Shoaib Abdullah B, Vawter-Lee Marissa, Venkatesan Charu, Soliman Ayman F
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Front Pediatr. 2023 Jun 13;11:1204941. doi: 10.3389/fped.2023.1204941. eCollection 2023.
Muslims comprise nearly a quarter of the worldwide population, with significant populations in the United States, Canada, and Europe. As clinicians, it is important to be familiar with Islamic religious and cultural perspectives on medical treatment, life-prolonging measures and comfort and palliative care, but historically, this has been a gap in the literature. Recently, there have been multiple papers discussing Islamic bioethics, particularly in regards to end of life care in adults; however, there has been a lack of literature discussing the Islamic perspective on issues related to neonatal and perinatal end of life care. This paper uses clinical scenarios to review key relevant principles of Islamic law, discussing the primary and secondary sources used in formulating including the Quran, , and ', and the importance of preservation of life and upholding of human dignity (). Neonatal and perinatal scenarios are used to specifically explore the Islamic perspective on withholding and withdrawal of life-sustaining measures and determining what constitutes an acceptable quality of life. In some Islamic cultures the expertise of the patient's physician is given significant weight in making these judgments, and as such, families may appreciate frank assessment of the situation by the clinical team. Because of the various factors involved in issuing religious ruling, or , there is a wide spectrum of opinions on these rulings, and physicians should be aware of these differences, seek counsel and guidance from local Islamic leaders, and support families in their decision-making process.
穆斯林占全球人口近四分之一,在美国、加拿大和欧洲有相当多的人口。作为临床医生,熟悉伊斯兰教在医疗、延长生命措施以及舒适和姑息治疗方面的宗教和文化观点很重要,但从历史上看,这一直是文献中的一个空白。最近,有多篇论文讨论伊斯兰生物伦理学,特别是关于成人临终关怀的问题;然而,缺乏关于伊斯兰教对新生儿和围产期临终关怀相关问题观点的文献。本文通过临床案例回顾伊斯兰法律的关键相关原则,讨论在制定这些原则时所使用的主要和次要来源,包括《古兰经》、圣训、公议和类比,并探讨保护生命和维护人类尊严的重要性。新生儿和围产期案例被用于具体探讨伊斯兰教对维持生命措施的 withhold 和 withdrawal 的观点,以及确定什么构成可接受的生活质量。在一些伊斯兰文化中,患者医生的专业意见在做出这些判断时具有重要权重,因此,家属可能会感激临床团队对情况的坦诚评估。由于发布宗教裁决(即法特瓦)涉及多种因素,关于这些裁决存在广泛的意见分歧,医生应意识到这些差异,向当地伊斯兰领袖寻求建议和指导,并在家庭决策过程中提供支持。