Islamic Center of Southern California

The International Islamic Code for Medical and Health Ethics

CHAPTER 5

Medical Behavior and Physician Rights and Duties

Social Issues

Utilization of Health Resources

Article Forty-Nine:

Physicians bear the moral responsibility of employing all the professional experience they have to contribute to the decision-making process relevant to the distribution or rational utilization of limited medical resources in a way that protects patient interests and observes the principle of equity and equality.

Article Fifty:

The decision-making process concerning the distribution of limited medical resources should be based on the medical, scientific, and moral criteria applicable to the patient's health condition. These criteria include the extent of the patient's need for these limited resources, the duration of treatment, the likelihood of the patient's death, and, in certain cases, the amount of materials needed for the treatment to succeed.

Article Fifty-One:

A physician should not abandon his role as a patron of the patient entrusted with the task of guarding the patient's interest, particularly what concerns his treatment needs.

Article Fifty-Two:

Patients who are denied certain medical resources have the right to know the reason for that. The policies practiced by some institutions of controlling scarce medical resources should be made known to the public. Moreover, these policies should be subject to the occasional revision of supervisory medical authorities.

Supporting Islamic Legal Evidence:

The rules of the Islamic Jurisprudence (Fiqh) include the following:

1. A lesser evil is given precedence [in being tolerated] over a more common one.

2. Prevention of harm has precedence over the acquisition of benefits.

3. Intention is the criterion of actions.

Article Fifty-Three:

A physician should not make a decision to admit a patient into a hospital, to discharge him, or to engage in any diagnosis or treatment procedure for the purpose of financial gain and without considering the actual need of the patient.

Article Fifty-Four:

Physicians should prescribe medicines and medical aids, equipment, or other approved therapeutic methods only on the basis of medical considerations and patient needs and not under any type of pressure. A physician should not accept offers from other parties.

Article Fifty-Four:

Every physician should endeavor to suggest policies aimed at equity in providing a decent standard of health care to all society members.

Article Fifty-Five:

When selecting the preventive and therapeutic procedures and approaches which guarantee a decent standard of health care, physicians should observe the following ethical considerations:

a. the extent to which a patient benefits from the course of treatment,

b. the likelihood of benefit to the patient from the treatment,

c. the duration of that benefit,

d. the cost of the treatment, and

e. the number of patients benefiting from the treatment.

Supporting Islamic Legal Evidence:

The rules of the Islamic Jurisprudence (Fiqh) include the following:

1. A lesser evil is given precedence [in being tolerated] over a more common one.

2. Prevention of harm has precedence over the acquisition of benefits.

3. Intention is the criterion of actions.

Patients with AIDS or Any Other Communicable Disease

Article Fifty-Seven:

It is the right of a patient infected with AIDS or with another communicable disease to receive the treatment and health care that his condition warrants, regardless of the cause of his infection. The physician is obliged to treat such a patient, taking the necessary precautions to protect himself and others.

Article Fifty-Eight:

A patient with an AIDS or another communicable infection should be told how to prevent further deterioration of his condition and to avoid transmitting the disease to other people.

Article Fifty-Nine:

A physician who knows that he himself is HIV-positive or a carrier of some other communicable disease must not engage in any activity that involves a clear risk of transmitting the disease to his patients, his colleagues, or others. In such a case, the physician should consult the proper authority at the health establishment where he works to determine the tasks he may perform.

Article Sixty:

Taking the stipulation of Article 28 (d) into consideration, a physician should inform the spouse of a patient with AIDS or another communicable disease of his or her spouse's infection in accordance with existing regulations and in the presence of the patient.

Supporting Islamic Legal Evidence:

The purposes of Islamic Law include

1. self and mind preservation and protection of personal honor,

2. relieving any strain to which the nation is exposed, and

3. bringing benefits and preventing harm.

Euthanasia and Physician-Assisted Death

Article Sixty-One:

Human life is sacred, and it should never be wasted except in the cases specified by shari'a and the law. This is a question that lies completely outside the scope of the medical profession. A physician should not take an active part in terminating the life of a patient, even if it is at his or his guardian's request, and even if the reason is severe deformity; a hopeless, incurable disease; or severe, unbearable pain that cannot be alleviated by the usual pain killers. The physician should urge his patient to endure and remind him of the reward of those who tolerate their suffering. This particularly applies to the following cases of what is known as mercy killing:

a. the deliberate killing of a person who voluntarily asks for his life to be ended,

b. physician-assisted suicide, and

c. the deliberate killing of newly born infants with deformities that may or may not threaten their lives.

