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INTERNATIONAL ORGANIZATION

OF ISLAMIC MEDICINE

Kuwait Document

ISLAMIC CODE OF

MEDICAL ETHICS

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C O N T E N T S ____

Chapter T itle PageIntroduction 15

First Definition of Medical 19Profession

Second Characterization of 27Medical Practitioner

Third Relation between 35Doctor and Doctor

Fourth Relation between 41Doctor and Patient

Fifth Professional Secrecy 47Sixth Doctor’s duty in 50

War TimeSeventh Responsibility 55

and LiabilityEighth The Sanctity 62

of Human LifeNinth Doctor and Society 69Tenth Doctor and Bio- 77

Technological AdvancesEleventh Medical Education 85Twelfth The Oath of the Doctor 91

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IN T H E N A M E O F GOD A N D IN HIS PR A IS E

Current progress in medical and life sciences has acquired revolutoinary features ... and heralds breath - taking developments in medical technology and human engineering. Like any force, biosciences need to be harnessed for the welfare of humanity, and be so guided as never to stray to be a destructive power, as happened to nuclear fission in the near past.

In the wake of application of modern discoveries in human reproduction, here­dity, recombinant DNA and synthesis of behaviour-influencing drugs, our genera­tion is witnessing a radical shaking of our heritage of moral values and codes of behaviour.

In an attempt to keep human knowledge on the proper track prescribed by God as HE declared Man as HIS viceroy on

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this planet, colonizing earth, searching for God’s laws and putting them to beneficial use, this document was submit­ted to-the First International Conference on Islamic Medicine held in Kwait at the onset of the Fifteenth Hijri Century (6 -10 Rabie Awal 1401 : 12 - 16 January 1981).

The document was endorsed by that conference as the Islamic Code of Medi­cal Ethics.

The adoption of this document by all medical bodies in the Islamic world is hoped to be an area we converge upon... in these times when there is so much that diverges us.

Every muslim doctor will hopefully find in it the guiding light to maintain his professional behaviour wthin the bound­aries of Islamic teachings.

Medical and paramedical students

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should find in it a window over the future, so that they enter their professional life conversant with what to do and what to avoid, well prepared to face pressures or temptations or uncertainties.

To medical scientists it subserves the function of rudder to the ship .. directing their efforts to harness science and technology only to the welfare of human­ity but not to its danger or destructin.

We are confident that nonmuslim col­leagues will also see in it a reflection of what God wishes man to be, and to do.

It is in God that we trust .. and Him that we seek guidance from.

International Organization of Islamic Medicine

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First

Definition of Medical Profession

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D E F IN IT IO N O F M E D IC A L PRO FESSIO N

• “ THERAPEUSIS” is a noble Profe­ssion.. God honoured it by making it the miracle of Jesus son of Mary. Abraham enumerating his Lord’s gifts upon him - included “ and if I fall ill He cures me” .

• Like all aspects of knowledge, medi­cal knowledge is part of the knowledge of God “ who taught man what man never knew’,. The study of Medicine entails the revealing of God’s signs in His crea­tion. ‘And in yourselves..do you not see’ ?. The practice of Medicine brings God’s mercy unto His subjects. Medical prac­tice is therefore an act of worship and charity on top of being a career to make a living.

• But God’s mercy is as accessible to all people including good and evil, vir­tuous and vicious and friend and foe — as are the rays fo His sun, the comfort of

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His breeze, the coolness of His water and the bounty of His provision. And upon this basis must the medical profession operate, along the single track of God’s mercy, never adversive and never puni­tive, never taking justice as its goal but mercy, under whatever situations and circumstances.

• In this respect the medical profession is unique. It shall never yield to social pressures motivated by enmity or feud be it personal, political or military. Enlightened statesmanship will do good by preserving the integrity of the medi­cal profession and protecting its position beyond enmity or hostility.

• The provision of medical practice is a religious dictate upon the community, ‘Fardh Kifaya’, that can be satisfied on behalf of the community by some citizens taking up medicine. It is the duty of the state to ensure the needs of the nation to doctors in the various needed speciali­ties. In Islam, this is a duty that the ruler owes the nation.

