayed for him اللهم أكثر ماله وولده وأطل عمره واغفرذنبه  
• The prophet treated Anas as his son.  Anas took the Prophet as his qudwah and murabbi.
• He never punished or blamed him. He never told him why did you do this and why didn’t you do this?

• ما قال لشيء صنعته لم صنعته ولا لشيء تركته لم تركته.
• فما ضربني ضربة، ولا سبني سبة، ولا انتهرني، ولا عبس في وجهي، فكان أول ما أوصاني به أن قال: (يا بني اكتم سري تك مؤمنا) فكانت أمي وأزواج النبي يسألونني عن سر رسول الله فلا أخبرهم به، وما أنا مخبر بسرِّ رسول الله - صلى الله عليه وسلم - أحداً أبدا.
• فقد أرسلني يوما لحاجة فخرجت، وقصدت صبيانا كانوا يلعبون في السوق لألعب معهم، ولم أذهب إلى ما أمرني به، فلما صرت إليهم شعرت بإنسان يقف خلفي، ويأخذ بثوبي، فالتفت فإذا رسول الله صلى الله عليه وسلم يبتسم ويقول: “يا أنيس، أذهبت إلى حيث أمرتك؟”، فارتبكت وقلت: نعم، إني ذاهب الآن يا رسول الله

• The Prophet used to joke with Anas’s brother: يا أبا عمير ما فعل النغير؟
• Practical experience: While young he participated in the campaigns of Hudaybiyyah, Khaybar, umrat al qadha, conquest of Makka, Hunain, Taif, and Hajj al widae. He participated in the riddat wars and was a famous arrow man. He accompanied the prophet on his journeys.

 

4.3 Anas became a great leader because of the prophet’s tarbiyah

• Abubakar after consulting Omar Ibn Khattab appointed him to collect zakat in Bahrain. He participated in the wars of conquest in Iraq and Persia, after which he settled down in Basra to teach hadith.
• He resisted Hajjaj bin Yusuf who wanted to despise him.
• Allah gave him a long life being the last companion to die.
• He taught 285 Sahabi and followers. He narrated 2200 hadith. Some hadiths were told only to Anas.
• Allah responded to his dua

• وعن أنس بن مالك رضي الله عنه قال: خرجت وأنا أريد المسجد فإذا بزيد بن مالك رضي الله عنه، فوضع يده على منكبي يتكئ علي، فذهبت وأنا شاب أخطو خطا الشباب، فقال لي زيد: قارب الخطا، فإن رسول الله صلى الله عليه وسلم قال: “من مشى إلى المسجد كان له بكل خطوة عشر حسنات”
• . وقال الزهري: دخلت على أنس بن مالك رضي الله عنه بدمشق وهو يبكي، فقلت: ما يبكيك؟ فقال: لا أعرف شيئا مما أدركت إلا هذه الصلاة، وهذه الصلاة قد ضيعت،
•  قال أبو هريرة: “ما رأيت أحدًا أشبه بصلاة رسول الله ﷺ من ابن أم سليم”، وقال أنس بن سيرين: “كان أنس بن مالك أحسن الناس صلاة في الحضر والسفر”، وقال حفيده ثمامة بن عبد الله: “كان أنس يصلي حتى تفطر قدماه دمًا، مما يطيل القيام”.

4.4 Usamah Bin Zayd: preparation of love with firmness

• Background: Usamah was born in Islam and never knew jahiliyyah.
• The prophet considered him a son until the Qur'an abolished adoption. اشهدكم ان زيدا هذا ابني يرثني ارثه

• وقد أدخل مولد أسامة السرور على قلب رسول الله -صلى الله عليه وسلم-، وكان يحبه حبًّا عظيمًا؛ لذلك لقبه الصحابة بـ"الحب ابن الحب"
• ولم يكن النبي -صلى الله عليه وسلم- يفرق بين حبه لحفيده الحسن وحبه لأسامة؛ إذ كانا متقاربين في السن، وكان عليه الصلاة والسلام يأخذ الحسن، ويضعه على أحد فخذيه، ويضع أسامة على فخذه الأخرى، ويضمهما معًا على صدره قائلاً: "اللهم إني أحبهما فأحبهما".

• Firmness on principles: Usamah was so close to the prophet that he was asked to intercede for a Makhzumi woman who had stolen the prophet told him أتشفع في حد من حدود الله يا أسامة؟».
• Firmness on principles: The prophet is a great teacher whose lessons persist. Usamah killed a non-believer who shouted ‘la ilaah illa Allah’ to save his life. When the fitnah started, he remembered the lesson and never participated although he loved Ali.