Article Sixty-Two:

The following cases are examples of what is not covered by the term "mercy killing":

a. the termination of a treatment when its continuation is confirmed, by the medical committee concerned, to be useless, and this includes artificial respirators, in as much as allowed by existing laws and regulations;

b. declining to begin a treatment that is confirmed to be useless; and

c. The intensified administration of a strong medication to stop a severe pain, although it is known that this medication might ultimately end the patient's life.

Supporting Islamic Legal Evidence:

The purposes of Islamic Law include

1. self and mind preservation and protection of personal honor,

2. relieving any strain to which the nation is exposed, and

3. bringing benefits and preventing harm.

Abortion

Article Sixty-Three

A physician should not cause a pregnant woman to abort, unless when medical considerations call for it, the mother's health and life being threatened. Abortion, however, is permissible before the end of the fourth month of pregnancy when it is definitely established that continued pregnancy involves a risk of a serious injury to the mother. This, however, should be confirmed by a medical committee of specialists of no less than three members, one of whom familiar with the disease for which the termination of pregnancy is recommended. The committee members should prepare a report in which they specify the definite risk that threatens the mother's health if the pregnancy continues. When abortion is recommended, the mother and her husband or guardian should be advised of the fact and their written consent obtained. All other exceptional cases, including pregnancy resulting from rape, should be referred to the authorities of Islamic fatwa and legislation, and to the laws and regulations in force.

Supporting Islamic Legal Evidence:

The purposes of Islamic Law include

1. self and mind preservation and protection of personal honor,

2. relieving any strain to which the nation is exposed, and

3. bringing benefits and preventing harm.

Organ Transplants

Article Sixty-Four:

The procedure of transplanting organs from a living donor or a dead body is one of the most important methods of life saving, a method in which the mutual love, sympathy, and compassion of society members is clearly manifested, provided that Islamic ethical and legal controls are exercised.

Article Sixty-Five:

When physicians declare the death of a certain patient who may have donated some of his organs, they should not get directly involved in removing these organs from his body or in the consequent implanting procedures, and should not be the physicians attending the potential recipients of these organs.

Article Sixty-Six:

Before initiating the procedures of organ transplantation in accordance with the applicable legal regulations, a physician should explain to the donor the medical consequences and hazards he may be exposed to as a result of the procedure. He should also obtain, before the operation, the necessary statements from the donor that indicate his awareness of all such consequences.

Article Sixty-Seven:

It is not permissible to transplant an organ from the body of a living minor to another individual. An exception may be made in the case of regenerative tissues if the law of the nation allows it.

Article Sixty-Eight:

It is not permissible to subject the human body and its components to commercial transactions, and any commerce in organs, tissues, cells, or human genes is prohibited. It is forbidden to advertise the need or the availability of organs in return for a price to be paid or received. A physician should under no circumstances take part in such commercial traffic. Physicians, as well as all other health professionals, should not undertake organ transplant procedures if there is anything that suggests to them that the organs to be transplanted were subject to commercial transactions.

Article Sixty-Nine:

A physician who undertakes an organ transplant procedure should guarantee that full medical care is provided to the donor, ensuring that he would not suffer in any way as a result of that procedure.

Article Seventy:

Physicians are forbidden to transplant testicles or ovaries.

Supporting Islamic Legal Evidence:

The purposes of Islamic Law include

1. self and mind preservation and protection of personal honor,

2. relieving any strain to which the nation is exposed, and

3. bringing benefits and preventing harm.

Cases of Violence

Article Seventy-One:

A physician has the right to report to the proper authorities the cases of violence he learns of in the course of his work, particularly when the victim is a juvenile, a woman, or a helpless person who cannot defend himself either because of old age or due to physical or mental illness, if the physician believes that such an action on his part protects the victim from further physical, mental or psychological violence.

Supporting Islamic Legal Evidence:

The purposes of Islamic Law include

1. self and mind preservation and protection of personal honor,

2. relieving any strain to which the nation is exposed, and

3. bringing benefits and preventing harm. Islamic Center of Southern California