Islamic Center of Southern California

The Arguments of Islamic Law Rulings on Recent Medical Issues

Topic Eleven

Definition of Death Which Terminates Human Life and for Which a Death Certificate Is Issued

Definition

People used to recognize death through one of its clear signs, which include respiration, pulse, and motion. With the great progress in medicine and its technologically-sophisticated equipment, it has been possible, in some cases, to restore respiration and heart beat when the brain stem has suffered no injury. If damage directly hits the brain stem, death symptoms follow each other in succession: consciousness is lost, breathing ceases, the heart stops, and one by one, the other organs die. There is no way to replace damaged brain cells, even through artificial respirators and vascular nutrition, which keep alive organs of the human body other than the brain for a period that ranges approximately between few hours and two weeks.

This medical progress has raised questions about the true nature of death and the time at which legal stipulations related to it become valid, whether it is when the brain stem dies, but not the heart and other organs, or when respiration and the heart stop, but not the brain stem. It is unanimously agreed that a person is dead when both his brain and his heart die.

This question entails that

1. the living organs of a person ruled to be dead can be used in organ transplant procedures;

2. respirators may be removed in the case of people ruled to be dead, and resuscitation should be applied to a person whose heart stops while his brain is still alive; and

3. arrangements have to be made concerning those entitled to inheritance, and other rulings concerning the dead have to be applied.

The Legal Position Chosen by the IOMS and Its Argument

In its second seminar, Human Life: Its Inception and End, the IOMS adopted the ruling favored by the majority of participating physicians, which holds that death occurs with brain death as technically defined. This ruling is quite close to the majority opinion of the participating jurisprudence (fiqh) scholars, who hold that brain death should be the decisive factor for certain stipulations concerning death.

The fourth seminar, Health Policy: Ethics and Human Values, in 1988 had no recommendations on the subject. However, the ninth seminar, The Medical Definition of Death, in 1996 reaffirmed the recommendations of the 1985 seminar.

Some of the recommendations of the second seminar, Human Life: Its Inception and End, are:

Fourth: It was clear to the seminar after hearing the presentations of physicians that what they recognize as a sign of human death is the inactivity of the brain area that performs the vital functions, and this is referred to as death of the brain stem.

Fifth: Scholars of jurisprudence (fiqh) (fiqh) tend, on the basis of the presentation made by physicians, to the view that when a person enters the certain stage of brain stem death, he has departed from life, and some of the rulings pertaining to the dead apply to him in analogy - albeit the clear difference of the two cases - with the jurisprudence (fiqh) (fiqh) handling of the case of an injured person who shows the symptoms of being slain. As for applying the rest of those rulings, the conferring scholars are inclined to have them postponed until his major systems cease to function. The seminar recommends that another detailed study should be conducted to decide which rulings should apply immediately and which should be postponed.

Issued as a statement, the Recommendations of the ninth seminar, The Medical Definition of Death, in December 1996 include the following:

A person is regarded as dead in the case of

1. a complete and irreversible cessation of the functions of the respiratory and cardio-vascular systems, or

2. a complete and irreversible cessation of all functions of the brain, including those of the brain stem.

The occurrence of one of these two cases should be determined in accordance with recognized medical criteria.

The Opinion of the Islamic Jurisprudence (fiqh) Academy

The Islamic Jurisprudence (fiqh) Academy, in its conference in Amman in October 1986, endorsed the ruling that brain death or the death of the heart coupled with complete cessation of respiration, is the decisive criterion of death. Resolution No. (5) of the conference stipulates that

In Islamic Law, a person is regarded as dead, and all the legal consequences of death become operative, if one of the following symptoms is detected:

1. if his heart and respiratory system stop completely and physicians decide that this cessation is irrevocable, or

2. if all functions of his brain cease completely, physicians decide that this cessation is irrevocable, and his brain is subjected to analysis. Islamic Center of Southern California