of ddiin is essentially involves ibadat in the wide sense that every human endeavor is a form of ibadat. Thus medical treatment
makes a direct contribution to ibadat by protecting and promoting good health so that the worshipper will have the energy
to undertake all the responsibilities of ibadat. The principal forms of physical ibadat are the 4 pillars of Islam: prayer,
salat; fasting, siyaam; pilgrimage,
hajj, and jihad. A sick or a weak body can perform none of them properly. Balanced
mental health is necessary for understanding aqidat and avoiding false ideas that violate aqidat. Thus medical treatment of
mental disorders thus contributes to ibadat. General public health has a special relation to jihad. If the general health
of a population is not satisfactory, there will not enough youths to be recruited into the armed forces. There will also not
be enough healthy workers to provide the material and logistics required for successful prosecution of war. If the obligation
of jihad is not fulfilled, the Muslim community will be defeated and subjugated by others who will not give Muslims freedom
to practice religion.
PROTECTION OF LIFE, hifdh al nafs
purpose of medicine is to fulfill the second purpose of the shari’at, the preservation of life, hifdh al nafs. Medicine
cannot prevent or postpone death since such matters are in the hands of Allah alone. It however tries to maintain as high
a quality of life until the appointed time of death arrives. Medicine contributes to the preservation and continuation of
life by making sure that the nutritional functions are well maintained. Medical knowledge is used in the prevention of disease
that impairs human health. Disease treatment and rehabilitation lead to better quality health.
PROTECTION OF PROGENY, hifdh al nasl
contributes to the fulfillment of this function by making sure that children are cared for well so that they grow into healthy
adults who can bear children. Treatment of infertility ensures successful child bearing. The care for the pregnant woman,
perinatal medicine, and pediatric medicine all ensure that children are born and grow healthy. Intra-partum care, infant and
child care ensure survival of healthy children.
PROTECTION OF THE MIND, hifdh al ‘aql
treatment plays a very important role in protection of the mind. Treatment of physical illnesses removes stress that affects
the mental state. Treatment of neuroses and psychoses restores intellectual and emotional functions. Medical treatment of
alcohol and drug abuse prevents deterioration of the intellect.
PROTECTION OF WEALTH, hifdh al mal
of any community depends on the productive activities of its healthy citizens. Medicine contributes to wealth generation by
prevention of disease, promotion of health, and treatment of any diseases and their sequelae. Communities with general poor
health are less productive than a healthy vibrant community. The principles of protection of life and protection of wealth
may conflict in cases of terminal illness. Care for the terminally ill consumes a lot of resources that could have been used
to treat other persons with treatable conditions. The question may be posed whether the effort to protect life is worth the
cost. The issue of opportunity cost and equitable resource distribution also arises.
PRINCIPLE OF INTENTION
of intention comprises several sub principles. The sub principle that each action is judged by the intention behind it calls
upon the physician to consult his inner conscience and make sure that his actions, seen or not seen, are based on good intentions.
The sub principle ‘what matters is the intention and not the letter of the law’ rejects the wrong use of data
to justify wrong or immoral actions. The sub principle that means are judged with the same criteria as the intentions implies
that no useful medical purpose should be achieved by using immoral methods.
THE PRINCIPLE OF CERTAINTY, qaidat al yaqeen
diagnosis does cannot reach the legal standard of yaqeen. Treatment decisions are best on a balance of probabilities. Each
diagnosis is treated as a working diagnosis that is changed and refined as new information emerges. This provides for stability
and a situation of quasi-certainty without which practical procedures will be taken reluctantly and inefficiently. Existing
assertions should continue in force until there is compelling evidence to change them. Established medical procedures and
protocols are treated as customs or precedents. What has been accepted as customary over a long time is not considered harmful
unless there is evidence to the contrary. All medical procedures are considered permissible unless there is evidence to prove
their prohibition. Exceptions to this rule are conditions related to the sexual and reproductive functions. All matters related
to the sexual function are presumed forbidden unless there is evidence to prove permissibility.
THE PRINCIPLE OF INJURY, qaidat al dharar
intervention is justified on the basic principle is that injury, if it occurs, should be relieved. An injury should not be
relieved by a medical procedure that leads to an injury of the same magnitude as a side effect. In a situation in which the
proposed medical intervention has side effects, we follow the principle that prevention of a harm has priority over pursuit
of a benefit of equal worth. If the benefit has far more importance and worth than the harm, then the pursuit of the benefit
has priority. Physicians sometimes are confronted with medical interventions that are double edged; they have both prohibited
and permitted effects. The guidance of the Law is that the prohibited has priority of recognition over the permitted if the
two occur together and a choice has to be made. If confronted with 2 medical situations both of which are harmful and there
is no way but to choose one of them, the lesser harm is committed. A lesser harm is committed in order to prevent a bigger
harm. In the same way medical interventions that in the public interest have priority over consideration of the individual
interest. The individual may have to sustain a harm in order to protect public interest. In the course of combating communicable
diseases, the state cannot infringe the rights of the public unless there is a public benefit to be achieved. In many situations,
the line between benefit and injury is so fine that salat al istikharat is needed to reach a solution since no empirical methods
can be used.
PRINCIPLE OF HARDSHIP, qaidat al mashaqqat
interventions that would otherwise be prohibited actions are permitted under the principle of hardship if there is a necessity.
Necessity legalizes the prohibited. In the medical setting a hardship is defined as any condition that will seriously impair
physical and mental health if not relieved promptly. Hardship mitigates easing of the sharia rules and obligations. Committing
the otherwise prohibited action should not extend beyond the limits needed to preserve the Purpose of the Law that is the
basis for the legalization. Necessity however does not permanently abrogate the patient’s rights that must be restored
or recompensed in due course; necessity only legalizes temporary violation of rights. The temporary legalization of prohibited
medical action ends with the end of the necessity that justified it in the first place. This can be stated in al alternative
way if the obstacle ends, enforcement of the prohibited resumes/ It is illegal to get out of a difficulty by delegating to
someone else to undertake a harmful act.
THE PRINCIPLE OF CUSTOM or PRECEDENT, qaidat al urf
of medical care is defined by custom. The basic principle is that custom or precedent has legal force. What is considered
customary is what is uniform, widespread, and predominant and not rare. The customary must also be old and not a recent phenomenon
to give chance for a medical consensus to be formed.