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• Need may arise to import from afar such medical expertise that is not locally available. It is the duty of the State to satisfy this need.

• It also behoves the State to recruit suitable candidates from the nation’s youth to be trained as doctors. An ensu­ing duty therefore is to establish relevant schools, faculties, clinics, hospitals and institutions that are a dequately equipped and manned to fufiillthat purpose.

• “ Medicine” is a religious necessity for society. In religious terms, whatever is necessary to satisfy that “ necessity” automaticially acquires the status of a “necessity” . Exceptions shall therefore be made from certain general rules of jurisprudence for the sake of making medical education possible. One such example is the intimate inspection of’the human body whether alive or dead, with­out in any way compromising the respect befitting the human body in life and death, and always in a climate of piety and awareness of the presence of God.

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• The preservation of man’s life should embrace also the utmost regard to his dignity, feelings, tenderness and the privacy of his sentiments and body parts. A patient is entitled to full attention, care and feeling of security while with his doctor. The doctor’s privilege of being exempted from some general rules is only coupled with more responsibility and duty that he should carry out in conscien- tionsness and excellence in observing God. “ excellence that entails that you worship God as if you see Him. for even though you dont see Him, He sees you:”

“ A1— Ghazali considered the pro­fession of medicine as (fardh— Kifaya), a duty on society that Some of its members can carry in lieu of the whole. This is natural since the need of health is a pri­mary need and not a subsequent one. If health is seriously impaired hardly anything in life remains enjoyable.

That it is permissible for the pur-

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pose of treatment to look at hidden and private parts of the body, derives from the rule of jurispru­dence ‘necessities override prohibi­tions’ ... and complies with the Qoranic excuse when “ compelled to do something but without ill— intention” . Since the early days of Islam the Lady— Healer’s corps joined the Prophet’s army to battle caring for the casualties and dress­ing their wounds on whatever part of the body. This provoked no dispute or divergence of opinion.

To import medical expertise and to treat muslims by non — muslim physicians should be decided only by the condition of the patient and the capability of the doctor.

Since an early time the muslim state employed Christian doctors from lundishapur and treated them very generously. In this context it is also worthy remembering that the Prophet’s guide on the

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journey of Hijra was Abdullah Ibn Uraikit, a nonmuslim, chosen by the Prophet on account of his honesty and thorough knowledge of the road” .

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Second

Characterization of Medical Practitioner

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CHARACTERS O F T H E P H Y S IC IA N

• The physician should be amongst those who believe in God,Yulfil His rights, are aware of His greatness, obedient to His orders, refraining from His prohibi­tions, and observing Him in secret and in public.

• The physician should be endowed with wisdom and graceful admonition. He should be cheering not dispiriting, smiling and not frowning, loving and not hateful, tolerant and not edgy. He should never succumb to a grudge or fall short of clemency. He should be an instrument of God’s justice, forgiveness and not punishment, coverage and not exposure.

• He should be so tranquil as never to be rash even when he is right . . chaste of words even when joking . . tame of voice and not noisy or loud, neat and trim and not shabby or unkempt. . conducive of trust and inspiring of respect . . well

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mannered in his dealings with the poor or rich, modest or great.. in perfect control of his composure . . and never compro­mising his dignity, however modest and forebearing.

• The physician should firmly know that ‘life’ is God’s . . awarded only by Him . . and that ‘Death’ is the conclusion of one life and the beginning of another. Death is a solid truth .. and it is the end of all but God. In his profession the Physi­cian is a soldier for “ Life” only . . defe­nding and preserving it as best as it can be, to the best of his ability.

# The Physician should offer the good example by caring for his own health. It is not befitting for him that his “ do’s” and “ dont’s” are not observed primarily by himself. He should not turn his back on the lessons of medical progress, because he will never convice his patie­nts unless they see the evidence of his own conviction . . God adresses us in the Qoran by saying “ and make not your own

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hands throw you into destruction” . The Prophet says “ your body has a right on you” . . and the known dictum is “ no harm or harming in Islam” .