 

4.5 Practical experiences

• He wanted to go to Uhud, but the prophet returned him because he was too young. When he was older he participated in the War of the Ditch. Participated in the battle of Muutah under the command of his father Zayd. He stayed with the prophet when others ran away in defeat.

• واشتُهر أسامة بن زيد بالشجاعة والقوة والجهاد في سبيل الله منذ صغره؛ ففي العاشرة من عمره علم بأن النبي يجهز للغزو؛ فأصر على أن يكون له دور؛ فذهب يعرض نفسه على النبي إلا أن الرسول رده لصغر سنه؛ فعاد باكيًا، وعاود الكرَّة مرة ثانية وثالثة، فطلب منه النبي أن يطبب الجرحى من المقاتلين؛ ففرح فرحًا شديدًا.

• Usamah at the battle of the ditch 

• وفي يوم الخندق كان أسامة في الخامسة عشرة من عمره؛ فجاء إلى رسول الله، وجعل يشد قامته ليجيزه للجهاد في سبيل الله؛فرقَّ له النبي وأجازه.

• Usamah at the battle of Hunain

• وفي يوم حنين حينما انهزم المسلمون في البداية ثبت أسامة مدافعًا عن رسول الله -صلى الله عليه وسلم- مع نفر من الصحابة، واستطاع النبي بهذه الفئة الصغيرة الباسلة أن يغيّر هزيمة أصحابه إلى نصر، وأن يحمي المسلمين الفارين من أن يفتك بهم المشركون.

• Usamah at the battle of Mutah

• وقبل أن يبلغ الثامنة عشرة من عمره شارك أسامة في معركة مؤتة تحت إمرة أبيه زيد بن حارثة، وحين استُشهد أبوه ظل يقاتل تحت لواء جعفر بن أبي طالب، ثم تحت لواء عبدالله بن رواحة، ثم تحت لواء خالد بن الوليد، ثم عاد أسامة إلى المدينة محتسبًا أباه عند الله، راكبًا جواده الذي استُشهد عليه.

 

4.6 Usamah bin Zayd: Support of self-confidence and self-esteem

• Usamah was riding behind the prophet on the entry into Makka at the conquest.
• Abubakar asked Usamah for permission for Omar to stay back.
• Prophet’s garment on Usamah.

• ولبس النبي بردته اليمنية الثمينة مرة واحدة، ثم خلعها على أسامة، فكان أسامة يروح بها ويغدو بين أقرانه من أطفال الأنصار والمهاجرين.

• Abubakr’s respect for Usamah

• خرج أبو بكر حتى أتى الجيش وأشخصهم وشيعهم وهو ماش وأسامة راكب وعبد الرحمن بن عوف يقود دابة أبي بكر فقال له أسامة: يا خليفة رسول الله، والله لتركبن أو لأنزلن. فقال «والله لا تنزل ووالله لا أركب وما عليَّ أن أغبر قدمي في سبيل الله ساعة. فإن للغازي بكل خطوة يخطوها سبعمائة حسنة تكتب له وسبعمائة درجة ترفع له وترفع عنه سبعمائة خطيئة» حتى إذا انتهى قال إن رأيت أن تعينني بعمر فافعل، ومعنى ومعنى ذلك أنه يستأذن أسامة - قائد الجيش - أن يترك له عمر لأنه كان في الجيش فأذن له 3 وكان إرسال الجيش بعد بيعة أبي بكر بيوم أعني يوم الأربعاء 14 من ربيع الأول.

• Omar Ibn Al Khattab loved and respected Usamah bin Zayd".

• ويُروى أن عمر بن الخطاب في خلافته فرض لأسامة عطاء أكثر من عطاء ابنه عبدالله بن عمر، فقال عبدالله لأبيه: "يا أبتِ، فرضت لأسامة أربعة آلاف وفرضت لي ثلاثة آلاف، وما كان لأبيه من الفضل أكثر مما كان لك، وليس له من الفضل أكثر مما هو لي!"
• فقال له عمر: "إن أباه كان أحب إلى النبي من أبيك، وكان هو أحب إلى رسول الله منك."
• وكان عمر إذا لقي أسامة قال له: "مرحبًا بأميري"..

4.7 Achievements

• Prophet defended his appointment of Usamah as commander.

