The issue of euthanasia or ‘mercy killing’ continues to divide opinion across the world but Islam is clear about its impermissibility, says Hamid Waqar
Sometimes for terminally ill patients, as well as their families and friends, with no apparent medical hope for survival, putting an end to their misery seems to be the only remaining option. Euthanasia has no doubt occurred to many who are desperately ill.
Recent years have seen pro euthanasia campaigns gather pace in the west and more and more governments are confronting demands to legalise assisted suicide.
Euthanasia bills were defeated in the Canadian Parliament, South Australia, and the Scottish Parliament in 2010. The following year saw a landmark ruling in a case brought before the European Court of Human Rights. Ernst Haas, a 57-year-old man suffering from bipolar disease, sued the Swiss government for failing to provide him with lethal drugs with which to kill himself. He argued that this violated his right to privacy. The court ruled that the right to die was included in Article 8 of the European Convention on Human Rights, but the obligation for states toensure the protection of the right to life under Article 2 was stronger.
This ruling was welcomed by anti-euthanasia organisations. Peter Saunders, CEO of Christian Medical Fellowship, said: “In a democratic society there are limits to human autonomy. The law is there to primarily to protect vulnerable people and public safety will always trump the demands of determined individuals backed by pressure groups who want to undermine existing laws.”
Currently euthanasia is legal in many European countries. In the Nether-lands euthanasia has been legal since 2001. The legalisation of this practice constitutes one of the most fatal slippery slopes of all time. Euthanasia started with the terminally ill, and then expanded to cover the chronically ill. The practice eventually allowed the assisted suicide of patients with serious disabilities and the mentally ill. Today Dutch doctors also terminate infants who are born with serious disabilities or terminal illnesses. The Dutch Medical Association (KNMG) wants to take euthanasia yet further and include those who fall under the category of “unbearable suffering,” which would take in non-medical issues, such as poverty and loneliness.
In the Netherlands’ southern neighbour, Belgium, euthanasia has been legal since 2002. Today euthanasia here is coupled with organ harvesting, raising the prospect that the decision to terminate may be motivated, at least partially, by considerations that are not solely confined to the suffering of the patient or indeed his prospects of improvement. Euthanasia patients are told that by terminating their lives they will be saving or improving the lives of others. Doctors in Belgium have also started the practice of performing joint euthanasia of elderly couples: a spouse who is terminally ill is euthanised with her partner who is not terminally ill but who does not want to live without his/her other half.
Euthanasia stems from the Greek word euthanatos, which in turn is derived from ‘eu’ and ‘thanatos’ meaning good and death. Therefore, the literal definition of euthanasia is an ‘easy and good death’.
Euthanasia is performed medically in three different ways. In the first method an overdose of barbiturates or other lethal injections is administered to the patient, which eventually leads to the termination of life. Another way is to withhold life-prolonging treatment with the aim of hastening the patient’s death.
The third method relies on administering large doses of opioids, thus dramatically increasing the probability of death, with no apparent intention of causing the patient’s immediate death. Euthanasia is also categorised into active and passive types. Active euthanasia is a deliberate act undertaken by the attending physician to cause the death of a patient, with or without his consent – what is referred to by its proponents as “assisted suicide”. The first and third methods described above would fall under this category. Islam strongly opposes this type of euthanasia, regardless of whether it is the patient’s desire or not.
The Qur’an states: “Do not kill a soul [whose life] God has made inviolable, except with due cause.” (17:33). Active euthanasia has not been presented through traditions as being a “due cause.” An example of a due cause would be cases of capital punishment.
The Islamic Code of Medical Ethics endorsed by the First International Conference on Islamic Medicine concluded: “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. The claim of killing for painful hope-less illness is also refuted, for there is no human pain that cannot be largely conquered by medication or by suitable neurosurgery…”
Addressing this issue, Ayatollah Sayyid Ali Khamenei has said: “Murder is not permissible in any case and one would have to pay blood money [if he performed this form of euthanasia].”
The Qur’an clearly denies granting the choice of taking one’s own life and committing suicide. It states: “And do not kill yourselves. Indeed God is most merciful to you.” (4:29) Hence, life is sacred and the physician is not given the permission to actively terminate his patient’s life, even if the patient requests it.
The following tradition found in the collection of al-Bukhari is narrated from the Prophet Muhammad (s) : “Amongst the nations before you there was a man who got a wound and growing impatient [with its pain], he took a knife and cut his hand with it and the blood did not stop till he died. God said, ‘“My slave hurried to bring death upon himself so I have forbidden him [to enter] Paradise’.” This tradition illustrates the extent to which Islam is opposed to suicide, whether self-inflicted or assisted.
The second type of euthanasia is passive euthanasia. This is defined as an omission on the part of the attending physician to resuscitate the terminally ill, which results in the death of the patient.
Islam may allow this type of euthanasia to take place under strict conditions. These are mentioned by the Islamic Medical Association of America (IMANA): “When death becomes inevitable, as determined by physicians taking care of terminally ill patients, the patient should be allowed to die without unnecessary procedures.” Unnecessary procedures can also be interpreted as ceasing any further actions prolonging the patient’s life.
The physician does not administer lethal medication; rather he withholds medication or surgery which might prolong the patient’s life. Regarding this type of euthanasia Ayatollah Sayyid Ali Khamenei has stated: “It is not obligatory to keep the dying person alive or delay his death, [the passive method].
But, any action that would cause death would not be permissible, [the active methods].” The Fiqh Council of North America has a similar opinion. “Islam considers human life sacred. Life is to be protected and promoted as much as possible. …. there is no provision in Islam for killing a person to reduce his pain or suffering from sickness. It is the duty of the doctors, patient’s relatives and the state to take care of the sick and to do their best to reduce the pain and suffering of the sick, but they are not allowed under any circumstances to kill the ill person”.
“If, however, a number of medical experts determine that a patient is in a terminal condition and there is no hope for h/her recovery, then it could be permissible for them to stop the medication.”
In conclusion, as with many other contemporary ethical issues in the world, euthanasia cannot be seen as a black and white or right and wrong matter. But what is clear from Islamic sources is active euthanasia is not permitted. Human life is sacred and terminating it is the prerogative of God alone.
Written by Hamid Waqar
This article was originally published in Islam Today magazine.