• The Physician is truthful whenever he speaks, writes or gives testimony. He should be invincible to the dictates of creed, greed, friendship or authority pressurizing him to make a statement or testimony that he knows is false. Tes­timony is a grave responsibility in Islam. The Prophet once asked his companions “ shall I tell you about the gravest sins ?” When they said yes he said “ claiming partners with God, being undutiful to one’s parents . and after a short pause he repeatedly said “ and indeed the giving of false talk or false testimony” .

• The Physician should be in possessior of a threshold knowledge of jurispru dence, worship and essentials of Fiqh enabling him to give counsel to patient seeking his guidance about health an* bodily conditions with a bearing on th rites of worship. Men and women ar

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subject to symptoms, ailments or physio­logical situations like pregnancy, and would wish to know the religious ruling pertaining to prayer, fasting, pilgrimage, family planning etc..

• Although ‘necessity overrides prohibi­tion’, the Muslim Physician — never­theless — should spare no effort in avoid­ing the recourse to medicines or ways of therapy — be they surgical, medical or behavioural — that are prohibited by Islam.

• The role of Physician is that of a catalyst through whom God, the Creator, works to preserve life and health. He is merely an instrument of God in alleviat­ing people’s illness. For being so designa­ted the Physician should be grateful and forever seeking Gojd’s help. He should be modest, free from arrogance an4 pride and never fall into boasting or hint at self glorification through speech, writing or direct or subtle advertisement.

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• The Physician should strive to keep abreast of scientific progress and innova­tion. His zeal or complacency and knowledge or ignorance, directly bear on the health and well - being of his patients. Responsibility for others should limit his freedom to expend his time. As the poor and needy have a recognized right in the money of the capable, so the patients own a share of the Doctor’s time spent in study and in following the progress of medicine.

• The Physician should also know that the pursuit of knowledge has a double in­dication in Islam. Apart from the applied therapeutic aspect, pursuit of knowledge is in itself worship, according to the Qoranic guidance: “And say .. My Lord., advance me in knowledge.’ ’and: “ Among His worshippers .. the learned fear Him most” .. and : “ God will raise up the ranks of those of you who believed and those who have been given knowledge” .

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Third

Relation between Doctor and Doctor

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DOCTOR-DOCTOR R E L A T IO N S H IP

• A doctor is a brother to every doctor and a fellow companion in the noblest mission that is a direct answer to God’s commandment in the Qoran : “ Arid help one another in charity and piety . . but help not one another in sin and rancour” .

• Physicians are jointly responsible for the health care of the Nation . . and com­plement one another through the variety of their medical specialization be they preventive or therapeutic, in the private sector or in State employment . .all abi­ding by the ethics and rules of their profession.

• As a professional group in the Nation, Doctor’s are collectively responsible for drawing plans and taking measures and developing traditions and regulations that are necessary to enable them colle­ctively and individually to Carry out their duties as best as possible.

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• Within their fraternity, a Doctor should respect his fellow Doctor in his absence. He should offer him advice and /or help whenever sought. A Doctor shall not eat his brother’s flesh by speaking ill of him from behind his back .. nor shall he pursue his shortcomings or tarnish his reputation or exhibit his deficits. He shall never extend a harming hand to his brother. This does not absolve the doctor however, from absolute honesty when giving legal testimony or aiding in the prevention of a crime : according to the dictates of the Law.

• The mutual relation between Physi­cians is additive and not competitive ... and collaboration in good faith for the best interests of the patient.

If more than one doctor handle the patient, medical data should not be with­held from the treating doctor (s).

These data should be conveyed in a clear lucid talk or neat legible writing.

These data should be kept in confi­dence, within the boundaries of the medical circle without leakage.

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• If in doubt, it is the duty of the Doctor (and the right of the patient) that consul­tation should be arranged or the case referred to a specialist. This is also inspired by the Qoranic saying : “ Ask of the people who possess the message if you do not know” .

The specialist will take whatever steps he deems necessary . . but he shall keep the referring Doctor informed about the current and subsequent happenings.

• It is a Doctor’s duty to avail his juniors of the fruits of his experience, knowledge and acumen . He should pro­vide for their education and training . . for “ The concealer of knowledge is cursed’, and because it is in answer to the rights of colleagues, patients and the profession at large from one generation to another.