• كان في تلك السرية وقت تجهيزها كبار المهاجرين الأولين والأنصار، ومنهم أبو بكر الصديق، وعمر بن الخطاب، وأبو عبيدة بن الجراح، وسعد بن أبي وقاص، وسعيد بن زيد، فتكلم الناس في إمرة أسامة: وقالوا: يستعمل هذا الغلام على المهاجرين الأولين!
• غضب رسول الله صلى الله عليه وسلم وخرج وقد عصب على رأسه عصابة وعليه قطيفة، فصعد المنبر فحمد الله وأثنى عليه ثم قال: أما بعد، أيها الناس: فما مقالة بلغتني عن بعضكم في تأميري أسامة، ولئن طعنتم في إمارتي أسامة، لقد طعنتم في إمارتي أباه من قبله! و«أيم الله إن كان للإمارة لخليقًا، وإن ابنه من بعده لخليق للإمارة، وإن كان لمن أحب الناس إليَّ، وإنَّ هذا (أي أسامة) لمن أحَبِّ الناسِ إليَّ بعدَه » [رواه البخاري: 4469]

• Usamah and narration of hadith

• وروى أسامة عن النبي ﷺ 128 حديثًا، أخرج الشيخان منها 18 حديثًا، واتفق الشيخان على 15 حديثًا، وانفرد البخاري بثلاثة أحاديث؛ فكان مجموع ما له من الأحاديث في الصحيحين 18 حديثًا.
• ر وروى عنه ابن عباس وجماعة من كبار التابعين.

231028P - WORLDWIDE ABSENCE OF ISLAMIC VALUES AND ETHICS IN HEALTH PRACTICE: FACTS AND IMPACTS

Presentation at an Online Symposium held on October 28, 2023 by Professor Omar Hasan Kasule Sr MB ChB (MUK). MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Bioethics

 

1.0 DEFINITION OF VALUES AND ETHICS

• Ethics: a branch of philosophy that studies what is right and wrong.
• Akhlaqiyyat is not an Arabic translation for ethics; the difference between ethics and law.
• Western perspective ethics is not always legal and vice versa.
• Islamic perspective ethics = Law. Haram = unethical and halal is ethical.

 

2.0 ISLAMIC VALUES

• Islamic values (القيم الاخلاقية) are universal human values that shape the human personality and behavior and apply to every place and time. They are not exclusive to Muslims others may share some of them with Muslims.
• Values reflect the basic fitra of the human and are consonant with the mission of the human on earth which is ibadat in its widest sense manifested at the societal level by the three concepts of: istikhlaf (استخلاف), taskhiir (تسخير), and isti’maar (استعمار). The three are closely related to respect for life.
• Values are understandable from appreciating the duality of the human as nafs and jasad as well as the balance between the two in varying circumstances

 

3.0 SOURCES OF VALUES

• The Qur’an and sunnat are the primary source of all values.
• Some secondary values can be derived from the primary sources by human reasoning.  There is harmony between the 2 sources: تكامل القل والنقل
• The prophet’s life was a practical manifestation of the Islamic values.
•  لَّقَدْ كَانَ لَكُمْ فِي رَسُولِ اللَّهِ أُسْوَةٌ حَسَنَةٌ لِّمَن كَانَ يَرْجُو اللَّهَ وَالْيَوْمَ الْآخِرَ وَذَكَرَ اللَّهَ كَثِيرًا . الأحزاب ٢١
• The shari’at comprises all values.  It is positive law + morality/ethics.
•  لِكُلٍّ جَعَلْنَا مِنكُمْ شِرْعَةً وَمِنْهَاجًا. المائدة ٤٨
• Maqasid al shari’at. Values are practical and not only philosophical constructs.
• Values depend on the worldview: Quranic worldview is holistic = nafs + jasad). A secular worldview is material jasad only.

 

