Chamsi-Pasha Hassan, Albar Mohammed Ali
Department of Cardiology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
Department of Medical Ethics, International Medical Center, Jeddah, Saudi Arabia.
Avicenna J Med. 2017 Apr-Jun;7(2):35-45. doi: 10.4103/2231-0770.203608.
Muslim patients and families are often reluctant to discuss and accept fatal diagnoses and prognoses. In many instances, aggressive therapy is requested by a patient's family, prolonging the life of the patient at all costs. Islamic law permits the withdrawal of futile treatment, including life support, from terminally ill patients allowing death to take its natural course. "Do not resuscitate" is permitted in Islamic law in certain situations. Debate continues about the certainty of brain death criteria within Islamic scholars. Although brain death is accepted as true death by the majority of Muslim scholars and medical organizations, the consensus in the Muslim world is not unanimous, and some scholars still accept death only by cardiopulmonary criteria. Organ transplantation has been accepted in Islamic countries (with some resistance from some jurists). Many fatwas (decrees) of Islamic Jurisprudence Councils have been issued and allowed organs to be donated from living competent adult donor; and from deceased (cadavers), provided that they have agreed to donate or their families have agreed to donate after their death (usually these are brain-dead cases). A clear and well-defined policy from the ministry of health regarding do not resuscitate, brain death, and other end-of-life issues is urgently needed for all hospitals and health providers in most (if not all) Muslim and Arab countries.
穆斯林患者及其家属往往不愿讨论和接受致命的诊断结果及预后情况。在许多情况下,患者家属会要求采取积极的治疗措施,不惜一切代价延长患者的生命。伊斯兰法律允许对绝症患者停止无效治疗,包括停止维持生命的支持措施,让死亡自然降临。在某些情况下,伊斯兰法律允许“不要复苏”。关于脑死亡标准在伊斯兰学者内部的确定性,争论仍在继续。尽管大多数穆斯林学者和医学组织都将脑死亡视为真正的死亡,但在穆斯林世界并未达成一致共识,一些学者仍然只认可心肺标准判定的死亡。器官移植在伊斯兰国家已被接受(一些法学家对此存在一定抵制)。伊斯兰法学理事会发布了许多法特瓦(教令),允许有行为能力的成年活体捐赠器官;也允许从死者(尸体)身上获取器官,前提是死者生前同意捐赠或其家属在其死后同意捐赠(通常这些是脑死亡病例)。对于大多数(如果不是全部)穆斯林和阿拉伯国家的所有医院及医疗服务提供者而言,卫生部迫切需要出台一项关于“不要复苏”、脑死亡及其他临终问题的明确且定义清晰的政策。