“ In this context it is worthly to remember the Prophet’s saying:

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‘When the son— of— Adam dies he is completely cut off except from three things : a running charity, knowledge that be had taught and remains put to good use and virtuous progeny praying God for him’

• Doctors shall be also mutually coope­rative and shall promptly rally to the aid of one another if inflicted by sickness affecting a colleague or a member of his family, as well as under conditions of stress, need, disability or death.

• At this age the Doctor is hardly the individualist he was in old ... for medical care nowadays is given by a team com­prising — apart from the Doctor-nursing, laboratory, physiotherapy, social service and other personnel. The doctor shall foster the team spirit and perfect coope­ration so that the team achieves best results in patient care.• This code shall be binding also to all personnel of all ranks in all fields of health care.

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Fourth

Relation between Doctor and Patient

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D O C TO R -P A TIE N T R E L A T IO N S H IP

• For the sake of the patient the Doctor was . . and not the other way round. Health is the goal and medical care is the means . . the “ patient” is master and the “Doctor” is at his service. As the Prophet says “ The strongest should fol­low the pace of the weakest..for he is the one to be considered in deciding the pace of travel. Rules, schedules, time-tables and services should be so manipulated as to revolve around the patient and comply with his welfare and comfort as the top and overriding priority . . other considerations coming next.

# That top-priority status is conferred on the patient because and as long as he is a patient ... no matter who he is or what he is, a patient is in the sanctuary of his illness and not of his social eminence, authority or personal relations. The way a Doctor deals with his various patients is a perfect portrayal of his personal integrity.

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# The sphere of a Doctor’s charity, nicety, tolerance and patience should be large enough to encompass the paitent s relatives, friends and those who care for or worry about him..but without of course compromising the dictates of “ Profes­sional Secrecy” .

• Health is a basic human necessity and is not a matter of luxury. It follows that the Medical Profession is unique in that the client is not denied the service even if he cannot afford the fee. Medical legislature should ensure medical help to all needy of it, by issuing and execut­ing the necessary laws and regulations.

• In Private Practice the Doctor’s fees are his lawful right ..and his earnings are legitimate ... and his conscience is his censor, aware that God’s eye is ever watching.

• If medical necessity or emergency, however, puts a needy person under his

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care, it should be the Doctor’s duty to be considerate and kind, and avoid his fees- if any-being a further burden atop of the ailment. For as you give the poor it is God you are giving and alms giving is not only due on material possessions but on knowledge and skills too. The Medical Profession is fundamentally the vocation to help Man under stress and not to ex­ploit his need.

# Fully entitiled to make a decent living and earn a clean income., a Doctor shall always honour the high standards of his profession and hold it in the highest regard, never prescribing to activities of propaganda, receiving a commission or cutting earnings or similar misdoings.

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Fifth

Professional Secrecy

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PR O FESSIO N AL SECRECY

Keeping other persons’ secrets is decreed on all the Faithful... the more so if these were Doctors, for people willfully disclose their secrets and feelings to their doctors, confident of the time old heritage of Professional Secrecy, that the medical profession embraced since the dawn of history. The Prophet (peace be upon Him) described the three signs of the hypocrite as : “ He lies when he speaks, he breaks his promise and he betrays when confided in” . The Doctor shall put the seal of confidentiality on all information acquired by him through sight, hearing or deduction. Islamic spirit also requires that the items of the Law should stress the right of the patient to protect his secrets that he confides to his Doctor. A breach thereof would be detrimental to the practice of medicine, beside precluding several categories of patients from seeking medical help.

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Sixth

Doctor’s duty in War Time

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DOCTOR'S ROLE D U R IN G W A R

• Since the earliest battles of Islam it was decreed that the wounded is prote­cted by his wound and the captive by his captivity. The faithful are praised in the Qoran as : “ they offer food — dear as it is — to the needy, orphan or captive, (saying) we feed you for the sake of God without seeking any reward or gratitude from you” . The Prophet (peace be upon him) said to his companions : “ I entrust the captives to your charity” . . and they did . . even giving them priority over themselves in the best of the food they shared. It is of interest to note that this was thirteen centuries prior to the Geneva Convention and the Red Cross.