4.0 FOCUS ON RESPECT FOR LIFE

• Khilafa has to do with life. First failure of the human was when he killed. The angels knew the human nature fisq and fasaad
• وَإِذْ قَالَ رَبُّكَ لِلْمَلَائِكَةِ إِنِّي جَاعِلٌ فِي الْأَرْضِ خَلِيفَةً ۖ قَالُوا أَتَجْعَلُ فِيهَا مَن يُفْسِدُ فِيهَا وَيَسْفِكُ الدِّمَاءَ وَنَحْنُ نُسَبِّحُ بِحَمْدِكَ وَنُقَدِّسُ لَكَ ۖ قَالَ إِنِّي أَعْلَمُ مَا لَا تَعْلَمُونَ . البقرة ٣٠
• For lack of time and expertise focus on only the value of respecting human life. It is the main one: مِنْ أَجْلِ ذَٰلِكَ كَتَبْنَا عَلَىٰ بَنِي إِسْرَائِيلَ أَنَّهُ مَن قَتَلَ نَفْسًا بِغَيْرِ نَفْسٍ أَوْ فَسَادٍ فِي الْأَرْضِ فَكَأَنَّمَا قَتَلَ النَّاسَ جَمِيعًا وَمَنْ أَحْيَاهَا فَكَأَنَّمَا أَحْيَا النَّاسَ جَمِيعًا ۚ وَلَقَدْ جَاءَتْهُمْ رُسُلُنَا بِالْبَيِّنَاتِ ثُمَّ إِنَّ كَثِيرًا مِّنْهُم بَعْدَ ذَٰلِكَ فِي الْأَرْضِ لَمُسْرِفُونَ. المائدة ٣٢.

 

5.0 SOURCE OF SECULAR ETHICS: EUROPEAN ETHICAL THEORIES

• Utilitarian consequence-based theory (balance of good and bad, relative, no absolute right and wrong). JEREMY BENTHAM 1747-1832 & JOHN STUART MILL 1806-1873
• Obligation-based theory (moral obligations, absolute right and wrong). IMMANUEL KANT 1724-1804
• Rights-based theory based on respect for human rights (individual rights).
• Community-based theory (community decides).
• Relation-based theory (family and physician-patient relations).
• Case-based theory (practical case-by-case decision)

 

6.0 UNESCO UNIVERSAL DECLARATION ON BIOETHICS AND HUMAN RIGHTS 2005

 

7.0 SOURCE OF ISLAMIC ETHICS: Maqasid from Qur’an and sunnat

• Protection of Morality, حفظ الدين
• Protection of Life, حفظ النفس
• Protection of Progeny, حفظ النسل
• Protection of the Mind, حفظ القل
• Protection of Wealth / resources, حفظ المال

 

8.0 AL MUAWAFAQAAT FI USUUL AL SHARIA’T

 

9.0 OATH OF A MUSLIM PHYSICIAN

 

10.0 MALAYSIAN MEDICAL GRADUATES TAKING THE OATH OF THE MUSLIM PHYSICIAN

 

11.0 BOOK OF MEDICAL JURISPRUDENCE

 

12.0 NAZI VIOLATIONS OF LIFE IN WWII

 

13.0 JAPANESE HUMAN EXPERIMENTS

 

14.0 THE TUSKEGEE SYPHILIS STUDY 1932 – 1972

 

15.0 THE BELMONT REPORT 1972

 

16.0 ABORTION: COMPARISON OF FETAL WASTAGE US vs NIGER in 2020

•  وَلَا تَقْتُلُوا أَوْلَادَكُمْ خَشْيَةَ إِمْلَاقٍ ۖ نَّحْنُ نَرْزُقُهُمْ وَإِيَّاكُمْ ۚ إِنَّ قَتْلَهُمْ كَانَ خِطْئًا كَبِيرًا . الاسراء ٣١

• The US induced abortion ratio was 198 abortions per 1,000 live births in 2020[1].
• The US-induced abortion rate was 11.2 abortions per 1,000 women aged 15–44 years,
• The US infant mortality ratio was 5.44 deaths per 1,000 live births in 2021[2],
• Niger-induced abortion ratio in 2020 0.4-6.7 per 1000 women[3]
• The infant mortality rate for Niger in 2020 was 43.495 deaths per 1000 live births[4]

 

17.0 SELECTIVE FEMALE ABORTION IN INDIA

• وَلَا تَقْتُلُوا أَوْلَادَكُمْ خَشْيَةَ إِمْلَاقٍ ۖ نَّحْنُ نَرْزُقُهُمْ وَإِيَّاكُمْ ۚ إِنَّ قَتْلَهُمْ كَانَ خِطْئًا كَبِيرًا. تكوير ٨-٩ 

 

18.0 FORCED STERILIZATION IN INDIA

• On 6 August 1976, the state of Maharashtra became the first governmental unit to enact legislation mandating compulsory sterilization of men and women after the birth of a third child

 

19.0 FORCED STERILIZATION IN BANGLADESH

• Bangladesh had a long-running government-operated civilian sterilization program as a part of its population control policy, which targets mainly poor women and men.
• The government offers money for women to undergo tubal ligation and men to undergo vasectomy

 

20.0 COMPULSORY STERILIZATION IN Xinjian, CHINA

Xinjiang

• Forced sterilization in Xinjiang
• Part of Uyghur genocide

 

21.0 EUTHANASIA and PHYSICIAN ASSISTED SUICIDE

Euthanasia: active vs passive.

