Islam & Issues : Ethics , Medicine and Islam - have a read

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Assalamualaikum semua

Berikut adalah paparan article yg bagi saya relevan untuk semua pembaca dalam kalangan umat Islam memahami akan beberapa konsep dan perkara penting berkisar ethics  dalam  dunia yg berkaitan dengan perubatan. Penulis membicarakan tentang prinsip etika dalam perubatan dan praktisnya di negara Barat dan apa maknanya pada kita dan kesannya. Silalah ye membaca dan fahamkan isi kandungan article dan

a. nyatakan pendapat atau komen
b. nyatakan isu atau perkara yg bersangkutan dengan article ini dan sebab dinyatakan sedemikian.

secara ringkasnya article ini juga memperkenalkan perkara perkara yg kritikal yg sering dihadapai oleh profesional kesihatan dalam bidang yg krotikal atau yg berkaitan dengan  soal - switching off / withdrawal ventilator etc ...pada kes kes seprti koma, brain dead dan sebagainya di mana pesakit tidak berkapasiti untuk membuat keputusan dan apa ertinya dalam perspektif Islam sekiranya situasi ini  terjadi.  Euthanasia juga turut disentuh dalam article ini dan antara aspek yg berkaitan ialah tentang konsep ini dan bagaimana dalam konteks Malaysia isu dan hal ini dilihat - of course dalam konteks budaya dan agama.

menarik.

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Advance Medical Directive: How Prepared Are We?

Ditulis oleh Shaikh Mohd Saifuddeen Shaikh Mohd Salleh. Posted in The Star       

From the perspective of the medical practitioner, advance medical directive or AMD, for short, is a proactive measure by an individual done in order to help family members and next-of-kin to decide the forms of treatment that must be provided when the individual lost the ability to make his/her own decisions.

However, in Malaysia, there is no standardised guidelines on AMD to ensure that the care and management of patients who lost their decision-making ability is ethically done unlike some countries such as USA, Australia, Holland, Germany, Italy, Switzerland, Canada, England, Wales and Singapore.

In the Malaysian and Muslim contexts, it is noted that discussions on AMD among community members outside the medical fraternity is still in its infancy. Because of this, public awareness on AMD is poor and consequently discussions on AMD from Islamic perspective are very limited.

Even among medical practitioners, AMD may not be something that everyone can agree on a definitive term. However, in simple terms, AMD includes aspects of care, treatment and disclosure of patient’s wishes after death. This may help the next-of-kin to make the decision when the time comes.

It is known that modern medicine nowadays has enabled physicians to perform intervention in order to “prolong” one’s life, for example by using a ventilator machine to mechanically assist or take over the breathing process of a patient.

Although such interventions are capable of “prolonging” one’s life, there are implications that may arise such as ethical dilemmas, treatment costs, argument between healthcare providers and family members, and possible violation of patient’s wish in the choice of treatments.

This is so because modern medical practice today emphasises on patient autonomy especially in making his/her own medical decision, shifting away from physician’s paternalism.

Patient autonomy is an important basis in modern medicine practice because medical bioethics focus has started to shift from doctor's benevolence to patient's autonomy. However, when patient is unable to make his/her own decisions, doctors face difficulties in deciding whether a particular course of treatment would be acceptable to the patient or not. Family members would also face the same difficulties.

The bottom line is that everyone wants what is best for the patient. But who makes the final call? Would an AMD, made before the patient was not able to communicate his/her wishes, be the best thing to base the decision on?

AMD is a documentation method to keep the patient's right to autonomy in making decisions, while helping family members and next-of-kin to choose the form of treatment which is agreeable to the patient in the situation where the patient lost the ability to decide. In developed countries, AMD has become a part of a comprehensive approach to health care.

Although AMD is seen to be capable of empowering patient’s autonomy in decision making, the document cannot be considered as “complete” which is capable of expecting every probability that may happen, or even addressing the change of patient’s attitude. The effectiveness of AMD as a tool to protect patient’s autonomy is also being questioned by certain parties as the document might be abused by irresponsible parties.

With regards to the Islamic perspective in Malaysia, there is yet any specific view on AMD. Previous discussions mainly focussed on issues that is outwardly related to AMD such as euthanasia, brain death, organ donation and body donation after death. In discussing these issues, Islamic jurists may not realise that issues such as euthanasia, brain death, organ donation and body donation after death are related to the issue of AMD.

In fact, the desire of patients to choose euthanasia as a way out of the unbearable illness he suffered, the patient’s wish to continue or withdraw mechanical ventilation when diagnosed with brain death, and the desire of patients to donate or not to donate an organ or body after death can be articulated in the AMD document.

Generally, Muslim scholars view that there is a limit to patient’s autonomy in choosing the forms of medical treatment and care, as doctor’s professional advice should also be considered. This is because choices made to satisfy personal interests and satisfaction are contrary to Islamic values. The emphasis in Islam is more on public interest compared to personal interest.

Furthermore, Islam puts the emphasis on doctor’s efforts in saving lives. However, Islam also recognises the limitation of human endeavour, and as such all efforts must be followed by tawakkal. Having said that, doctors should exhaust all possible avenues in order to save a patient’s life.

Realising that there is no specific guidelines on AMD, discussions on this issue have begun to take place. In April, the Institute of Islamic Understanding Malaysia (IKIM) have initiated preliminary discussions to identify issues pertaining to AMD that need to be looked at from the Islamic perspective. This is an on-going process which has received support from the stakeholders.

Involvement of stakeholders is important to ensure uniformity in providing guidelines on AMD which is applicable to all hospitals in Malaysia. These guidelines must also take into consideration the religious and cultural aspects of the Malaysian community, and not just simply adopted from other countries without taking into account the local context.

In discussing AMD within the framework of Islam, the aspect of maintaining and preserving life as outlined by maqasid al-shariah must be given the priority. The challenge is to get the medical practitioners and Islamic scholars to study this issue collaboratively and to understand each other’s point-of-view.

In this regard, IKIM plays the role as the “bridge” that links the two. The outcome should be something that is practical, implementable and most importantly, upholds the objective of saving a patient's life while protecting his/her right to decide.

source :


http://www.ikim.gov.my/index.php ... how-prepared-are-we [23-10-2015] 12:42  BST GMT

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pada saya secara personal di sinilah penglibatan multidisplinari dalam kes kes ini penting dan kita lihat fungsi dan kepentingan institusi kerajaan seperti ini yg terlibat dalam ice breaking , mengkaji dan meneliti aspek aspek polisi dan impak.


so, u know , pada saya crucial golongan sebegini dan kita lihat tak ada pun dikotomi ilmu ...semuanya bersepadu dalam menangani  hal hal seperti ini.