• Whatever the feelings of the Doctor and wherever they lie, he shall stick to the one and only duty of protecting life and treating ailment or casualty.

• Whatever the behaviour of the enemy,

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the Muslim Doctor shall not change his course . . for each side reflects his own code of behaviour. God made it clear in the Qoran : “ Let not the wrong doing of others sway you into injustice” .

• As part of the international medical family, Muslim Doctors should lend all support on a global scale to protect and support this one-track noble course of the medical profession . . for it is a blessing to all humanity if this huminitarian role is abided with on both sides of the battle front.

• The Medical Profession shall not permit its technical, scientific or other resources to be utilized in any sort of harm or destruction or infliction upon man of physical, psychological, moral or other damage .. regardless of all political or military considerations.

• The doings of the Doctor shall be uni­directional aiming at the offering of treatment and cure to ally and enemy, be this at the personal or general level.

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Seventh

Responsibility and Liability

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R E S P O N S IB IL IT Y A N D L IA B IL IT Y

• The Practice of Medicine is lawful only to persons suitably educated, trai­ned and qualified, fulfilling the criteria spelt out in the Law. A clear guidance is the Prophet’s tradition : “ Who-so-ever treats people without knowledge of medi­cine, becomes liable” .

• With the availability of medical spe­cialization, problem cases shall be refe­rred to the relevant specialist. “ Each one is better suited to cope with what he was meant for” .

• In managing a medical case the Doctor shall do what he can to the best of his ability. If he does, without negli­gence, taking the measures and precau­tions expected from his equals then he is not to blame or punish even of the results were not satisfactory.

The Doctor is the patients’s agent on

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his body. The acceptance by the patient of a Doctor to treat him is considered an acceptance of any line of treatment the Doctor prescribes.

If treatment entails surgical interference the initial acceptance referred to should be documented in writing, for the sake of protecting the Doctor against possible eventualities. If the patient declines or refuses the Doctor’s prescribed plan of treatment, this refusal should also be documented by writing, witnesses or patient’s signature as the situation war­rants or permits.

• When fear is the obstacle preventing the patient from consent, the Doctor may help his patient with a medicine such as a tranquillizer to free his patient from fear but without abolishing or supressing his consciousness, so that the patient is able to make his choice in calmness and tranquility. By far the best method to achieve this is the poise of the Doctor himself and his personality, kindness, patience and the proper use of the spoken word.

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• In situations where urgent and im­mediate surgical or other interference is necessary to save life, the Doctor should go ahead according to the Islamic rule “ necessities override prohibitions” . His position shall be safe and secure whatever the result achieved, on condi­tion that he has followed established medical methodology in a correct way. The “ bad” inherent in not saving the patient outweighs the presumptive ‘good’ in leaving him to his self destructive decision. The Islamic rule proclaims that “ warding off” the ‘bad’ takes priority over bringing about the ‘good’ .

The Prophetic guidance is “ Help your brother when he is right and when he is wrong” . When concurring with helping a brother if right but surprised at helping him when wrong, the Prophet ansewred his companions : “ Forbid him from being wrong .. for this is the help he is in need of” .

“ In conclusion, the basic religious criteria protecting the Medical

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Practitioner/are 1) Recognized certification 2) Acceptance of the Doctor by his patient 3) Good faith on part of the Doctor and sole aim of curing his patient 4) Absence of unacceptable fault as defined by medical by laws.

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Eighth

The Sanctity of Human Life

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# “ On that account we decreed for the Children of Israel that whoerver kills a human soul for other than manslaughter or corruption in the land, it shall be as if he killed all mankind, and who-so-ever saves the life of one, it shall be as if he saved the life of all mankind” . 5-32.

• Human Life is sacred .. and should not be willfully taken except upon the indications specified in Islamic Jurispru­dence, all of which are outside the do­main of the Medical Profession.

• A Doctor shall not take away life even when motivated by mercy. This is pro­hibited because this is not one of the legitimate indications for killing. Direct guidance in this respect is given by the Prophet’s tradition : “ In old times there was a man with an ailment that taxed his endurance. He cut his wrist with a knife and bled to death. God was displeased and said “ My subject hastened his end...