• حَدَّثَنَا الحُمَيْدِيُّ عَبْدُ اللَّهِ بْنُ الزُّبَيْرِ، قَالَ: حَدَّثَنَا سُفْيَانُ، قَالَ: حَدَّثَنَا يَحْيَى بْنُ سَعِيدٍ الأَنْصَارِيُّ، قَالَ: أَخْبَرَنِي مُحَمَّدُ بْنُ إِبْرَاهِيمَ التَّيْمِيُّ، أَنَّهُ سَمِعَ عَلْقَمَةَ بْنَ وَقَّاصٍ اللَّيْثِيَّ، يَقُولُ: سَمِعْتُ عُمَرَ بْنَ الخَطَّابِ t عَلَى المِنْبَرِ قَالَ: سَمِعْتُ رَسُولَ اللَّهِ ﷺ يَقُولُ: إِنَّمَا الأَعْمَالُ بِالنِّيَّاتِ، وَإِنَّمَا لِكُلِّ امْرِئٍ مَا نَوَى، فَمَنْ كَانَتْ هِجْرَتُهُ إِلَى دُنْيَا يُصِيبُهَا، أَوْ إِلَى امْرَأَةٍ يَنْكِحُهَا، فَهِجْرَتُهُ إِلَى مَا هَاجَرَ إِلَيْهِ

الأمور بمقاصدها

• Physician-assisted suicide is legal in some countries
• Austria, Belgium, Canada, Germany, Luxembourg,the Netherlands, New Zealand, Portugal, Spain, Switzerland, parts of the United States and Australia.

• وَهُوَ الَّذِي يُحْيِي وَيُمِيتُ وَلَهُ اخْتِلَافُ اللَّيْلِ وَالنَّهَارِ أَفَلَا تَعْقِلُونَ (80) (المؤمنون: 80(

 

22.0 UNETHICAL CLINICAL TRIALS IN AFRICA

• Uneducated research subjects ignorant of their rights
• Recruited into research without proper consent
• Exposed to risks that cannot be accepted in Europe and America
• Pfizer meningitis trial in Nigeria 1996 meningitis epidemic
• the company tested its antibiotic trovafloxacin (Trovan) against ceftriaxone. Families were not informed that Trovan was an experimental drug. Randomization was not proper. Parents did not know that the standard treatment was available.

 

Reference:

---

[1] https://www.cdc.gov/reproductivehealth/data_stats/abortion.htm

[2] National Vital Statistics Reports - CDC

[3] PLOS Glob Public Health 023 Oct 13;3(10) 13;3(10):

[4] https://www.macrotrends.net/countries/NER/niger/infant-mortality-rate

231028P - RESEARCH PRIORITIES ON EPISTEMOLOGY AND KNOWLEDGE

Presented at a Workshop on Integration of Knowledge held in Lusaka, Zambia on October 27-28, 2023 by Dr Omar Hasan Kasule Sr MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Bioethics.

 

OVERVIEW: The Problems

• We start from the assertion that 2 internal factors, a knowledge crisis, and a thought crisis, are major causes of ummatic weakness. These 2 factors combine to lead to ummatic malaise manifesting in the religious, social, economic, and technological dimensions.
• The knowledge crisis can be resolved by reforming the epistemology methodology of research in the various disciplines of knowledge so that it conforms to the paradigms of unity, universality, and objectivity.
• The disciplines to be covered by epistemological reform are education (pedagogy and andragogy), social sciences and humanities (sociology, anthropology, psychology, political science, historiography, literature, etc.), natural sciences and technology (medical and health disciplines, engineering, architecture, economics, etc.).
• The thought crisis will be resolved by research that identifies and defines problems of the society and then proposed solutions based on the bird-eye view framework of the higher purposes of the Law, maqasid al shariah.
•  
• OVERVIEW: The Tasks
• On the practical level, academic seminars need to be held in many places and involving all intellectuals to discuss the 2 crises of knowledge and thought.
• Two types of seminars can be held. General seminars lasting one day will introduce the problems and motivate the intellectuals to make contributions.
• Specialized 1-day seminars will bring together 3-5 specialists in each discipline at a time to present fully written papers on given topics followed by deep and serious discussion after which the authors can revise the papers and have them published online for wide and immediate access with printed versions being made available later.
• Books and articles written on epistemology and thought in other parts of the world can be made accessible by local intellectuals writing reviews that incorporate commentaries that reflect local problems. These reviews can also be published online for wider access.
• A measure of success will be the number of seminars held and the total number of online publications.

