Q: What is the Islamic ruling on euthanasia?
A: The definition of euthanasia is: a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering. There are two types of euthanasia: Passive and Active
Passive euthanasia is the withholding of common treatments (such as antibiotics, drugs, or surgery) or giving a medication (such as morphine) to relieve pain, knowing that it may also result in death.
Withholding artificial life support, such as breathing, feeding tubes, respirators, or other life-sustaining machinery is also referred to as passive euthanasia or non-aggressive euthanasia. This is often termed the ‘right to die.’
Another common form of passive euthanasia is to give the patient large doses of morphine to control pain, which usually suppress respiration and causes the patient to die much earlier. These procedures are performed on terminally ill, so that natural death will occur sooner.
In Islam all forms of euthanasia are Haraam and forbidden because this procedure is designed to bring the life of a human being to an end. In the case of active euthanasia, as well as the passive form where large doses of morphine are ministered to the patient, such actions are akin to murder. Whereas in other forms of this procedure the sin will not be equal to murder, there is however, sin incurred because of the intentional termination of a sacred life. It is still, therefore, a major sin. The prohibition will apply even if the patient requested such a procedure.
As for the removal of life-supporting apparatus, this will be permitted on condition that doctors believe these systems will serve no purpose other than to keep the heart or respiratory system functioning. If there is unanimity among the doctors on this matter, then the patient’s family may ask for these systems to be disconnected. This will not be sinful, for at the end death will come at its appointed time. Nothing can expedite death, nor prolong it.
Mufti Siraj Desai
Euthanasia comes in a number of different means:
- Direct or deliberate euthanasia:
Active euthanasia, an act of commission, is taking some action that leads to death like a fatal injection. Passive euthanasia, an act of omission, is letting a person die by taking no action to maintain life.
This is done through giving the patient a lethal dose of curare or barbiturates or other derivatives of cyanide with the intention of killing. This has three cases:
1. The voluntary case, when the process is carried out at the pressing request of the patient who desires to die while he is fully conscious, or according to an already written testament.
2. The involuntary case, which is the case of a sane unconscious adult patient. The action to end his life is taken on the decision of the physician who thinks that killing him is for his or her own good, or according to the decision of the patient’s guardian or relatives who think that killing is in his or her best interests.
3. In the involuntary case where the patient is incapable of reasoning, whether a child or insane, the action is taken according to a decision made by the treating physician.
The prohibition of direct active euthanasia, the prohibition of suicide and assisting in bringing it about, for according to the Shari`ah killing a patient suffering from a terminal illness is not permissible for the physician, the patient’s family, or the patient himself. The patient, whatever his illness, and however sick he (or she) is, shall not be killed because of desperation and loss of hope in recovery or to prevent the transfer of the patient’s disease to others, and whoever commits the act of killing will be a deliberate killer.
The Qur’an confirms without a shadow of a doubt that homicide is absolutely forbidden, as Allah Almighty says:
(And take not life, which Allah has made sacred, except by way of justice and law.)
(Al-An`am 6: 151)
We ordained for the Children of Israel that if anyone killed a person not in retaliation of murder or for spreading mischief in the land—it would be as if he killed all mankind.)
(Al-Ma`idah 5: 32)
- Assisted suicide:
In this case the patient ends his (or her) life by himself according to instructions given to him by another person that provides him with the information and devices that help him to die.
It is unlawful for the patient to kill himself (or herself) and it is unlawful for somebody else to kill him (or her) even if he is given leave to kill him. The former case will be suicide and the latter will be aggression against the other by killing him, for his permission does not render the unlawful act lawful. The patient does not posses his own soul to permit somebody else to take it. The Prophetic hadith is known regarding the prohibition of suicide in general. The person who commits suicide will be tortured in the Hellfire in the same way he (or she) killed himself. If he believes that suicide is lawful, he will be a disbeliever and will abide in the Hellfire forever; otherwise, he will be severely punished.
- Indirect euthanasia:
This is done through giving the patient doses of tranquilizers or sedatives to abate the severe pain. With time the doctor will have to increase the doses to control the pain. It is a procedure preferred by therapists, but large doses may lead to difficulties in breathing and dysfunction of the cardiac muscle, which will result in death that was intended though anticipated beforehand.
It is impermissible to kill the patient for fear that his (or her) disease may transfer through contagious infection, even if he is terminally sick (such as one suffering from AIDS). It is not permissible to kill him to prevent the spread of the disease, for there are many other means to do so, such as quarantine. On the contrary, the patient must be protected as a human being and be provided with the required food and medicine till his or her life comes to its natural end.
The Prophet (Sallallaaahu ‘alayki wassalam) is reported to have said,“Allah created no disease but created something to cure it.”(Reported by Al-Bukhari and Muslim)
In another hadith narrated in Tirmidhi:
“O Allah’s Servants! Seek treatment, for Allah does not create a disease but creates a treatment for it.”
The hadith in Muwatta Imaam Ahmad: “Allah created no disease but created something to cure it. Some may know it and some may not.” So these Prophetic hadiths give us hope of discovering cures for what we term today as ‘incurable’ diseases.
Indeed, we have witnessed the discovery of cures for what people considered at one time incurable diseases. Therefore, it is impermissible to kill the carrier of the disease because it is incurable, nor on the pretext of protecting the healthy people from it.
- Passive euthanasia
This is achieved by refusing to treat the patient or interrupting the treatment necessary for his survival, including the removal of the apparatus of artificial breathing from the patient in the resuscitating room when it is confirmed that his (or her) brain is dead and there is no hope of restoring his consciousness.
As for facilitating death by withdrawing artificial resuscitating apparatus from the patient who is clinically regarded as “dead” or “practically dead” because of the damage to the brainstem or brain, with which human beings live and feel; if the action of the physician is merely stopping the treatment instruments, it will be no more than giving up the treatment, in which case his action is legal and permissible, bearing in mind that these instruments can preserve the apparent life of the patient – represented by breathing.
And Allah Ta’ala Knows Best
Ml. Mohammad Ashhad bin Said
Correspondence Iftaa Student, Mauritius
Checked and Approved by:
Mufti Ebrahim Desai