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I deny him paradise’

“ Mercy killing — like suicide — finds no support except in the atheistic way of thinking that believes that our life on this earth is followed by void. If this is sound thinking, it would have been reasonable for almost all of the human race to commit suicide and get rid of the difficulties of life... for indeed hardly a life is devoid of difficulty or pain. The claim of killing for painful hopeless illness is also refuted, for there is no hu­man pain that cannot be conquered by medication or by suitable neuro­surgery. Another category is killing to obviate the miseries presumably ensuing upon deformity. If this earns acceptance, then it will not be long until claims are made to kill the aged and unproductive members of society as a measure of combating the sequelae of population growth beyond avail­able resources” .

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• The sanctity of human Life covers all its stages including intrauterine life of the embryo and fetus. This shall not be compromised by the Doctor save for the absolute medical necessity recognised by Islamic Jurisprudence.

“ This is completely in harmony with modern medical science which lately has embraced a new speciality called Fetal Medicine... striving to diagnose and treat af­fliction of the fetus in utero, and devise an artificial placenta to sustain fetuses aborted before viability.

Modern permissive abortion poli­cies are not sanctioned by Islam, which accords several rights to the fetus. There is a money ransom on abortion in Islam.A fetus has rights of inheritance and if aborted alive and dies it is inherited by its legal heirs. If a pregnant woman is sentenced to death for a crime, execution is postponed until she

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delivers and nurses the baby ... even if that pregnancy was illegi­timate. The bpsic right to life of the fetus is therefore self evident”

• In his defence of Life, however, the Doctor is well advised to realize his limit and not transgress it. If it is scientifically certain that life cannot be restored, then it is futile to deligently keep on the vege­tative state of the patient by heroic means of animation or preserve him by deep­freezing or other artificial methods. It is the process of life that the Doctor aims to maintain and not the process of dying. In any case, the Doctor shall not take a positive measure to terminate the patient’s life.

# To declare a person dead is a grave responsibility that ultimately rests with the Doctor. He shall appreciate the seri­ousness of his verdict and pass it in £ill honesty and only when sure of it. He may dispel any trace of doubt by seeking counsel and resorting to modern scien­tific gear.

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• The Doctor shall do his best that what remains of the life of an incurable patient will be spent under good care, moral support and freedom from pain and misery.

• The Doctor shall comply with the patient’s right to know his illness. The Doctor’s particular way of answering should however be tailored to the parti­cular patient in question. It is the Doctor’s duty to thoroughly study the psy­chological acumen of his patient. He shall never fall short of suitable vocabulary if the situation warrants the deletion of frightening nomenclature or coinage of new names, expressions or descriptions.

• In all cases the Doctor should have the ability to bolster his patient’s faith and endow him with tranquility and peace of mind.

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Ninth

Doctor and Society

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• The Doctor is in every sense a meniber of Society, fully acting, interact­ing and caring for it. The prophet says.. Religion is to give honest advice for God and His apostle and to muslim leaders and public.

•The Doctor’s mission exceeds the treat­ment of disease to taking all measurs to prevent its occurrence, in compliance with the Qoranic command : “ Let not your own hands push you into destruc­tion” . The hint to a “ preventive” policy is evident in the saying of the Prophet : “When pestilence is rampant in a locality do not go inside it .. but if you are already inside then do not come out of it” .

# The Medical Profession shall take it as duty to combat such health-destructive habits as smoking, uncleanliness etc. Apart from mass education and adver­tence, the Medical Profession should un-

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relentlessly pressurize the judiciary to issue necessary legislation.The combat and prevention of environ­mental pollution falls under this cate­gory.

• The natural prophylaxis against venereal diseases and the other complica­tions ensuing upon sexual licence, lies in revival of the human values of chastity, purity, self-restraint and refraining from advertently or inadvertently inflicting harm on self or others. To preach these religious values is ‘Preventive Medicine’ and therefore lies within the jurisdiction and obligation of the medical profession.