 

THE CRISIS OF KNOWLEDGE:

• The most important manifestation of the knowledge crisis is the dichotomy in the education system: traditional vs. imported European. Integration of the 2 systems has failed.
• Removal of the moral dimension in education violated the aim of education to produce an integrated individual.
• The Ummatic malaise was due to the knowledge crisis that started with the fall of the Khilafat Rashidah when the authentic ‘ulama was marginalized.
• Society suffered because the leaders of society with power to influence were in one valley and the scholars with knowledge were in another valley.
• This dichotomy between social leaders and intellectual leaders eventually led to and nurtured the knowledge crisis we have today.

 

THE NEED FOR A NEW KNOWLEDGE STRATEGY:

• Educational and knowledge reform are a pre-requisite for renewal (tajdid)
• The vision of the knowledge strategy is an upright balanced person who understands the creator and knows his place, his roles, his rights, and his responsibilities in the cosmic order.
• The mission of the knowledge strategy is a conceptual transformation of the education system from kindergarten to postgraduate studies to reflect positive moral values, objectivity, and universality, and serve the larger causes of humanity and the environment

 

REFORM OF RESEARCH METHODOLOGY:

• Modern research is based on the empirical method that unfortunately ignores other traditional sources of knowledge
• There is no essential contradiction between the two sources of knowledge: human empirical and rational knowledge (‘ilm aqli) and transmitted knowledge (‘ilm naqli).
• Revealed knowledge provides guiding principles for knowledge, science, and technology to build civilization.
• Muslims taught the empirical methodology to Europeans pre-renaissance and thus triggered scientific and technological revolutions in the 15^th and 6^th centuries
• Muslims forgot the empirical methodology during the era of their decline. It is now coming back to them in a new context that reflects the European and not the traditional worldview.
• Muslims accept the empirical methods but reject concepts that reject the Creator and an integrative worldview (Weltanschauung).
• A tauhidi universal, objective, and unbiased research methodology must replace the biased methodology.

 

PRECEPTS OF INTEGRATED KNOWLEDGE - 1:

• Unity and comprehensiveness of knowledge
• Causality as the basis for human action
• Limitation of human knowledge
• Constant and fixed natural laws
• Harmony between the seen and the unseen
• 2 sources of knowledge: ‘ilm naqli and ‘ilm aqli

 

PRECEPTS OF INTEGRATED KNOWLEDGE - 2:

• Khilafat is moral accountability for the ability of humans to change the environment (taskhir) and build a civilization (isti’mar)
• Creation and existence have a purpose (ghaiyat al khalq)
• Truth is both absolute and relative
• Limited human free will is the basis of accountability
• Tawakkul in its correct sense

 

REFORM OF THE DISCIPLINES OF KNOWLEDGE:

• Reform 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 a transformation of the paradigms, methodologies, and uses of disciplines of knowledge to conform to universal tauhidi values.

 

GOALS OF DISCIPLINE REFORM:

• De-colonizing paradigms of existing disciplines to change them from parochiality to universal objectivity,
• Reconstruction of the paradigms using universal guidelines,
• Re-classifying disciplines to reflect universal values,
• Reforming research methodology to become objective, purposeful, and comprehensive
• Growth of knowledge by empirical research
• Inculcating morally correct application of knowledge.

 

ROLE OF REVEALED KNOWLEDGE:

• Revealed knowledge gives general principles that establish objectivity and protect against biased research methodology.
• It creates a worldview 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 revealed parameters to expand the frontiers of knowledge through research, basic and applied.

 

PRACTICAL STEPS / TASKS OF THE REFORM PROCESS:

• The first step is a good grounding in methodological sciences of usul al fiqh, ulum al Qur’an, ulum al hadith, and 'uluum al llughat.
• This is followed by reading the revelation with an understanding of the changing time-space dimensions.
• This is followed by clarification of basic epistemological issues and relations: revelation and the mind, the seen and the unseen, faith and work.
• This is followed by a critique of basic paradigms, basic assumptions, and basic concepts of various disciplines using universal epistemological criteria.
• Critical reviews of existing teaching materials are then undertaken to identify deviations from the universal values.
• Publication and testing of new teaching materials is a necessary step towards reform by putting them 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.