Islam and Secular Medical Ethics

In the past few days there has been in interesting story concerning a Muslim family and their fight to reverse the doctor’s decision to withdraw life support from ‘Mr A’. What is interesting about the case is how it exposes the different worldviews and approaches to the issue of who lives and who die and how one distinguishes between actively letting someone die and consciously helping another human being die.

Another interesting aspect of this debate is the framework it is conducted in. Secular medical ethics is often conducted in the language of high utilitarianism in which concepts like ‘quality of life’ are bandied about. It is a language of clean measurements and distinctions, with scales for measuring a patient’s well-being. What is interesting about secular medical ethics is that is based around the idea ends rather than means, the value of life in this mode of thinking is not absolute but contingent on other external factors, like for example whether the patients condition will ‘improve’ or assumptions of how they will experience the world.

Indeed the whole enterprise of medical ethics is permeated with ideas of externally measuring a persons worth and this has become the establishment view. Without this backdrop it is impossible to understand why the family of the man known as ‘Mr A’(due to court rules on anonymity) is fighting so hard to put him back on the life support machine. Islam like the main Abrahamic faiths is based fundamentally on the idea of regulating the means not the ends. Its concern is not so much that the actions of believers and their effects on other people, but that their actions are ‘just’ and reflects the will of Allah. Another key difference to secular medical ethics is that all life, in fact everything comes from Allah. Allah is the ultimate power and ultimate arbiter of human affairs. He chooses when people die and when they live. Secular medical ethics starting point is the humanistic post-enlightenment philosophies of John Stuart-Mill, Jeremy Bentham et al. For the medical ethicist man is the measure of all things, god or anything faintly transcendent is scrubbed from the picture an unhelpful irrationality for the medical calculus.

So what the battle of ‘Mr A’s’ life support being switched off demonstrates is a clash of worldviews that would, at first sight seem hard to reconcile. The family and the doctors are speaking mutually exclusive languages. From the family’s perspective it is of no matter as to ‘Mr A’s’ quality of life, it is irrelevant as how he lives just that he lives. In some respects this can be seen as quite a progressive viewpoint as they do not quibble with any of the modern medical interventions that have so far been needed to keep ‘Mr A’ alive. This does conflict with the implied wish of the family for ‘Mr A’ to have a natural death, i.e. a death chosen by Allah rather than man and that the doctors do everything possible to keep him alive. The doctors however see things differently from their perspective they are taking away artificial interventions that are preventing a man from dying from what they would see as a ‘peaceful death’.