In certain developed countries gonorrhoea and syphylis have, reached epidemic proportions inducing health authorities to re­quest the declaration of a national emergency situation.Yet all medicla preaching regrettably goes on the tone of: it is alright, it is no shame, it is normal, but please seek me­dical advice promptly if you

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suspect catching the disease. No pamphlet or other message over the njiedia has dared to touch on chastity even as one of several prophylactic alternatives.

In contrast with anti-pollution, anti-smoking, anti-saccharine anti­fat and several other anti’s sexual licence has been signled out as the area where ‘ a doctor should not moralize ... but just treat’ ,*

• The Muslim Medical Profession should be conversant with Islam’s teach­ings and abiding by them. It should also thoroughly study at first hand the data, facts, figures and projections of various parameters actually existent in Muslim societies. Upon this should be decided what to take and what to reject from the experiences and conclusions of other societies. Reconciliation with a policy of uncritical copying of alien experience should be stopped.

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• Society owes the Doctor his right to be trusted, to live comfortably, to earn an adequate income and to keep his dignity.

A Doctor should prove worthy of these rights .. or else he is vulnerable to puni- tion.

“ In all communities there are elements who through thank­lessness, ignorance or a flare for sensationalism, attempt to tarnish the public portrait of the Medical Profession. The brunt of such cruelty falls mainly on the poor patient who has no choice but to surrender himself to the Doctor for thrapy or surgery. If is mental torture then if a bad portrait of the Doctor was inculcated on his mind. The press in particular should consider these implications and avoid unscrutinized, wrong or slanted information. Health auth­orities should not refrain from

-taking legal action against these distorted publications, not particul-

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arly in short term defence of the Doctor but mainly for the long term security of the nation, if a Doctor behaved in an unbecoming or unlawful way, the Profession should be even harsher on him ... in order to preseve the good repute of medical pratice” .

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Tenth

Doctor and Bio-Technological Advances

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• There is no censorship in Islam on scientific research, be it academic to reveal the signs of God in His creation, or applied aiming at the solution of a particular problem.

• Freedom of scientific research shall not entail the subjugation of Man, telling him, harming him or subjecting him to definite or probable harm, withholding his therapeutic needs, defrauding him or exploiting his material need.

• Freedom of scientific research shall not entail cruelty to anmials, or their torture. Suitable protocols should be laid upon for the uncruel handling of experi­mental animals during experimentation.

• The methodology of scientific research and the applications resultant thereof,

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shall not entail the commission of sin prohibited by Islam such as fornication, confounding of genealogy, deformity or tampering with the essence of the human personality, its freedom and eligibility to bear responsibility.

• The Medical Profession has the right- and owes the duty—of effective participa­tion in the formulation and issuing of religious verdict concerning the lawful­ness or otherwise of the unprecedented outcomes of current and future advan­ces in biological science. The verdict should be reached in togetherness bet­ween Muslim specialists in jurisprudence and Muslim specialists in biosciences. Single-sided opinions have always suf­fered from lack of comprehension of technical or legal aspects.

• The guiding rule in unprecedented matters falling under no extant text or law, is the Islamic dictum : “ Wherever welfare is found, there exists the statute of God” .

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• The individual patient is the collective responsibility of Society, that has to ensure his health needs by any means inflicting no harm on others. This comprises the donation of body fluids or organs such as blood transfusion to the bleeding or a kidney transplant to the patient with bilateral irreparable renal damage. This is another ‘Fardh Kifaya’, a duty that donors fulfill on behalf of society. Apart from the technical pro­cedure, the onus of public education falls on the medical Profession, which should also draw the procedural, organizational and technical regulations and the policy of priorities.

• Organ donation shall never be the outcome of compulsion, family embar­rassment, social or other pressure or exploitation of financial need.

# Donation shall not entail the exposure of the donor to harm.

• The Medical Profession bears the

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greatest portion of responsibility for lay­ing down the laws, rules and regulations organizing organ donation during life or after death by a statement in the donor’s will or the consent of his family; as well as the establishment of tissue and organ banks for tissues amenable to storage. Cooperation with similar banks abroad is to be established on the basis of reciprocal aid.

“ Umar ibnul - Khattab, second Caliph, decreed that if a man liv­ing in a locality died of hunger being unable of self-sustenance, then the community should pay his money ransom (fidiah) as if they had killed him. The similitude to people dying because of lack of blood transfusion or a donated kidney is very close.

Two traditions of the Prophet seem to be quite relevant in this respect. The one is : ‘The faithful in their mutual love and compas­sion are like the body ... if one

�� ��� �

member complains of an ailment all other members will rally in res­ponse. The other tradition says, “ The faithful to one another are like the blocks in a whole build­ing... they fortify one another” .

God described the Faithful in the Qoran saying: “ They give priority over themselves even though they are needy” . This is even a step further than donating a kid­ney, for the donor can dispense with one kidney and live normally with the other ... as routinely as­certained medically prior to dona­tion.

If the living are able to donate, then the dead are even more so: and no harm will afflict the cada­ver if heart, kidneys, eyes or arte­ries are taken to be put to good use in a living person. This is indeed a charity ... and directly fulfils God’s words : ‘And who-so-ever saves a human life it is as though he has saved all mankind’.

�� � � �

A word of caution, however, is necessary. Donation should be voluntary by free will ... or the dictatorships will c o n f i s c a t e people’s organs thus violating two basic Islamic rights : the right of freedom and the right of owner­ship.

In the society of the Faithful dona­tion should be in generous supply and should be the fruit of faith and love of God and His subjects. Other scieties should not beat us to this noble goal” .

� � ��� �

Eleventh

Medical Education

��

��� �������� ���������

• Medical Education, despite being a speciality, is but one fiber in a whole mesh founded on the belief in God, His oneness and absolute ability, and that He alone is the Creator and giver of life, knowledge, death, this world and the hereafter.

• In planning the making of a Doctor, a principal goal is to make him a living example of all that God loves, free from all that God hates, well saturated with the love of God, of people and of know­ledge.

• The Medical Teacher owes his students the p rov is ion of the good example, adequate teaching, sound guidance and continual care in and out of classes and before and after gradua­tion.

• Medical Education picks from all

�� ��� �

trees without refractoriness or prejudice. Yet it has to be protected and purified from every positive activity towards atheism or infidelity.

• Medical Education is neither passive nor authoritarian. It aims at sparking mental activity, fostering observation, analysis and reasoning, development of independent thought and the evolvement of fresh questions. The Qoran blamed those who said : “As such we have found our fathers and we will follow on their footsteps” .. an attitude which is only conductive to stagnation and arrest of progress.

• “ Faith” is remedial, a healer, a conqueror of stress and a procurer of cure. The training of the Doctor should prepare him to bolster “ Faith” and avail the patient of its unlimited blessings.

• Medical school curricula should in­clude the teaching of matters of jurisp­

��

rudence and worship pertaining to or influenced by various health aspects and problems.

• Medical School curricula should familiarise the student with the medical and other scientific heritage of the era of Islamic civilization, the factors under­lying the rise of Muslim civilizaton, those that lead to its eclipse, and the way(s) to its revival.

• Medical school curricula should em­phasize that medicine is worship., both as an approach to belief by contemplation on the signs of God, as well as from the applied aspect by helping Man in distress.

• Medical school curricula should comprise the teaching and study of this “ Islamic Code of MeScal Ethics” .

��� �

Twelfth

The Oath of the Doctor

�� ��� �

���� ����� ��� ���� ������

I swear by God ... The GreatTo regard God in carrying out my profes­sion

To protect human life in all stages and under all circumstances, doing my utmost to rescue it from death, mala­dy, pain and anxiety ..

To keep peoples’ dignity, cover their privacies and lock up their secrets...

To be, all the way, an instrument of God’s mercy, extending my medical care to near and far, virtuous and sinner and friend and enemy ...

To strive in the pursuit of knowledge and harnessing it for the benefit but not the harm of Mankind..

To rever my teacher, teach my junior, and be brother to members of the Medical Profession joined in piety and charity...

To live my Faith in private and in public, avoiding whatever blemishes me in the eyes of God, His apostle and my fellow Faithful.

And may God be witness to this Oath.

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